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Principles of ethics in nursing
Cultural competence at the forefront of care
Chapter 2 the basics of ethics in nursing
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In 1893, Mrs. Lystra E. Gretter, an instructor of nursing at the old Harper Hospital in Detroit, Michigan created an adaptation to the Hippocratic Oath. She titled it the Florence Nightingale pledge. It was used for nursing students to be sworn in on upon graduation (American Nursing Association). It is named after Florence Nightingale, who was classified as the "founder of modern nursing", after she spent time in the Crimean war caring for sick and injured soldiers. Up until this point in time nurses and hospitals were there only to care for individuals that were dying, but not to prevent death (Bassendowski, 2014). If it were not for Nightingale’s advocacy for “improvements in sanitation, crowding, and nutrition for the soldiers…, the
It focuses on the relative position of one social group in relation to others in society as well as on the root causes of disparities and what can be done to eliminate them (p. 28).
In the code of ethics advocacy is defined as “actively supporting a right and good cause, supporting others in speaking for themselves, or speaking on behalf of those who cannot speak for themselves” (p. 22).
As healthcare providers, it is necessary that we treat all patients with the respect and dignity that they deserve. Karen Roush a doctoral candidate at New York University College of Nursing wrote in her paper Speaking Out on Justice that, “Ignorance is no excuse”. She explained that it is a nurse’s responsibility to remain informed not only on new drugs and evidence-based treatments. Also it is essential for nurses to be educated on the topics of human rights, hunger, abuse, oppression and privilege that occur in our own backyards. (p. 11). This is a powerful message as providing safe, competent care to a patient requires more than just understanding drug interactions and which drug works best for which illness. It requires understanding those individuals that we as nurses are working for. It requires, knowing their background, their history, their culture and their traditions. As a nurse you can have all the knowledge in the world when it comes to how to properly treat a wound, care for a cardiac
The principles include providing care that is patient centered, equitable, and sustainable. Providing quality of care, health promotion and illness prevention. Most of all remaining accountable for the care that is provided (Canadian Nurses Association). A major fragment in providing patient centered care is realizing that not all patients are the same. A treatment that works for one patient may not work for another patient. Also, that not all patients were born and raised in Canada. Statistics shows “approximately 19.8% (one per five) of Canada 's total population were born outside of the country" (Potter & Perry, 2009, p. 115). Thereby, meaning that a nurse needs to take into consideration that these individuals originate from another culture and therefore could maintain different beliefs and perceptions in regards to their health care. This is classified as providing culturally safe care. A concept that was not recognized until 1988. When a nursing student in New Zealand stood up during an education meeting and asked "you people talk about legal safety, ethical safety, safety in clinical practice and a safe knowledge base, but what about cultural safety? (Richardson & Williams, 2007, p. 701) Also when a group of Maori nurses felt they as insiders were incapable of providing appropriate
Environmental justice can influence the population’s health. This environmental justice is relevant to nursing, because awareness brings changes and can save and improve many lives. When a person in a hospital or in a community setting is affected by a health problem, the entire community is at risk, knowing the population is lack of knowledge and have limited access to understand health care system. Therefore, a solution to eliminating cultural disparities is optimal for immigrant communities. In conformity with the Journal of Transcultural Nursing journal, nurses need to follow 12 steps to have a successful result when integrating cultural competence in the health care environment: social justice, critical reflection, knowledge of cultures, culturally competent practice, cultural competence in the health care systems and organizations, patient advocacy and empowerment, multicultural workforce, education and training in culturally competent care, cross-cultural communication, cross-cultural leadership, policy development, a...
Canada is a multicultural country where our government recognizes and ensures that the value and dignity of all citizens’ ethnic backgrounds, religions and languages are maintained (Government of Canada, 2017). In 2016, almost one-fifth of Canada’s population were immigrants. (Statistics Canada, 2017). With this continual increase in diversity, it is essential for students and future registered nurses to understand how to provide culturally competent care in any setting. Culture can be described as the specific characteristics and knowledge shared between individuals and/or groups within a society that encompasses elements such as language, beliefs, and values (Canadian Nurses Association, 2010). The Canadian Nurses Association (2010) defines cultural competence as “the application of knowledge, skills, attitudes, or personal
...ir personal encounters with Aboriginal classmates that they might have had in high school. Life experiences, parental upbringing, ethnic roots, social status and education all shape nursing practices. Nurses and other health care professionals are trained in institutions that fail to recognise the socio-political injustices that occur in health care settings. In addition to this, their experiences in their work and in their personal lives and communities, they already have opinions about certain groups of people. “Cultural safety would encourage nurses to question popular notions of culture and cultural differences, to be more aware of the dominant social assumptions that misrepresent certain people and groups, and to reflect critically on the wider social discourses that inevitably influence nurses’ interpretive perspectives and practices” (Browne, 2009, p. 21).
Nightingale, F. (1898). Notes on nursing: what it is and what it is not. New York, NY:
Integrating the framework will enable nurses to become culturally competent health care providers. First and foremost, the framework permit patients’ the opportunity to express their concerns and perception of their problem (Campinha-Bacote, 2011). Additionally, it focuses on incorporating the patients beliefs, values, and needs into the plan of care. The framework further give nurses an opportunity to better understand and evaluate their patients’ concerns. Campinha-Bacote (2011) reported that continuous encounters with culturally diverse backgrounds will lead nurses to validate, refine, or modify what they know of existing values, beliefs, and practices of a cultural group. This in turn, will develop into cultural desire, cultural awareness, and cultural knowledge. With the end result, being cultural
The job of a professional nurse today is one that requires high intellect, accountability, expertise, selflessness, dedication, and a compassionate heart to help those who are hurting. In past years, nursing has been regarded as a job and not a profession. Today, professional nurses assume the vital responsibility of upholding the moral and ethical principles of nursing in order to better advocate and care for their patients. These principles include autonomy, beneficence, nonmaleficence, fidelity, justice, and veracity (Zerwekh and Garneau 2015, 423). Nurses today work autonomously to assist patient and write appropriate care plans, mentor student nurses, and facilitate communication between families, patients,
233). She studied anthropology and applied the research findings in nursing. Later, she developed the theory of “culture care diversity and universality” from her personal experience as a nurse and other factors that influenced such as ethnic conflicts, commuting, and technology changes. It is illustrated and described by the Sunrise four-level model, and it is labeled as “an enabler” (Masters, 2014, p. 69). The first level represents a “worldview”, the second level presents “knowledge concerning individuals and groups”, the third level includes “specific features of care in the system”, and the fourth level is “specific nursing care” (Masters, 2014, p. 69; Jarošová, 2014, p. 47). The main purpose of this theory is “to generate knowledge related to the nursing care of people who value their cultural heritage” (McEwen & Wills, 2014, p. 233). The major concepts in this theory include: culture, culture care, and diversities and similarities and sub-concepts include care and caring, emic view (language expression, perceptions, beliefs, and practice), and etic view (universal language expressions beliefs and practices in regard to certain phenomena) (McEwen & Wills, 2014, p. 233). The base knowledge
Taleghani, Alimohammadi, Mohammadi and Akbarian (2013) define nurses as individuals who are caring and fulfill the needs of individuals. In fact, nurses care for individuals of varying ages, with specific needs, requiring them to not only provide care but to provide individualized care. Rahim (2013), reports Nightingale’s definition of a nurse as a person that recognizes patients in need and assists them to reach their desired health status. Therefore, nurses are required to be multifaceted persons with proper education and clinical training. Through their many acts of caring, the nurse must be diverse and knowledgeable of various cultures, skilled clinically and knowledgeable of the most current scientific research. They may act as a mentor, educator, confidant, support system, and clinical competent individual at any time necessary (Taleghani et al., 2013). A nurse encompasses all of these qualities and works in a variety of settings in collaboration with other medical providers to promote health and wellness and improve the quality of life for individuals. An example of this includes, nursing the emergency department. Here nurses are individuals trained to provide medical care for individuals of varying ages with varying illnesses. They also must collaborate with many interdisciplinary teams to promote the best possible outcome for their
Cultural safety is an important concept in nursing as it is reflected in the Nursing Council of New Zealand, (2011) competencies as it outlines the ethical and legal nursing practice. The nursing concept of cultural safety is defined by health consumers who have received care which also relates to the practice that respects and does not impose on patient’s cultural beliefs and values (Wepa, 2005). Cultural safety aims to improve the health status of consumers through nurses by acknowledging the different beliefs and practices of others. It is intended to improve the delivery of health and disability services though nurses. Cultural safety includes the nurse’s understanding of diversity within their own culture and the impact of that on others. Providing effective care for consumers with diverse needs and them considering it safe. Cultural safety is focused on understanding the impact of the nurses own culture, reflecting and challenging their own practice and to improve any issues by resolving and comprising issues (Nursing Council of New Zealand, 2011). The code of health and disability services
I feel as a nurse that I need more education to become more culturally competent. There are many routes that I can take to increase my knowledge and cultural awareness. If I had more worldly knowledge it would improve my awareness, strengthen my nursing skills, give me a more positive attitude. This, in turn, could change my behaviors and will improve my direct patient care in an acute setting. I remind myself each day to work as a non-judgmental nurse, free of biases and prejudices and to integrate research, knowledge, skill, flexibility, and creativity into my practice in order to deliver culturally appropriate and sensitive health care.
Florence Nightingale, named after the city of Florence, was born in Florence, Italy, on May 12, 1820. She would pursue a career in nursing and later find herself studying data of the soldiers she so cringingly looking after. Born into the Crimean War, Florence Nightingale took the lead role amongst her and her colleges to improve the inhabitable hospitals all across Great Britten; reduce the death count by more than two-thirds. Her love for helping people didn’t go unnoticed and would continue to increase throughout her life. In 1860 she opened up the St. Tomas’ Hospital and the Nightingale Training School for Nurses before passing August 13, 1910 in London. Her willingness to care for her patients was never overlooked and wound establishing
Nightingale’s concepts are used a great deal in everyday nursing. Nightingale referred to the person as a patient (Alligood, 2014, p. 65). She defined health and that it was maintained by the prevention of disease and through health promotion (Alligood, 2014, p. 65). She believed that health would benefit from environmental improvements (Alligood, 2014, p. 66). For professional nursing, Nightingale defined the skills, behaviors, and knowledge that is required for further
Though a form of caring existed since the creation of human beings, the image merely consisted of a form of health promotion or health maintenance (Stanley & Sharret, 2010). Florence Nightingale, a pioneer, who took advantage of the contributions women made in society in promoting health and caring aimed to address that caring is something more substantial and based on scientific knowledge and evidence than just simply a given task. The ideas and the care practice approach Nightingale created is the foundation of the nursing profession and continues to influence modern day nursing.
The link between nursing and cultural safety is that it ensures a better health outcome for the patient. Cultural safety in New Zealand was enforced in 1992 by the Nursing Council of New Zealand (Papps and Ramsden, 1996). O’Toole (1996) States ‘if an indigenous person feels their culture is not respected or accepted they can feel a power imbalance. From this, the patient may not trust the health professional, and negatively affect the patient’s health
The first concept, Cultural Safety, is relatively new. It emerged in New Zealand and has been incorporated into the Canadian Health Care Systems. Dr. Irihapeti Ramsden developed the concept to promote awareness of cultural differences and to recognize the inequities present in health care. (Ramsden, 2002).