Nursing Case Study Essay Example

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NURS2002C Case-study Assignment


This is a case study which I underwent during my nursing placement which took me a maximum of four weeks in a large metropolitan public hospital on a medical ward mainly specializing in patients with respiratory conditions. Am a second year nursing student pursuing nursing program, and it is a requirement for a student at least to have a Professional Experience Placement for nursing before going out to the field or workplace. I was allocated in wards mainly dealing with patients with respiratory conditions where I leant more lessons which were pertaining to my profession. Nursing is a profession that should be taken with great care since it deals with patients who need medical care in order to save their life or health. I was allocated four patients who had different medical needs and needed my services during my placement. I encountered some challenges in offering services such as language barrier and lack of good information on patients’ orders. The following are incidents which cover scenario that I underwent:

  • Communication

  • Health informatics

  • Law and ethics


Communication is the process of conveying information from one end (sender) to the receiver. It is the backbone of every institution to enhance coherent relationship between employees, management and customers. Effective communication is of great importance in resolving differences, building respect and trust and creates a favorable environment for working. Effective communication eradicates the frustration that appears in the organization, as a result of poor communication and misunderstandings
(US Department of Health and Human Services 2013). In metropolitan public hospital, large numbers of people have a communication problem since other patients do not understand and use English. Individuals with English problems also have difficulties in writing and reading. As such, they need assistance from interpreters so that they may get the correct information from their health care providers. Studies show that those individuals who are affected by poor communication such as English have limited health care, and thus, receive less health care services

between Nurse Kylie Scott and team leader Adam Vronsky. The communication between the staff of the hospital and patients was also not good enough. Effective communication helps to improve working relationships within the hospital especially between the nurses and the patients. In this metropolitan public hospital, communication was poor, and this caused misunderstandings This will ensure that all major aspects of the patient are met.In the course of nursing placement, I realized that the language barrier affects the offering of services and give rise to serious medical problems. I also found out that patients with language barriers encounter interpretation mistakes that may lead to consequences such as providing the wrong dose. Therefore, it is important to identify the type of language and know the interpreter who is representing the patient for proper treatment or services.

Bad attitude is a communication suicide among employees of an organization. Adam Vronsky displayed a bad attitude and impatience when he said “Just go give it will you, for goodness sake, you do not have to get every little thing checked.” This approach creates a communication barrier since, after the statement, a person could not get any other chance of explaining the real situation and how I thought it could be done. The patient also had a bad attitude towards the instructions from the nurses. Mrs. Gianopolis instead of accepting my instructions she went ahead with a lot of determination not to take the medicine. She did not explain the reason for refusing the medicine offered to her, because of the bad attitude that had already developed in her mind.

The remedy to these misunderstanding between the staff of the hospital is to develop good communication skills. The team leader, Adam, should learn good communication skills in order to deliver his service in the best possible manner. He should learn that listening is very significant in the process of communication. Careful listening enables the receiver of the information to have the right perception of the information, and in turn, give a response accordingly.

Health Informatics

. (Sullivan & Wyatt 2006)Health informatics is the information generated from the patient through examination, observation and patient’s account of the disease. This information is collected using the people and technology and help to convey the best information flow from the patient to the clinical officers. If a patient moves from one health care facility to another, health informatics enables clinical officers to make use of the information collected by the previous health officer in providing the best medicine for the patient. This information can be of great significance if it can only be accessible and well organized. Informatics is the best technology that can enable contact to broader information. Health informatics also encourages modernizing of work to enable people to develop new working ways

. Health Informatics in any health institution helps and supports all dimensions of safety and provision of effective and efficient health services. These services include planning, development, research, business, evolution of services, and provision among many others. (Canada’s Health Informatics Association, 2012)Health informatics makes use of information technology application to provide facilitation and use of health generated data

. This information is paramount in ensuring the patient receives the right medication at the appropriate time in the right proportion. Mrs. Gianopolis breached the health informatics policy of collecting information from the patient first before administering medication to the patient. (Yasnoff et. al, 2000)In the Metropolitan Public Hospital, the use of health informatics was very poor and still underdeveloped. Nurse Kylie Scott and team leader Adam Vronsky never made use of health informatics in order to provide best medications for their patients. When I approached Mrs. Gianopolis to attend to her, I found out that she did not have any medication order yet she had been attended by Nurse Kylie Scott the day before. This was a breach of information because a health officer should provide for the use in treating the patient in any given time

The metropolitan Hospital should ensure the following health applications informatics is implemented. First, the hospital should have a well systematized communication protocols this will ensure efficient and effective transmission of data. Good communication would have enabled the hospital to have a proper channel of administering medication to the patients. The hospital should come up with electronic record systems for the patients. This record would have enabled Nurse Kylie Scott to store the information of Mrs. Gianopolis that would help in her future medications even by a different health officer. Mr. Adam the team leader should adopt the use of evidence-based decision in administering medication. He instructed the patient to be given two tablets of Panadol without knowing what exactly the patient suffering is from. This is very dangerous because the patient might be at risk of being given a wrong medication.

The Metropolitan Hospital should embrace the use of modern technology in attending to patients. The use of patient monitoring system should be adopted. This includes the use of computer generated information to monitor the patient’s improvements and development. The hospital can also use image processing systems and digital imaging to help in providing clear information of the patients’ diseases. The information on computer will help the clinical officers effectively and efficiently analyze the patient’s situation (Department of Health 2002).

Health informatics will be of high significance to Metropolitan Hospital since it will ensure proper management of patient’s information. This information will help in improving communication and hence delivery of best services to the clients of the hospital. Health informatics will ensure a provision of up-to-date and reliable information about the patient under the health facility. This will allow the health officers of Metropolitan Hospital to provide the best medical services to the patient. It also helps in instant access of information about a patient.

Laws and Ethics

. In the laws and policies of Australia, a health care provider should meet established ethical cords and standards and should be able to deliver high quality health care. (Pope 2011)The observation of laws and ethics in every business is paramount for individuals and organizations. Ethical issues and concerns should be resolved in order to reduce errors and wrong decisions which can be costly to the business. A health facility is not an exception to moral issues

In the health policies of Australia, a training student on the medical profession or unauthorized person is not allowed to attend to patients without the supervision of an authorized health officer. Adam, the team leader, breached this law by allowing a trainee to attend the patients before Nurse Kylie Scott, who is the supervisor, arrived. There was a breach of medical treatment where the patient was given medication without a test to identify the real cause of the pain or disease.

The following recommendations will be suitable in eradicating unethical practices in Metropolitan Hospital. The hospital should develop policies and protocols that promote ethical practices. These policies should be adopted by the company as a culture and the daily practice (Fox et al 2013, p.11-14). No patient should be offered medication before check up and medical examination is carried out. The hospital should also redesign its working processes so that health officers should be readily available to attend the patients at any given time.

Lessons from the incidence

The lessons learnt from this occurrence have impact on my career as a nursing student. First, the communication between the health officer and patients is crucial in administering the right medication. I personally leant that language barrier affects the offering of services and give rise to serious medical problems. Basing on the incident Mrs. Gianopolis could not express the problem in her health due to the language barrier. Therefore, the presence of an interpreter was necessary.

I leant that it is important to keep patients records that are up-to-date. This will allow the patient to receive proper medication at the right time. In this incident, Mrs. Gianopolis did not have updated medication order; and therefore, determining the right medication was not easy. Offering of any medication without the study of the patient is ethically wrong. The health policies of Australia strongly condemn the act of providing patients with medication without first examining the disease.

The importance of health informatics is another key lesson drawn from this incident. With proper information put in the records of the hospital, Mr. Adam would have been in a better position to make a sound decision regarding the proper medication for the patient. The lack of proper records made Mr. Adam to rely only on the prescription from a doctor who, at that time, had not arrived in the hospital. The use of information technology in information sharing could have been the best solution to the confusion and misunderstanding which emerged from this incident. Clinical systems give healthcare officers with the ways of sharing quality knowledge and data in a timely fashion. This guarantees that patients receive the best treatment efficiently and effectively.


Canada’s Health Informatics Association. (2012). Health Informatics Professional Core Competencies (Vol. 1). Toronto, Canada: Coach.

Department of Health. (2002, October). Making Information Count: A Human Resources Strategy for Health Informatics Professionals. Retrieved 06 2014, 01, from

Fox, E. K. (2013). Intergrated Ethics: Improving Ethics in Quality in Health Care. Retrieved 06 2014, 01, from

Pope, T. M. (2011). Legal Briefing: Healthcare Ethics Committees. The Journal of Clinical Ethics 22, no. 1 , 74-80.

Sullivan & Wyatt, F. (2006). ABC of Health Informatics (1 ed.). (E. Lines, Ed.) Malden, USA: BlackWell Publishing Ltd.

US Department of Health and Human Services. (2013). Advancing Effective Communication In Critical Access Hospitals. COMPLIANCE REVIEW INITIATIVE:
, 1, 1-5.

William A. Yasnoff, P. W. (2000). Public Health Informatics: Improving and Transforming Public Health in the Information Age. Atlanta: USA.