Unprofessional Behavior in Clinical Practice Evidence Based Case Study Answer

Introduction

Reflective practice is a desirable competency for registered nurse as it allows them to evaluate their action and engage in on-going learning process. It enables them to reflect on their practice, identify their strengths and weaknesses and engage in self-directed learning (Galutira, 2018). There are different reflection theories and models that can guide the reflection process. In this poster, I will use the Gibb’s reflective model to reflect on a clinical situation of unprofessional behaviour in practice. Using the model, the good and bad about the experience and ways to improve skills in dealing with similar situation in the future will be discussed.

Description

During my placement at an obstetric and gynaecology unit, I witnessed unprofessional behaviour of the ED physician as his action was not aligned to professional standards of practice. A patient named Mrs. Y (real name avoided due to confidentiality issues) was transferred from general emergency department due to ruptured ectopic pregnancy. She was due for laparoscopy or laparotomy. The patient wanted to inform about it to her husband but the ED physician refused to do the same as the on call gynaecologist had left. The behaviour shown is unprofessional as it was not the ideal response in such situation. I tried to explain the ED consultant about the importance of informing her husband about the surgery. Following my advice, her husband was called on time and explained about the need for surgery. He agreed to the surgery and the process for surgery was initiated.

Feelings

In that situation, I was worried about the rights of patient. I felt that the ED physician did not followed the principles of person-centred approach. All health care professionals have the duty to provide person-centred care and it involves making informed decisions about their health (Byrne, Baldwin & Harvey, 2020). I was concerned about the patient as well as she may be anxious if her husband is not informed and this may affect the outcome of the surgery. I wanted to ensure no conflict both for the patient as well as the ED consultant. Hence, to ensure smooth process before surgery and avoid delay during the surgery, I decided to advise patient regarding the same. This step helped to ensure an optimal ending at the end as the surgery was completed successful and the situation was resolved.

Evaluation

On reflecting on the situation now, I feel that the good thing about my action was that I intervened on a timely basis. I reflected on the NMBA code of conduct 2.1 which states that nurses should apply person-centred and evidence-based approach in delivering quality care to patients. The use of person-centred approach involves managing the concern, personal values and preferences of patient (NMBA, 2018). In the context of the situation, it was important to support the right of patients in engaging in care and treatment. As per the shared decision making process, it was important to promote shared decision making by discussing with patients, their family member or any nominated partner (Truglio-Londrigan & Slyer, 2018). To resolve the situation, I escalated the issue to the nurse-in charge. The head nurse and the ED consultant had a discussion about the issue and the ED doctor apologized for his unprofessional behaviour. The issue was ultimately resolved by professional collaboration process. According to Choi and Ahn (2021), conflict can take place between many professional group and problem solving ability and communication is the key to resolve such conflict.

Analysis

On analysis of the situation, I found that the situation was challenging for me a novice nurse. This was because the conflict was between the patient and the ED doctor. Ideally, I did not had the positive to question the action of an ED nurse. However, due to my duty towards patient safety and advocacy, I decided to intervene. This action was in relevance with NMBA standard 2.5 which states that the RN should advocate on behalf of people and respect the autonomy of patient during care. In the situation, the patient was aware about the need for surgery. However, her husband was not informed about the process. To avoid delay during the surgery, I engaged in coordination, consultation and referral with professional to ensure optimal outcome for the patient. This outcome is in relevance with the NMBA standard 2.6 (NMBA, 2016)

Conclusion

When reflecting on the situation now, I feel that managing any unprofessional behaviour or conflict of interest required effective problem solving skill. To avoid the issue of disrespect, it is important to preserve the interest of both parties (Labrague, Al Hamdan & McEnroe‐Petitte, 2018). The professional standards of practice and the code of conduct document gave me the guidance to resolve conflict and promote safety of client. Based on my experience, I feel that nurses should be given training on effective conflict management style so that they handle similar situations in practice.

Action Plan

Based on my experience of handling unprofessional behaviour in practice, I have planned to learn more about resolution steps and conflict management style. To achieve competence in this area, I plan to take part in continuous professional development training to increase my confidence in conflict resolution. In addition, I plan to learn more about ways to report incident in clinical settings.

Rationale For the Selection of the Model

I have selected Gibb’s reflective cycle as a model for reflection as it offers an effective framework for evaluating experiences (Markkanen et al., 2020). The stages of the reflective cycle allows learning from past experience and systematically evaluation the pros and cons of our action.

References

Byrne, A. L., Baldwin, A., & Harvey, C. (2020). Whose centre is it anyway? Defining person-centred care in nursing: An integrative review. PLoS One , 15 (3), e0229923.

Choi, H. G., & Ahn, S. H. (2021). Effects of a conflict resolution training program on nursing students: A quasi-experimental study based on the situated learning theory. Nurse Education Today , 103 , 104951.

Galutira, G. D. (2018). Theory of reflective practice in nursing. International Journal of Nursing Science , 8 (3), 51-56.

Labrague, L. J., Al Hamdan, Z., & McEnroe‐Petitte, D. M. (2018). An integrative review on conflict management styles among nursing professionals: implications for nursing management. Journal of nursing management , 26 (8), 902-917 

Markkanen, P., Välimäki, M., Anttila, M., & Kuuskorpi, M. (2020). A reflective cycle: Understanding challenging situations in a school setting. Educational Research , 62 (1), 46-62.. 

NMBA (2016). REGISTERED NURSE STANDARDS FOR PRACTICE . Retrieved from: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx

NMBA (2018). Code of Conduct for nurses. Retrieved from: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx

Truglio-Londrigan, M., & Slyer, J. T. (2018). Shared decision-making for nursing practice: an integrative review. The open nursing journal , 12 , 1.

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