Professional Nursing: Preserving Human Dignity - Essay Example

Professional Nursing: Preserving Human Dignity The essay aims to address a two-fold objective, to wit to identify and describe an incident or situation that has occurred during student practice, and (2) to discuss a related professional issue. Professional Nursing: Preserving Human Dignity Introduction Professional nurses have the ability and power to work independently, respecting the ethical concerns of patients and taking accountability for own actions (Mallik, 2009, p. 14). When I was working in a hospital, a patient that needed feeding was put into the dayroom with other patients where she would have to be fed in front of them. I noticed she was refusing her food which was unusual for this lady. So I asked her, in a discreet manner what was wrong. She explained that she was embarrassed so I wheeled her back into her room and fed her in there. If this lady had been asked where she would like to eat, her choice would have been to stay in her room and eat where she felt her dignity would have been maintained. If I had not of spoken to her she would rather chose not to eat, or other patients, having no intentions, will invade her privacy and see her feed. As a nurse, it is vital that a patient’s dignity is respected at all times. By preserving dignity, a nurse can also preserve the integrity of the patient. In this scenario, it is clear that a violation in privacy and person’s dignity occurred through humiliation, embarrassment, not respecting patient’s autonomy regarding preferred feeding, and depersonalization (Watson, 2008, p. 133). Healthcare delivery in the contemporary era focuses on being patient centered, risk managed, quality assured and cost effective (Mallik, 2009, p. 14). Accountability has grown increase importance in delivering quality health care by expanding the responsibility of caring and accountability to a health team instead of individuals. Accountability and Human Dignity Accountability is defined as being accountable of your actions by explaining and justifying why and what you did. It involves assessment of the best interests for patients, knowledge and judgment in decision-making, and explanation to defend course of action (Walsh, p. 89). Since accountability promotes the best interests of the patients, it is essential that nurses respect privacy, which is one basic right of human dignity. Privacy is a major factor considered in caring. Among of the privacy concerns of patients are depersonalization and intimate questions, hospital procedures, and treatments (Watson, 2008, p. 133). Privacy was linked to preservation of human dignity and maintenance of integrity and hence is considered as an essential health need and a professional issue. Often, the nurses omit the concept of privacy in providing basic support, protection, and correction procedures which mean that human dignity are more often violated in nursing procedures. The scenario stated earlier describes the best example of violation of privacy and human dignity. The case describes a patient scheduled for feeding. The nurse caring for this patient did not ask the patient’s preferred place for feeding and decided to put the patient in the dayroom, along with other patients. I noticed that this patient refused to eat her food which was unusual because the patient is very cooperative with regards to feeding schedule. Seeing this, I asked her what was wrong. I found out that the patient feel embarrassed that other patient might see her in feeding so I decided to wheel her back into her room where she will be fed. In the example, the nurse and I have accountability to that patient. As a health practitioner, both of us have the background knowledge with regards on how this patient should be treated. We had provided different course of action because we differ in assessment process and perhaps, our explanation in doing the course of action. Accountability promotes the best interests of patients so I modified the procedure other nurses did on that patient. In putting the patient in dayroom for feeding, several violations of privacy and human dignity were noted such as exposure of one’s body, perceived invasion of privacy, inadequate participation in decision making, and perceived humiliation. It is evident that these violations occurred because the patient felt embarrassment on the perceived idea that others might see her in feeding (a clear indication of breach in privacy and human dignity). Meanwhile, privacy and human dignity are very important functions and determinant of human behavior. With this in mind, I became curious of why did a very cooperative patient suddenly refused her treatment. I made further assessments and determined that this behavior was linked to violation of human dignity. Watson (2008) delineates steps in attending to the privacy and human dignity needs of patients, which includes: Maintaining personal autonomy which preserves uniqueness of human being. Allowing the patient to verbalize emotional and safety concerns to protect them from stress and strains of the environment. Engaging the patient in self-affirmation and reflection to enable them to pause, reflect, explore and integrate feelings and experiences. This step also promotes spiritual and creative-meditative activities that bring meaning to one’s life. Engaging in limited and protective, intimate communication. This step preserves confidentiality of information and sets boundaries in a nurse-patient relationship. In addition, the cultural beliefs of a person are also important in preserving human dignity in nursing. For example, this patient probably refused feeding because foods served to her is forbidden in their cultural tradition. Nurses may not know this unless they conducted a comprehensive assessment of the patient. Today, we are confronted with several issues affecting preservation of human dignity. Among these issues were euthanasia, physician-assisted suicide, malnutrition, assisted nutrition and hydration, persistent vegetative states and post coma unresponsiveness, stigmatism, abortions, health services accessibility, unresponsive human need legislation, and national health care system (Feldman, 2008, p. 281). Regardless of the patient’s reason for making it unable to give decisions, nurses should still apply the doctrine of human dignity to make participative ethical decisions on what should be one for the patient. Review of Literatures There are different researchers and book authors who took part in enriching the literatures about professional issues and human dignity. The concept of human dignity and their respective authors were described chronologically in the following: There are some perceptions held in common by most patients. They believed that a good death signifies dying with dignity, which is dying with self control, privacy, comfort, attention, and supports a dying person, wants to achieve. It entails decision of death made solely by the person. Human dignity is defined as the attributes that contribute to the grandeur or excellence of humankind. Human dignity is loss if the patient becomes irrational and unconscious, which support the idea that life-prolonging treatments should be stopped not to support death of human dignity but to support death devoid of human dignity (Petrosino, 1986, p. 13). Human dignity is one of the basic needs of all people and does not disappear as one goes older. Even the elderly expressed human dignity by maintaining activity and independence. Although there are some restrictions as one gets older, elderly should be allowed to take control of their possessions and choices must be offered as long as they can still make rational decisions. In case of elderly care, nurses established interdependence within older adults to preserve human dignity while assisting in elderly care and decision making (Davies & Janosik, 1991, p. 432). In line with the nursing profession is a respect for life, dignity, and social justice. Professional nurses provide services with respect for human dignity and uniqueness of each client, not affected by status in the community, health conditions, or personal attributes (Long, Phipps, & Cassmeyer, 1995, p. 217). Non paternalistic values such as giving honor, autonomy, and freedom of choice seek to preserve human dignity, preserve personhood and humanity at individual and global levels (Walker & Neuman, 1996, p. 148). Human dignity is the foundation of all human rights. The value of each individual cannot be estimated and nobody is insignificant. People are valued because of their self-worth not because of their usefulness to the society. Even people with disabilities must be honored and be preserved of their human dignity (Quinn & Degener, 2002, p. 14). The two primary values of the nursing profession are altruism and respect for the human dignity of patients and colleagues. Being disrespectful to others indicates essential lack of value for human dignity and altruism and thus, making a nurse unprofessional to their adhered values, standards, and ethics (Oermann & Heinrich, 2005, p. 25). Respect for human dignity is the fundamental principle for nursing practice. Nurses are morally obligated to respect human life and individuality and are obligated to take actions to promote human life and benefits of life-prolonging treatments. Nurses serve as patient-advocates of patient’s right to autonomy and human dignity (Schwab & Gelfman, 2005, p. 518). People appeal to their rights when they are morally challenged by injustice, or are protecting their dignity due to social degradations. Patients appeal to the right to adequate care and treatment based on the principle of beneficence. Universal moral rights rest on the concept of human dignity and on what is the right thing that should be done (Thompson, Melia, & Boyd, 2006, p. 160). The right to human dignity belongs to first generation human rights. In line with human dignity rights are the rights to life, to privacy, to freedom of association, to equality, and the right to property. These rights are rights on which the government on which the government is not permitted to intrude, even members of the health team (Verschoor, Fick, Jansen, & Viljoen, 2007, p. 34). Respect for human dignity is a fundamental principle of modern research ethics. This ethical principle aims to protect the research subjects and encompasses the right to self-determination and the right to full disclosure. Self-determination means that an individual decides freely on activities or treatment without threats or coercion. Human dignity also involves the right of the individual to full disclosure, providing complete information about the undertaken health activity (Loiselle, McGrath, Polit, & Beck, 2010, p. 73). Privacy and confidentiality are closely related to human dignity and respect. Nursing judgments about patient competence and safety defined the boundaries or limits to confidentiality. Nurses find it hard to maintain parameters within the context of law that is why human dignity of patients were override if not, omitted. Ethical and legal approaches must be applied to ensure delivery of quality health care (Humphreys & Campbell, 2011, p. 80). The tradition of human caring and preserving human dignity is timeless. The enduring relationship between essentials of human nature such as love, caring, beauty, and soul relates to inner healing and the art of becoming human (Basford & Slevin, 2003, p. 809). Conclusion Nurses respect the ethical concerns of patient such as respecting human dignity. In the delivery of nursing care, it is not only respect for human dignity that is taken into consideration but the accountability of health professionals as well. It is vital that the patient’s dignity and integrity are respected at all times by demonstrating privacy, autonomy, and confidentiality. Contemporary nursing faced a wide range of accountability and ethical issues in delivering quality health care. Accountability is taking responsibility for the actions that you did and promotes the best interest of the patient. Nurses often omit the concept of privacy in providing basic support, protection, and correction procedures (such in the case of a patient brought into the dayroom for feeding) which mean that human dignity are more often violated in nursing procedures. Preserving human dignity is an important indicator of behavior. The cultural beliefs also affect the consideration for human dignity and nurses may not know this unless they conducted a comprehensive assessment of the patient. Regardless of the reasons, nurses are expected to apply the doctrine of human dignity at all times. Along with the concept of human dignity are book authors, theorist and researchers that helped in elaborating issues concerning human dignity. Nurses are expected to be accountable of their actions at all times by ensuring that clinical judgment and actions is in line with the professional standards such as preserving and respecting human dignity. Implications for Practice Accountability allows nurses to grow and develop a profession based on sound theoretical foundations. Accountability is a complex issue that requires nurses to examine their practice relative to the needs of healthcare consumers, their relationships with other healthcare professional, and the increasingly critical role of nursing in the healthcare system. Preserving human dignity in nursing produces an ethically-aware nurse protecting other people from unethical and valuing their dignity as a human being. Recommendation Literatures revealed that Nurses face the ambiguity in setting boundaries for human dignity. The main regulator body must make some clarifications regarding practices that overlap human dignity. The different organizations from the ethical, legal, and health care group should make a joint effort to clearly feature practices that promote preservation of human dignity. A need of further research is necessary in order to reiterate to the nurses the importance of accountability in nursing practice and some of the nursing interventions that not intently disregard the concept of human dignity. Since there is a lack of clarity regarding the role of each health practitioner, it is necessary that a continuous professional education must be conducted. References: Basford, L. & Slevin, O. (2003). Into the Future: Post Modern and Beyond. Theory and Practice of Nursing: An Integrated Approach to Caring Practice (2nd ed.) (p. 808-811) Cheltenham: Nelson Thornes. Davies, J.L. & Janosik, E.H. (1991). Maturational Variations and Disruptions. Mental Health and Psychiatric Nursing: A Caring Approach (p. 405-438) Massachusetts: Jones and Bartlett Publishers, Inc. Feldman, H.R. (2008). Human Dignity and Ethical Decisions in Nursing. Nursing Leadership: A Concise Encyclopedia (p. 281-282) New York: Springer Publishing Company, LLC. Hitchcock, J.E., Schubert, P.E. & Thomas, S.A. (2003). Nursing and Caring in the Community. Community Health Nursing: Caring in Action, Volume 1 (2nd ed.) (p. 1-44) New York: Delmar Learning. Humphreys, J. & Campbell, J.C. (2011). Family Violence and Ethics. Family Violence and Nursing Practice (2nd ed.) (p. 381-410) New York: Springer Publishing Company, LLC. Loiselle, C.G., McGrath, J.P., Polit, D.F. & Beck C.T. (2010). Reviewing the Ethical Aspects of a Nursing Study. Canadian Essentials of Nursing Research (p. 73-90) Canada: Lippincott Williams and Wilkins. Long, B.C., Phipps, W.J. & Cassmeyer, V.L. (1995). Management of People with HIV Infection and AIDS. Adult Nursing: A Nursing Process Approach (p. 206-222) London: Times Mirror International Publishers Limited. Mallik, M., Hall, C. & Howard, D. (2009). Nursing Knowledge and Practice. Nursing Knowledge and Practice: Foundations for Decision Making (3rd ed.) (p. 1-20) New York: Elsevier Limited. Oermann, M.H. & Heinrich, K.T. (2005). Why and How We Should Address Student Incivility in Nursing Programs. Annual Review of Nursing Education: Strategies for Teaching, Assessment, and Program Planning (p. 23-36) New York: Springer Publishing Company, Inc.  Petrosino, B.M. (1986). Research Challenges in Hospice Nursing. Nursing in Hospice and Terminal Care: Research and Practice (p. 1-21) Philadelphia: The Haworth Press, Inc. Quinn, G. & Degener, T. (2002). Human rights and disability: The current use and future potential of United Nations human rights instruments in the context of disability. Office of the High Commissioner for Human Rights. Retrieved on June 04, 2011, from http://unhchr.ch/html/menu6/2/disability.doc Schwab, N. & Gelfman, M.H. (2005). Codes for Nurses with Interpretive Statements. Legal Issues in School Health Services (p. 517-524) Nebraska: Sunrise River Press. Thompson, I.E., Melia, K.M. & Boyd, K.M. (2006). Direct Responsibility in Nurse/Patient Relationships. Nursing Ethics (p. 153-176) London: Elsevier Limited. Verschoor, T., Fick, G. H., Jansen, R. M. & Viljoen, D. J. (2007). Human Rights and the Nurse. Nursing and the Law (p. 34-36) South Africa: Creda Press. Walker, P.H. & Neuman, B.M. (1996). Watson’s Theory of Transpersonal Caring. Blueprint for Use of Nursing Models: Education, Research, Practice, and Practice Administration (p. 141-186) New York: National League for Nursing. Walsh, M. (2004). Accountability. Nursing Frontiers: Accountability and the Boundaries of Care. (p. 88-106). London: Elsevier Limited. Watson, J. (2008). Creating a Healing Environment at all Levels. Nursing: The Philosophy and Science of Caring (Revised ed.) (p. 129-140) Colorado: University Press of Colorado. Read More