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a replay to this answer as on the assignment about night shift we just need to comment.
200 words
below you will have the student answer and comment on it 200 words with references please
thank you.
student 1:
PART 1: Risks

Outline the risks to patient, paramedics and organisation

Patient risks: Not receiving proper care, what is going to be missed if this patient is not assessed properly?

Alcohol intoxication could explain why the patient is abusive and uncooperative. Alcohol reduces neuro transmission from the prefrontal cortex to the frontal cortex,
and this can lead to outbursts of aggression and uncooperativeness (Faccidomo, Bannai, & Miczek 2008). Facial contusions and a scalp laceration could suggest some kind
of damage to the frontal lobe which could contribute to, or be the primary reason for this behaviour (Faccidomo, Bannai, & Miczek 2008). Failure to assess this patient
properly could miss a severe head injury.

Paramedics:

Paramedics face aggression and violence on a frequent basis (Carolan 2007). In this situation, there may be a threat to their health and wellbeing from an aggressive
patient, resulting in Elyse not wanting to be left alone with this patient.

Risks of aggression are documented worldwide and paramedics have the right to put their safety before patient care. Patient aggression and endangerment to the safety
of practitioners is linked to increased adverse patient outcomes and injury to practitioners (Weaver et. al 2012)

Organisation:

Medical organisations are there to help people without judgment or bias, and have a responsibility to provide adequate and timely healthcare, that is non-
discriminatory in nature (Paramedics Australiaisia 2011). My understanding is that the organisation takes responsibility for patient outcome in this instance and would
be liable for any adverse outcomes.

Describe why the situation is a risk and what possible consequences could result

Head injury and facial contusions: damage to the frontal lobe could be the reason for him being abusive. An undiagnosed head injury could be fatal and consequences
could ensue for the paramedics/ organisation who denied treatment to a person who needed it.

PART 2: Obligations

What obligations would you have as a health professional? (you may refer to unregister or registered health professional policy)

The obligation of the health professional is to provide timely care to a patient, provided there is no danger to themselves. This obligation includes advocating for
patients and considering other evaluations and possibilities that may be presented.

While Paramedics have the right to a safe working environment and should put their safety first, Elyse has not done an assessment and therefore is failing to provide:

· Timely and proper care to the patient, and fails in her obligations to identify necessary interventions to improve health or relieve suffering of patients, and

· Fails to modify care based on the evaluation of clinical practice.

(Paramedics Australaisia 2011).

I have an obligation to remain safe and to not put myself or my partner in danger. Secondly, I have an obligation to help the patient and provide a proper assessment
and adequate patient care. Furthermore, I am not meeting my obligations for providing this care if I go with Elyse’ decision, as I am bound by the same patient
charters above. But I also have an obligation to report unsafe practise and advocate for patients in an unbiased and non-discriminating manner.

PART 3: Strategies

Outline appropriate methods of managing the problem: according to typical organisational policy and according to principles of professional conduct

Typical organisation policy reflects an overarching approach to providing timely, fair and effective care which is provided by skilled professionals acting on the
organisations behalf. For example, the standards for safety and quality in health service organisations reflect the need to be able to recognise risks, and develop
continuing improvement process; which aim to improve the level of care provided, and prevent the problem from reoccurring.

In the case of Elyse denying treatment, this policy would seek to explore the Elyse’s actions through her clinical practice. Did she clinically assess the patient
adequately? Did she abide by her organisations guidelines? Did she comply with the necessary treatment pathways? Was she trained adequately? Health organisations have
governance process’ which aim to protect patients from bias or substandard care. Elyse has not provided clinical evidence or assessment, and therefore has not abided
by the governance policies for health service within Australia

(NSQHS 2012)

Because I am obliged to advocate for the patient, as a health worker and as an employee, I have a responsibility to discuss the events with Elyse, highlight my
concerns and advocate for the patient to receive care and assessment. Even if treatment is not required, this still must be determined as a result of clinically
gathered evidence, obtained via a patient assessment.

REFERENCS

Australasian Competency Standards for Paramedics 2011, Paramedics Australaisia, Victoria

Carolan P 2011, ‘in the line of fire’,The Safety & Health Practitioner, vol. 25, no. 4, p. 7.

Faccidomo, S, Bannai, M &Miczek, K 2008, ‘Escalated Aggression after Alcohol Drinking in Male Mice: Dorsal Raphe´ and Prefrontal Cortex Serotonin and 5-HT1B
Receptors’, Neuropsychopharmacology, vol. 33, nn, pp. 2888–2899.

Weaver, M, Wang, H, Fairbanks, M & Patterson, D 2012, ‘the association between EMS workplace safety culture and Safety outcomes’, Prehospital emergency care, vol. 16,
no. 10, pp. 43-52

Standard 1, Governance for Safety and Quality in Health Service Organisations 2012, Australian Commission on Safety and Quality in Health Care.

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Picture of Kimberley Wade
Re: Professional scenario 4
by Kimberley Wade – Tuesday, 2 May 2017, 5:09 PM
PART 1: Risks:

The consequences of not transferring this patient to higher care could be extremely detrimental to the patient. Alcohol intoxication can interfere with initial
assessments of traumatic head trauma and/or injury since alcohol consumption can mimic the signs and symptoms and because of this, paramedics should maintain a high
level of suspicion in these patients for spinal injury, traumatic brain injury (TBI), fractures and intracranial complications, especially with the potential mechanism
of injury (MOI) surrounding assault cases (Barton et al. 2016; Vos & Muresanu 2014, p. 79). However, paramedics must make succinct clinical judgement on whether the
patient poses an immediate hazard to their own safety. Aggressive and uncooperative behaviour poses risks to the paramedics’ wellbeing, which is of course, of upmost
importance (Maguire et al. 2014). However, not transporting a patient in such a condition could be disastrous to the patient’s outcome. If one paramedic is in dispute
or has serious concerns about the treatment being or not being supplied to the patient, it is their responsibility to speak up and communicate their concerns with
their paramedic colleague and if not heard, notify appropriate services (AHPRA 2013). If this does not occur, not only will the paramedic crew be held responsible and
accountable for their negligent conduct, equally, it poses immense harm to the reputation of the ambulance service (Kilner 2014).

• PART 2: Obligations:

As a health professional, standards of practice must be adhered to. This ensures health services are provided to a patient in a safe and ethical manner, protecting
both the patient and clinician (AHPRA 2013). As paramedics, there are obligations placed on the ability to communicate and cooperate with your partner to come to
decisions on treatment and plans of actions that benefit the best interests of the patient (AHPRA 2013). In this scenario, it is the responsibility of the paramedic to
voice their concerns on their colleague’s clinical judgement and advocate for their patient. To be able to competently do this however, they must maintain a reasonable
level of clinical capability in their field of work and recognise and seek additional health service providers when limitations to treatment exists (AHPRA 2013).

Despite the patient’s level of willingness to cooperate, the paramedics have an obligation and duty to explain as far as practical and reasonable, the consequences of
not not being transported to hospital. Not only this, but a thorough assessment of the patient should be conducted prior to departing the scene and leaving the patient
(Gaisford 2017). However, when a patient is deemed incapable of consenting to transport or treatment, or there is an imminent risk to their life or health, as in this
situation, the paramedics can and should override his decision. According to the Consent to Medical Treatment and Palliative Care Act 1995 (SA) s 13, if a patient is
incapable or has impaired decision-making capacity, not being able to understand, retain or repeat to the treatment options and consequences of non-compliance, health
professionals can implement necessary treatment (Bastian et al. 2015; Sweet 2014).
• PART 3: Strategies

In complying with most organisations, the first method of managing a scenario such as this would be to implement the most minimally invasive and restrictive practices
as a starting point. Communication becomes a huge skill in persuading not only the patient to opt for further consultation, but also convincing the colleague paramedic
that this case should be managed with more cautionary action (Kilner 2014). Most literature states that besides most patients’ being unnecessarily transported to
hospital, it is better to be safe than sorry and as paramedics with limited diagnostic tools, to always err on the side of caution especially with potential head
injuries (Heinelt et al. 2015; Hertzum 2016). Communication with the paramedic colleague about the risks of negligence in not transporting this patient and how that
could impact their career and pose issues to their employment organisation, should first be attempted. If serious concerns are still present with the management of the
patient, consultation with more advanced clinicians and teams should then be a suggestion to gain an opinion and legally discuss and cover the decisions of their
treatment (Gaisford 2017; Heinelt et al. 2015). Following these actions, further notification of the concerns of treatment from a colleague despite best efforts should
be documented and reported to the Health and Community Services Complaints Commissioner (AHPRA 2013).
REFERENCES

Australian Health Practitioners’’ Regulation Agency (AHPRA) 2013, The code of conduct for unregistered health practitioners, Adelaide, Government of South Australia.

Barton, DJ, Tift, FW, Cournoyer, LE, Vieth, JT & Hudson, KB 2016, ‘Acute alcohol use and injury patterns in young adult prehospital patients’, Prehospital emergency
care, vol. 20, no. 2, pp. 206-11.

Bastian, PD, Eng, A, Denson, LA & Ward, L 2015, ‘Consent, capacity and the right to say no’, The Medical journal of Australia, vol. 202, no. 8, pp. 417-.

Gaisford, M 2017, ‘Informed consent in paramedic practice’, Journal of Paramedic Practice, vol. 9, no. 2, pp. 80-5.

Heinelt, M, Drennan, IR, Kim, J, Lucas, S, Grant, K, Spearen, C, Tavares, W, Al-Imari, L, Philpott, J & Hoogeveen, P 2015, ‘Prehospital identification of underlying
coronary artery disease by community paramedics’, Prehospital Emergency Care, vol. 19, no. 4, pp. 548-53.

Hertzum, M 2016, ‘Information behavior and workplace procedures: The case of emergency-department triage’, in ASIS&T Annual Meeting.

Kilner, T 2014, ‘When Discharging a Patient at Scene Can Lead to a Claim of Clinical Negligence’.

Maguire, BJ, O’Meara, PF, Brightwell, RF, O’Neill, BJ & Fitzgerald, GJ 2014, ‘Occupational injury risk among Australian paramedics: an analysis of national data’, Med
J Aust, vol. 200, no. 8, pp. 477-80.

Sweet, A 2014, ‘Consent, capacity and the right to say no’, Med J Aust, vol. 201, no. 8, pp. 486-8.

Vos, PE & Muresanu, DF 2014, ‘In?hospital observation for mild traumatic brain injury’, Traumatic Brain Injury, p. 71.