Engagement in Professional Nursing-Case Study

Engagement in Professional Nursing- Nursing Case Study Assignment Help

Task:

This assessment will talk about the inquiry at the Bundaberg Base Hospital involving an overseas trained doctor. Surgeon Jayant Patel was arrested over the deaths of patients on whom he operated when he was the director of surgery at the Bundaberg Base Hospital (Wilkinson, Townsend, Graham, & Muurlink, 2015, p. 265). The two modules will examine the poor implementation of credentialing combined with the failure of transparent leadership and management that led to the deaths of 88 patients. The inquiry was highly publicised in the international media and demonstrates what can happen when these core elements are undervalued. This raised many questions about the Australian public hospital system in 2005.

Credentialing at Bundaberg Hospital failed. Dr Patel was appointed as Director of Surgery by the Medical Board of Queensland senior medical officer in surgery at Bundaberg Base Hospital on 11 February 2003. Weyden (2005) reported that in his two years of practice at Bundaberg, he performed about 1000 surgeries patients, of whom 88 died and 14 suffered serious complications (p. 284). “A clinical review has found that Patel directly contributed to the deaths of some patients and may have exhibited an unacceptable level of care in others who died because lacked many of the attributes of a competent surgeon” (Weyden, 2006, p.284). This appointment occurred through negligence by the Medical Board and by administrators at Bundaberg Base Hospital. The Medical Board failed to properly check Dr Patel’s paper credentials and to make any assessment of whether he had the qualifications and experience for practising surgery in Bundaberg.

Engagement in Professional Nursing-Case Study

Engagement in Professional Nursing-Case Study

“In obtaining his registration in Queensland, Dr Patel did not disclose prior incidents reflecting incompetence, even though the application documentation specifically sought such information” (Freckelton, 2006, p. 77). “Dr Patel submitted a proof of licensure certificate issued by the Oregon Board of Medical Examiners with his application to the Queensland Medical Board, but he failed to attach a document that showed the restrictions that had been placed on his practising license” (Freckelton, 2006, p.79). The event could have been prevented had risk management strategy, credentialing been established. Credentialing “is the formal process used to verify the qualifications, experience professional standing and other relevant professional attributes of medical practitioners for the purpose of forming a view about their competence, performance and professional suitability to provide safe, high quality health care services within specific organisational environments”
(Australian Council for Safety and Quality in Health care, 2004, p. 3). After credentialing, the Australian Council for Safety and Quality in Health care (2004) stated that the scope of clinical practice of a medical practitioner is established through outlining the degree of clinical practice according to the individual’s credentials, competence, and performance and professional suitability (p.4). This process was adopted at Bundaberg by the local hospital employing the doctor. Morton (2005) stated that due to workforce shortage, the clinical leaders and managers were caught between credentialing someone about whom they are uncertain or having no one to deliver the service as evidenced by Dr Patel’s appointment as medical officer at Bundaberg Hospital and promotion to Director of Surgery without thorough scrutiny by the Queensland Medical Board of his registration and history (p. 328). It is therefore essential that credentialing of medical practitioners is undertaken by a committee that is not part of the health service organisation. Dr Patel’s appointment based on ‘area of need’ as part of credentialing was incorrectly managed. The correct process for the selection of the applicant was not followed.

When applied according to Hawken (2005), overseas trained doctor should be assessed English proficiency, clinical competence and provides training and education relevant to clinical practice in Australia with an in-depth review that includes a formal application letter, the applicant’s performance during the interview, reference check, and clinical skills assessment (pp. 1-3).

The second module is transparent leadership. According to Baum (2005) transparent leadership is founded on the basis of integrity, trust, respect, inclusion, openness, and honesty and is dependent on values based leadership being put into practice (p. 41). Baum (2005) noted that the two traits of a good leader are integrity and being a good listener (p. 44). As a first trait, the integrity of a leader and the values that support this go hand in hand. The leader through his integrity should represent the core organisational values. The values start with the leader and flow
down through the organisation as a behavioural expectation. Values define how well an organisation operates from day to day, this includes listening to employees regarding positive and negative feedback, being open and honest about everything, questioning decisions, and understanding what the next move is that is best for employees.

Reward should be given to employees showing initiative. When implemented correctly, becomes a standard operating culture. There is a need for employees to feel empowered and engaged to make decisions with the running of the organisation. This is how transparent leadership, which starts at the top of an organisation can create a successful business model. Because Dr Patel’s integrity was untested and questionable, Bundaberg Base Hospital required an external investigation into its organisational operation.

On the other hand, “a leader who listens hears both positive and negative issues and views that contradict his” (Baum, 2005, p. 46). Baum (2005) added that a good listener wants the whole truth and not pieces of information that are filtered out by the staff and the supervisors, coming out as faultless and tampered (p.46).

The Bundaberg Health system was contrary to transparent leadership. “It was a system of concealment and blame that led to loss of trust in the administration, among clinical colleagues, and trust from the patients and the public” (Dunbar, Reddy, Beresford, Ramsey, & Lord, 2007, p. 80). According to Weyden (2005), Dr Patel concealed his disciplinary history in the United States (p. 284). “The hospital was focused on budgets, business plans, and targets and failed to follow its values” (Morton, 2005, p. 328). Being under pressure to fill medical vacancies, Fitzgerald (2006) expressed that Queensland Health did not conduct an assessment regarding the clinical competence of an applicant for an “area of need” position (p. 199). The way it operated was not embedded “in core values, specifically based on the greatest good for the greatest number of people” (Baum, 2005, p. 42). Allegations of poor professional performance and adverse events were not investigated that resulted in whistleblowing of nurses and doctors.

“Doctors and nurses did not trust that complaints would be addressed, so they did not report the problems” (Dunbar, Reddy, Beresford, Ramsey, & Lord, 2007, p. 81).

 

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