Clinical Specialist Nurse: A Case Study

The district nursing team were now to be responsible for the wound care of an ulcer on the sole of her right foot on her impending discharge. She had previously attended the practice nurse and a podiatry service based within her local clinic. Due to a change in circumstances, she was now clearly housebound for the near future due to mobility issues. Prior to an arranged visit, the patient had called the nurse to advise her that she was pyrexial and was experiencing a pain in her right foot that was different from her normal neuropathic pain, which was often problematic. She was also finding it difficult to mobilise and was disinclined for diet but was taking oral fluids.

While reflecting back on the previous weeks, I have to say that this was the foundational class for the FNP students. Before this class, I used to think how I am going to fulfill the role of a Nurse Practitioner (NP). This class helped me to better understand my role and gave me the confidence that I can fulfill the role of an NP. Today, when I look at myself, I know I am in the stage of advanced beginner in Patricia Benner’s Novice to expert theory. The case studies in the discussion threads really put me in the real world of practical nursing as an NP fulfilling the role of a provider. Thorough the case studies, I have learned how to make a best differential diagnosis based on the patients presenting symptoms. The interaction and sharing

The negligence of this incident had a negative impact on the patient’s family members. Approximately 25% of cases involving medical negligence involve poor nursing care. Another negative aspect was patient’s family follow up was poor resulting in lack of importance highlighted on the pressure wounds. Ashley (2003) states nurses can be sued for malpractice, this means he or she is being sued for “negligence”. Furthermore, the nursing health professionals can lose its credibility among a community as they failed to provide a holistic care for the patient. However, a positive outcome was nurses were able to reflect among this evidence based practice to assist in better quality in patient

The aim of this study is to provide a detailed account of the nursing care for a patient who is experiencing a breakdown in health. One aspect of their care will be discussed in relation to the nursing process. The model used to provide an individualised programme of care will be discussed and critically analysed.

Poor record-keeping can have serious implications for the patient and the nurse. Professionally, colleagues rely on the information recorded on a patient to maintain continuity of care (Wood 2003). The patient’s progress could rapidly deteriorate due to poor record-keeping, holding the nurse responsible and accountable for the patient’s decline in condition. Poor record-keeping in this instance could include a nurse not documenting a nursing intervention such as administration of a medication. If this is not recorded another nurse could easily believe the patient did not get the medication and administer it again, causing overdose and possibly have severe implications for the patient depending on the medication. Another example could be if the nurse noticed the patient’s condition worsening but did not document it. Consequently the patient may get significantly worse before it is detected by the next nurse on duty. In these instances the nurse responsible for the poor record-keeping will most likely be brought to the Fitness to Practice Inquiry and as a result may lose his/her registration as a practicing nurse. If the nurse has made a grievous error a patient or family member could take civil action.

The aim of this assignment is to demonstrate the use of safe and effective prescribing in practice. I will achieve this by presenting and analysing a prescribing scenario which I have encountered in my current area of practice within a District Nursing Team. During the case study the patient I have chosen will be referred to as Jean. This is to maintain her anonymity in line with the Nursing and Midwifery Council (2008) guidelines of confidentiality.

Issues and dilemmas highlighted by this incident Management issues Several management issues where highlighted by the incident. The analysis will focus on record keeping, effective communication, risk management and ethical issues. The day to day management issues affecting nursing practice such as record keeping, effective communication and risk management do not operate in isolation but are frequently interdependent and affect each other. The central focus will be on the observed failure by the night duty nurse to record or pass on information on Mark’s report. The Nottinghamshire Healthcare NHS Trust (2009) policy on record keeping states that a record of an event must be made immediately or within 24 hours of the occurrence. The rationale for this requirement is that an immediate record of

According to the Nurses Practice Act (2015) set by IDFPR, unethical or unprofessional conduct includes actions or practices that causes harm, fraud, disregard for health, welfare or safety of the patient, sexual conduct, substance abuse, inability to practice nursing, behavior that crosses professional boundaries, and failure to confirm to standards of nursing practice. Examples of these actions would be medication errors, falsely documenting patient records, claiming unworked hours on payroll, or being verbally abusive to patients. The Board of Nursing is responsible to investigate the complaints. The National

Healthcare provider’s perception and judgment in the patient’s well being as well as taking into account the right of the patient in every action is one of the key elements in nursing practice. International Council of Nurses (ICN), (2006) states “The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance public confidence” (p. 3). Furthermore, nursing action guided by theory and principles of moral and legal

The definition of malpractice according to Merriam-Webster dictionary is dereliction of professional duty or a failure to exercise an ordinary degree of professional skill or learning by one rendering professional services which results in injury, loss, or damage. The nurse did have a professional duty which including following her medication rights, administering the drug correctly after consent had been obtained, and documenting the events clearly and precisely. There could have possibly been a breach in professional duty regarding the choice of injection site. This is dependent on the time period of which the medication was administered and the evidence and practices at that current

Beneficence compounded by nurse-physician communication created ethical problems in this case. Mainly, Joanna’s assessment of Mrs. Kelly being ignored by the resident physician and the nursing supervisor. Joanna worked within the scope and standards of practice, she assessed, evaluated, and monitored her patient’s condition. She then reported her findings to the resident twice, and also sought nursing support from her shift supervisor. After Joanna’s first call to the resident, and her continued concern she needed to advocate in a proactive manner. Continuing her assessment of Mrs. Kelly to include palpation and auscultation could have offered additional clinical information enabling her to articulate the problem to the resident and nursing supervisor.

malpractice and negligence. The Darling's (Plaintiff) felt that the hospital, nursing staff and emergency room doctor all played an important part in the Plaintiff losing his leg due to neglect.

Clinical Nurse Specialists (CNSs) and Nurse Practitioners (NPs) are both considered advanced practice nurses (APNs) in Canada (Donald et al., 2010). Although these roles have existed in Canada for decades (Canadian Nurses Association, 2008), confusion still remains about the titles and exact roles that these professionals play (Donald et al., 2010). This paper will use the Saskatchewan Nursing Advanced Practice model as a framework to highlight the similarities and differences between both types of advanced practice nurse. The scope of practice, registration, education, practice settings, and effectiveness of CNSs and NPs will be examined. Although their roles overlap, CNSs and NPs have both been shown to be important members of the health care team (DiCenso & Bryant-Lukosius, 2010). Research has shown that adding CNSs and NPs to our health care system can increase patient satisfaction, decrease wait times, and decrease readmissions (DiCenso & Bryant-Lukosius, 2010). Increased public and health care professional awareness is needed to have these roles fully incorporated into our current health care system (DiCenso & Bryant-Lukosius, 2010).

Nurses are subject to a plethora of legal, ethical, and professional duties which can be very challenging on a day to day basis. Some of these duties include respecting a patient 's confidentiality and autonomy, and to recognize the duty of care that is owed to all patients. As nurses our duties are always professional; however there are legal implications if these duties are breached. We also must consider when it is okay as nurses to breach these duties and therefore ethical issues arise. As nurses one of our main priorities is to advocate for our patients, without our own personal feelings on the matter taking over.

Professional nurses encounter a variety of legal ethical and bioethical issues on a daily basis. For this reason, it is essential that all nurses are aware of current state and national legislation, acts and guidelines and the implications of these for nursing practices as well as legal processes, principles of open disclosure and the role of a coroner in the health sector. In this way, nurses can adhere to the overarching guidelines for practice as well as working within the code of conduct, competency standards and scope of practice. This paper will provide an overview of legal and ethical parameters of professional nursing practice.