Katie died just before Christmas in 2013 Forensic pathology found no evidence of any disease to account for her death Autopsy revealed fentanyl overdose is the cause of death HOW DID KATIE DETERIORATE? She was found unconscious in a hospital bathroom after selfadministering IV fentanyl and was fortunately resuscitated She had unmanaged mental health issues ▪ suspended from nursing for 6 months ▪ referred to a psychiatrist and psychologist ▪ mandatory drug testing NMBA Standard 1 Thinks critically and analyses nursing practice ▪ Katie breached this standard when she took the leftover fentanyl from a patient instead of discarding it ▪ Two nurse checks for schedule 8 medications NMBA Standard 3: Maintains capability for practice NMBA Standard 3: Maintains capability for practice standard 3 maintain the capability for practice ▪ standard 6 provides safe appropriate and responsive quality nursing practice ▪ standard 7 evaluate outcomes to inform nursing practice ▪ compromising the safety of patients ▪ compromising the safety of staff ▪ documenting and reporting to provide the correct and beneficial pathway for them to recover and return to work (Stodart, 2010) Five stages in identifying a nurse who is about to be burnt out (Mudallal et. al, 2017) HONEYMOON PHASE ▪ Commitment to the job at hand ▪ Compulsion to prove oneself ▪ Free-flowing creativity ▪ •High productivity levels Anxiety Irritability Fatigue High blood pressure Job dissatisfaction Inability to focus Lack of sleep or reduced sleep quality Denial of problems at work or home Feeling threatened or panicked Feeling pressured or out of control Increased alcohol/drug consumption CHRONIC STRESS Missed work deadlines and/or targets Anger or aggressive behaviour Apathy Chronic exhaustion Behavioural changes Physical symptoms intensify and/or increase Development of an escapist mentality Complete neglect of personal needs Continuation or increase in escapist activities Burnout syndrome Chronic mental fatigue Depression Chronic sadness Chronic physical fatigue ▪ changing her wards ▪ More support ▪ implemented drug testing for more drugs and medications instead of the few she was tested on ▪ follow and monitor staff members using the burn out chart stages ▪ provide more support and counselling for their staff members ▪ ongoing medicals and mental health checks for their staff members just as much as they do with FIFO workers Rebar et al, (2018) ▪ American Addiction Centres Editorial Staff. (2020). Taking action: How to intervene during an overdose. American Addiction Centres. https://drugabuse.com/blog/taking-action-how-to-intervene-during-an-overdose/ ▪ Cumming, S. (2015). Husband to tell wife’s tragic death. Press Reader. https://www.pressreader.com/australia/the-chronicle-8992/20150219/281487864789282 ▪ Duquesne University. (2020). Ethical issues in nursing: Explanations and solutions. Duquesne University School of Nursing. https://onlinenursing.duq.edu/blog/ethical-issues-in-nursing/ ▪ Edwards Duthie Shamash Solicitors East London. (2020). Work suspension and disciplinary issues. Edwards Duthie Shamash. https://edwardsduthieshamash.co.uk/employment/work-suspension-and-disciplinary-issues/ ▪ Frost, P. (2015). Drug addict Toowoomba nurse did not die in vain. The Courier Mail. ▪ https://www.couriermail.com.au/news/queensland/chinchilla/drug-addict-toowoomba-nurse-did-not-die-in-vain/news-story/4c2471a6094b399f4e4e1ff79fb418e1 ▪ Health Care Australia. (2021). New South Wales: Nurses, midwifery, doctors, allied and support workers jobs. Health Care Australia. https://healthcareaustralia.com.au/jobseekers/nursing-doctor-jobs-in-new-south-wales/ ▪ International Council of Nurses. (2012). The ICN code of ethics for nurses. https://www.icn.ch/sites/default/files/inline-files/2012_ICN_Codeofethicsfornurses_%20eng.pdf ▪ Koffel, C., Burke, K. G., McGuinn, K., & Miltner, R. S. (2017). Integration of quality and safety education for nurses into practice: Academic-practice Partnership’s role. Nurse Educator, 42(5S Suppl 1), S49S52. https://doi.org/10.1097/NNE.0000000000000424 ▪ Martyn, J., Paliadelis, P., & Perry, C. (2019). The safe administration of medication: Nursing behaviours beyond the five-rights. Nurse Education in Practice, 37, 109-114. https://doi.org/10.1016/j.nepr.2019.05.006 ▪ Mojarad, F., Jouybari, L., & Sanagoo, A. (2017). Drug abuse among nurses: A neglected challenge. Journal of Nursing and Midwifery Sciences, 4(1), 1-2. https://doi.org/10.18869/acadpub.jnms.4.1.1 ▪ Mudallal, R. H., Othman, W. M., & Al Hassan, N. F. (2017). Nurses' Burnout: The Influence of Leader Empowering Behaviors, Work Conditions, and Demographic Traits. Inquiry : a journal of medical care organization, provision and financing, 54, 46958017724944. https://doi.org/10.1177/0046958017724944 ▪ MyDeathSpace. (2016). Kate Howman (30) died after a battle with Fentanyl addiction. MyDeathSpace. http://www.mydeathspace.com/article/2016/01/21/Kate_Howman_(30)_died_after_a_battle_with_Fentanyl_addiction ▪ Nico El Nino. (2016). Work safety: What travel nurses need to know. Onward Healthcare. https://www.onwardhealthcare.com/workplace-safety-what-travel-nurses-should-know/ ▪ Nursing and Midwifery Board of Australia. (2016). Registered nurses standards for practice. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-forpractice.aspx ▪ Nursing and Midwifery Board of Australia. (2018). Code of conduct for nurses. https://www.nursingmidwiferyboard.gov.au/documents/default.aspx?record=WD17%2f23847&dbid=AP&chksum=BIvAWN0iQspBLSXlDBR1pQ%3d%3d ▪ Rebar, A. L., Alfrey, K. L., Gardner, B., & Vandelanotte, C. (2018). Health behaviours of Australian fly-in, fly-out workers and partners during on-shift and off-shift days: an ecological momentary assessment study. BMJ open, 8(12), e023631. https://doi.org/10.1136/bmjopen-2018-023631 ▪ Stodart, K. (2010). Nursing council expands scopes of practice and works on improving communication: The nursing council has rewritten the scopes of practice for both enrolled nurses and registered nurses and has worked on improving communication with nurses and the wider health sector.(NEWS FOCUS). Nursing New Zealand (Wellington, N.Z. : 1995), 16(10), 10. IGNITE PRESENTATION Instructions Pick key eras relevant to nursing practice (NMBA + NSQH) THINK from a Nursing aspects and what’s relevant to nursing practice and link it to those standards Review the coroner’s case you have been allocated and identify any legal, ethical, quality and/or safety issues involved in the death of the patient, reflecting upon your own knowledge acquired from your theoretical education and clinical experience thus far. 1. Introduction: Overview of the background and context of the case. (who the patient Is? Quick for audience to understand what the case is about or Introduce it in a short way but in a way where someone who hasn’t read the case will understand the case • Brief Timeline of what’s going on (Time line of actions taken and medications given, consider if the actions and/or medications given were appropriate OR what should have been done according to current practice) 2. Link it to latest evidence and what the evidence say include NMBA standards and code of ethics (the case might be old and some things in practice have been changed or developed) • • • Current practice and research evidence in relation to this case Relevant professional, legal, ethics, equality, quality and safety issues Relevant NMBA Standards-link to specific standards, not just broadly. 3. Conclusion: Include recommendation for practice MORE than what’s listed in the coroner’s case. Think about what you’ve taken away from the case and how it can inform my future practice and colleague • Clearly and succinctly summarized what has been learnt and how can this be applied in future practice • Include relevant and comprehensive nursing practice recommendations to lessen the likelihood of further and similar outcomes • Audience left with a Clear understanding • 4. PRESENTATION: 6-7 MINUTES 20 slides, each slide 20seconds per Slide-Using auto forward. • Add relevant and main points for audience to understand the case. EACH slide needs to complement what you’re saying. (Images and words can be added on the slide for audience to read more or understand better) • • REFERENCE IMAGES END REFERENCE NEEDED
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