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Ethical And Professional Nursing Practice System

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Question:

Discuss about the Ethical and Professional Nursing Practice System.
 
 

Answer:

Introduction:

Nursing practice can be defined as the overall care of the patients ensuring the physical and psychological safety and wellbeing of the patients. A nurse assigned to a patient takes utmost care of the patient assisting him or her in any activities that the individual faces difficulties in or is incapable of doing. The prior responsibility along with providing care and assistance to the patients is also administering medication, monitoring the patient for progress or deterioration and coordinating with the clinical practitioners to provide updates on the progress or complications of the patient (Tabloski, 2013).

Along with that the nurses are also responsible for providing the link between the patients and their families with the physicians and specialists. The nurses are required to interact with the families of the patients to educate and update them about the condition of the patient and the treatment plan designed for them, it is the responsibility of the nurses to explain to the family members and the patients about the effectiveness of the treatment plan and medication decided for their loved ones and how it can benefit the individuals in turn (Yoder-Wise, 2014). Lastly the nurses spend the majority of their times interacting with and assisting the patients. Hence it is vital that the nurses develop a mutually respectful relationship with them so that the patients feel comfortable around them and can share their response and grievances with the nursing professionals without any hesitations.

With so many different but interlinked responsibilities on their shoulders there are a myriad of external and internal factors that affect the outcome of their services, hence it is vital for them to maintain ethical, empathetic but professional service at all circumstances. This report will attempt to highlight different aspect of ethically reasonable nursing practice taking the example of the case scenario provided (Yoder-Wise, 2014).

A professional as multidisciplinary as health care there are unavoidable conflicting situations. With so many different professionals working together under a constrained setting there will inevitably be professional ethical dilemmas.   The case study selected for this assignment provides a very likely ethical conundrum within the health care setting. Here an elderly patient suffering from risks to high falls and dealing with severe confusion is cared by a clueless nursing professional who has very inhumanely tide him to his chair using the bed sheets. Such behavior is not only immoral, but can lead to severe legal consequences. The caring for psychologically unstable patients need to safe, empathetic and following some regulatory legislation.

 

Immediate nursing intervention: 

An elderly patient dealing with confusion and on high risk to falling should be treated very delicately. The manner with which the nursing professional assigned to him was treating the patient is unethical and punishable and should be reported to the supervisory authority immediately. The immediate nursing intervention in this situation should be freeing the patient from the hold to the chair and should be allowed to sit comfortably (Yoder-Wise, 2014). Then his primary assessment should continue to assure that the patient has not suffered any injuries due to being tied up. The nursing professional responsible for this should be handed over to the management for his or her malpractices and should be penalized for the maltreatment of patients (Urden, Stacy & Lough, 2017).

Afterwards the patent should be hydrated and relaxed so that his confusion subsides and the patent should be encouraged to lie down on the hospital bed so that he is relaxed and the following nursing interventions can be followed (Urden, Stacy & Lough, 2017).

Following nursing care:

Risks to falling are a very common medical concern among the elderly population. There are varieties of reasons that can lead to mobility instability in the elderly however this medical concern is neglected highly. Studies suggest that the reason behind more than 70 % of the elderly population bidding their time in health care facilities lead back to fall injury (Tabloski, 2013). It has to be considered that the fall in the old age can lead to injuries and concussion which if not treated immediately can get very complicated within a very short period of time. This patient under consideration has faced the same consequences as well, and in such cases a thorough and empathetic nursing intervention can the relieve the patient from  a lot of stress and panic (Tabloski, 2013).

The next section of the discussion would look into the nursing interventions and their rationale. The very first step to nursing intervention should be the assessment of the fall history of the patient, so that the reason and consequences leading to present condition can be assessed. The past medical history can provide valid information about the condition o the patent that can be effective in judging the severity of their condition (Milos et al., 2014). The next possible intervention should be administering fall prevention and precaution behaviors with bed rails and secure wristbands (Milos et al., 2014). Bed rails would ensure that the patient can not fall from the bed due to any circumstances. Wristbands would also encourage safety prevention technique for the patient (Runciman et al., 2012). Moving all the items that the patent might need to reach such as the call light, urinal and water table is beneficial. Far placed items that the patient might need can increase the possibilities of hazards and increase the potential for the patient to fall. Adjustment of the bed as closer to the floor as  possible since positioning the bed closest to the floor will ensure that even if the patient managed to fall he will not experience any serious injuries (Karlsson et al., 2013). Keep the lighting in the room bright enough and encourage the patient to wear non skid footwear (Kalisch, Tschannen & Lee, 2012). As the patient is elderly, there are high chances of the patient having reduced visibility hence bright lighting would minimize the risk of falling. Nonskid footwear will provide the patent with sure footing and with diminished foot and toe lift while walking. Orient the patent with the interiors of the room and remove heavy ad prone to toppling furniture from the room. Making the patient accustomed to his surroundings will ensure that he would not trip over and fall due to any circumstances and removing heavy furniture will also help the patient move around with his faulty balance (Kalisch, Tschannen & Lee,  2012). Encourage the patient to wear a hippad and other assistive devices like eyeglasses and hearing aids to ensure that the patient does not suffer from any falls. With patents with sensory disabilities it is advisable to outfit them with protective gears that will either assist them or provide protection. Avoid any restraining devices and wheelchairs (Huston, 2013). Restraining devices will only increase the cumbersome environment of the room and prove be a hindrance to the patient from feeling relaxed and cause more agitation and panic in him. Communicate with the family of the patient to educate them about home care and supportive assistance. As the patient starts to recover the patient family has to be properly informed and educated about the health care concerns of the patent and eh family members should be educated about home care (Huston, 2013).

 

Australian Registered Nurse Standards for Practice:

As mentioned above nursing is a professional practice that is associated with a number of different law and legislations. These legislations not only provide law and order within nursing practice but also provide certain practice standards that guides the nursing professionals through a safe and ethical professional practice (Gastmans, 2013). There are different regulatory authorities that looks over the nursing practices an allows the nurses to take part in a safe and ethically sound reflective practice and enlightens them with a clear and transparent knowledge about the scope of their practice (Gaudinen & Beaton, 2016).

Different regions have different regulatory authorities looking over the nursing practices with different legislations but similar desired outcomes (Eneh et al., 2012). The Australian nursing and midwifery board is one conspicuous example of a nursing regulatory board that strives to improve the health care standards every day. There are different standards within their list of professional codes of ethics and some of them can be applied here to determine the course of action and their relevance in such situations (Butts & Rich, 2012).

The first standard that applies in this situation is standard 1, think critically and analyses nursing practice. This standard speaks in details about how every patent should be treated equally and each one of separate concerns of each patients should be carefully and critically assessed so that an evidence based and safe nursing intervention can be planned (Althaus, Bridgman & Davis, 2012). In this situation as well the nursing professional assigned to the elderly patient should have carefully and critically analyzed the situation going through different database literature should have arrived on a intervention that would be custom made for the patient only and would provide him relief (Nursing and Midwifery Board of Australia, 2017).

The second standard that can be applied is standard 2, enagages in therapeutic professional relationship. The patient has suffered falls and was dealing with confusion, in this situation if the nursing professional had attempted to engage him in relaxed conversation and tried to build a trusting relationship with him, it would have been easier for her to calm he patient (Nursing and Midwifery Board of Australia, 2017).

The third standard that applies to this situation is the 6th one, providing safe, appropriate and responsive quality nursing care. An elderly patient dealing with confusion and risks to fall should be handed carefully and delicately (Blais, 2015). This standard speaks about ethical goal oriented actions that will provide safe and comfortable environment for the patent so that the patent is cared for in accordance to the regulatory safety policies and is treated according his clinical requirements as well (Nursing and Midwifery Board of Australia, 2017).

 

Ethical implications of maltreatment:

Patient maltreatment has severe ethical and professional consequences, there are various laws and legislations that protects the patients from any harm or maltreatment from the health care professionals under any circumstances. The patients in Australia have all rights to sue the health care practitioner for any maltreatment to the patients at any point of time. Different elder abuse laws that are n place in Australia include Commonwealth Aged acre act that protects the elderly patient from being harmed by the hospital authorities and the staff (Australian Health Practitioner Regulation Agency, 2017). Apart from that different health care legislations that provides the patents with protection in such circumstances include Patient Safety Act, Drug safety act and others (Australian Health Practitioner Regulation Agency, 2017).

 

Conclusion:

Therefore health care practices might be intricately liked with a number of external and internal variables that can affect the health care standards however the patent safety is at all times at the pinnacle of the health care industry. That is the reason various health regulatory authorities are rolling out provisions and amendments everyday to ensure that the patient safety and comfort is maintained at all costs.

However it has to mentioned that prevention is always better than cure, with so many laws and legislations protecting the patients  there are still gaps left behind. There is need for more emphasis on the professional training of heath care professionals so that the staff knows exactly how to handle different types of patients with various kinds of complications. The health care staff as well need to take the moral responsibility that comes coupled with their noble profession so that they can provide ethical and professional nursing services.

 

References:

Althaus, C., Bridgman, P., & Davis, G. (2012). The Australian policy handbook. Allen & Unwin.

Australian Health Practitioner Regulation Agency - Home. (2017). Ahpra.gov.au. Retrieved 15 April 2017, from https://www.ahpra.gov.au

Blais, K. (2015). Professional nursing practice: Concepts and perspectives. Pearson.

Butts, J. B., & Rich, K. L. (2012). Nursing ethics. Jones & Bartlett Publishers.

Eneh, V. O., VEHVILÄINEN?JULKUNEN, K. A. T. R. I., & Kvist, T. (2012). Nursing leadership practices as perceived by Finnish nursing staff: high ethics, less feedback and rewards. Journal of nursing management, 20(2), 159-169.

Gastmans, C. (2013). Dignity-enhancing nursing care: a foundational ethical framework. Nursing Ethics, 20(2), 142-149.

Gaudine, A. P., & Beaton, M. R. (2016). Employed to go against one's values: nurse managers' accounts of ethical conflict with their organizations.Canadian Journal of Nursing Research Archive, 34(2).

Huston, C. J. (2013). Professional issues in nursing: Challenges and opportunities. Lippincott Williams & Wilkins.

Kalisch, B. J., Tschannen, D., & Lee, K. H. (2012). Missed nursing care, staffing, and patient falls. Journal of nursing care quality, 27(1), 6-12.

Karlsson, M. K., Magnusson, H., von Schewelov, T., & Rosengren, B. E. (2013). Prevention of falls in the elderly—a review. Osteoporosis international,24(3), 747-762.

Milos, V., Bondesson, Å., Magnusson, M., Jakobsson, U., Westerlund, T., & Midlöv, P. (2014). Fall risk-increasing drugs and falls: a cross-sectional study among elderly patients in primary care. BMC geriatrics, 14(1), 40.

Nursing and Midwifery Board of Australia - Home. (2017). Nursingmidwiferyboard.gov.au. Retrieved 15 April 2017, from https://www.nursingmidwiferyboard.gov.au

Runciman, W. B., Hunt, T. D., Hannaford, N. A., Hibbert, P. D., Westbrook, J. I., Coiera, E. W., ... & Braithwaite, J. (2012). CareTrack: assessing the appropriateness of health care delivery in Australia. Medical Journal of Australia, 197(10), 549.

Tabloski, P. A. (2013). Gerontological nursing. Pearson Higher Ed.

Urden, L. D., Stacy, K. M., & Lough, M. E. (2017). Critical care nursing: diagnosis and management. Elsevier Health Sciences.

Yoder-Wise, P. S. (2014). Leading and managing in nursing. Elsevier Health Sciences.

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