Introduction
This paper considers the complex case of Rebecca—an RPN facing major personal barriers at a juncture when her professional Practice is also under question. In the middle of a seriously bitter divorce, Rebecca’s situation shows how personal adversities and professional commitments blend into a complex nursing situation. This story shows, against the background of great life upheavals, a great devotion to patients and allows considering this Practice in comparison with the rigorous standards described by CNO. This paper will examine Rebecca’s experiences and reflections in detail, dissecting the subtleties of her situation and looking into how her quality and integrity in nursing could be affected by the consequences of some personal challenges. The intention is to derive actionable insight from formulating a targeted recommendation congruent with CNO Practice Standards, aiming to enhance Rebecca’s nursing practice. This essay tries to summarise a wider understanding of how nurses can face personal difficulties yet still be excellent in their Practice and ethics.
Case Study Summary
Rebeca is an experienced Registered Practical Nurse (RPN) with four years of experience providing home service to clients. She is a staff nurse responsible for all aspects of patient care, from administration to medication, home chemotherapy treatment, and teaching on managing Diabetes Mellitus and other specific home care teaching. Very professional and loyal, today Rebecca is an extroverted woman confined in the turmoil of a poisonous divorce that has confronted her with many passionate and financial tasks. This personal strife had found its way into her professional life unconsciously, manifested in occasional lapses of documentation and perceived quality of care provided on her part. These were in sharp contrast to the high standards that, generally, Rebecca sets for herself, and it deeply troubled her for a while and ushered in time for reflection. However, driven strongly by professional integrity and commitment to her clients, she needs to confront these challenges head-on to resume services to her clientele with the same vigour as before.
CNO Practice Standard Discussion
In the case of Rebecca, the course of her actions is parallel to the CNO Practice Standards for Documentation and Therapeutic Relationships, bringing out areas of incongruence. These standards underline accurate and timely documentation, which forms the foundation for the maintenance of the continuum of care for the patient (Mehta et al., 2023). It also ensures that accurate records can be used for decision-making by any other healthcare professional who comes into contact with the client, thus improving the quality of care. Further, the standards underline the need to develop and maintain professional and therapeutic relationships with clients, putting their well-being and trust in the healthcare system at the forefront.
Rebecca’s case, in which she is in some personal turmoil, affects how she is doing her professional duties and puts it slightly deviant from the standards. Instances, where she needs to document or omit from the records the important interaction with the client, are not only interrupting the continuity of care but also showing tampering with the therapeutic trust developed by her clients. Lapses like this would mean that other medical caregivers adopt care strategies with the wrong information—thus compromising patient safety and outcomes.
Moreover, the Code of Conduct for CNO dictates that the nurse is responsible for the client and places his interests above his own, avoiding any situation in which his circumstances are likely to compromise those professional responsibilities (SAMUEL, 2022). This is what Rebecca is in, and where the emotional and financial strains caused by the divorce penetrate her professional conduct, a violation of these directives. From this view, they could balance their personal lives so that their professional duties never suffer.
Recommendation One: Embracing Reflective Practice for Enhanced Nursing Care
The ability to use structured reflective Practice, which is invaluable in a dynamic profession like Rebecca’s personal and professional development if she could adopt it, is imperative. Reflective Practice is not simply a surface review of tasks completed during the day; it allows the practitioner to contemplate experiences, understand emotional responses, and critically analyze the decisions and actions implemented in a clinical sense. This self-assessment approach provided further self-understanding of his Practice and the situational factors influencing his decision-making and patient care (Udoudo et al., 2022).
For Rebecca, setting aside dedicated time for reflection can transform challenges into learning opportunities. The first means she could be maintaining a reflective journal where she documents her thoughts and feelings toward her interactions with clients, care given, and areas where she felt some conflict or was unsure. This Practice motivates her to reflect on the complexity of each case, the rationale for clinical choices, and the influence of outside stressors on professional attitude and the capacity to operate (Ross et al., 2019).
Indeed, scholarly proof emphasizes that the impact of reflective Practice on nursing professionals is very big. An article in the “Journal of Hostilic Nursing” further illustrates how reflective Practice underlies clinical reasoning and supports the development of further empathy for more caring and patient-centred soft service (Udoudo et al., 2022). This is in line with what the CNO expects under the standard of Practice, where one is to keep learning and bettering oneself. Each of these documents centres on reflection as an element to maintain quality of service, ensure ethical Practice, and enhance the nature of the nurse-client relationship.
The introduction of regular reflective Practice will help Rebecca cope with the immediate demands that come about through her circumstances and also help to build further resilience and adaptability within her professional role. This reflective approach may assist her in identifying the different effective approaches to managing stress and keeping her high standard of care even in the face of personal adversities (Shin et al., 2022). The CNO documents support this by requiring that the nurse reflects on Practice in ways that will improve it, ensure the safety of the patient, and at the same time preserve the honour of her profession.
Recommendation Two: Emphasis on Continuing Education
Rebecca’s focused continuing education is needed to bridge the prevailing gaps in documentation and therapeutic communication skills. Interacting with the said courses or workshops would greatly equip her in the mentioned areas to deliver care more effectively while dealing with her challenges. The goal of these educational programs is to equip staff with practical strategies for better efficiency with documentation, all in a bid to ensure that all patients’ interactions are documented accurately and comprehensively as a way of safeguarding the continuity and quality of the patient’s care (Docherty-Skippen et al., 2019).
In addition, the improved communication skills will put Rebecca in a better position to realize and enhance stronger therapeutic relationships with her clients, which make up the nucleus of community nursing. This recommendation is not a presumptive resolution but is based on evidence from scholarly research. Peer-reviewed journal papers always reveal that continuous professional development directly influences improvement in patient outcomes and nurse satisfaction, especially in main areas like documentation and communication (Hurley et al., 2022).
The College of Nurses of Ontario (CNO) supports this position in its documentation, reiterating that the professional development of the nurse continues. In addition, for the CNO, lifelong learning is a part of nursing practice without which full competence cannot be maintained, and adaptation to changing scopes within the health delivery system needs to be developed (College of Nurses of Ontario, 2023). Thus, furthering their education, Rebecca seeks to comply with the established standards in the CNO and makes a big step in improving the service quality she provides to her clients despite personal problems.
Recommendation Three: Embracing Accountability
Accountability is the core of Practice in the nursing profession. The first step in the remediation process for Rebecca is coming to terms with the fact that those specific instances relating to her troubles did arise in the context of her professional responsibilities. She takes full responsibility for any inadequacy in the delivery of care, especially during documentation and the interactions made by the client, which are the key factors for maintaining the flow and quality of delivery (Folse, 2013).
Developing a structured action plan is essential for Rebecca to address these issues effectively. It should include specific and only measurable goals to improve the accuracy and timeliness in documentation, communication with clients, and ways to manage personal stress from bleeding into your professional responsibilities. Techniques include time management strategies, stress reduction exercises, and delegation, where appropriate.
One of the things that will help Rebecca greatly is the good source of motivation and strategies she will get through professional mentorship and community support in solving her current problems. She could join peer support groups or professional networks offering emotional support and pragmatic advice from colleagues who may have walked in similar shoes. The scholarly literature highlights accountability as a critical attribute in nursing practice. The reviewed literature emphasized that one of the roles of a nurse is to continue improving Practice so that the required level of Practice meets both professional standards and ethical obligations. The CNO documents further enforce this expectation, ensuring the nurse practices care at high standards regardless of personal circumstances while maintaining that the patient’s safety and quality care comes above everything else (Mottaghi et al., 2019). Rebecca would ensure that her professional Practice is conducted with integrity, that adherence is maintained to the ethical and professional standards enshrined in the CNO, and that the quality of care to clients is ensured by observing the following actions.
Conclusion
This paper highlights the critical scenario in which Rebecca, an RPN, finds herself in a case against the CNO Practice Standards through critical recommendations: reflective Practice, pursuit of continuing education, and accountability. The strategies would thus be helpful to Rebecca in dealing with her challenges in such a way that she keeps focused on her professional philosophies. The reflective Practice would further improve self-awareness and development, and continuing education would help Rebecca develop clinical skills related to documentation and communication with patients. Ensuring accountability will allow Rebecca to confess and rectify shortcomings to protect the quality of care. All these would help her deliver top quality despite adversities, representing resilience and dedication to nursing.
References:
College of Nurses of Ontario. (2023). Code of conduct. https://www.cno.org/globalassets/docs/prac/49040_code-of-conduct.pdf
Folse, V. N. (2013). Self-Care, Nursing Theory, and Evidence-Based Practice, by S. G. Taylor and K. Renpenning. (New York: Springer, 2011). Nursing Science Quarterly, 26(3), 290–291. https://doi.org/10.1177/0894318413489155
Mottaghi, S., Poursheikhali, H., & Shameli, L. (2019). Empathy, compassion fatigue, guilt and secondary traumatic stress in nurses. Nursing Ethics, 27(2), 096973301985154. https://doi.org/10.1177/0969733019851548
Ross, A., Touchton-Leonard, K., Perez, A., Wehrlen, L., Kazmi, N., & Gibbons, S. (2019). Factors That Influence Health-Promoting Self-care in Registered Nurses. Advances in Nursing Science, 42(4), 1. https://doi.org/10.1097/ans.0000000000000274
Udoudo, D. A., Agu, C. F., Lawrence, E. S., Woolcock, A. M. M., Emanuel-Frith, M., & Kahwa, E. (2022). Factors Influencing Nurses’ Self-Care Practices. Journal of Holistic Nursing, 41(3), 089801012211197. https://doi.org/10.1177/08980101221119776
Appendix A
Team Member #1
Shin, S., Hong, E., Do, J., Lee, M. S., Jung, Y., & Lee, I. (2022). Development of Critical Reflection Competency Scale for Clinical Nurses. International Journal of Environmental Research and Public Health, 19(6), 3483. https://www.mdpi.com/1660-4601/19/6/3483/htm
Team Member #2
SAMUEL. (2022, September 23). Patient Care Report: How To Ensure Accuracy And Completeness – excel-medical.com. https://www.excel-medical.com/patient-care-report-how-to-ensure-accuracy-and-completeness/
Team Member #3
Mehta, S., Lyles, C. R., Rubinsky, A. D., Kemper, K. E., Auerbach, J., Sarkar, U., Gottlieb, L., & Iii, W. B. (2023). Social Determinants of Health Documentation in Structured and Unstructured Clinical Data of Patients With Diabetes: Comparative Analysis. JMIR Medical Informatics, 11(1), e46159. https://doi.org/10.2196/46159
Team Member #4
Hurley, T., Hurley, M. A. E. T., belt, M. A. E. W. a M. of E. under her, academic, T. had years of experience writing in both the, Spheres, P., Subjects, S. C. W. on A. S. of, Collecting, S., & Policy, antiques R. M. L. about our E. (2022, December 2). Tips for Finding an Effective Stress Reduction Workshop. LoveToKnow. https://www.lovetoknow.com/life/wellness/stress-reduction-workshop
Team Member #5
Docherty-Skippen, S. M., Hansen, A., & Engel, J. (2019). Teaching and assessment strategies for nursing self-care competencies in Ontario’s nursing education programs. Nurse Education in Practice, 36, 108–113. https://doi.org/10.1016/j.nepr.2019.03.011
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