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Nursing Essay on The Importance of Medications in Patient’s Care


Task: Standard 1 of the NMBA Registered Nurse Standards for Practice outlines the requirement for nurses to use best available evidence for safe, quality practice and to develop practice through reflection on experience, knowledge, actions, feelings and beliefs (NMBA, 2016).

The aim of this nursing essay is for students to describe and reflect on, a nursing related event reported in the media and using the National Safety and Quality Health Service (NSQHS) standards developed by ACSQHC (Australian Commission for Safety and Quality in Healthcare) identify what nurses might do to improve their practice and reduce the risk of a similar error.


Introduction to the theme of nursing essay
Sarah Hassan and Touhidul Sunny Alam who were longing to see their child after five years had to face the pain and the distress due to the medication error of the nurse (Mendes et al., 2018). This was because the nurse did not have any prior idea of morphine and when Sunny Hassan was in labor pain, she was given 100 mg of morphine instead of 10 mg. The medication errors by the nurses and the midwives are the most common health threatening mistakes affecting the patient’s care. Such mistakes have been increasing at a global rate thereby affecting the mortality rate, the length of stay as well as the related costs (Jember et al., 2018). The thesis statement of this study is to analyze the importance of medications in a patient’s care thereby trying to reduce the errors. This study will highlight the description of the nursing incident, the consequences of the incident for the nurse and the consumers, the nursing action plan and a reflection on the incident using Rolfe’s model.

Description of the nursing incident and the role of the nurses
When Mrs. Sarah Hassan started having contractions during her pregnancy, she was rushed to the hospital where the midwives offered her morphine to make her comfortable. Within few minutes, Mrs. Hassan fell asleep and her husband was relaxed to see her sleeping. However, he didn’t realize that her wife was in a coma and the child was on the verge of death due to the overdose of the painkiller (Hessels et al., 2019). When in the morning, another nurse visited Mrs. Hassan, she couldn’t find out her pulse and the doctors performed the C-section immediately. The child was dead and Mrs. Hassan was also in a coma with all her body parts not functioning effectively. This entire situation took place due to the irresponsibility or the lack of knowledge of the nurses. The midwife who has carried this mistake stood silent and another nurse resigned because of her (Dyab et al., 2018). However, according to the ACQSHC standard 4, it is the responsibility of the nurse to adhere to the medication safety before providing any form of treatment. It is the responsibility of the nurses not to provide medicines that are beyond one’s knowledge and thus take care of the patient’s safety accordingly.

Consequences of this incident for the nurse and the health consumers
The consequences of this medication error by the nurses have led to the failure of trust among the patients and the carers. As it leads to adverse outcomes such as mortality, the increased medical expenses, and the duration of hospitalization. In this case, it has been found that the couple had to lose their child due to the wrong medication and thus the entire blame was put upon the nurses associated with the hospital (Alomari et al.,2018). Mrs. Hassan was very conscious and she avoided consuming any forms of painkillers during her entire phase of pregnancy, but the poor knowledge of the nurse has led their dreams to fall in vain. In this extreme case, the nurses might also be in a situation to resign from their job. Further, according to the NMBA standards, the nurses must work in partnership with the midwives and the nursing students to save the lives of the patient. On the other hand, the effect on the health consumers who have lost their loved ones due to the carelessness of the nurses is likely to be devastating (Alomari et al.,2018). It might be difficult for the patients to trust or rely on the medical system.

Nursing action plan
The nursing action plan to remove the medication error is described below:



Outcome Measures

Responsibility and Timeframe

Develop transparent and accountable safety culture involving excellent professional practice

·         Develop anefficient system to review and communicate with the nurses related to the quality and safety of the medicines.

·         There should be support for the use of Nursing and Midwifery data informing the patient care.

·         Implementation of the system and the processes to support partnership with the consumers and the carers (Recio?Saucedo et al., 2018)

·         Implement the system to communicate and review with the N&M safety and quality data contributing to learning and development (Hammoudi et al.,2018).

·         Nurses to promote the use of sensitive data for informing patient care outcomes.

·         Reflect on the system to facilitate the partnership between families, nursing, and midwifery (Salami et al., 2019)

The nurses and their board members (3 months)

Support the other staff to demonstrate a measurable increase in the family and patient-centered care

·         Implement, evaluate and design the programs for compassion, mindfulness, coaching, personalized belief, and patient-centered care (Walsh et al.,2017).

·         Developing a team of facilitators for supporting the sustainability and the scalability of the patient’s wellness

·         Compassion, mindfulness, enabling, and coaching.

·         The facility and the service within the group members

The nurses and the executive team members (2 months)

A positive workplace culture that is sustained and developed through the patient care initiatives empowering the midwives and the nurses

·         Measure the effective centered care initiatives.

·         Develop training strategy to support the patient care initiatives

·         Continuous generation of the research projects.

·         Implementation of nursing and midwifery staffs to enable the baseline.


The nurses and the team members (3 months)

The nursing staffs engage in the reflective practice to improve the experiences of care as well as the staff knowledge

·         Develop the nurses and the midwives to facilitate the reflection and the process of inquiry (Gracia et al.,2019)

·         Increase in the number of related and quality awards.

·         Increase in the number of quality and associated awards.

Nurses and the team members (2 months)

Reflection of the incident using Rolfe et al reflective model
The situation has developed a sad feeling as it has taken the life of a child and has put risk on the mother. I think it is difficult to judge on the part of the nurse who does not have knowledge but has been assigned to take care of critical patients in the maternity ward. The entire situation looked gloomy and thus I found it essential for the hospital authority to assign tasks to the nurses based on their experience and qualification. Moreover, the nurse did not adhere to the NMBA or the ACQSHC standards in the provision of treatment to the patient.

So What?
The role of the nurse cannot be considered to be appropriate as the wrong medication and the poor experience took away the life of the child. The nurses must take prior training and knowledge before handling the critical patient. I have observed that the nurses have felt very sorry and ashamed when they could not save the life of the child and put the patient in a critical situation. The hospital authority must also take strict actions as the nurse did not adhere to the basic standards and the principles of nursing that is to be followed in the hospitals and the nursing homes across Australia.

Now What?
As per the case study, I have found that one of the nurses has resigned from her position due to the carelessness of her colleagues. However, this cannot be considered to be appropriate and the nurses need to consult the higher authority and then prescribe the medicine. Further, the nurses must also be made mandatory to undergo training and thus provide the appropriate care to the patient accordingly.

Thus, it can be said that the nurses must try to consult the higher authority or cooperate with their colleagues before prescribing the medicine to the patient. Moreover, the patient or the family carers must also not trust the nurses or the doctors and thus make a query to them before consuming any medicine. It is also the responsibility of the hospital authority to not appoint doctors or nurses who do not have experience in solely handling the ward. As in this case study, it has been found that the medication error has taken the life of the child as well as made the situation of the mother critical. The hospital authority must take proper care in managing such actions so that it does not get repeated in the future and thus saves the lives of the patients. Therefore, it is important to focus on the role of medications and double-check or cross-check it before prescribing them to the patient.

Alomari, A., Wilson, V., Solman, A., Bajorek, B., & Tinsley, P. (2018). Pediatric nurses’ perceptions of medication safety and medication error: a mixed methods study. Comprehensive child and adolescent nursing, 41(2), 94-110.

Dyab, E. A., Elkalmi, R. M., Bux, S. H., &Jamshed, S. Q. (2018). Exploration of nurses’ knowledge, attitudes, and perceived barriers towards medication error reporting in a tertiary health care facility: a qualitative approach. Pharmacy, 6(4), 120.

Gracia, J. E., Serrano, R. B., &Garrido, J. F. (2019). Medication errors and drug knowledge gaps among critical-care nurses: a mixed multi-method study. BMC health services research, 19(1), 1-9

Hammoudi, B. M., Ismaile, S., & Abu Yahya, O. (2018). Factors associated with medication administration errors and why nurses fail to report them. Scandinavian journal of caring sciences, 32(3), 1038-1046.

Hessels, A., Paliwal, M., Weaver, S. H., Siddiqui, D., &Wurmser, T. A. (2019). Impact of patient safety culture on missed nursing care and adverse patient events. Nursing essay Journal of nursing care quality, 34(4), 287.

Jember, A., Hailu, M., Messele, A., Demeke, T., &Hassen, M. (2018). Proportion of medication error reporting and associated factors among nurses: a cross sectional study. BMC nursing, 17(1), 1-8.

Mendes, J. R., Lopes, M. C. B. T., Vancini-Campanharo, C. R., Okuno, M. F. P., & Batista, R. E. A. (2018). Types and frequency of errors in the preparation and administration of drugs.Einstein (São Paulo), 16.

Recio?Saucedo, A., Dall'Ora, C., Maruotti, A., Ball, J., Briggs, J., Meredith, P., ...& Griffiths, P. (2018). What impact does nursing care left undone have on patient outcomes? Review of the literature. Journal of clinical nursing, 27(11-12), 2248-2259.

Salami, I., Subih, M., Darwish, R., Al-Jbarat, M., Saleh, Z., Maharmeh, M., ...& Al-Amer, R. (2019). Medication administration errors: Perceptions of Jordanian nurses. Journal of nursing care quality, 34(2), E7-E12.

Walsh, E. K., Hansen, C. R., Sahm, L. J., Kearney, P. M., Doherty, E., & Bradley, C. P. (2017). Economic impact of medication error: a systematic review. Pharmacoepidemiology and drug safety, 26(5), 481-497.


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