Foundations for Professional Practice

Introduction to Foundations for Professional Practice

This assessment is a reflection of the given scenario, and for this, I will be using the Driscoll Model of Reflection. Reflection helps an individual in developing skills as well as knowledge along with helping the individual in maintaining and developing that skills and knowledge throughout their career (Nicol and Dosser, 2016). Throughout this reflective essay, I’ll be focusing on the ethical practices implemented/breached in the provision of nursing care to the patient addressed in the case scenario.

What?

I believe that quality nursing care is all about taking care of the patient at a good quality standard by taking an account on Ethical considerations. In the contemporary complex healthcare environments, it is important for nurses to potentially identify and address the aroused ethical issues (Milliken, 2018). I am an undergraduate nurse and during my professional experience placement program I was asked to take care of a patient named Shelley who was found was found roaming the streets. After her return to the hospital by the local police, I was advised in the handover and was told that the patient will now be nursed in bed all the time, along with the bed rails and in the closed doors. She was also prescribed a regular dose of sedative medication. When I entered the patient’s room, she was screaming for letting her out of the bed and was strongly refusing to take the medication. The patient was admitted to the hospital as she was suspected of left lower lobe pneumonia. She also has a medical history of acquired brain injury that has been sustained already. The patient lives with her mother, but at that time was her mother was not there. The patient often require intermittent assistance and need close supervision because of her propensity to ramble into the rooms of other patients and escaping out from the hospital altogether.

So What?

During the whole scenario, I personally felt that there were some ethical values that were breached. Ethical values play a very important role in any healthcare system. Ethical values are considered as universal norms of conduct that help in providing a practical basis for the identification of the types of actions, purposes, and objectives that are being valued (Ostman et al, 2019). They are the moral principles that administer how an individual or a group will conduct themselves. The main focus of ethics pertains to the right and wrong of the actions (Trobec and Starcic, 2015). Breaching of any of the ethical principles and values can result in causing harm to the patient as well as in implicating some legal actions from the patient or his family’s end to the healthcare providers and the organization. In Shelley’s case, there were some ethical values that were breached and they were:

Negligence: It is usually expected that all the patients must be treated with sombreness and be shielded from any destruction that may happen. It is an act of slip-off of the services that could not meet the code of conduct and standards of care. This often results in client injury because of the failure to take the right care standards to prevent the patient from injury (Kadiver et al. 2017). Shelley, was being neglected The nurses were fully capable of providing appropriate care but they did not, they could have looked after her and as a result of such negligence, Shelley went out and was found roaming on the streets this led her to suffer unnecessarily and have risked her life along with placing her in jeopardy for negligence.
Malpractice: Malpractice is the act of causing harm to the patient and Shelley was forcefully given a high dosage of sedative drugs that could also turn threatening for her and is considered as an act of malpractice.
Autonomy: The principle of respect for patient’s autonomy is concerned with the patients to enable them to take their own decisions regarding the health care interventions they want to receive or not. The thought behind this is that the patients must be offered an alternative and should be allowed to make deliberate selection as per their preference is concerned with the significance of potentially life-changing health care interventions (Agianto, 2016). Acknowledging the patient’s decisions regarding their care and respecting the patient’s autonomy, even if the patient’s decisions contradict the recommendations of the clinicians is an important aspect of patient-centered care (Sedig, 2016). When Shelley was screaming to get out of the bed, she was forcefully kept there and even after denying for the medication, she was forcefully being given that and this clearly shows that her autonomy was not respected and her decisions regarding the health care interventions given to her were not considered.

Now What?

In relation to the whole scenario, I felt the situation won’t have gone like this if there was an effective teamwork and provision of code of ethics. Effective teamwork wouldn’t have resulted in Shelley being roaming on streets because, if the nurse who was given the duty at that time isn’t there for some time then, other nurses could have been there to take care of her and supervise that she didn’t go anywhere. Lack of teamwork was found there and if there was an effective teamwork in delivering health care to Shelly, it would have positively affected her, ensured her safety and have enhanced her health outcome. Effective teamwork helps in the provision of health care services to the patients and their family members. With the help of at least two healthcare professionals for a single patient who work collaboratively can easily accomplish shared goals. However, collaborating with the patient and his family can help in accomplishing the shared goals within the settings and this will help in achieving coordinated and high-quality care. With accountability among the team members, the amalgamation of the shared responsibilities offers great benefits. While, Poor shared responsibility within the teamwork without high-quality of care can lead to immediate risks for patients (Babiker et al, 2014).

Another thing that could have made the whole scenario better for the patient was the code of ethics as patient safety is ashore & multidimensional in context to the ethical and legal imperative; there is always a need to consider both ethical and legal challenges. Ethical and legal issues are entwined elementary concepts in the field of nursing whenever it comes to assure patient safety and these are often termed as care quality indicators. There is a strapping requirement for being adhered to the principles of ethics and law by the healthcare providers in order to identify the possible safety failures that can occur and can prevent the falling incidents likewise. During the examination of the ethical issues and applying suitable frameworks likewise helps in analyzing the clinical scenario. For attaining a patient’s safety it is required to implement a professional code of ethics (McBride, 2018).

Nurses have been increasingly brazen out with the complex disquiets in their practice. Codes of ethics provide the primary framework for nursing as well as for many other professions. The Code of conduct highlights the legal needs, professional actions, and conduct expectations of all nurses. This offers the guidelines for the principles of the professional behavior that leads to the safe practice (Nursing and Midwifery Board of Australia, 2017).

The codes play a very important role in the nursing profession, this is so because they help in providing safe practices along with providing assistance on the issues that are important and need to be focused. Professional nursing standards describe the practice and behavior of the nurses. It also provides an outline of the dedication of the nurses to respect, guard, endorse and uphold the basic fundamental rights of the patients as well as their family members. This encompasses codes of conduct, standards for practice, and codes of ethics (Park, Jeon, Hong and Cho, 2014).

Conclusion on Foundations for Professional Practice

This reflective essay has provided a brief reflection regarding the legal & ethical challenges that were faced in the given scenario. The ethical, professional, legal framework addresses the conduct of the healthcare provider to make sure that the mistakes that have happened do not occur again in the future. This reflection focuses on the role of ethical principles in the provision of nursing health care and how the breaching of any ethical value or principle can potentially increase the risk for the patients. Effective teamwork and provision of code of ethics is the fundamental duty of nurses while taking care of their patients and nurses must consider these aspects as an important part of their professional life.

References for Foundations for Professional Practice

Agianto. 2016. Understanding ethical principles in nursing research. Belitung Nursing Journal. 2, pp. 22-24. doi: 10.33546/bnj.10

Babiker, A., El Husseini, M., Al Nemri, A., Al Frayh, A., Al Juryyan, N., Faki, M. O., Assiri, A., Al Saadi, M., Shaikh, F., and Al Zamil, F. 2014. Health care professional development: Working as a team to improve patient care. Sudanese Journal of Paediatrics, 14(2), pp. 9–16.

Kadivar, M., Manookian, A., Asghari, F., Niknafs, N., Okazi, A., and Zarvani, A. 2017. Ethical and legal aspects of patient's safety: a clinical case report. Journal of medical ethics and history of medicine, 10(15).

McBride, S., Teitze, M., Robichaux, C., Stokes, L., and Weber, E. 2018. Identifying and Addressing Ethical Issues with Use of Electronic Health Records. The Online Journal of Issues in Nursing, 23.

Millinken, A. 2018. Ethical awareness: What it is and why it matters. The Online Journal of Issues in Nursing, 23(1). doi: 10.3912/OJIN.Vol23No01Man01

Nicol, J. S. and Dosser, I. 2016. Understanding reflective practice. Nursing Standards, 30(36), pp. 34-42. doi:10.7748/ns.30.36.34.s44

Nursing and Midewifery Board. 2017. Registered nurse standards for practise. Accessed from: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx

Ostman, L., Nasman, Y., Eriksson, K., and Nystrom ,L. 2019. Ethos: The heart of ethics and health. Nursing Ethics, 26(1), pp. 26-36. doi:10.1177/0969733017695655

Park, M., Jeon, S. H., Hong, H. J., and Cho, S. H. 2014. A comparison of ethical issues in nursing practice across nursing units. Nursing Ethics, 21(5), pp. 594–607. https://doi.org/10.1177/0969733013513212

Sedig, L. 2016. What’s the role of autonomy in patient- and family-centered care when patients and family members don’t agree? AMA Journal of Ethics, 18(1), pp. 12-17. doi: 10.1001/journalofethics.2017.18.1.ecas2-1601.

Trobec, I. and Starcic, A. I. 2015. Developing nursing ethical competences online versus in the traditional classroom. Nursing Ethics. 22(3), pp. 352-366. doi:10.1177/0969733014533241

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