Step 1: Look back at the experience, present a brief overview of your life crisis event and identify 2 social justice principles related to your reflected event
As a student nurse, I was appointed in the care setting where I had to work in a clinical care setting. As a student nurse, my responsibility was to adhere to the directions of seniors and help to ensure the wellbeing of the patients. A precipitation event occurred when one of my patients confessed to me that she has been feeling isolated and uncared for in the care setting by one of the nurses in our team. I perceived this event to be threatening and damaging to the patient health and well being as it is an essential responsibility of the healthcare professionals to ensure the wellbeing of the patients by making them feel safe, comforted, and dignified in the care environment.
The patient belonged to the aboriginal community so this was also in consideration with the lack of cultural competence in nursing practice. As a student nurse, it was my duty to report this incident to my senior nurse. The registered nurse told me that this was not my matter to interfere and therefore I should not be bothered. Further, the senior nurse also asked me to change my ward. This caused severe emotional distress to me. When I was placed in a new ward I was constantly wondering about what had happened and this had affected my functionality in the new ward and I was not being able to pay attention the concerns of the patients and directions of my seniors. Distressed and exhausted by the event, I reported the event to the head nurse and with the testament of the patient, the problem was resolved with utmost priority and the two justice problems, a risk to patient beneficence and cultural competence were resolved.
Step 2: Elaborate and describe your life crisis reflected event
When I was first informed by the patient that she did not feel respected and cared for in the hospital setting I was extremely worried. She also expressed that she was feeling left out being from a non-native community and an immigrant. I noted this situation and ensured the patient that she must feel safe and comforted and appropriate action will be taken so that such incidences are not followed. When I complained to my senior nurse she asked me not to bother. This indicated of ignorance and of the fact that she might have been aware of this incident. I think she felt ignorant and not bothered by this complaint and as she refused to focus on it and even asked me to change my ward. This made me feel extremely disturbed as I did not know how to react appropriately to the situation. I was feeling annoyed as I realized that what had happened was unjustified and ethically and legally wrong.
Therefore, I took the initiative and talked about the incident with the head nurse. The response of the head nurse was supportive and she heard the problem with attention and patience. When she cross-checked and verified the incidence with the patient, I think she felt responsible and apologized for the misconduct of the team immediately and also promised to resort the issue on an urgent basis. I felt relieved and appropriate action was taken by providing competence counselling to the identified nurse for the cause with a warning. When the patient thanked me for the assistance I felt happy and confident that I was able to resolve the concern expressed to me. I felt responsible as the patient had felt confident enough and trusted me to share her concern. Therefore, it was my responsibility to ensure that her needs and concerns were attended to.
This incident provided insights into two social justice principles. First, violation of patient rights to be treated with dignity and respect, and secondly the lack of cultural competence in care. Every patient has the right to be treated with dignity, respect, and justice to ensure the beneficence of their health. The care providers should provide equal treatment and be free from biases. The prejudiced behaviour of the nurses with the patient raised an issue of social justice. Further, it is also mandated that every patient is treated with the consideration of their social and cultural values with competence. Since the patient was an immigrant, she felt detached in the care setting. This could be due to a lack of competent care provided. The Nursing and the Midwifery Board of Australia has established a code of conduct that asserts that every patient must be treated with dignity and respect to ensure their wellbeing (Cowin et al. 2019). Therefore, the actions of the nursing team were unjust and violations of the same.
Step 3: Analyse the outcomes of your life crisis reflected event
The primary responsibility of healthcare professionals is to ensure the well-being of the patients and provide them with the highest quality care (Kersey-Matusiak 2018). The head nurse in the clinical setting was able to assist the concern raised by the patient as the healthcare professionals are under a legal obligation to ensure the patient beneficence and competent care. It was the responsibility of the head nurse and the senior officials to overlook the processes and improve the care facility leading to the course of actions taken. When the patient expressed her concern to me, I realized that the behaviour was unjust because I had been constantly taught in my academia that it is crucial to practice justice, cultural competence, and empathy in nursing to ensure the best care and ensure the wellness of the patient. Further, the ethical code of conduct by the Nursing and midwifery Board asserts the importance of just, righteous, and competent practice as an essential duty of the healthcare practitioners (Govere et al. 2016). Therefore, I felt extremely responsible and acted by reporting my concern to a senior nurse.
The unjust treatment of the patient by the nurses in the ward can be understood by the lack of cultural competence and tolerance. The healthcare workers need to develop understanding and respect for diversity of cultures and social notions to advance as competent nursing (Sharifi et al. 2019). This can be developed by the promotion of understanding of different cultural values and to understand them and respect them. Not being able to develop cultural competence, empathy, and respect for all the social and cultural values can result in a prejudiced and a biased behaviour in provision of care to the patient (Kurtz et al. 2018). This is of essential consideration as it can affect the quality of care the patient receives and overall healthcare experience. These outcomes could have been further improved if no such incident like this had occurred in the first place. Cultural competence is of crucial importance in nursing and ensures the wellbeing of the patients through empathetic, person-centred, and an understanding approach (Lor et al. 2016).
As a student nurse, I was initially hesitant to report to the head nurse when the senior nurse had asked me to shift to another ward. If I had been able to make the decision earlier, it would have saved time and the concerns of the patient would have been resolved faster. In retrospect, the outcomes of this incident were dependent on the overall care provided to the patient with competence, cultural safety, dignity, and respect. Therefore, if cultural competence was ensured in the care setting, the quality of care and overall patient experience could be enhanced. I was also unable to function effectively in the new ward as I was concerned about the patient and was in a dilemma that preoccupied my mind and affected my functioning. Through inculcation of conflict resolution and leadership skills, the outcome of this incident could have been further improved.
Step 4: Revise your approach for caring in a similar life crisis event
In future, if a similar situation arises, I will be ensuring to take the following steps to improve the outcome. First, I will adhere to the lawful action and the guidelines and report the mishappening if noted by me directly to the supervisors to ensure that the wellbeing of the patient is not ignored (Walter 2017).
Secondly, I will also work on my skills so that I do not get anxious and am able to work even in stressful situations with timely management of the situation. I will also ensure I have a strong rapport with the patients. I will also develop strong competent skills and work with cultural safety and regularizations to ensure the well-being of the patients and promotion of health. Also, further, I will also advance my skills by reading and learning to ensure delivery of justice for the patients in the care setting. Cultural competence is essential in nursing as it helps the nurses to build a stronger rapport with the patients and establish strong communication (Small 2019). This in turn, helps in addressing the patient needs more clearly and effectively. Justice in nursing implies that the care provisions provided to the patient are fair and impartial without any prejudices (Black 2019). The health charter of Australia gives every patient equal right to be treated with cultural safety, dignity, and respect. Therefore, to advance as a competent nurse in care, I will work on my soft skills and ensure highest quality care.
At institutional level, I will promote participation in workshops and skill development sessions and enhance my capabilities as a nurse (Perry et al. 2017). Since, caring for patient and promoting health in healthcare setting is a participatory team effort, I will also ensure that everyone along with me working for the welfare of the patient practices cultural competence and performs justified care for the patient (Fukada 2018). In future, if a similar situation arises, I will also focus on planning, setting goals for the improvement and ensuring the resolution of problem with a prompt approach (Sherwood and Barnsteiner 2017). I will also work on my personal skills so that future events of such precipitation do not provide me emotional distress and am able to function effectively in care setting by fulfilling my designated duties (Vaughn et al. 2016).
Step 5: Confirm how your revised approach aligns with your Professional NMBA Practice standards
The NMBA has listed the code of conduct that guides the healthcare professionals and nurses to take the suitable steps towards care (Bryce et al. 2017). The purpose of the code of conduct is to enhance the practice of the nurses and healthcare professionals and promotes the well-being of the patients by providing a moral guideline for action. The code abides the working health professionals to ensure the well-being of the patient through legal obligations under the national law (Forrester 2018). Under the principle one, every professional must adhere to justified care practices and cause no intentional harm to patient. The goals and the course of actions as a plan for future incidences developed falls in the alignment of this code to ensure the highest quality care, evidence based analytical approach, and overall improvement in the care practice (Bryce et al. 2017).
The principle three of nursing and the midwifery board asserts the importance of cultural practice and respectful relationships. This approach will assure that the patient is able to receive culturally safe and comprehensive care for the treatment and management of their health condition. Further, through ensuring the suitable actions everyone working with me in the nursing team, the principle five of the code of conduct will be aligned that asserts the importance of assessment of practice of colleagues for the improvement in care and overall ensuring the beneficence of the patient (Forrester 2018). Moreover, as I will be gaining knowledge and learning about the new skills and practices to improve my practices, this goal aligns with ensuring research in health and admission to nursing responsibilities that forms the principle 6 of the code of conduct (Bryce et al. 2017).
Therefore, the actions are in alignment with principle one, principle three, principle, five, and principle six of the code of conduct by the NMBA.
Black, B. 2019. Professional nursing E-Book: Concepts & challenges. Australia: Elsevier Health Sciences.
Bryce, J., Foley, E. and Reeves, J. 2017. Conduct most becoming. Australian Nursing and Midwifery Journal, 25(6), p.25.
Cowin, L.S., Riley, T.K., Heiler, J. and Gregory, L.R. 2019. The relevance of nurses and midwives code of conduct in Australia. International Nursing Review, 66(3), pp.320-328.
Forrester, K. 2018. Codes of Conduct-A New Era for Nursing and Midwifery in Australia. Journal of law and medicine, 25(4), pp.929-933.
Fukada, M. 2018. Nursing competency: Definition, structure and development. Yonago Acta Medica, 61(1), pp.001-007.
Govere, L., Fioravanti, M.A. and Tuite, P.K. 2016. Increasing the cultural competence levels of undergraduate nursing students. Journal of Nursing Education, 55(3), pp.155-159.
Kersey-Matusiak, G. 2018. Delivering Culturally Competent Nursing Care: Working with Diverse and Vulnerable Populations. USA: Springer Publishing Company.
Kurtz, D. L. M., Janke, R., Vinek, J., Wells, T., Hutchinson, P. & Froste, A. (2018). Health sciences cultural safety education in Australia, Canada, New Zealand, and the United States: Aa literature review. International Journal of Medical Education, 9, 271.
Lor, M., Crooks, N. and Tluczek, A. 2016. A proposed model of person-, family-, and culture-centered nursing care. Nursing Outlook, 64(4), pp.352-366.
Perry, D.J., Willis, D.G., Peterson, K.S. and Grace, P.J. 2017. Exercising nursing essential and effective freedom in behalf of social justice: A humanizing model. Advances in Nursing Science, 40(3), pp.244-262.
Sharifi, N., Adib-Hajbaghery, M. and Najafi, M. 2019. Cultural competence in nursing: A concept analysis. International Journal of Nursing Studies, 99, p.103386.
Sherwood, G. and Barnsteiner, J. eds. 2017. Quality and safety in nursing: A competency approach to improving outcomes. USA: John Wiley & Sons.
Small, P.M. 2019. Structural justice and nursing: Inpatient nurses’ obligation to address social justice needs of patients. Nursing ethics, 26(7-8), pp.1928-1935.
Vaughn, S., Mauk, K.L., Jacelon, C.S., Larsen, P.D., Rye, J., Wintersgill, W., Cave, C.E. and Dufresne, D. 2016. The competency model for professional rehabilitation nursing. Rehabilitation Nursing, 41(1), pp.33-44.
Walter, R.R, 2017. Emancipatory nursing praxis: A theory of social justice in nursing. Advances in Nursing Science, 40(3), pp.225-243.
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