Engaging with Vulnerable People - Essay Example

?Engaging with Vulnerable People Introduction Perception of vulnerable person has been a hot topic explored and remarked by several health care analysts and eminent professionals in medical field. Even when there is a clear and understandable statement is available about who can be referred as a vulnerable person, it is too difficult to provide a comprehensible and succinct definition about the concept due to the varying characteristics and time in which it is viewed. This paper will discuss the case study of Miss Jaya, a 74 years old Hindu lady admitted in the ward. From within the case scenario, the paper will analyze in detail about the concept of vulnerability and whether Miss Jaya could be regarded as a vulnerable patient. I will also investigate through the professional values with reference to the Nursing and Midwifery Council (NMC)’s Code of Professional Conduct with regard to the care provided to Miss. Jaya. This essay will find out whether the staff had given respect while maintaining the patient’s dignity and self-respect. The anti discriminatory practice concerns in the case study are explained in the essay while analyzing how these elements affect providing care. A personal perspective about the issue and lessons obtained from the assignment is added in the conclusion. The Concept of Vulnerability The concept of vulnerability has been widely used to explain a situation in which the physical as well as the mental well-being needed for a normal productive life is impaired and at continuous risk (‘The concept of vulnerability’, n.d.). In simple terms of general usage, vulnerability can be denoted as the state of being exposed to hazards, risks, and stresses. When it comes to health-related vulnerability, poor health grade causes the entry into the condition of vulnerability. The vulnerability in the health care system is affected with the people and society in the form mortality, morbidity, and more commonly in various forms of social deprivation. The concept of vulnerability itself is evident in the perception of health risk, and has always been affecting the public health systems. In each country, the state of vulnerability depends on the level of development and stages of health transition. Even when there are certain patterns, certain population sections of society are highly exposed to the health hazards and poorest quality of life. The group extremely exposed to vulnerability is women, under the categories of women in rural areas, abandoned old women, and teenage mothers. Such identification and categorization of the highly vulnerable group has facilitated the investigators to conceptualize health care as multi-sectored service. The Royal College of Nursing (Cited by Dyson, 2007) suggests that while taking care of the old people, the nurses should realise the multi-ethnic backgrounds of the patient, which can greatly influence the quality of care; assessment and evaluation of care in a rage of acute care setting will help in developing and promoting fair and anti-discriminatory healthcare practice. The strategies must be formulated at the local level as well as the national level, in order to tackle down the vulnerability towards women, especially towards the aged women. At the same time, policy formulation intended to eradicate vulnerability must not end up in creating new forms of vulnerability against the existing ones. Each nurse, regardless of their practise and service is expected to adhere to the NMC codes of conduct as well as to its recommendation and guidelines, in order to promote a safe environment for clients and others. Nurses are ought to preserve the patient’s safety, and this practise can be considered to be the base for behaviour and code of conduct. Patients under the care of a nurse, like Miss. Jaya in the case study who was admitted in the ward under the care of nurse, are vulnerable by virtue of illness, injury, and more of dependent nature and undesired incidents. And such incidents create an unequal influence base within the nurse-patient relationship. Here, the dual-vulnerability elements, the patient status and nurse’s influence base, create a responsibility for nurse to preserve the patient. A nurse breaching her obligation to protect the patient’s respect and dignity is an issue of licensure harsher than a nurse leaving her profession. After all, a nurse duty can not be determined or defined to be a single event, such as making rounds or taking reports. The first phase of the nurse’s responsibility comes not towards the employer or the employment settings, but to the relationship with the patient. The vulnerability associated with the old age, in many cases like that of Miss. Jaya, is a result of negative stereotypical views. Such negative impacts created within them from an embarrassing or discomforting events occurred by the conduct of people around them. In the present case study, the patient feels worried and the pain she experiences cannot be relieved by the prescribed medication. The uncommunicative behaviour and negative stereotypical view evolved within the patient are out of the approaches of health care professional in particular rather than of the attitudes and assumptions of society at large. By understanding the concept of vulnerability, the nurses can recognize the centrality of older people particularly, in their service provision. It will ultimately help nurses in contributing positively to the patients’ autonomy, acting as their advocates and supporters. Professional Values in accordance with NMC Code of Conduct The Code of professional conduct was implemented by the Nursing and Midwifery Council in April 2002 (‘The NMC code of professional conduct, 2004). The NMC code of professional conduct deals with the standards of conduct, performance and ethics for nurses in caring while caring patients and clients, in order to make them personally accountable for their practice. As a registered nurse, one should show her professional values by preserving and supporting the health of individual patients and clients as well as the health of the wider community. In the same way, a nurses must maintain and develop the good reputation of the profession while acting in a way that proves worthy of the trust and confidence that the public has in them. A nurse must be always accountable for their practices and answerable for their actions and omissions. The values make them adhere to the laws of the country and to the duty to provide reasonable care to the patients, who are entitled to receive the same. Keeping in mind the NMC Code of Conduct, a nurse should demonstrate her respect and maintain dignity while practising their professional values. An important element in empowering patients and maintaining their dignity is to recognize and respect the role of patient as a partner in their care and also the contribution they can make to it (ibid). It requires the nurses to set preferences related to care from within the boundaries of professional practice, guidelines, and objective of the therapeutic relationship. A nurse is always personally responsible for preserving and promoting the dignity and interests of the patient, irrespective of their age, gender, economic status, culture, lifestyle, beliefs or ideologies. Each exclusive need of the patient must be focused upon. A clear and suitable professional boundary in relationship should be maintained between the patient and nurse. In order to empower the patient, a nurse must uphold the interests of the patient by helping them to get access to health and social care, information, and support significant to their needs. On the other hand, any conscientious objection that affects the professional practice must be reported to a relevant authority. However, a nurse should protect the confidential information of a patient from revealing to unwanted persons. A nurse always must behave the way that upholds the reputation of the profession. Behaviours that seem to compromise the reputation, such happened in the case study may call the profession into question. Reasonable and anti-discriminatory practice Dalrymple and Burke in their book Anti-Oppressive Practice state that “Anti-discriminatory practice uses particular legislation to challenge the discrimination faced by some groups of people” (Cited in Beckett, Maynard, 2005, p. 158). Moral principles of justice, such as fairness and autonomy are the vital element to health care practice and central to medical ethics. Both of these moral principles provide the base for carrying out the duties ascertained with the profession of nursing. In the case study of Miss. Jaya, these principles have been ignored as she had been embarrassed by the unwanted incident. When a nurse feels confused while facing a critical situation, she must return to the two moral principles and consider how she is applying them in each situation she is facing. Such analysis would help her to get back on track by asking herself that if she had respected and recognized the patient’s autonomy. Here, the nurse was seen forgetting her duty for maintain the autonomy of the patient. Besides, an anti-discriminatory practice requires a nurse to reflect and question whether she can demonstrate that she is acting true and fair while caring her patients. However, the nurse had failed to show an anti-discriminatory attitude towards Miss. Jaya. According to Whaite (2007), fair and anti-discriminatory nursing practise, a key value in the NMC Code of professional conduct, must be implemented by recognizing and respecting cultures and philosophy of a patient as an individual with rights. The most important factor of discriminatory practise arises when a nurse find herself treating a patient unfavourably compared to her act of caring towards other patients. In such situation, she must reflect herself what may be the reason for her discrimination. It may be a good reason or due to some unfairness on the basis of age, race, or gender. However, if there are chances for another member of the staff to intrude into the dignity of the patient, the nurse should take all the possible ways to prevent such incidents from happening. The Nursing and Midwifery Council requires all nurses to “....act quickly to protect patients from risk if you have good reason to believe that you or a colleague, from your own or another profession, may not be fit to practise for reasons of conduct, health or competence” (‘The NMC code of professional conduct’, 2004). The anti-discriminatory process must value a patient as an individual with rights, and accept the differences such as ethnic origin, beliefs and ideologies, personal attributes, and social status. Besides protecting the confidential information, as a health care provider, a nurse should always preserve the privacy of the patient. In the case study of Miss. Jaya, the nurse had to preserve the privacy and dignity of the patient. She had the obligation to take steps to stop anything that would intrude into Miss. Jaya’s privacy. The nurse supposed to have taken extra care in locking the door before giving bath to the patient. That could have been enough for stopping a male member of staff from entering the bathroom unannounced. To overcome the discrimination, new strategies and procedure could be put into place. This procedure includes the steps to inform people about the discrimination with its effects like victimization and marginalisation caused by the treatment of caretakers. However, not every strategy is straight forward in implementing procedures of anti-discrimination, but includes difficulties. There are chances for some staff members to reject the proposed guidelines on overcoming discrimination. In such case, the management should pay genuine attention to make sure that policies are followed efficiently. The overall objective of the anti-discrimination process is to improve patient’s quality of life by ensuring adequate care for each patient. Conclusion This assignment has enabled me to understand that cultural, social, and ethical competence is the integral part of health care system. And such competence elements help the providers to educate themselves on the various requirements of diverse patient groups they come across every day. In total, when cultural and social elements constitute a part of the healthcare, the chances for discrimination lessens as professional are able to understand each one of the clients. So understanding bias and the way it affects their practises makes the healthcare providers to improve their efficiency in caring patients. Undoubtedly, this assignment has improved my knowledge about the nursing profession to a great extent, especially with regard to managing vulnerable people. Reference Beckett, C & Maynard, A 2005, Values & Ethics in Social Work: An Introduction, Sage Publications Ltd, London. ‘The concept of vulnerability’, n.d, Health Dimensions of Economic Reform, pp.11-26, Viewed 24 September 2011, Dyson, S 2007, ‘Core practice module chapter three: Transcultural nursing care of adults’, Royal College of Nursing, Viewed 24 September 2011, ‘The NMC code of professional conduct: Standards for conduct, performance and ethics’, 2004, Nursing & Midwifery Council, pp. 1-15. Whaite, I 2007, ‘Professional standards and rules: The professional regulatory body and the nursing student’, Personal, Professional and Ethical Aspects of Becoming a Nurse, pp.89-124, Viewed 24 September 2011, Read More