Nurses in the Discharge of Their Duties - Essay Example

Introduction The cycle of life is a distressing reality that each and every one of us must face. There is no getting around it as it is as inevitable as life and death itself. Thorough care is a much needed quality in order to ensure that there is no one that is put to a disadvantage because of the incompetency of the health professional who is in charge with the steady and expedient recovery of a client. In a case where the clients are of a more progressive age, people often forget that it requires the same, if not the more, of the time patience and effort that must be given compared to a regular client. The Eskimos have a tradition wherein when a member of the family has reached an age where he or she is no longer an active participant of the tribe, the son or the closest member of the family is tasked to take him miles from the home and leave him in the freezing cold. Such practice, although barbaric, was accepted not only by the family member who has to do the form of euthanasia but also by elderly himself to be his fate. In simple logic, those who no longer contribute to the benefit of the family has lost his worth and must therefore accept the reality of death as promulgated by those close to him. The very thought of this scenario where an old person is left to die in frigid weather arouses disturbing thoughts in a humane perspective. The necessity to enforce that every person must be attributed with not only the quality of life but also the quality of death should be affixed to the elderly. The elderly psychiatry ward poses a professional challenge to the individuals assigned to it. But most importantly, it also yields the obligation to impart an emotional aspect to the care that they receive. Otherwise, rather than being treated as individuals, they may be deprived of the respect that is not entirely undue to them. There are a number of problems that arises in the nursing profession. One of such that persists is the ethical dilemmas that health professionals face in their career. Ethics, or in simple interpretation is the ability to distinguish between right and wrong is embraced in the moral conception of decision-making for individuals. Being professional is synonymous to doing the right thing that is good not only for the client but also for one’s own being. The Nursing & Midwifery Council’s promulgation of a Code of Conduct provides for set guidelines that must be met by nurses and midwives in their careers and their interaction with clients to ensure that they remain faithful to their oath. Rumbold (as quoted in Burnand and Chapman) gave three functions to the necessity of a professional code, 1st it serves to reassure the public, 2nd it provides guidelines for the profession to regulate and discipline its members and 3rd it provides a framework on which individual members can formulate decisions (p.16). This is important in that there is solid ground on which professionals can stand on, meaning that they will not be at a lost when there is a moment whrein they have to make hard decisions. It is suffice to say that for most of the people, one way or another we become ill. And when this happens the most logical way to proceed is to consult a medical professional. For majority of the people, we have experienced the simple pattern of getting sick, consulting for a cure, obtaining the treatment and going back to being healthy. When this happens, thanks to the implementation of scientific medical procedures, we attain well-being for our own sake. Medical advice is necessary especially for the aches and pains or even behaviour that is no longer tolerable. We adhere to the solemn belief that they have the knowledge to help make us well again to the best of their abilities. Professionalism is an indispensable quality for any medical officer regardless of the client he is tasked to help. The Concept of Confidentiality In any profession there always exists a code that contains the standards of conducts, performance and ethics that must be observed while rendering one’s professional services. In the world of Nursing and Midwifery, The Nursing and Midwifery Council (NMC) Code of Conduct is being followed. It serves as the guide for the nurses and midwives while performing their duties. The relationship between the nurse/ midwife and the client while he/she is in need of the health care/services is very significant. In dealing with this relationship, trust and confidentiality are two concepts that require much attention. In this regard, the client or John must be treated with utmost respect as to his privacy. As a health care and service provider, it’s included as the goal of the nurse or the midwife to gain trust from the people or individual under their care. Because of this trust, their client will be giving them their consent and confidence to do whatever must be done for their health and well-being purposes. This trust is justified when the nurse or midwife makes the care of people as his/her first concern, treating them as individuals and respecting their dignity (Nursing and Midwifery Council, p.1). This was implemented when, upon taking his background information, John was taken aside to be able to tell his feelings without scaring him. You must respect peoples right to confidentiality (Nursing and Midwifery Council, p.2). and to show respect for one’s dignity, confidentiality regarding personal matters should be strictly observed. The nurse or the midwife must ensure their clients that information gathered from them will be kept confidential. This will help both of them as the nurse/midwife will not have a hard time getting the information he/she needs to properly assess the health condition of the client and the client will get the care or medication he/she needs in time. Sometimes clients become hesitant to give information regarding their health condition because of trust issues. Or the worse scenario is when they give misleading information about themselves. As a result, they will not be given the health care they should get. You must ensure people are informed about how and why information is shared by those who will be providing their care (Nursing and Midwifery Council, p.2). It’s the right of the clients to be informed properly and it’s the duty of the attending nurse or midwife to make sure that the clients under his/her care are informed about how and why information about them is shared to those people who will be providing them their health care needs. The nurse or the midwife should not make assumptions that clients will know and understand the situation by themselves. Proper communication is very essential when we talk about disclosure of one’s personal information. This does not only show respect to one’s dignity but also we want them to feel valued as important individual. You must disclose information if you believe someone may be at risk of harm, in line with the law of the country in which you are practising (Nursing and Midwifery Council, p.2). This means that disclosure of information happens only when the nurse or the midwife believes that their clients’ health and well-being is at risk of harm as according to the law of the country in which they are rendering their service. And the nurses or midwives should always justify and held accountable for all their actions and decisions. It is important for professionals like nurses and midwives to always act lawfully, whether those laws relate to their professional practice or personal life (Nursing and Midwifery Council, p.1). Placement Profile Name: Nmasebe Kouyate Educational Competency: Mental Health Nursing Institution/ Hospital: Address: Placement: Psychiatric Ward for Elderly Patients Person in Charge: Type of Placement: I was assigned to the psychiatric ward for elderly patients where they are confined under close monitoring and supervision. There are doctors assigned to conduct routine checks on the patients at different time intervals. There are also staffs that take care of the needs of the patients. The medical team consists of different professionals that attend to them. Shift Patterns: Special Requirements: Confidentiality policy is strictly implemented. The employees are forbidden to talk privately about the patients and their particular illnesses or habits. As with other professions, the health care providers are not to gossip or divulge information about the clients. Client Profile Department: Psychiatric Elderly Patients Ward Name of Client: John Gender: Male Age: 74 years old Diagnosis: Mild depression Pre-existing Condition: Type II diabetes Date of Admission: October 12, 2010 Overview: John, a widower, is clearly displaying signs of depression over the loss of his wife almost a year ago. Since then he has lost interest in activities he had previously enjoyed and his health and appearance has deteriorated even though he has no previous bouts of psychological issues. The Client- Nature Problem The difficulty of differentiating between dementia and Alzheimer’s disease is among the problems in elderly patients. Although it may seem that they are the same or interrelated, there are actually differences that may factor in the administration of treatment and in understanding the client. Roeltgen defined dementia as “an impairment of thinking and memory that interferes with a persons ability to do things which he or she previously was able to do” while he provided that “Alzheimers disease is the common cause of dementia, and is particularly common in older people. Because it is the most common cause of dementia, Alzheimers disease is commonly equated with the general term dementia. However, there are many other causes of dementia” (par.1-3). John shows relative signs of this. The biggest problem was in how to go about overcoming his depression over losing his wife. The best way to diagnose is for the physician to do a background check and determine through an examination that may be able to pinpoint the actual ailment of the client. The erratic behaviors of the clients are also a contributor to the problems that persist. In the case of John, it was not as difficult to figure out his problem because the stories that he himself told about his wife is very telling of his burden. It was relatively not difficult to handle him compared to other patients. They may be obstinate at times and may not follow the instructions that are given to them. But there are also those who are not as difficult to handle. There is also care that is attributed to the diet of John as he requires a different type of diet as he has a pre-existing condition which is diabetes that requires specific types of food to be avoided. Care-Setting Within SMART The utilization of the SMART nursing is an ideal framework in the delivery of health care. This, as a system, focuses on the entirety of the intertwined necessity of each part of the process and the members of the organization. It is a long-term based undertaking that the organization, led by its heads, must fully commit to in order that its ideal outcomes are fully realized. There are six basic elements that must be adhered to and these are; “respect, simplicity, flexibility, integrity, communication and professional culture” (Fabre, p.5). The system is aimed to eliminate medical errors that are committed rampantly by many health care professionals. It is developed to help nurses realize the full potency of their impact to society without having to be reduced because of the conditions they experience. There is much weight given to the establishment of a nurturing culture that does not alienate nurses to the community. It emphasizes on the integrity given not only to the clients but also to the nurses as vital parts of the health organization. The implementation and planning of interventions for John was a group effort that required the participation of health professionals and including his family. It was particularly interesting to be a part of the intervention that was designed specifically for John. There was empathy because the background of John is a fascinating story between him and his wife. The main task was to figure out the right motivation for him to snap out of his depression. Luckily, he has his family. It was important to respect the issues of John over his sadness because death brings about intolerable grief especially because he has gone through decades with his wife beside him. Analyses of Care Delivered for Client In my analyses of the care that was delivered to John, we have used the Guidance for the Care of Older People as a basis. The essence of nursing care for older people is about getting to know and value people as individuals through effective assessment, finding out how they want to be cared for from their perspective and providing care which ensures that respect, dignity and fairness are maintained (Nursing and Midwifery Council, p. 6 ). My delivery of care always starts with a review of the client health history which we integrated based on hospital admission form and proceed with my assessment. Effective assessment of my client was attained by understanding their conditions first. In addition to this is the fact that we all know. Older people are more likely to experience bad health conditions and are more susceptible to illnesses than younger ones, the same goes for emotional distress. Realizing this fact gave us the overview of mental health care and treatment that nurses like me can provide him and intervention was the best fit for him. If only all nurses will value and respect older people as individual needing care and not just treat them as persons with bad condition, then older people will be able to get the care that they require and desire (Nursing and Midwifery Council, p.7 ). There are three main elements to providing the fundamentals of care in a safe and effective way to older people: people, process and place (Nursing and Midwifery Council, p.8 ). I am one of the people here because as a nursing student I am expected to be competent enough to deliver safe, effective and quality care to my clients. My competency relies on the skills and trainings that I have regarding mental health as I am assigned to the psychiatric ward with the elderly patient. So, the issues on trust and confidentiality plays an important role here. After gaining the trust and confidence of my client, I was able to move on with the process of health care provision. The process involved here is when nurses deliver quality care which is also intended to promote dignity to the clients by nurturing and supporting their self-respect and self-worth. This happens when we are able to establish good communication with our clients. We are actually not just talking to them to communicate but we also lend them our ears to listen to anything they have to say. And finally, the place is a diverse environment where older people are cared for in the community. In my case, it is the hospital which also serves as a rehabilitation in my client’s mental health. Places like hospitals providing care for older people is important because it is only here where they get proper health services and attention. So, hospitals should also be efficiently and properly managed together with the care of his own family. Evaluation of Professional Role in Delivery Care After my analyses to the care that I have delivered to John, I can now evaluate my professional role in delivery care. In this evaluation, the NMC Code of Conduct still rules out. It provides us the guidelines whether nurses or midwives are performing their roles- both personal and professional – in delivering services and care to their clients. My personal role in the delivery of health care for my client sometimes interferes and even merges with my professional role. As a person with parents also, there are times when I treat my clients as my own parents. I began to understand and reflect on the impact of their conditions to their families. As a professional, you are personally accountable for actions and omissions in your practice and must always be able to justify your decisions (Nursing and Midwifery Council, p.1). Everytime I perform my duty and deliver care to my client, I make sure that it is the right and best thing to do. I check on my asssessments, the laboratory and diagnostis testing results, the client’s medications and the appropriate mental health program for the clients’ condition to see to it that I am giving them the best care that they need. But my role does not stop on checking, I am expected to give them all the mental health care needs that their condition require and desire. In here, the intervention was the key. Afterall, I am a nurse- liable and responsible in delivering my client’s mental health care needs. Conclusion There are number of things that must be contemplated and carefully reconsidered to be able to qualify that the best possible health program is administered to clients. When the former is in a progressive age suffering from psychological ailments where there seems to be no bright end in sight, this does not equate to providing them with any less care and attention than any other who needs medical intervention. On contrary, because they have lived a full life where their families still hold fast to the memory of their glorious days, they must be treated with respect. As the Code has reiterated, elderly patients must be treated as individuals. Yes, in some cases, they may be delivered to homes in order for them to spend their last days there. But this does not mean that they deserve any less than what is due to them. For most of the clients, the institution is their last stop. It is where they are brought to have at their convenience the care of professionals to help them in their last few remaining days. It is not only a psychiatric ward but also a home for most of the elderly patients. They are to be regarded as people and not left in the cold. This is the real meaning of professionalism, compassion. There is also emphasis due on the administration of nurses in the discharge of their duties. In this case, they must be provided with a favorable work environment that should make it easier for them to function. They are also to be treated with respect and not as second-rate workers. The organization must see to it that they are enjoying what they are doing because it is not always in monetary compensation that they are to achieve fulfillment. There are many aspects to this and communication between the staff and those higher is position is imperative for this. The carrying out of band-aid solutions would not lead to any growth. Everyone must be able to put in their two cents worth. Bibliography Arnst, Catherine. "The Right Cure for Ailing Elder Care." BusinessWeek 11 June 2007. Burnand, Philip and Christine Chapman. Professional and Ethical Issues in Nursing. London: Elsevier Limited, 1993. Fabre, June. Smart Nursing. New York: Springer Publishing Co., Inc., 2005. Kaiser, Guy. "Housing for the Elderly- A Guide to the Best Practice." Home of the Future. Welhops, July 2009. Macdonald, A.J.D. "ABC of mental health: Mental health in old age." BMJ 16 August 1997: 413-417. MENCAP. Death by Indifference. Case Studies. London: Mencap, 2007. Nursing & Midwifery Council. "Guidance for the Care of Elder People." NMC (2009): 2-38. —. "The Code Standards of Conduct, Performance and Ethics for Nurses and Midwives." May 2008. NMC UK. 21 December 2010 . Roeltgen, David. "The Difference Between Dementia and Alzheimers ." 16 April 2007. Health Central. 22 December 2010 . Read More