Practice in the workplace Essay Example

  • Category:
    Nursing
  • Document type:
    Coursework
  • Level:
    Undergraduate
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    4
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    2456

Practice in the Workplace

Practice in the Workplace

There are four main principles in medical ethics. These ethics are come into play in the evaluation of difficulties and merits of various medical procedures. For any practice to be regarded as being ethical, it should respect the four principles; beneficence, autonomy, non-maleficence and justice. Good clinical practice (GCP) usually follows ICH (international conference in harmonization). Good clinical practices help in enhancement of guidelines concerning the ethical aspects in any clinical study (Meryl, 2012). Inspection and quality assurance ensures that high clinical practices are maintained. Good clinical practices helps in ensuring that the scientific studies that have been performed in the past are authentic. The guidelines in good clinical practices include the maintenance of human rights.

In the case between Pamela and Jane, Jane could be said to have followed the principle of beneficence. Her intentions were genuine since she noticed that the patient receiving morphine by intravenous infusion was not improving, but in stead kept vomiting a lot. Jane noticed that this could even kill her. She decided to administer the metoclapramide to the patient. Jane had a good intention towards the patient considering the patient’s condition as at that moment. Pamela also had a right in declining to do as Jane requested. The principle of autonomy calls for the patient to be aware on any action carried out on him/her in regards to any health care procedure (Dobb, 2013). The patient should have been informed concerning the underlying benefit and risk in the administration of metoclopramide, but the patient was in a bad condition to understand this. Both the nurses where right in taking the stands they took since Pamela thought that by administering the 10mg of metaclapramide would help the patient’s condition while Jane thought that the patient had the right to know the possible effects of the drug administered.

Jane had good intentions for the patient in trying to change the medication, the patient’s condition worsened from the allergic reaction of the drug resulting into an emergency medical intervention. Her actions had some legal repercussion. The first repercussion is the administration of drug to a patient without being involved in making of the decision. Good clinical practices dictate that the doctor should notify the patient concerning any health procedure carried on them. This includes advising them about the benefits and risks involved. In Jane’s case, the patient was not involved in making the decision. This is equivalent to violating the patient’s right though the move was meant to save his/her life (Thomas, 2009). The second legal repercussion is from the fact that Jane’s medication negatively affected the patient where the patient had to get emergency intervention.

Nurse’s professional conduct defines the manner through which individual’s behave in their professional capacity. When individuals are performing their expected duties and affairs professionals are expected to maintain excellent standards of conduct. The nurse’s professional code of conduct introduces the minimum set of standards in the field of nursing. These conducts should be upheld by a professional either in their work place or elsewhere. Both the code of ethics and professional conduct provides a structure for professionally and legally responsible and accountable while undertaking clinical practices. The nurses’ code of ethics is designed for individuals receiving or requiring nursing care, nurses, nurse’s employers, other health workers, consumer protection agencies, and regulatory authorities in the field of nursing.

This professional code of conduct dictates that nurses ought to practice in a competent and safe manner; nurses should practice in accordance to the professional and broader health standards; nurses ought to respect the ethnicity, dignity, beliefs and values of individual’s receiving treatment and care for other colleagues; nurses should be impartial, accurate and honest when providing information in relation to health and nursing care products; nurses preserve and promote the privilege and trust existing in the relationship between nurses and the recipients of care.

Professional code of conduct plays an extremely significant role for nurses. It describes the minimum set of national standards that the nursing professional should uphold at all times. It also helps in informing the community on the degree of professional conduct expected from the nurses. The professional code of conduct provides regulatory, consumer, professional and employing bodies with a structure nurses evaluation. ANMAC (Australia nursing & midwifery accreditation council) have set standards that all the nurses are expected to follow. These standards for the nurses are the main competency standard that assesses one’s performances to become a registered Australian nurse. Once registered, the key competency structures provide the nurses with a framework that assesses the nurse’s competence.

The national board could apply the competency structures so as to create a communication forum with consumers advising them on what to expect from the nurses. Universities also utilize the structures in the development of nursing curricula, and assessing the students and the performance of the new graduates. The registered nurses should portray competence while providing care as stipulated by nurse’s registration requirements, codes, national board structures, important legislation and nurses’ educational background. Once a nurse becomes a registered, he/she ought to practice interdependently and independently, assuming responsibility and accountability for their action and the provision of care to enrolled health care and nurses.

The registered nurses offer evidence-based care to individual of all cultures and age group, including people, communities and families. The nurses play a significant role in the maintenance and promotion of health and illness prevention for people with mental or physical illness, rehabilitation and disability requirements. They also help in pain and suffering alleviation to their patients. The nurses help in the assessment of plans, evaluation and implementation of nursing care while incorporating multidisciplinary health care in order to achieve health outcomes. The nurses provide care in wide range of setting including community, homes, acute, educational institutions, residential and other different work settings.

They are well versed with leadership role in health care and nursing coordination across and within varied context facilitating optimal health results. This role involves significant referral to, consultation with, service provision, other significant health professionals, and support and community services. The registered nurses contribute positively in the quality of health through their professional development, clinical supervision, and generation of research data, clinical practice and policy development. The nurses enhance their professional practices according to the population’s health needs, as well as, altering patterns of illness and disease.

The nursing scope of practice can be divided into three principles (Cayley, 2010). The first set of principle includes the advancement of scope of practice in regards to registered nurses, midwives and enrolled nurses. These principles are significant in enabling EN’s midwives and RNs to alter or advance the nurses scope of practice by employing the delegation process. This principle is best utilized when making new delegation (LaDuke, 2008). New delegation involves assigning an individual to undertake activities that the individual is used to doing. A possible occurrence when delegating activities include shifting an EN to EN. These principles are also utilized by midwives and RNs after advancing their practice by self-assessment and self-education gaining competence (Bagg, 2004). The main significance of delegation is meeting the patient’s needs in order to improve health results.

The second set of principles aims at the expansion of scope of practice of the registered midwives and nurses. Midwifery and nursing practices help in meeting the client’s health requirements, midwives and registered nurses (RNs) have been actively involved in expanding the scope of practice through the integration of latest health services(ANMC, 2003). The expansion is experienced once the registered nurses or the midwives take the responsibility of providing latest health care services (Day, Minichiello, and Madison, 2007).

The expansion of scope includes the employment of latest technologies such as patient’s treatment using laser for cosmetic reasons (Carniol, Meshkov and Grunebaum, 2011). It also includes the increment of autonomous roles like effective management of client’s suffering from chronic heart failure. In this stage, there is the inclusion of complementary care through hypnotherapy, therapeutic massage naturopathy and healing touch (Hartman, 2010). The expansion also includes the alterations in referral, medication, diagnosis and prescription authorizations. Nurse’s skills can also be improved through the sharing of activities with different health professionals in the improvement of accessibility to skilled health professional such as ultrasounds and performing of x-rays.

The third set of principles involves the delegation of unlicensed health care team. Here, the council is not responsible of regulating or determining the scope of practice of health care workers. This principle is employed in assisting midwives and registered nurses in the determination of appropriate and safe delegate activities for the health care workers. This principle could also be utilized in the delegation of activities for volunteers. It is also significant for the midwives and registered nurses to perform care activities where they assume a comprehensive dimension, which includes consideration of complex emotional, mental and physical requirements for the patient, but the health care works are one dimensional and so they might emphasize on a single delegated activity.

The health care workers are assigned to routine activities, which might need a small range of knowledge. Any activity is qualifies as a routine in the event that the underlying procedure and the expected patient’s condition have been established over a big time span. This means that, the results expected are predictable. In terms of accountability and supervision, the health care workers are delegated to work under indirect or direct supervision of the midwife or a registered nurse.

Nurse-Client relationship

At the center of nursing, there is the existence of therapeutic nurse-to-client relationship. The nurse utilizes the acquired skills and knowledge in establishing and maintaining this relationship. The therapeutic services are centered towards the wellbeing of the client’s health. This relationship is based on professional intimacy, trust, empathy and respect (Kleier, 2013). It calls for appropriate utilization of the inherent power from the role played by the caregiver. Among the five main components of nurse-client relationship trust is extremely significant. Trust is significant since client is at a vulnerable position (Thobaben, 2007). Breach of trust from the nurse to the client could have an adverse effect in the relationship. Professional intimacy is dependent in the nature of care provided to the client. The services involved could be physical where the nurse could be forced to perform some activities such as bathing the client. Professional intimacy could include spiritual, social and psychological elements, which are identifiable when developing care plan.

The four main standard statements that elaborate the nurse’s accountability in this relationship include; therapeutic communication, client-centered care, boundaries maintenance and protection of the client from abuse. Nurses employ different effective strategies of communication and other interpersonal skills in re-establishing, establishing, terminating and maintaining the relationship between the nurse and the client. In employing the therapeutic communication, the nurse should ensure that he/she meets the required standard through his/her introduction. The nurse should introduce himself/herself by name. The nurse goes further to discuss their role in therapeutic relationship. The nurse should give the client ample time to explain herself/himself with an intention of understanding the client.

In performing the client-centered care, the nurses perform various activities with the client in ensuring that the all professional actions and behavior meet the expected therapeutic requirements (Brodley, 2006). In the enhancement of client-centered care, the nurse should include the patient as a partner since the client is his own expert, as far as, his life is concerned. The nurse should be in a position maintain his/her boundary with the patient. Setting and the maintenance of boundaries within this relationship helps the client in learning when their need exceeds the limits. The nurse should avoid the interference into the client’s personal life. The nurse should abstain from receiving gifts from the client. Accepting and giving of gifts could affect the mutual relationship between the nurse and the client

The nurse can enhance the nurse-client relationship by protecting the patient from any existing harm, through preventing abuses by stopping or reporting those hauling the insults. This is enhanced by not being involved in a sexual or a romantic relationship with the patient during the existence of therapeutic relationship. It is significant to avoid engaging into personal friendship for at least one year after termination of the nurse-client relationship.

Nurse-Nurse relationship

The nurse-nurse relationship is mainly governed by empathy and interpersonal trust. The mutual hardships experienced in their line of service create a bond between the nurses. The interpersonal trust is extremely significance in the work place since it boosts the team spirit creating a cordial environment. Once the nurses are at ease with each other their service delivery to other clients are also improved. Professional code and ethics taught to a registered nurse gives him/her a guideline on the manner that, they are supposed to relate to each other, as well as, with their clients (Woods, 2009). This suggests that any sexual or romantic relationship between nurses cannot exist in work place since this distraction will affect the service delivery of the nurses. In an event that this could happen, it individuals in this relationship will be going against the professional ethics. Existence of good interpersonal trust enhances sound relationships between the nurses giving room for effective delegation of activities.

Bibliography

Australian Nursing and Midwifery Council (2003). Code of Professional Conduct for Nurses in Australia, ANMC, Canberra – under review. Retrieved from: www.anmc.org.au.

Bagg, J. (2004). Rural Nurse Practitioners In South Australia: Recognition For Registered Nurses Already Fulfilling The Role. Australian Journal of Rural Health
, 12 (1), pp.3.

Brodley, B. T. (2006). Client-Initiated Homework in Client-Centered Therapy. Journal of Psychotherapy Integration
, 16 (2), pp.140-161.

Carniol, P., Meshkov, L., & Grunebaum, L. D. (2011). Laser treatment of facial scars. Current opinion in otolaryngology & head and neck surgery
, 19 (4), pp.283.

Cayley, J. (2010). Guidance for expanding family physician medical home scope of practice. Family medicine
, 42 (3), 214.

Day, G., Minichiello, V., and Madison, J. (2007). Nursing morale: predictive variables among a sample of registered nurses in Australia. Journal of nursing management
, 15 (3), pp.274-284.

Dobb, L. (2013). Ethical practice. Nursing standard
, 27 (44), pp.57.

Hartman, D. (2010). Hypnosis & hypnotherapy citations. Journal of Heart Centered Therapies
, 13 (1), pp.3.

Kleier, J. A. (2013). Disarming the patient through therapeutic communication. Urologic nursing,
33 (3), pp.110-133.

LaDuke, S. (2008). Death to nursing care plans. The American journal of nursing
, 108 (6), pp.13.

Thobaben, M. (2007). Improving Nurse-Client relationship by developing a communicating plan. Home health care management & practice, 19 (3), pp.213-215.

Thomas, J. (2009). Ethical and legal issues in medical practices. Indian Journal of urology, 25 (3), pp.335-336.

Woods, M. E. (2009). Leadership and ethics in nurse-nurse relationships. Nursing science quarterly, 22 (4), pp.383.