The case study below and make three practice recommendations.

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analyze the case study below and make three practice recommendations. Rationale and support is to be provided from three scholarly resources and at least two CNO Documents (A Practice Standard and the Code of Conduct).
· Title page: follows APA 7th edition guidelines.

· Introduction: Describes the context of the paper, the topic, and what the reader can expect.

· Case Study Summary: includes a summary of important data from case study.

· CNO Practice Standard Discussion: includes an explanation of the chosen CNO Standard, describes the relevant indicators from the CNO document and how they relate to the case. Include relevant Code of Conduct Statements.

· Recommendation One: includes a recommendation for the RPN’s practice, with discussion around reflection. Support this recommendation with information from one scholarly peer-reviewed journal article and CNO Documents.

· Recommendation Two: Includes a recommendation for the RPN’s practice, with discussion around improving competence through education. Support with information from one scholarly peer-reviewed journal article and CNO documents.

· Recommendation Three: Includes a recommendation for the RPN’s practice, with discussion around taking accountability for their actions. Support with information from one scholarly peer reviewed journal article and CNO documents.

· Conclusion: includes a comprehensive summary of the discussion.

· Reference Page: follows APA guidelines, includes the three selected research articles, and all CNO documents used in the paper

· Appendix A: includes a list of ALL research articles found (one for each team member) with the name of which team member was responsible for each article

Case study

Olivia has a history of anxiety and depression. She experiences frequent challenging periods every year and has been admitted to the local hospital’s Mental Health Unit on four occasions over the past 10 months. She has been struggling to deal with a family crisis that took place 12 months ago.

During her last 3 admissions, Gordon, an RPN on the Mental Health Unit has been Olivia’s primary nurse providing care. Olivia has developed a comfort in talking with Gordon and sharing details about the problems and challenges she faces.

Olivia feels her recovery with each admission is partly because of the support she has received from Gordon. Olivia expresses this to her sister and also reveals that she is very attached to him and feels emotionally attracted to him.

Prior to her final discharge she expressed her gratitude and tells Gordon that it is because of him that she feels so much better. She thanks him with a gift, which he accepts, not wanting to hurt her feelings. Olivia goes home and that week, discovers Gordon’s social media account through a friend. She sends him a message, which he replies to, and they begin to message back and forth over the next several months.

Six months after the discharge Olivia and Gordon, along with four other individuals, two friends of each, decide to rent a house together. While being roommates, Olivia faces two admissions to the Mental Health Unit where Gordon still works. Despite the fact that they are roommates, Gordon provides care to Olivia and does not disclose their roommate relationship at work.

 

Sample Solution

Analysis of Registered Nurse Practice (RPN) Conduct – Case of Olivia and Gordon

Introduction

This paper analyzes the case of Olivia, a patient with a history of mental health challenges, and Gordon, a Registered Psychiatric Nurse (RPN) who provided her care during multiple hospital admissions. The analysis focuses on Gordon’s professional conduct and identifies recommendations to ensure ethical and responsible nursing practice, referencing relevant College of Nurses of Ontario (CNO) documents and scholarly sources.

Case Study Summary

Olivia, a patient with anxiety and depression, formed a bond with Gordon, her RPN, during several hospital admissions. She felt emotionally attached to him and expressed gratitude for his support. Despite accepting a gift from Olivia and maintaining social media contact after her discharge, Gordon continued to care for her as a patient while living as her roommate, failing to disclose this relationship to his workplace.

CNO Practice Standard Discussion

The CNO document most relevant to this case is the Therapeutic Nurse-Client Relationship (revised 2006) practice standard. This standard emphasizes establishing and maintaining a professional, trusting relationship that prioritizes the client’s well-being.

Indicators from the Standard and their Relevance:

  • Respect for Client Dignity: Gordon accepting Olivia’s gift and engaging in social media communication after discharge potentially compromised his professional boundaries and disrespected Olivia’s vulnerability. (CNO, 2006)
  • Power Imbalance: The power dynamic between a nurse and patient is inherent. By blurring professional boundaries and becoming roommates, Gordon risked exploiting this imbalance for personal gain. (CNO, 2006)
  • Impaired Judgment: Olivia’s emotional attachment and mental health challenges raise concerns about her ability to maintain a healthy patient-nurse relationship. Gordon’s actions suggest a potential lack of professional judgment in engaging with Olivia outside the therapeutic context. (CNO, 2006)

Relevant Code of Conduct Statements:

The CNO’s Code of Conduct (revised 2018) outlines principles and statements that guide professional nursing behavior. The following statements are particularly relevant:

  • Nurses respect clients’ dignity. (Statement 1.1)
  • Nurses work respectfully with the health care team. (Statement 5.5)

By failing to disclose his relationship with Olivia to his colleagues, Gordon potentially compromised patient confidentiality and team dynamics.

Recommendations

Recommendation One: Reflection and Boundary Setting

  • Practice Recommendation: Gordon should engage in self-reflection to understand how his actions affected his professional judgment and patient care. He should utilize reflective practice resources from the CNO or professional nursing organizations.
  • Rationale and Support: Reflecting on ethical dilemmas is crucial for professional growth (McAllister, 2018). The CNO encourages nurses to “continuously reflect on their practice” (https://www.cno.org/globalassets/docs/prac/41033_therapeutic.pdf).

Recommendation Two: Education and Boundary Management

  • Practice Recommendation: Gordon should undertake continuing education courses on maintaining professional boundaries and therapeutic nurse-client relationships. The CNO offers various resources and workshops on these topics.
  • Rationale and Support: Boundary violations are a common ethical concern in nursing (McAllister, 2018). Educational resources can equip Gordon with strategies to maintain professional boundaries and avoid similar situations in the future. (CNO, 2006)

Recommendation Three: Accountability and Disclosure

  • Practice Recommendation: Gordon should disclose his relationship with Olivia to his supervisor and potentially seek guidance from the CNO. Transparency and accountability are essential for maintaining professional integrity.
  • Rationale and Support: Failing to disclose a relationship with a patient constitutes a breach of trust and ethical code violations (McAllister, 2018). The CNO provides guidance for nurses navigating ethical dilemmas, and seeking their support demonstrates accountability (CNO, 2018).

Conclusion

Gordon’s actions raise concerns about his professional conduct regarding boundaries, power dynamics, and patient confidentiality. By implementing the recommendations for self-reflection, education, and accountability, Gordon can demonstrate a commitment to ethical nursing practice and prioritize the well-being of his patients.

Reference Page

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