Assessing the Importance of Using the Principles B and Principle C in Nursing Practice - Essay Example

?Assessing the Importance of using the Principles B (consulting with patients and their families prior to treatment) and Principle C (managing all possibilities of risk when treating patients) in Nursing Practice As a student nurse, I find that all aspects of nursing interest me. Ethics is the one nursing principle that I find particularly interesting. Different medical practitioners in the health sector have different views of what can be considered to be an ethical nursing practice. In nursing practice, it is generally accepted that ethical practice has to be the foundation of all discourse between the nurses and patients. Nurses have to have a particular code from which to determine the correct way of tending their patients. To reduce confusion, the Nursing and Midwifery Council created numerous principles that determine how all interactions between nurses and patients should be conducted. The principals established by the 'NMC' are meant to generate a pattern that allows health care workers to avoid issues that might stall patient treatment. There are different factors in the wider society as well as in the healthcare sector that affect nursing ethics. For instance, the reality of evolving and improving technical operations means that health workers constantly have to revise or add to the existing code of medical principles. Nurses are at the fore front of this development as they are the ones that administer the recommended treatments to patients. The situation becomes particularly complicated when they have to make decisions concerning medical developments that have not yet been thoroughly researched or tested. It is true that a nursing license does not necessarily confirm that a nurse will only engage in ethical nursing practices (O’Carroll and Park 2007). This is why the NMC was created to underline the basic moral and ethical obligations that a practicing nurse is compelled to observe. Nurses are not only compelled to follow the guidelines of the NMC, but also the government’s laws pertaining to the rights of their patients. Nurses can be held accountable for unethical actions by the government. Whenever nurses make ethical decisions that countermand some aspect of the government's rules, they can be held liable in a court of law (Griffiths and Tengnah 2008). There are some circumstances in which implementing the principles denoted by the NMC is difficult or impractical (Nursing and Midwifery Council 2008). For instance, as a student nurse, I observed that many doctors who have patients in the intensive care unit have to work under serious pressure to preserve the lives of their patients while also remembering to observe the instructions of the patient's family members. There was a patient of mine who was of a religious denomination that did not believe in blood transfusion. Even though my patient was in serious need of a blood transfusion, her family members refused to allow it. Soon was tension between the family members and patient's doctors. At one point, one of the younger doctors suggested transfusing the patient while the nurses diverted the attention of the family members. While this was being seriously considered, the patient began to show small signs of improvement. This averted what might have amounted to a breach of the Principle B which calls for nurses to make decisions on treatment after holding consultations with the patient’s family members because they can be held accountable for their actions. In the intensive care unit, the nursing ethical principle that is easier to apply is Principle C- ensuring that all risk to the patient is minimized in the course of administering treatment (Lawson and Peate 2009). In all that I do for my patients, or, as mentioned above, collaborate with other medical practitioners in, I always strive to ensure that it is for the betterment of the patient. Most of the time, patients in the intensive care unit are completely dependent on their doctors and nurses. The medical practitioners tending to them are not only charged with prescribing the correct treatment for them, but with also having to act as their legal advocates sometimes. For instance, in the case of the patient who urgently needed a blood transfusion, saving the patient’s life was my primary concern. The patient's family members did not seem to understand that their daughter would die if they continued to refuse a transfusion. It was their opinion that the hospital actually stood to benefit in some way if it conducted a certain number of transfusions every month. Taking into account the medical cases of such patients in the past, the attending doctors and I had to 'decide' on behalf of the seriously ill patient that she did not wish to die. Luckily, we did not have to follow with the discussed course of action. Transfusing the patient against the wishes of her family members might have left us open to litigation if our actions were discovered. Ethical principalism basically addresses the importance of ensuring justice, and autonomy, in patient – nurse relations. The Principle C- which has to do with reducing risks, calls for nurses to make all efforts towards ensuring that their patients are cared for in ways that will hasten their recovery (Hawley 2007). The Principle B also calls for nurses to only make decisions pertaining to the health care of their patients after consulting with the patient’s family members (Field and Smith 2008). Both of these principles clearly show that nursing is more than merely acquiring nursing skills (Davies and Davies 2011). A nurse has to be fully involved in what she is doing if she is going to be able to develop a positive relationship with her patient. As a student nurse I also discovered that nursing involves a lot of physical work. A nurse has to remain on her feet and constantly tend to patients even when they do not appreciate her efforts at first (Corking, Liggett and Clarke 2011). By seeking to avert all possible risk when ministering treatments, the patient's well being is put as the first consideration over all else (Goodman 2008). There are many opportunities for a nurse to be able to demonstrate care and concern for his or her patient. For instance, a nurse is obliged to support, listen to, and encourage a patient after he or she has undergone surgery (Hinchcliffe, Norman and Schober 2008). Moreover, few post-operative patients enjoy this because they are usually tired and experiencing some measure of pain. They are likely to be impatient and frustrated with the well-meaning efforts of their caregivers. It is a truly dedicated nurse who will push through the irritation of the patient to provide the needed encouragement which will later be appreciated. Also, nurses have to perform personal hygiene tasks for the patients who are seriously ill and cannot do so for themselves. This can be a real test for a person that chooses to become a nurse just for the salary (Koubel and Bungay 2009). Sometimes, patients themselves refuse the available treatments for varied reasons. The nurse, in such a case, has to use counselling skills while also giving practical advice to her patient. The nurse can better comprehend the significance of the recommended treatment (Burns and Bulman 2000). The nurse would be blameworthy if she or he did not make considerable attempts at reconciling the patient with the importance of accepting the prescribed treatment. During my placement, one of my patients was a suicidal prisoner who had been brought to the hospital after slitting her wrists. Even though she constantly ripped off her bandages when she was left alone, the hospital was reluctant to commit her to the psychiatric ward because it was felt that her problems could be more easily solved through counselling than the administration of medical treatments. Principle C – which advocates for nurses to minimize all risks to the patient when tending to them, meant that I had to find ways of trying to stop her from hurting or mutilating herself. In between her counselling sessions, I spoke to her regularly about why she was so depressed and emphasized on the importance of taking her medicines daily. Persuasion entails convincing the patient to accept the intentions and attitudes of the persuader without any actual force being used to assist this process (Brooker and Waugh 2007). A patient who is persuaded still acts voluntarily- which means that in the process of persuasion, the patient's right to give informed consent is not compromised (Gates 2007). As I spoke with my patient between her counselling sessions, I was careful not to bulldoze her into agreeing to stop her self-harming practices because I knew that if I did this, it would only temporarily stop the undesired behaviour. I merely spoke with my patient about the importance of taking her medicines and also tried to reassure her that the feelings of deep disillusionment would pass. I also encouraged her to speak at length about her family members and the existing family situation so that she could feel that she had at least one confidant. As time went by, her disposition improved considerably and she stopped wrenching bandages off of her wounded wrists. A different case that shows another side of the importance of the Principle B- which advocates for all nurses to ensure that they make decisions on treatment only after consulting with patients before their family members involved a seventy year old patient of mine. I had to get a blood sample for a diabetic review from this patient as she had ‘type 2’ diabetes and used insulin therapy. I was required to get the consent of the patient in order to take a sample of her blood. The NMC Principle B asserts that ' it is vital to get a patient's consent before any type of treatment can be administered' (Baughan and Smith 2009). This essentially means that patients have the legal right to refuse medical treatment. My patient was not only diabetic but also experiencing the symptoms of dementia. She was regularly confused about what she was doing and where she was. I naturally turned to other members of her family to obtain consent for taking the blood sample. My elderly patient became increasingly suspicious of me when she saw me speaking with her family members. It soon became apparent that my patient was not at all close to her adult children. She would later reveal to my co worker that she felt undermined by my efforts to talk to her children when she believed that she was the only one who had the right to make decisions about her own life. Even though she did not ask if she could be assigned a different nurse, my formerly cordial relationship with her suddenly became strained and would remain like that for some time. I was pestered by angry doctors who could not understand why I could not perform a simple task. Every time I approached my patient for a blood sample, she refused to cooperate with me and I grew more frustrated. Even though I felt uneasy at doing it, I finally decided to take a blood sample from my patient when she was deep asleep one night. I then took the sample to the attending doctor who asked how I had finally gotten it. I admitted that I had taken the sample while she was deep asleep because I did not think I would be able to get it any other way. I had a particularly friendly relationship with all other patients and felt deeply frustrated by my elderly patient who was slowly causing my colleagues to doubt my competence. Even though the doctor disagreed with my method, it took a while for me to accept her decision. She was not impressed by my efforts and stated that I had also not followed the Principle C -which states that a nurse, when administering treatment, should be careful to keep the herself, her patient, and others in the surroundings safe. She reminded me that if my patient had woken up while I was taking the blood sample, there might have been a scuffle that might have resulted in either one of us being badly hurt. It is obvious that obtaining a blood sample from my elderly patient was in her best interests. However, I came to understand that it is important for a nurse to accomplish this without necessarily infringing on his or her patient's rights. I feel that I have learned a lot through my time as student nurse about the importance of observing the personal rights of patients. I have also learned how to be kinder and more considerate of the opinions of my patients. At first, it was quite frustrating to have to wait for the consent of patients who were experiencing memory lapses before administering treatment that would benefit them in the final analysis. Moreover, I have become more adept at finding interesting ways of engaging patients so that they realize that the prescribed medicines are meant to benefit them and not harm them. References Baughan, J. & Smith, A. (2009) Caring in nursing practice, Pearson Education, Harlow. Brooker, C. & Waugh, A. (2007) Foundations of nursing practice, Mosby Elsevier, Edinburgh. Burns, S. & Bulman, C. (2000) Reflective practice in nursing: the growth of the professional practitioner, Blackwell Science, Oxford.  Corking, D., Liggett, L. & Clarke, S. (2011) Care planning in children and young people’s nursing, John Wiley, London. Davies, R. & Davies, A. (2011) Children and young people’s nursing, Hodder Arnold, London. Field, L. & Smith, B. (2008) Nursing care: an essential guide, Pearson Education Limited, Essex. Gates, B. (2007) Learning disabilities: towards inclusion, Churchill Livingstone, London. Goodman, B. (2008) Nursing and working with other people, Learning Matters, Essex. Griffiths, R. & Tengnah, C. (2008) Law and professional Issues in nursing, Learning Matters, Essex. Hawley, G. (2007) Ethics in clinical practice: An inter-professional approach, Pearson Education, London. Hinchcliffe, S., Norman, S. & Schober, J. (2008) Nursing practice and health care, Hodder Arnold, London. Koubel, G. & Bungay, H. (2009) The challenge of person-centred care: An inter-professional perspective, Palgrave Macmillan, Basingstoke. Lawson, L. & Peate, I. (2009) Essential nursing care: A workbook for clinical practice, Wiley Blackwell, Chichester. Nursing and Midwifery Council (2008) The Code - Standards of conduct, performance and ethics for nurses and midwives, NMC, London. O’Carroll, M. & Park, A. (2007) Essential mental health nursing skills, Mosby, London. Read More