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Title: The role of the nurse in providing professional, compassionate care. Students will be given a case study based on their own field of practice. 1. Drawing on the information given in the case study for your field of nursing, discuss relevant theory that underpins the • rinci • les of nursin. or, (750 words).
2. Drawing on the information in the case study for your field of practice, discuss relevant professional, legal and ethical aspects of the nurse's role 
3. Drawing on the information in the case study for your field of practice, discuss your understanding of holistic, person-centred nursing care, with reference to the 6Cs and the NHS Core Values 
Assessment Criteria The student will:

1. Draw upon module content to discuss the theoretical perspectives that underpin nursing practice and reflect the NHS core values (L.O. 1, 2, 3 and 4). 2. Discuss principles of nursing care whilst demonstrating an awareness of the professional, legal and ethical aspects of the nursing role (L.0.3). 3. Demonstrate an understanding that the person being cared for is at the heart of nursing practice in the context of the 6 C's and holistic care (L.O. 1, 2 and 5). 4. Presentation, structure, grammar and referencing consistent with level 4 academic study (L.0.7).

Theory Underpinning the Principles of Nursing Practice

The Role of the Nurse in Providing Professional, Compassionate Care

An important nursing approach underpinning best practices in nursing is the person-centered nursing care in which nurses are supposed to undertake their duties in consultation with patients and their families/caregivers opinion on what they feel constitute optimal healthcare. In their professional conduct, nurses ought to draw from the facets informing this type of care approach to for optimal output (Hope, Garside, and Prescott, 2011, pp.711-715). The paper draws from this background to discuss the role of the nurse in providing professional, compassionate, holistic, person-centered nursing care under the confines of nursing theories and professional, legal and ethical aspects informing the profession. In doing so, the discussion will draw insights from Meena Amin (80 years old) case study who is dementia-stricken and is currently under medication having fractured her right neck femur. Meena Amin lives with her husband as her principal caregiver.

Theory Underpinning the Principles of Nursing Practice

Nursing like many other professionals is highly dynamic. To this end, nursing theories play an important function in keeping the profession at bay besides proving to be significant structures from which nurses can borrow inspiration and direction while in practice. The ‘caring nursing model’ advanced by Dr. Jean Watson, for instance, is keen to emphasize why a humanistic viewpoint is paramount in the general care of patients. The model aspires to advance nursing care that is not selfish on abilities to pay but rather keen to meet the clinical needs of patients. In so doing, the model is able to advance a patient-centered care viewpoint while letting nurses showcase highest standards of professionalism. The patient-centered concept in nursing was particularly popularized by Dorothea Orem’ ‘Self-Care Deficit theory’ which observe that most nursing interventions are best effective when nurses are seen as conduits of assisting patients to recover and re-establish their own ability of self-care (George, 2002; Wilson, and Gramling, 2009, pp.852-858). In this case study, Meena Amin's condition can significantly improve if nurses advance a humanistic ambiance advocated for by the caring model besides being subjected to a patient-centered kind of care.

 The NHS nursing principles also receive the backing of the ‘adaptation theory’ of nursing care as propagated by Callista Roy (Roy, and Andrews, 1999). In this theory, a patient is seen as a ‘biopsychological being’ who is likely to change and adapt to a changing environment. Though Meena Amin’s husband is keen to go home to look after the family’s dog, Meena is likely to adapt to the new environment under the care of nurses as long as a favorable environment is created. The ‘adaptation theory’ is reinforced by ‘Health Promotion Model’ propagated by Nola J Pender (1982) in which he asserts that health constitutes a positive dynamic state and not superficially the absence of disease (Croyle, 2005; Walker, Sechrist, and Pender, 1995) It aims at elevating the patients’ levels of well-being since biopsychosocial aspect of patients allows them to progressively interact with the environment transforming it as well as being transformed by it. This seems to be the case with the ‘Human Becoming Theory’ analyzed by Melnechenko (1995, pp.122-127) which guides nurses to focus on the quality of life from a patient-centered perspective. This is exactly what Meena deserves.

Professional, legal and ethical aspects of the nurse’s role

However, Meena is upset on the news that her husband is keen to go home and her spirit is not at peace with this information. The application of the ‘Transcultural Nursing theory’ and the ‘Attribution Theory’ will come in handy to this end by granting Meena her wish not to let her husband go home despite her children being scheduled to visit her later in the day (Leininger, 1986, pp.144-60; Kelley, 1967). This underpins the nursing principles of acting in the best interests of the patient. The ‘Grounded Theory’ is aimed at assisting nurses to generate nursing theory in their everyday clinical practice (Glaser, 1992). In so doing, nurses can be able to enhance their skills and experience of handling different patient’s concerns.

Kurt Lewin theory of change (1890-1947) in which he envisaged that patients can be able to recover quite fast if they are subjected to an ‘unfreezing-change-refreeze model’ is very relevant for Meena’s case (Wirth, 2004). Lewin saw that patients’ healthcare condition are likely to transform fast if nurses take the precautions of unfreezing patients’ attitudes restricting their health transformation, subjecting them through the change process before finally refreezing their attitudes to a new healthier state. This is the case adopted by the ‘Behaviorist Theory’ advanced by van Petrovich Pavlov (1849–1936) in which he envisaged that the behaviors of patients are likely to change permanently with increased experience ( Demirezen, 1988). Overly, nurses ought to draw insights from ‘Decision Making Models’ and the ‘Helping and Human Relations Theory’ to make an informed deduction in their nursing practice for their services to remain relevant and up to date with latest practices (Croyle, 2005).

Nursing theories have been labeled to exert a lot of influence on the basic principles guiding the nursing profession (Iacobucci et al. 2013, pp.479-490). The National Health Service (NHS) constitution has instituted nursing principles that guide NHS in all its endeavors. These principles are in turn underpinned by the NHS values which by and large have been derived from massive discussions with healthcare practitioners including nurses, patients, and the public. In the principles, NHS seeks to extend comprehensive health care services based on the clinical needs of patients through the observation of the highest standards of excellence and professionalism. Moreover, a patient-centered viewpoint in the treatment of patients across organizational boundaries as well as in the best interest of the taxpayers' money has also been taken care of. Most nursing theories ride on such frameworks to solidify the kind of care nurses offer their patients.

Nursing theories and NHS nursing principles

Professional, legal and ethical aspects of the nurse’s role

Across the globe, nurses are increasingly being confronted with the complexity of their practice. The profession is inherently loaded by bountiful professional, legal and ethical requirements nurses are supposed to observe. Arnold and Boggs (2015) observe often time that nurses are caught in dilemmas of differentiating when they owe a duty to offer nursing care and when not to do it. With formidable codes of conduct and fundamental guidelines in place, then nurses can find it easy to maneuver within this complexity to make informed decisions which are legally and ethically acceptable. These can be derived from both the country-specific as well as the generally accepted international professional, legal and ethical requirements of the behavior of nurses. To cater to the care needs of Meena, surely these facets are of great significance.

Nurses are obligated to observe professional values and principles informing their profession. They are mandated to act in the best interest of the patients they serve by respecting and upholding their human dignity. Manley, Hills, and Marriot (2011, p.35) insists that this calls for their need to act altruistically and sympathetically towards the patients which by and large portray their devotion to the profession. Nurses will also come out as accountable, responsible and full of positive conscience when they attend to their core duties and responsibly with utmost good faith, due care and a great sense of professionalism. Such attitudes remove aspects of wanting to be discriminative, neglective or abusive in their practice which bringing out justice in healthcare care delivery (Curtis, de Vries, and Sheerin, 2011, pp.306-309). Professional nurses are also committed to absolute honesty and loyalty to whatever they do.

This is often brought out by their legal responsibility of remaining committed to maintaining patient's privacy, confidentiality, and trust. This relates to taking measures not to disclose the health conditions of patients to unauthorized persons or institutions as this may compromise the patient's integrity. Meena's dementia health condition is a very sensitive one since it is a mental health concern and therefore nurses ought to advance her compassionate treatment to boost her self-esteem. Failure to extend health care that is in the best interest of patients amount to a serious breach of the rights of the patients to receive adequate quality care. Nurses may be held legality accountable for failing in their duty to care.

Nurses ought to continue improving their professional proficiency through engaging in continues scientific and practical competence activities. This can be affected by attending healthcare best practices workshops, training, education and exchange programs for the same. In so doing, nurses can sharpen their on job hands skills, expertise, and knowledge in providing holistic health care. Catering to the needs of dementia patients with complications like Meena requires extra expertise that would be offered to other patients whose health condition may not be that bad. Professional development allows nurses to be more competent in areas such as effective communication, patient handling procedures, and administration of care services (Baughan, and Smith, 2013). A key component to this end is the issue of respecting the autonomy of the patient and recognizing that patient also can greatly contribute towards their own care (Antikainen, 2017).

Professional development for nurses

The NHS obligates all nurses to observe all the laid down guidelines, standards, codes of practice, and those specifically given by employers in advancing patients utmost healthcare. In observing these facets, nurses ought to collaborate with all healthcare practitioners, patients, the public and communities in the delivery of safe care by working through productive teams. It is ethical and extremely professional if nurses can strive to solicit alternative sources of care to patient besides reporting all genuine concerns that may jeopardize the same. It is the nurses’ legal and ethical responsibility to report any risks, malpractices, and wrongdoings in the cause of duty especially those that potentially impair patient’s integrity. The disclosure of patient’s records to other healthcare professionals should be done securely to protect their privacy. Overly, health care approach that customizes care to the particular needs of patients is by and large appropriate in harnessing the professionalism, legal, and ethical requirements of nurses (Olsson, et al. 2013, and pp.456-465). Meena is best suited to access such type of care.

Holistic Person-Centered Nursing Care; 6cs and the NHS Core Values

In the past, people seeking health care services were expected to fit and follow the laid down practices, procedures, and routines that health services had already put in place. However, this kind of healthcare delivery proved overly programmatic, autocratic and bureaucratic to most patients and their families. The invention of a person-centered care approach has proved to be a great reprieve to both nurses and the patients. Huston, (2013) observe that person-centered healthcare approach calls upon nurses to administer health care in partnership with patients, their families, and caregivers. Through such a framework, nurses are in a position to deliver holistic health care since it directly caters to the needs of a particular patient. This is because person-centered care recognizes that patients and their families are potential decision makers in the delivery of their own care. A nurse ought to harness from the vast knowledge, values, family conditions, desires, lifestyles and social orientations provided by the patient and their families and/or caregivers to be able to customize the kind of healthcare to these specific needs. The practice calls nurses to be empathic and view the patient as an individual working in association to come up with solutions to his/her healthcare condition (Waugh et al. 2014, pp.1190-1195).

 Nurses can advance person-centered care from a number of different dimensions. One such dimension is getting to personally know the patient as an individual. This may include getting to understand the biographies, aspirations, experiences and family stories from where the patients come from. Such a crackdown allows nurses to know what exact type of healthcare the patient requires (Moon, 2013). Drawing from Meena Amin's case, it is apparent from her age of 80 years that she has got along life history that might have contributed to her condition. She also currently lives with her husband alone pointing to another big indicator of her chronic dementia situation. Upon reaching the hospital, her husband is keen to leave her alone so that he can get back home to look after the couple's dog. She is upset by this action.

This shows that Meena Amin is extensively socially detached and lonely especially from the love of her husband from whom she would expect the greatest support from. Such a diagnosis will by and large help nurses to institute personalized care. Meena Amin deserves health care that is responsive and meanings to her needs in order to feel comfortable and emotionally supported. What the nurses ought to do, is to respect any wishes, preferences, and values Meena Amin may express during the care process. This will not only build trust and a formidable relationship between her and the nurses but also give her the freedom of choice of how best to be cared for. Since her children are scheduled to visit her later in the day, person-centered health care advocates that family members to be extensively involved.

 Person-centered care augers perfectly with the 6 NHS Core Values of nursing care. These are; respect and dignity, commitment to quality of care, compassion, improving lives, working together for patients, and everyone counts. With respect and dignity, NHS seeks to value everyone for who they are as individuals by respecting their aspirations, needs, abilities, priorities, limits, and commitments in life. This is the core of a person-centered approach in health care (Kitson et al. 2013. pp.4-15). Through the commitment to quality services, NHS places itself in the frontline of earning people's trust by advancing high-quality health care service full of safety, integrity, confidentiality, accountability, and efficient communication. This makes the service as compassionate as peoples' pain, anxiety, needs, and distress meet by a humanly and kind response. In so doing, the overall effect is to improve lives by working together with patients and their families, caregivers to accord their own healthcare (Morton et al. 2017, p. 1056). This, by and large, brings on board the greatest assumption of person-centered healthcare approach that everyone counts in the provision of compassionate health care (Colbert, et al. 2012).

 The 6 NHS Core Values of nursing care that underpin the person-centered care ride on the principles set out by NHS to advance healthcare provision (Baillie, 2015, pp.331-336). Comprehensive services that are available to all patients regardless of their backgrounds, gender, sexual orientation, race, disabilities and all manner of segregation constitutes the most primary principle. Services are advanced purely on the clinical needs of patients as opposed to individuals’ ability to pay. In achieving this milestone NHS has aspires the highest standards of excellence and professionalism, nurses are expected to achieve. Nurses are required to improve their professionalism through training and development, the outcomes being the better delivery of person-centered healthcare services (Bolster, and Manias, 2010, pp.154-165). As such, patients are at the heart of NHS where patients are promoted to manage their own health with the assistance of their families and caregivers. This gives them the opportunity to dictate how they wish to be treated and cared for.

Indeed, the nursing profession has undergone a tremendous transformation in the last several decades with both national and international bodies spelling out what ought to be the utmost conditions of professional nursing practice. Nurses all over the globe are expected to adhere to professional, legal and ethical standards for their practice to be compassionate. In so doing, nurses are supposed to borrow from the already developed nursing theories that by and large underpin the basic principles and values of the nursing profession (Hogston, and Marjoram, 2011). Theories provide nurses with a foundational and working framework over which they can anchor their knowledge, skills, and expertise upon. Moreover, by being professional while observing the laid out legal and ethical concerns that regulate and monitor the profession, nurses are in a good position to advance utmost person-centered healthcare care besides hedging themselves from professional and legal malpractices accusations (McCormack et al. 2010, pp.93-107).

References:

Arnold, E.C., and Boggs, K.U., 2015. Interpersonal Relationships-E-Book: Professional Communication Skills for Nurses. Elsevier Health Sciences.

Antikainen, M., 2017. Providing comfort for hospitalized children with mental problems through the nurse-patient relationship: A literature review.

Bolster, D. and Manias, E., 2010. Person-centered interactions between nurses and patients during medication activities in an acute hospital setting: qualitative observation and interview study. International journal of nursing studies, 47(2), pp.154-165.

Baillie, L., 2015. Perspectives: We need to talk about the 6Cs: Perspectives on a recent debate. Journal of Research in Nursing, 20(4), pp.331-336.

Baughan, J. and Smith, A., 2013. Compassion, caring, and communication: Skills for Nursing practice. Routledge.

Croyle, R.T., 2005. Theory at a glance: Application to health promotion and health behavior. Washington, DC: United States Department of Health and Human Services, National Cancer Institute.

Colbert, B.J., Ankney, J., Lee, K.T., Steggall, M. and Dingle, M., 2012. Anatomy and Physiology for Nursing and Healthcare Professionals. Pearson.

Curtis, E.A., de Vries, J. and Sheerin, F.K., 2011. Developing leadership in nursing: exploring core factors. British Journal of Nursing, 20(5), pp.306-309.

Demirezen, M., 1988. Behaviorist theory and language learning. Hacettepe Üniversitesi E?itim Fakültesi Dergisi, 3(3).

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Glaser, B.G., 1992. Basics of grounded theory analysis: Emergence vs forcing. Sociology press.

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Moon, J.A., 2013. Reflection in learning and professional development: Theory and practice. Routledge

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