CLINICAL PRACTICE 9_NBNC1102

ASSIGNMENT
SONAHS

SCHOOL OF NURSING AND ALLIED HEALTH SCIENCES

NBNC 1102
CLINICAL PRACTICE 9

ASSIGNMENT (100%)

SEPTEMBER SEMESTER 2010

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CLINICAL PRACTICE 9 RECORD

NBNC 1102
(2 credit hours = 2 x 60 hours = 120 hours)

STUDENT’S PARTICULAR

Name : __________________________________

Matrix No : __________________________________

Semester & Year : __________________________________

Ward / Area of Practice : __________________________________

INTRODUCTION

Clinical Practice 9 is a General Practicum focusing on Management and Medico Legal Studies that is
implemented in the student’s own ward or area of practice. You will continue to work in your
organization and your official working hours will be considered as practicum hours. Your learning
will take place as you work because you need to apply more of the theory that you have learnt into
your work tasks. You DO NOT need a Clinical Preceptor in the clinical practice.

You need to be self-directed in implementing your learning activities with support from your face-to-
face tutorials for the subject of Management and Medico Legal Studies B (NBBS1104).

COURSE OBJECTIVES

At the end of this course, students will be able to:

i. apply the management process in the clinical practice

ii. apply knowledge on ethics and medico legal in the clinical practice

iii. give recommendations to improve the management in the practice

iv. appreciate the importance of management and medico legal in the practice.

Students will need to make conscious effort to evaluate their current practice and clinical
performance.

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ASSESSMENT METHOD

The assessment for NBNC1102 Clinical Practice 9 consists of these components:

i. Clinical Practice Record 10%

(form is attached in this course kit)
ii. Written Assignment 60%

iii. Oral Presentation 30%

TOTAL 100%

a) Clinical Practice Record (10%)

General Practicum Record: (10 marks)

The assessment will be based on the following aspects:-

• Record of the Clinical Practice Hours - must not be less than 120 hours.
• Attachment of the valid photocopies of duty roster / working time.
• Verification of the Clinical Practice Record by the Superior Staff
(Matron/Sister/Director etc.)
• Accuracy, clarity and completeness of the recording.

b) Written Assignment (60%)

Ethical decision-making is inherent in nursing practice. The goal of the nurse in any decision-
making process is to advocate for patients’ rights of self-determination and to protect patients’
well-being. But when nurses face ethical dilemmas, they need to understand the process of
ethical decision making, the relative values, and which values take precedence.

The principles that underlie decision making are the basic principles of bioethics. The principle
of self-determination, or respect for autonomy, supports the right of competent patients to control
their own bodies and to make decisions that affect themselves. The principle of well-being, or
beneficence, doing good and preventing harm, obliges the nurse to promote the health and safety
of patients in decisions made by and for them. The principle of equity, or justice, requires that
patients be treated fairly and equally in the decision-making process.

Registered professional nurses are in the best position to advocate for the rights of their patients
and are frequently involved in ethical issues and ethical decision-making processes. Ethical
dilemmas arise daily when the nurse is confronted with a choice, in which ethical reasons both
for and against the choice are equally desirable (Pierce, 1997). These issues are often emotionally
charged. Recent literature (Clark, 2002; Dinc, 2003) has identified some of the more frequently
occurring ethical issues confronting nurses today, including:

• Staffing patterns that limit a patient’s access to care

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• Management/administration participation in down-sizing that reduces patient services and

staff while maintaining quality care and access to that care
• The protection of patients’ rights and human dignity
• The right to refuse treatment
• The prolongation of the living and dying process and the need to consider the impact on the
patient’s quality of life
• Informed consent
• Whether or not to use physical or chemical restraints
• Providing care that may be a risk to the nurse’s health
• Potential differences between nurse and patient belief systems regarding issues such as
abortion, euthanasia, and organ and tissue donation
• Bioethical issues raised by medical technologies and treatment such as the use of stem cells
from human embryos.

Consider ONE of the above Ethical Issues and address the issue accordingly:-

i) Assessment:
By using
• Five-Step Ethical Decision Making Process (refer to the NBBS1104 Module)
OR
• Eight-Step Ethical Assessment Framework (EAF) (refer to the Appendix 1)

ii) Plan of Action

• Select a morally justified action/option from alternatives identified

iii) Implementation
• Act upon/support the action/option selected (Describe the Implementation)

iv) Evaluation
• Evaluate action/option(s) taken
Short and long term

Outline of the Written Assignment (60%)

• Introduction – Definition of ethic and brief account on Ethical

Decision Making [5 marks]

• Description - the selected Issue; Give an example of a Scenario [10

marks]

• Critically Discuss – consider the 4 steps:

Assessment, [8 marks]

Plan of Action, [8 marks]

Implementation, and [8 marks]

Evaluation [8 marks]

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• Recommendations / suggestions [6 marks]

• Conclusion [4 marks]

• References - APA Style [3 marks]

Format of the Written Assignment

• Table of content
• Words - Minimum 2,500
• Font – Arial, Size 12
• Spacing - 1.5
• Binding - combed

c). Oral Presentation (30%)

• Title – Ethical Decision Making in ………………………….
• Mode – Power Point Presentation (Minimum of 20 slides)
• Allocated Time – 20 minutes:
Presentation - 15 minutes
Question & Answer – 5 minutes
• Prior to Presentation – submit the printed PP Slides to the Tutor (2 PP Slides per page)
• Presentation Criteria :
- Introduction
- Content - clear statement of the issue; and the Scenario
- Discussion – the 4 steps: Assessment, Plan of Action, Implementation, and
Evaluation
- Recommendations / suggestions
- Conclusion
- Delivery - clear speech & interesting, formal appearance and confident
- AVA presentation - clear and appropriate
- Time management - good

INSTRUCTION

1. Discuss the outline of your assignment with your tutor before you proceed.
2. Type, compile, and bind neatly and in sequence.
3. Be punctual in submission of the Assignments. Submit directly to your Tutor after the
Oral Presentation. Keep your submission assignment slip. Keep a soft copy of your
assignment for yourself as an evidence of submission.

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SUMMARY OF CLINICAL PRACTICE HOURS

Please record the summary of your Clinical Practice hours in the table below. Make sure that the
Clinical Practice hours are not less than 120 hours and the recording is complete.

No. Date & Time Total Hours Superior’s Initial

TOTAL HOURS

* Attach with additional paper if necessary. Attach roster / working time.

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Appendix 1

ETHICAL ASSESSMENT FRAMEWORK (EAF)*

Assessment:

1. Identify the problem

Issues, conflicts and/or uncertainties
2. Gather relevant facts
Medical (objective data); contextual (subjective data); policies, state and federal laws etc.
3. Identify methods of ethical justification to help resolve the dilemma
Consequentialism (consequences); deontology (duty); principalism (principles); care
(relationships); casuistry (cases); virtue (character)
4. Consciously clarify relevant values, rights, and duties of patient, self and significant persons
associated with the issue(s).
5. Identify if there is an ethical dilemma(s) present.
6. Identify guidelines from nursing and professional codes of ethics.
7. Identify and use relevant interdisciplinary resources.
Ethics committee, ethics consultants, clergy, literature, administrators, lawyers, colleagues,
etc.
8. Identify and prioritize alternative actions/options.

*© 1998: Ethical Assessment Framework (EAF)

Judith M. Casseus, RN, DNSC (et. al)