Introduction
As a nurse it is important to use a framework to which all your care is guided by. Critical aspects that should compose the framework to guide a nurses actions and decisions include the fundamental patterns of knowing, the bioethical principles and the Nursing and the Midwifery Board of Australia codes and guidelines. In the case scenario provided had the nurse Emma considered and used this framework in her actions and decisions the outcome for her patient could have possibly been avoided.
Ways of knowing
The fundamental patterns of knowing in nursing are empirics, aesthetics, personal and ethics.
Carper (1978) describes empirics, as the science of nursing. The empirical pattern of knowing in nursing is defined by the factual knowledge that underpins nursing actions. This pattern of knowing should have influenced Emma’s decision to allow Robert not to wear his Anti-Embolism Compression Stockings (TED stockings). As a registered nurse Emma should know the importance of wearing TED stockings and the implications that can result if they are not worn. Emma should have used her knowledge to inform Robert that after returning from the operating theater he is at risk of developing Deep Vein Thrombosis (DVT). DVT is the name given to blood clots that can form in the veins of the leg following surgery or long periods of bed rest in the hospital, among other reasons. If the clot becomes loose, it can break away and travel through the veins to the heart and lungs and may block a major blood vessel. This is known as a Pulmonary Embolism or PE. Pulmonary Embolism is a serious condition, which in some cases may be fatal (Harris 2012). Using this empirical knowledge Emma may have been able to convince Robert to wear his TED st...
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...sing and informing the NUM of Roberts choice to remove the stockings, Emma could seek other alternatives to the stockings that could decrease Robert’s risk of a PE.
Emma also should not have posted on social media about this incidence with Robert, although she didn’t reveal his name conduct statement 5 requires that “Nurses treat personal information obtained in a professional capacity as private and confidential” (NMBA). In posting on Facebook© Emma did not follow the NMBA’s codes and guidelines.
Conclusion
In the case scenario provided had Emma followed a framework to guide her actions and decisions that applied the fundamental patterns of knowing, the bioethical principles and the Nursing and the Midwifery Board of Australia codes and guidelines, Robert could have avoided the pulmonary embolism (PE) and would not have significant damage to his lungs.
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Through the utilisation of the accompanying text, I aim to discuss and reflect upon one person’s care, to which I have had previous involvement. Using the perspectives set out by Chapelhow et al (2005), I aim to gain a broader outlook on what is expected of me as a Student Nurse. Chapelhow et al (2005) has identified six skills that they feel are required of every Health Care Practitioner. These skills are defined as ‘enablers’ as they are fundamental skills that provide the means for expert professional practice (Chapelhow et al 2005). Although there are six skills outlined, I will only be using two of them to analyse the care I provided. I have chosen to use communication and risk management as my two enablers.
By using the NMBA’s Nursing Practice Decision Making Framework, it enables the clinician who are making the referral decide whether or not the person they are referring Angela to are accountable, responsible, have authority and competent and/or require supervision to carry out a particular task (Nursing and Midwifery Board of Australia, 2013). A range of inter-professional team which are considered essential for Angela’s care include GP, psychologists, psychiatrists, registered nurses, and social workers (Department of Health, 2014). These members can be delegated as well as are the delegator different roles and responsibilities as they all provide different aspects of Angela’s care as they have different skills and knowledge (Davies & Fox-Young,
A critical analysis of the four fundamental patterns of knowing in nursing is essential for nurses to be able to grasp the complicated nature of the nursing practice. Barbara Carper (1978) lists the four patterns of knowing as: empirics, esthetics, personal knowledge, and ethics or moral knowledge (p.14). The science of nursing is called empirics and the connection of art to nursing is referred to as esthetics (Carper, 1978, p.14). These patterns are four very complex areas of nursing that every nurse must consider in order to be as successful as possible in providing care. In this evaluation the author will discuss how these concepts affect present learning and practice.
Carper’s (1978) pivotal work of identifying nursing’s ways of knowing was a seminal work that laid the foundation for further analysis. Her ways of knowing have identified methods that have allowed the nursing discipline to further its own knowledge as well as the profession. Two other ways of knowing have emerged, Munall’s (1993) “unknowing” pattern; and also sociopolitical knowing by Zander (2011, p. 9) or emancipatory pattern (Chinn & Kramer, 2011, p. 5). Here these patterns are discussed through experiences in my personal practice.
...iately discovered and the patient was fine, but had there been proper communication between the healthcare staff, such blunders could have been avoided altogether (Dolanksy, 2013).
In this essay the author will rationalize the relevance of professional, ethical and legal regulations in the practice of nursing. The author will discuss and analyze the chosen scenario and critically review the action taken in the expense of the patient and the care workers. In addition, the author will also evaluates the strength and limitations of the scenario in a broader issue with reasonable judgement supported by theories and principles of ethical and legal standards.
Facione, Facione & Sanchez, 2010. How do nurses view the patients and the kinds of problems that the nurses manage in practice while they engage in patient care? They need to be certain, precise and just in front of the patient. Their reasoning is sufficient for their intended purpose. All reasoning can be assessed considering these standards, plus as nurses reflect upon the quality of their thinking, they begin to detect when they are being imprecise, unclear, inaccurate or vague.
1. Legal, ethical and professional principle frameworks underpin all fields of nursing, and it is a requirement for all Registered Nurses to be competent and knowledgeable, act with integrity and maintain professional standards set out by Nursing and Midwifery Council (NMC, 2015). Working with multidisciplinary teams within our profession, it is important to acknowledge and recognise the way in which all the professionals are guided by law and their independent regulatory bodies. The needs of the individual patient is to be considered by doctors and nurses alike, who share professional values and are set out in the respective codes of practice, The Code (NMC, 2015) and GMC (2013).
I was also responsible for implementing of therapies and interventions initiated by other IP members as I was expected to collaborate with my IP team to ensure positive patient outcomes. The proposed management for identified issues, for example, impaired mobility function were developed by me based on the evidence based tools used in hospitals such as Fall Risk Assessment and Management Tool. The decisions with respect to nursing care and my input in IP team care plan were influenced by not only the complex needs of the patient but also the Nursing and Midwifery Board of Australia (NMBA) nursing scope of practice, NMBA’s Code of Ethics and Conduct whilst upholding the four fundamental ethical principles: autonomy, beneficence, non-maleficence and justice. I believe making ethical decisions and collaboration practice is vital to ensure that I deliver the highest quality of care and safety to the patient. I can also guarantee that the positive and desired health outcomes of the patient is obtained as a result. It appears that in the development of IP care plan, the
My essay will include a discussion of communication, interpersonal skills used in the incident, and finally evidence-based practice. I will conclude by explaining what I have learned from the experience and how it will change my future actions. In accordance with the 2002 Nursing and Midwifery Council, the client details and placement setting has not been disclosed in order to maintain confidentiality. Critical incidents are snapshots of something that happens to a patient, their family, or nurse. It may be something positive, or it could be a situation where someone has suffered in some way (Rich & Parker 2001).
Which is very important for nurses or any medical professional to do in the healthcare profession. Nurses are receiving these patients in their most vulnerable state, nurses are exposed and trusted with the patients’ information to further assist them on providing optimum treatment. Keeping patient’s information private goes back to not just doing what’s morally right but also it also builds that nurse – patient relationship as well. We also have provision three that specifically taps on this issue as well, as it states: “The nurse seeks to protect the health, safety, and rights of patient.” (Nurses Code of Ethics,
Q.3 Nurses as part of regulated health care practitioners are responsible and accountable to abide by the standards, codes and guidelines of nursing practice (NMBA, 2016). The nurse in the case study has breached the standard 1.4 of the Registered Nurse Standards for Practice. According to standard 1.4, the registered nurse should comply with "legislation, regulation, policies, guidelines and other standards or requirements relevant to the context of practice” when making decisions because this will be the foundation of the nurse in delivering high quality services (NMBA, 2016). The nurse in the scenario did not follow the hospital policy concerning “Between the Flags” or “red zone” and a doctor should be notified of this condition. Furthermore, the nurse failed to effectively respond to a deteriorating patient.
There are legal requirements and policy to govern specific areas of health care practise. It differentiates nurse responsibilities, help establish boundaries of independent nursing action and assists in maintaining a standard to ma...
The following essay is a reflective paper on an event that I encountered as a student nurse during my first clinical placement in my first year of study. The event took place in a long term facility. This reflection is about the patient whom I will call Mrs. D. to protect her confidentiality. Throughout this essay I will be using LEARN model of reflection. I have decided to reflect on the event described in this essay since I believe that it highlights the need for nurses to have effective vital signs ‘assessment skills especially when treating older patients with complex medical diagnoses.
In conclusion, there are numerous legal and ethical issues apparent in the nursing practice. Nurses should study and be as informed as they can with ethics and legality within their field in order to ensure no mistakes occur. Ethical issues vary based on patient’s views, religion, and environment. Nurses are influenced by these same views, but most of the time they are not the same as the patients. As a nurse we must learn to put the care of our patients and their beliefs, rights, and wishes before our own personal