Dan is a registered nursing student, day 5 of his third-year placement at MyLocalHospital in Smithplace; his preceptor for today’s very busy morning shift is Registered Nurse Abi. Whilst getting ready for morning medication round, which was progressing unusually slowly, Dan noted preceptor RN Abi putting an Ondansetron wafer and some paracetamol from the medication room into her pocket. RN Abi winks at Dan and states, “God! I need this! I only got home a couple hours ago – I’m dead tired and I’ve got a shocking headache and hangover!!”. She jokingly said, “You better be in charge of me today – I can barely think… Hahaha!” RN Abi looked unwell, and Dan found himself keeping her on track with the daily planner and sometimes reminding RN Abi of each patient; he even pointed out medication discrepancies of those within his scope.

 

Dan was concerned but the morning got busy with their four patients and beds to be made, medication rounds and some dressings to be done before lunch. Prior to the planned wound dressing after lunch, RN Abi and Dan organised some analgesia for patient Mrs Freda Pickleton. A second RN (Bryan) joined Dan and RN Abi in the medication room to sign out some Oxycodone after which Bryan then left to answer a call bell. RN Abi was happy for Dan to witness administration of this analgesia to the patient. It had been organised that after lunch RN Abi would supervise Dan doing wound dressings. After lunch RN Abi was still feeling particularly unwell however she knew she had to supervise Dan with a complex vacuum dressing on the buttock of Mrs Pickleton in Bed 11, a blind elderly patient. Today Mrs Pickleton had a couple of family members present in the room. Just before entering the room, RN Abi said under her breath, “Damn! her stupid son is here again. The man is a bloody moron and asks so many dumb questions! and he stinks! Just leave it to me, I’ll get them to leave”. When taking down the dressing, Dan noted the wound was odorous and looked quite sloughy and purulent, very different to the one described on the Wound Chart.

 

Dan started to discuss this with RN Abi, who already ‘unwell’, advised “just do the same dressing, we will look at this more thoroughly tomorrow maybe”; she then abruptly left the room to go to the bathroom. Whilst Dan waited until she returned to finish the dressing, he chatted to Mrs Pickleton and then discretely took a couple of photos on his phone of the wound thinking it would help him to document it better when he did his notes; he also wanted to show his nursing friends this very complex dressing he was going to do. On return to the room, RN Abi hurried the process along as there was much to do before end of shift. The rest of shift was seemingly uneventful. Dan used the photo to complete his notes and then later, posted it to his ‘private’ Instagram account that only his fellow nursing friends could see – of course he did the right thing and changed up the name of his patient. One of his friends from this group, re-posted the picture on her Facebook account with “Look what our Danny Boy did today while we were at the beach on our roster day off!… ugh! Too funny LOL!” The following screen shot was sent to the Lecturer from a fellow student later that evening.

 

THE TASK : Based on the case study provided, please answer the following. Your essay must address the following:

 

• Identify 6 violations which have occurred in the case study scenario provided.

• From the violations you have identified, select two (2) only and discuss further. In your discussion of each, you need to address:

o Which sub-standard of the Australian RN Standards for Practice has been breached / violated.

 

You will need to justify your choice by providing evidence and at least one example from the literature to support your discussion.

o What are the possible future implications for the nursing student or RN regarding this breach/violation? o Briefly outline what the nursing student or RN should have done.

 

GUIDELINES

 

Your paper must include, in ESSAY format, the following: • Introduction (150 words) • Body of essay: o Identification of violations (200 words) o Discussion of violation/breach including future implications and correct action/s (850 words) o Discussion of violation/breach including future implications and correct action/s (850 words) • Conclusion (150 words)

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