Standards Of Nursing Care And Importance Of Professional Boundaries

You are required to reflect upon your own experiences of caring, as well as describing your understanding of professional caring and its fundamental role in providing quality nursing care.  

The Concept of Caring in Nursing

Few days earlier when I was traveling by metro to reach my college I came across a boy who was in his early twenties and was seated beside me. During the course of journey I noticed that something was disturbing the boy as he was continuously weeping silently which attracted my attention. After reaching my destination station when I was waiting for cab, I noticed the same boy who was beside me in the metro standing adjacent to me and staring confusingly at nearby surroundings. Suddenly I noticed that he was crossing road carelessly while staring at his phone when a speeding bus was approaching towards him. On realizing the danger I immediately rushed towards the boy and pulled his hand at right time to one side of the road which shocked him. Seeing the situation, nearby crowd gathered to confront the boy for his careless approach which made him burst into tears. I felt pity for the boy and took him away from spot and inquired about his problems, upon which he non-hesitatingly narrated his current situation. He narrated that his academic result was very poor and he lacked courage to face his parents. Therefore he was planning to run away from city in search of source of living as his parents could not afford any more to bear his educational costs. I felt bad for the boy and his situation and started consoling and motivating him. Then I took his smartphone and called up his parents to describe entire incident and asked them to reach that particular destination to take their son home. Until, his parents arrived at spot, I accompanied the boy and made him feel more relaxed by trying to divert his attention towards other topic of his interests and eventually his parents arrived at spot, thanked me immensely and left with their son for home.

As opined by Berman & Levett-Jones (2016) caring is perceived as human behaviour which includes cognitive, affective, psychomotor and administrative skills within which professional caring may be expressed. Caring is vital resource within highly technological area of Intensive Care Unit. Concept of caring is described as work or practise of taking care as well as display of kindness, concern for individuals who are not able to care for themselves specifically due to age or illness.  Moreover caring is also science that surrounds human science orientation, human caring phenomena and experiences and is a way of nurturing that is related to others with whom one feels personal sense of commitment and responsibility.  

Two Identified Nursing Standards

As opined by Watson & Woodward (2010) the terminology care and caring are mainly used to describe inherent work and value of nursing. Nursing is defined as a nurturing profession while caring is essential component of holistic practice of nursing especially when patient is critically ill. Although caring is not unique to nursing, but there is substantive and developing knowledge related to care in nursing.

The two identified nursing standards are as follows:

• Nurses should identify and seek to avoid actual, potential or perceived conflict of interest- As opined by Bowblis & Ghattas (2017) conflict of interest might affect nurses in any practice setting. A conflict of interest occurs when a nurse’s personal, business, commercial, political, academic or financial interests or interests of nurse’s family or friend interferes with professional responsibilities of nurse’s or a client’s best interest. A conflict of interest may also exist whether or not a nurse is actually influenced by competing interest. 

As opined by Berman et al. (2014) nurses should demonstrate caring within standards of nursing by avoiding all potential scenarios related to conflict of interest. It is very important for nurses to avoid potential scenarios of conflict of interests to provide highest quality care and service to patients. In case of potential conflict of interests it is observed that nurses are bound to various obligations which deter them from providing highest quality of care and service to patients. The nurses should ensure that choices that they make are in best interests for their clients and not based on interests of their self, family or friends.

• Nurses should use professional judgement to determine appropriate boundaries of therapeutic relationship with each patient and it is the nurse and not client who is always responsible for establishing and maintaining boundaries- According to Robert et al. (2019) relationship between client and nurse is basis of foundation for all nursing practices across all population and cultures and in all practical settings. The relation between nurse and client should be therapeutic in nature and it should focus on needs of client. As opined by Mastal (2018) this relationship should be based on trust, respect and professional intimacy and it requires appropriate use of authority. Also relationship between nurse and client should be conducted within boundaries which should separate professional and therapeutic behaviour from non-professional and non-therapeutic behaviour. A client’s dignity, autonomy and privacy should be kept safe within nurse-client relationship.

It is very important for nurses to demonstrate caring standards by maintaining boundary between themselves and their clients to provide best quality of therapeutic and professional services and care. It remains responsibility of nurses to maintain professional distance with their clients as mental and physical condition of clients remains vulnerable in nature so it is not possible for patients to maintain professional boundaries. As stated in Nursing Economics (2017) it is very important for nurses to abide by standard regarding maintaining professional boundaries with patients as mental and physical attachment of nurses with clients deter their ability to provide best quality service and care for patients due to weakness and affection towards clients. It is also important for nurses to abide by standards regarding maintaining of professional boundaries to ensure protection of confidential health data of patients.

Source- ounews.co (2018)

After completion of course it can be stated that I have gained a general overview of nursing profession and regarding concept of care in context of nursing. I have also learnt that profession of nursing is very sensitive in nature and it requires high levels of professionalism to effectively continue in successful manner (MacPhee, Dahinten & Havaei 2017).  Upon completion of unit I have also gained knowledge regarding various standards of nursing and its importance in context of nursing care. As said earlier, as profession of nursing is very sensible profession, it requires nurses to follow various standards in order to provide best quality of care and services to patients. After completion of course I have also gained knowledge regarding the actual meaning of care in context of nursing which refers to maximizing positive outcomes for patients.

The above image is best suitable image from my point of view which helps in reflecting what I feel about caring. The above image helps in highlighting professional boundaries which should be present between nurse and a patient which is considered most important aspect of nursing care. The above image helps in symbolizing trust based relationship between a nurse and patient which helps in maximizing positive outcomes for patients. Also image reflects that all nurses should treat their clients equally which helps in highlighting professionalism. As opined by Friese & Ailey (2015) the above image also emphasizes patent-client relationship which should end after completion of care given to client. This is because otherwise it may develop emotional attachment between nurses and clients which may affect quality of care provided by nurses to other clients. 

References

Berman, A., & Levett-Jones, T. (2016). Skills in Clinical Nursing. Pearson Australia: Melbourne:

Berman, A., Snyder, S. J., Kozier, B., Erb, G. L., Levett-Jones, T., Dwyer, T., ... & Parker, B. (2014). Kozier & Erb's Fundamentals of Nursing Australian Edition (Vol. 3). Pearson Higher Education AU.

Bowblis, J. R., & Ghattas, A. (2017). The impact of minimum quality standard regulations on nursing home staffing, quality, and exit decisions. Review of Industrial Organization, 50(1), 43-68. doi:https://dx.doi.org/10.1007/s11151-016-9528-x

Friese, T., & Ailey, S. (2015). Specific standards of care for adults with intellectual disabilities. Nursing Management (2014+), 22(1), 32. doi:https://dx.doi.org/10.7748/nm.22.1.32.e1296

MacPhee, M., Dahinten, V. S., & Havaei, F. (2017). The impact of heavy perceived nurse workloads on patient and nurse outcomes. Administrative Sciences, 7(1), 7. doi:https://dx.doi.org/10.3390/admsci7010007

Mastal, M. (2018). Evolution of a conceptual model: Ambulatory care nursing. Nursing Economics, 36(6), 296. Retrieved from https://search.proquest.com/docview/2161030469?accountid=30552 

Nursing Economics(2017).  American academy of ambulatory care nursing position paper: The role of the registered nurse in ambulatory care. Nursing Economics, 35(1), 39-47. Retrieved from https://search.proquest.com/docview/1870848270?accountid=30552 

Ounews.co(2018)New OU report reveals financial cost of the nursing shortage to the NHS Retrieved from- https://ounews.co/education-languages-health/health/new-report-reveals-financial-cost-of-the-nursing-shortage-to-the-nhs/

Robert, K. A., Tsikata, R., Tizaawaw, R. N., Prince, A. T., Perpetual, P. Q., Cecilia Aba, A. A., . . . Prudence, P. M. (2019). Adherence to standard nursing protocols on nasogastric tube feeding in a secondary referral hospital: Comparing self-ratings by professional and auxiliary nurses. BMC Health Services Research, 19 doi:https://dx.doi.org/10.1186/s12913-019-3931-6

Watson, J., & Woodward, T. K. (2010). Jean Watson’s theory of human caring. Nursing theories and nursing practice, 3, 351-369.