The case study below and make three practice recommendations.

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

• College of Nurses of Ontario (CNO). (2006). Therapeutic Nurse-Client Relationship (Revised 2006). https://www.cno.org/globalassets/docs/prac/41033_therapeutic.pdf
• College of Nurses of Ontario (CNO). (2018). Code of Conduct. https://www.cno.org/en/protect-public/code-of-conduct-for-nurses/
• McAllister, M.