Sadiq is 74 and has come into your care for assessment and is accompanied by his
daughter who lives in Newcastle and is an only child. He speaks very little English.
His daughter tells you that his dementia has got much worse recently and seems to
be losing the ability to speak and understand English. This is causing
communication difficulties for the family as her parents always insisted, she speak
English at home and consequently never learnt to speak Hindi.
Sadiqs wife, who is his main carer, has been hospitalised recently due to a stroke.
Sadiqs daughter tells you he is currently home alone but asks you not to tell anyone
as she doesn’t want him to go into a home.
As part of the assessment you need to take a blood sample but Sadiq becomes very
agitated and the daughter offers to hold him down while you quickly draw blood. You
are called away and when you return you find another member of staff performing
venepuncture while his daughter restrains him. Away from the patient you ask the
member of staff about consent and they reply ‘its ok, he wont remember soon, even
if he could understand a word I’ve said’.
Questions – highlighted text is areas to focus on and write about
Discuss the professional, legal and ethical frameworks that underpin Nursing Associate practice as related to the case study.
Q1. Explain the duty of care and duty of candour you have towards the patient. (NMC proficiencies 1.1; 1.3; Apprenticeship standards K1, K7)
Explain the duty of candour and care, discuss the NMC code and how it ties into the duty of candour and how it all relates to the patient. Sharing of information. Safeguarding – open about communication with the team. Referrals to interpreters, speak about challenges with family interpreting, potential of bias. confidentiality and GDPR
Q2. The patients capacity has changed. Explain your role in ensuring their best interests are met and that they are safeguarded. (NMC proficiencies 1.2; 1.14; 3.22; 3.24; Apprenticeship standards K6, S2, K26, S22)
Discuss ethical framework, beneficence, non malevolence, autonomy and justice. Safeguarding, capacity fluctuation, taking blood without consent, potential assault. whistle blowing importance of record keeping. best interest and sharing information in terms of safeguarding.
Q3. Discuss how you would ensure safe care and anti-discriminatory practice is provided for your patient. (NMC proficiencies 1.4; 1.11; 1.16; 5.1; Apprenticeship standards K8, S10, S6, K30)
What is anti-discriminatory practice and the law, equality act and protected characteristics, human rights act, culturally competent care, how would you challenge the behaviour of the person and why. Discuss safe environments in terms of no consent could link with confidentiality and GDPR