Values And Principles Of Nursing Practice

The Role of a Nurse

Discuss about the Law, Ethics and Professionalism in Nursing Practice.

Nursing practice is the habitual exercise of roles, responsibilities and activities that a registered nurse is eligible, authorized and is competent to perform (Lewis & Squires, 2016). The role of a nurse encompasses the care of a patient as an individual, family and community at large. The care is individualized and is client-centered. The nursing practice is governed by a set of laws, ethics and professional guidelines that determine the way care is administered in order to ensure rights of each individual are maintained and that outcome is of best quality. The governing criteria is in such a way that evidence based professionalism is administered to ensure client needs are met and efficiency of the organization is accounted for. They ensure safety of the client and the nurse at the same time. The laws, ethics and professional guidelines are constructed based on a set of principles and values underpinning the code of conduct.

There are values and characteristics of professionalism that contribute to health care through collaboration, cooperation and therapeutic communication. These values are; respect, honesty, responsibility, fairness and compassion. In order for professional standards to be observed in the healthcare, the registered nurse ought to show respect. Respect towards other clinicians, the patient and any individual or group offering assistance towards care delivery. The nurse should respect the cultures and embrace the diversity in customs regarding the patient and the members of healthcare team. The nurse should respect the dignity and patient’s confidentiality (Moss, Good, Gozal, Kleinpell & Sessler, 2016). Nurse should respect other people’s responsibilities and expertise and work in collaboration to achieve high quality of care. The nurse should be honest to self, the team members and the facility at large. Patient care should be explained and the nurse should be answerable. Honesty is a key value in patient care no matter the outcome. Honesty helps in building trust and confidentiality between the caregivers and the individuals receiving the care. This also contributes to maintenance of respect and professionalism in the care for patient. In the healthcare field, the nurse is responsible for the roles he is authorized. He is accountable for all the procedures and planning of patient care from the time of contact till discharge. He is responsible to ensure collaborative planning and patient care is administered to the patient. The nurse has a responsibility of ensuring the interests of the patient and needs are satisfied through collaborative approach and a therapeutic relationship is established.  He is responsible to ensure quality standards of practice and ethical conduct is maintained according to the code of conduct. He has a role in ensuring competence is applied in the field and the team member are working in cooperation towards achieving the best care. Fairness and justice in healthcare is a critical aspect. Regardless of the social status and condition of the patient (Yanicki, Kushner & Reutter, 2015).  To ensure collaboration the nursing fraternity ensures no discrimination among patients. This assurance promotes patient cooperation and trust. It encourages openness and confidentiality that at the end leads to better patient outcomes and issuance of quality standards. Therapeutic relationship is successful when patients are treated with fairness. Compassion and tenderheartedness is a core value when creating a therapeutic relationship and in ensuring professionalism in the healthcare field.

Values and Characteristics of Professionalism

The key principles implicating the legal, ethical and professional course of action and codes that corroborate the practice of registered nurses in Australia are; nonmaleficience, beneficence, Fidelity, autonomy and principle of totality and integrity (Preshaw, Brazil, McLaughlin & Frolic, 2016). Nonmaleficience principle constrains one not to instill any deliberate harm. This principle is based on four rules; the innate reason of an action is not wrong, the intended goal is not bad, in an action the benefit exceeds the bad and a good outcome is not as a result of a bad effect. This principle underlies the legal and ethical professionalism as it ensures no harm comes to the patient. It promotes competent actions and respect for one’s dignity (Ong-Flaherty, Banks, Doyle & Sharifi, 2016). This principle explains the role of a nurse in fighting for the rights of a patient and it helps in decision making as far as patient is concerned. Each decision made by the health team should ensure the intended result is of benefit to the patient. Beneficence is a principle that states that the nurse should always do good to the patient. All actions done should be of benefit to the patient. It also helps during the decision making process when handling option. The decision arrived at should be of benefit to the patient. Fidelity is a principle of nursing that describes that a nurse should show loyalty, be truthful, dedicated, fair and committed to the patient in the process of nursing care (Trobec & Starcic, 2015). The nurse ought to maintain confidentiality and privacy as far as patient feelings and condition is concerned. The nurse ought to be honest and committed in offering competent and quality care to ensure good patient outcome. Fidelity promotes collaboration from the patient and underpins trust and confidentiality. Maximum cooperation from patient lead to a therapeutic relationship hence promoting professional standards of care (Hanson et al., 2016). Autonomy principle stating that the patient has a right to decision on the course of action. The patient has a right to deny procedures and to choose the plan regardless of how the nurse views it. This promotes patient collaboration after giving consent on the procedures. Autonomy also promotes trust and confidentiality leading to quality standards of care. Justice means that patients should be treated fairly without discrimination. Regardless of patient condition, the nursing care should be fir and no individual should be looked down upon. This preserves the dignity of the patient leading to quality outcomes. Principle of totality and integrity explain on the holistic care of an individual. It covers the emotional, social, physical and mental care of an individual and explains how the aspects affects the wellbeing.

Evidence based practice encompasses how professionals make decisions by identifying the sources of evidence available for a particular practice and analyzing its applicability scientifically. The main purpose is to promote quality outcomes and eliminate negative practices (Jirojwong, Johnson, & Welch, 2014). The practice also analyses patient traits and priorities. This practice has its foundation in skills of academics and information literacy. Skills on the use and application of research is included in the curriculum and builds a foundation for evidence based practice since it prepares the learners on the best practices to perform to achieve better patient outcomes.  Information literacy programs are available to enroll individuals. Students enrolled are found to portray better practices as far as evidence based care is concerned (Castellan, Sluga, Spina & Sanson, 2016). Research has been included in the curriculum as a unit where students critically identify a gap in the healthcare field and carry out studies to test the hypothesis and come up with results on what should be added into practice and the safest procedures with good patient outcomes. Students are allocated to facilities to acquire skills and apply the theory learnt hence developing their knowledge on practice. This practical has in turn boosted their confidence and motivated them to learn more.

Legal, Ethical, and Professional Implications

NMBA Competency Standards, Codes of Ethics and Practice for the Registered Nurses are present to evaluate the performance of nurses in the field and appraise them either by promotion or incentives. The competency standards are; critical thinking and analysis of situations, collaboration and therapeutic care, evaluation of patient outcome, stipulation of safe and up to task practice, construction of nursing practice plan, coordination and provision of healthcare and instilling professionalism in practice (Halcomb, Stephens, Bryce, Foley, & Ashley, 2016). In critical thinking and analysis, the nurse reflects on previous experiences and uses available evidence in decision making. Nurse analyses cultural beliefs and ensures decision made are in line with policies and legal concerns. The nurse keeps timely records of assessments done and contributes to research. In therapeutic practice, the nurse establishes boundaries in the nurse-patient relationship and communicates effectively to promote collaborative care (Ignatavicius & Workman, 2015). The nurse acts as patients advocate and directs them towards better healthcare to promote patient outcomes. The nurse coordinates with other clinicians and supervises healthcare and referrals leading to recovery from unpleasant feelings. In developing a plan for nursing practice, the nurse collects the cluster of cues and evidence from the patient and investigations for planning (Grove, Burns & Gray, 2014). The nurse considers the desired goals and priorities and plans in line with them. Nurse documents the nursing care given, evaluates the patient’s condition and re plans according to the expected goals.  Evaluation of outcome is necessary in the nursing practice.

Evaluation enables one to assess the outcome of the patient, review the early plan and consider re planning depending on the presentation of the patient (Fan, Wang, Chao, Jane & Hsu, 2015). In ensuring safe and quality care is given, the nurse practices in areas where he is competent and uses the delegation principles to ensure patient is taken care of holistically. The nurse inspects to ensure delegated work is accomplished and reports impending risks of the patient. The nurses perform his duty based on the policies, ethical values and legislation laws. In professional practice, the nurse participates actively in patient care and receives feedback regarding the prognosis of conditions (Blais, 2015). The nurse offers health education to the patient and family at large and explains the condition and procedures to achieve understanding. The nurse is guided by integrity to ensure better patient outcomes at the end of management regime. The nurse is accountable and takes full responsibility in deeds and decisions made regarding the patient wellbeing. In provision and coordination of care, the nurse uses available evidence and holistic assessment to plan and prioritize care of the patient. The nurse uses professional assessment protocols in collecting data from the patient to enable quality healthcare provision. The nurse coordinates and consults other medical practitioners and works in collaboration towards best patient outcome. Code of ethics explains that nurses esteem respect and compassion for the patients (Senter et al., 2018). The nurse upholds the ethical issues for patients, respect and embrace cultural differences in the society, are more concerned with holistic care for patients and make use critical thinking during decision making.

Evidence-Based Practice

Nursing practice revolves around laws, ethics and professionalism. The practice is dynamic and keeps shifting due to the research and identifying gaps. Technology plays a major role in the changing code of conduct and the policies governing nursing practice. Due to the available ideas promoting evidence based practice, new techniques are being introduced in healthcare facilities after careful analysis and clinical trials. The main aim is to promote patient outcomes. The goals and outcomes remain constant but the underlying protocols keep advancing in line with technology.  Professionalism is guided by set of characteristics and values that contribute to quality healthcare. The evidence based practice is prerequisite by skills and information literacy to promote professional healthcare. The ethical, legal and professional care is governed by a set of principles that support them. These principles are constructed to ensure good and quality patient outcome. Competency standards are applied in assessing the performance and creativity of a nurse in the scope of practice. The standards are in line with the legal, ethical and professional issues in nursing. They promote holistic approach, quality standards of care and good patient outcomes.

References

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

Castellan, C., Sluga, S., Spina, E., & Sanson, G. (2016). Nursing diagnoses, outcomes and interventions as measures of patient complexity and nursing care requirement in Intensive Care Unit. Journal of advanced nursing, 72(6), 1273-1286.

Fan, J. Y., Wang, Y. H., Chao, L. F., Jane, S. W., & Hsu, L. L. (2015). Performance evaluation of nursing students following competency-based education. Nurse education today, 35(1), 97-103.

Grove, S. K., Burns, N., & Gray, J. (2014). Understanding nursing research: Building an evidence-based practice. Elsevier Health Sciences.

Halcomb, E., Stephens, M., Bryce, J., Foley, E., & Ashley, C. (2016). Nursing competency standards in primary health care: an integrative review. Journal of clinical nursing, 25(9-10), 1193-1205.

Hanson, L. C., Song, M. K., Zimmerman, S., Gilliam, R., Rosemond, C., Chisholm, L., & Lin, F. C. (2016). Fidelity to a behavioral intervention to improve goals of care decisions for nursing home residents with advanced dementia. Clinical Trials, 13(6), 599-604.

Ignatavicius, D. D., & Workman, M. L. (2015). Medical-Surgical Nursing-E-Book: Patient-Centered Collaborative Care. Elsevier Health Sciences.

Jirojwong, S., Johnson, M., & Welch, A. J. (2014). Research methods in nursing and midwifery pathways to evidence based practice

Lewis, K. B., & Squires, J. E. (2016). Shared decision-making models acknowledging an interprofessional approach: a theory analysis to inform nursing practice. Research and theory for nursing practice, 30(1), 26.

Moss, M., Good, V. S., Gozal, D., Kleinpell, R., & Sessler, C. N. (2016). An official critical care societies collaborative statement—burnout syndrome in critical care health-care professionals: a call for action. Chest, 150(1), 17-26.

Ong-Flaherty, D. N. P., Banks PhD, A., Doyle, M. S. N., & Sharifi, C. O. (2016). The meaning of evidence and nonmaleficence: cases from nursing. Online Journal of Health Ethics, 12(2), 2.

Preshaw, D. H., Brazil, K., McLaughlin, D., & Frolic, A. (2016). Ethical issues experienced by healthcare workers in nursing homes: Literature review. Nursing ethics, 23(5), 490-506.

Senter, L., Bennett, R. L., Madeo, A. C., Noblin, S., Ormond, K. E., Schneider, K. W., ... & Virani, A. (2018). National society of genetic counselor’s code of ethics: Explication of 2017 revisions. Journal of genetic counseling, 27(1), 9-15.

Trobec, I., & Starcic, A. I. (2015). Developing nursing ethical competences online versus in the traditional classroom. Nursing ethics, 22(3), 352-366.

Yanicki, S. M., Kushner, K. E., & Reutter, L. (2015). Social inclusion/exclusion as matters of social (in) justice: A call for nursing action. Nursing inquiry, 22(2), 121-133.