The Importance of Proper Skill and Knowledge in Nursing Profession

Nursing profession is more than just learning some skills to take care of patients or to act in a way. Nursing professional should very carefully and patiently do their duty as the task they perform is related to the wellbeing of a sick person. Before a person is declared as a nurse, they must qualify some series of exam and test to prove themselves fit for nursing professional. After getting their registration they can appeal to get employed in any healthcare center. However, even after getting proper training many nurses fails to deliver appropriate treatment and health care services to patient which result in adverse effect on the health of patient. After occurrence of such incident nurses are liable to get their registration canceled and in severs case they are even prosecuted legally. This essay addresses this topic in detail. For the purpose of highlighting the importance of nursing profession, case study of Mr. Raffel Ramirez is focused here.

Mr. Raffel Ramirez was a registered nurse of NSW for many years. He like all other nurses who worked here had to quality the exam for getting job in NSW. However, later it was found that he was not conducting and practicing his profession seriously and for this reason many patients had faced severe health issues. It was found that he did not possess enough knowledge, skill and mental capacity required for this profession. Multiple times he had administered wrong medicine to patient or had overdosed them with certain amount of drug. According to the opinion of Daly, Speedy and Jackson (2017), a nurse should possess enough knowledge about different drugs and different types of ailment of human bodies and at the same time must possess mental stability to deal with different type of patients. This helps to communicate properly with patient and enables them to understand any problem that the patient is facing.

For lack of skill, knowledge and mental stability many patients who were under the responsibility of Mr. Ramirez, suffered serious health issue even after being admitted in healthcare unit. After continuous repetition of such unresponsive activities Mr. Raffel Ramirez was prosecuted and finally had his registration canceled.

There were multiple patients who suffered due to Mr. Ramirez. Under investigation it was found that he failed to administer Lasix to a patient and for which that patient suffered from severe edema. In another case, he failed to detect appropriate medical review of patient (O'Callaghan et al. 2018). He was also found to overdose a patient with drugs instead administering the prescribed amount by doctors. He did not possess knowledge about what emergency action must be taken for patient who was under cardiac arrest. For his action the authority of NSW was facing legal problems and their organization's reputation was degrading. After detailed investigation it was found that Mr. Ramirez was suffering from a mental disease namely paranoid personality disorder and for this reason his mental capability was reduced. Finally, his registration was cancelled and presently he was under treatment.

The organization where Mr. Ramirez worked is a reputed organization for providing best treatment to patient. They ensure that every patient is provided with appropriate and efficient treatment so that they can recover soon. However, the case of Mr. Ramirez contradicts the organization’s objectives. Investigation report states that once a patient was admitted in this organization with cardiac arrest, the doctors quickly conducted various test and administered the required drug to that patient as a primary treatment. Later, the doctor gave the responsibility of that patient to Mr. Ramirez and asked him to monitor him properly and to report his health condition to doctor on regular basis. The doctor asked Mr. Ramirez to put the patient under cardiac monitor. However, instead of following doctor's instruction, Mr. Ramirez took that patient out of cardiac monitor. For this reason, Mr. Ramirez failed to report the patient health condition to doctor and this caused delay in providing necessary medication and other clinical facility to patient. As a result, the patient took long time to recover.

There are many other cases related to Mr. Ramirez which justifies the action of tribunal to cancel his registration. In one case Mr. Ramirez was asked to administer 1.25mg of Ramipril drug to a patient. Instead of following the instruction provided to him, he had given 12.5 mg of Ramipril drug to that patient. As result of this the patient suffered from serious health problem. This shows that Mr. Ramirez poses communication gap and unable to cooperate with others working within the organization.

In another case, Mr. Ramirez had administered Parvolex drug to a patient who had already had the medication once, therefore as a result of having the drug twice, patient had to suffer consequences. Parvolex drug is generally administered to patient as treatment of paracetamol overdose. Paracetamol overdose affect the liver of a person adversely and as a remedy to it, parvolex drug is given. This patient on whom Mr. Ramirez had administered parvolex drug twice suffered from liver problems. This shows that Mr. Ramirez was very careless during his duty hours and paid less attention to the patient who were under his responsibility (Campbell, Coyer and Osborne, 2016).

In another case, Mr. Ramirez failed to continue IV Heparin on a patient and failed to ensure proper medical review. This shows that Mr. Ramirez does not possess enough skill, knowledge and patient to deal with a patient. As result to this the patient suffered from acute blood clotting problem. Anticoagulant drug like Heparin is administered to patient who have undergone surgery or to prevent the formation of blood clots within the blood vessels.

It was later found that Mr. Ramirez was mentally unstable and was suffering from paranoid personality disorder. People who are suffering from paranoid personality disorder develop the feeling of mistrust and suspicion regarding others. This kind of person usually does not trust other people and do thing that appears to be justified according to that person. The same happened in the case of Mr. Ramirez, where he thought that the instructions provided to him by doctors or any superiors are wrong. In response to this, he performed task that was right according to him and this resulted in adverse health issues of patient. Patient’s family also claimed that Mr. Ramirez did not provide medicine on due time to patients and such delay in health care’s service affect the condition of patient.

People who are suffering from paranoid personality problem are found to be very stubborn, hostile and argumentative; like Mr. Ramirez. He was reluctant to follow instruction provided to him and continuously argues with his superior regarding their decision. He also lacked proper communication skills and for this reason he was unable to establish healthy bond either with patient or with his colleagues. He also lacks fast thinking in response to an urgent situation. This causes delay in providing health care service to patient in urgent need. Negligence was not only from the part of Mr. Ramirez, but also the authorities. The authorities should also be questioning on the basis that how they can hire such an imperfect candidate for providing health care to patient. Before hiring, the company did not check the mental and physical condition of Mr. Ramirez before but only checked whether he possess a valid registration or not. This can be due to two reason, first one is that during the time of getting registration, the authorities did not examine Mr. Ramirez potentiality, skill and knowledge (Bennett and Johnson, 2017). The second one could be that healthcare organization required more nurses during that time and so they hastily conduct their recruitment process and did not verify the credentials of Mr. Ramirez properly. As per the opinion of Runciman, Merry and Walton (2017), every healthcare unit must maintain safety and ethics within their organization and only then they can provide efficient and appropriate service to those who seeks for it. That organization failed to provide safety to patient due to Mr. Ramirez. In future to avoid the repetition of such situations they must carefully hire employees so that efficient health care services can be provided to patients.

In order to provide appropriate health care, NSW have developed certain policy that must be followed by every nurse. Following these guidelines helped nurses to provide appropriate health care services to patient. Mr. Ramirez possessed little knowledge about nursing profession and so he should have applied those techniques provided to him during training. He should have listened to the instruction provided to him by doctors or by his seniors’ nurses (Maier and Aiken, 2016). Administering excess amount of Parvolex to the patient and the whole situation could have been avoided if he had carefully listened to doctor and follow their instruction.

As for the case of cardiac arrest patient, he should have monitored him more carefully and reported his condition to doctor regularly. He should not have removed him from cardiac monitor as it would help him monitor the pulse rate of the patient.

According to the policies of NSW, a nurse should monitor the patient regularly and should take prompt action in response to the situation. This helps to prevent adverse health issues of patients. NSW policies also mention that every nurse must develop effective communication with their colleagues and with patient.

Mr. Ramirez should have been more careful while injecting drug to patient and should make sure about the quantity of drug that has been administered. He should have administered the right drug with right dose as per the doctor’s instruction and in case of any doubt he should have referred to the doctor. As for the time when he had administered 12.5 mg of Ramipril drug instead of 1.25 mg, the patient had to suffer serious health issue afterwards. This situation could have been easily avoided if Mr. Ramirez was more careful with his task and performed his 5 rights of medication. This way the cancellation of his registration could have been avoided.

As from the above-mentioned discussion, healthcare unit must be very careful while recruiting employees. The reputation of an organization totally depends upon the employees working within (Gill et al. 2017). As for the organization where Mr. Ramirez worked, they hired him without the knowledge that he was mentally impaired. The activities of Mr. Ramirez had increased the health issues of patient as he did not possess proper skill, knowledge required for nursing profession. There were many cases where Mr. Ramirez had administered wrong medicine to patient or had given overdose of medicine. He was incapable of taking prompt action in case of emergency and this causes delay in providing health care services to patient. Later, for these reasons, the tribunal had canceled his registration. From this case study, it can be said that nurses should possess enough skill and knowledge to tackle patient, but at the same time they must develop appropriate communication with the patient so that they can very easily identify the problem areas of the patient.

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