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Essay on safety in nursing practice
Nursing fundamental safety needs
Essay on safety in nursing practice
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I worked with a supernumerary nurse for the first week of their familiarisation period. We were looking after a thirty-nine year old woman, Ms LC, who had undergone a laparoscopic peritonectomy. We had to start her on NPWT; as suggested by wound clinical nurse consultant and the doctors during their ward round, since this would allow faster healing of her wound.
Since this is the first time for the patient to have this type of dressing on her wound, thorough information had been provided to the patient. At the same time, a verbal consent was also necessary before commencing on NPWT in order to make sure that Ms LC is fully aware of the intervention, which Ms LC consented to proceed with the application of NPWT.
We applied an
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This ethical principle of non-maleficence is critical to nursing safe practice where nurses will not harm their patient, which is ideally by avoiding any possible injuries to the patient. However, the main goal must be favourable or has more advantage to the patient wellness. According to Johnstone and Crock (2008), the responsibility of the nurses is to prevent any discomfort or injury to the patient as possible as they can. By balancing the principle of double effect between the principle of beneficence which is embodied by the phrase ‘doing good’ and the non-maleficence, this can focus more on the advantage of the NPWT and the risks that is linked to it; in order to avoid the patient getting harmed. This is also very evident in many traditions of different cultures, where, according to Thompson et al. (2006); a basic principle of ‘do unto others as you would have them do unto you’ applies to all professions. This is one of the reasons why health professionals should treat their patients with kindness, and in return the patient might show their concerns and kindness with trust to the healthcare
Additionally, the LPN cannot push medications into a peripheral intravenous line if the patient “weighs less than 80 lbs, is prenatal, pediatric, or antepartum”, although given that the situation is on a general med-surg floor it is unlikely these patients would be under Sarah’s care at this time. (Rules and Regulations of Practical Nurses. 2015) Sarah can delegate the postoperative patients who need dressing changes and ambulating them to the LPN, but Sarah should assess the wounds for complications initially and serve as resource to the LPN if she has questions about the wounds. Additionally, she could help the nursing assistant with answering calls and serve as a reference for the nursing assistant to ask questions or help with tasks if Sarah is not available. With regards to supervision, the LPN would need continuous supervision given that the working relationship is new. (Cherry and Jacob, 2014) Sarah should be available and willing to answer any questions or address any concerns the LPN
One cannot fake being a nurse, one must be extremely genuine in order to perfect being a nurse; therefore, explaining why nurses enforce and value their code of ethics. The purpose of the code of ethics is to ensure patient safety and implement standard of care by following the nine provisions of ethics. The nine provisions explain the nurses’ responsibility while caring for a patient; for example, maintaining the rights and autonomy of a patient. Another point that the provisions highlight is being the patient advocate, nurses are in the front line of patient care and they must protect their patients. An important guideline that the nine provision emphasize is the need and requirement for nurses to continue with their education to promote beneficent and to avoid maleficent. The National Nursing Association (ANA) states that the nursing code of ethics “reiterates the fundamental and the commitment of the nurse” (Lachman, Swanson, & Windland-brown, 2015). The purpose of this paper is to highlight the obligations and duty of a nurse and why it is important when attempting to maintain standard of care.
Although nursing is universally practiced, not all nurses values and morals are the same. Nurses and nursing students are usually put in situations where they must operate within an ethical structure which is either unfamiliar to their cultural criterion or those of the patients for whom they are taking care of. The most prominent values and morals of nurses are based on human dignity and benevolence. Human dignity is the main component that branches off into other values under caring for health and well-being. Trust, integrity, autonomy, and privacy are one of the many sub-values that fall under human dignity. It is important for the nurses to respect and understand the culture and beliefs of the patient without being judgmental or confrontational. The wellbeing of the patient is priority and so the nurses must focus on gaining the patients trust first by tending to their needs and exhibiting
During a pandemic in India, a doctor did exploits and was praised by other team members as Fink narrates: “Colleagues credited her quick thinking with saving lives” (p.472). The respect for the person and his or her dignity is at the core of the nursing practice. The registered nurse, as a member of the discipline of nursing should always remember before any action, this strong ethical piece: First, do no harm.
Nurses everywhere face problems and challenges in practice. Most of the challenges occur due to a struggle with the use of ethical principles in patient care. Ethical principles are “basic and obvious moral truths that guide deliberation and action,” (Burkhardt, Nathaniel, 2014). Ethical principles that are used in nursing practice include autonomy, beneficence, non-maleficence, veracity, confidentiality, justice, and fidelity. These challenges not only affect them, but the quality of care they provide as well. According to the article, some of the most frequently occurring and most stressful ethical issues were protecting patient rights, autonomy and informed consent to treatment, staffing problems, advanced care planning, and surrogate decision making (Ulrich et. al, 2013). The ethical issue of inadequate staffing conflicts with the principle of non-maleficence.
Davenport, Joan M., Stacy Estridge, and Dolores M. Zygmont. Medical-surgical nursing. 2nd ed. Upper Saddle River, N.J.: Pearson Prentice Hall, 2008, 66-88.
To sustained the PSI a clear recognition from senior healthcare staffs such as continence nurse advisers, the nurse specialist and community nurse and support by training, coping and adopting strategy to change is needed (NHS ΙΙΙ 2008). The role of the nurse involves investigating patient, communicating with the other healthcare team members such as community nurses to help ensuring the use of the cover for the catheter stand is an essential element of care, rather than being dismissed or patient isolating them self due to stigma (RCN 2013).
Healthcare provider’s perception and judgment in the patient’s well being as well as taking into account the right of the patient in every action is one of the key elements in nursing practice. International Council of Nurses (ICN), (2006) states “The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance public confidence” (p. 3). Furthermore, nursing action guided by theory and principles of moral and legal rights complements excellent nursing care. Nurse’s awareness in moral and legal codes helps them control the complicated scenario encountered and direct the nurses in the best possible action answerable by law (Lachman, 2006).
Poor care does not only result in bad press and public perception but also break the trust between the patient and nurse. Utilising the theoretical framework developed by Todres et all (2009) which explores eight central aspects of what it is to be human. Todres et al (2009). This model can be used to improve nursing care. Referring to the term ‘being treated as human beings’ not being treated as a number or object.
Brunner, L.S. & Suddarth, D. S Textbook of Medical- Surgical Nursing, 1988 6th ed. J. B. Lippincott Company, Philadelphia
Nursing surrounds the concept of patient care physically, mentally and ethically. The therapeutic relationship that is created is built on the knowledge and skills of the nurse and relies on patient and nurse trusting one another. The use of nursing skills can ensure these boundaries are maintained, it allows for safe patient care. Professional boundaries are the line that nurses cannot cross, involving aspects such as patient confidentiality and privacy, ensuring legal aspects of nursing and the boundaries put in place are not breached. However, nurses accepting financial or personal gain from patient can also cross these professional boundaries. It is only through education in this area that the rights of patients can be preserved, as well as the nursing standards. Through education in areas such as confidentiality, boundaries can remain in tact and the patient care can remain within the zone of helpfulness.
Deontology is an ethical theory concerned with duties and rights. The founder of deontological ethics was a German philosopher named Immanuel Kant. Kant’s deontological perspective implies people are sensitive to moral duties that require or prohibit certain behaviors, irrespective of the consequences (Tanner, Medin, & Iliev, 2008). The main focus of deontology is duty: deontology is derived from the Greek word deon, meaning duty. A duty is morally mandated action, for instance, the duty never to lie and always to keep your word. Based on Kant, even when individuals do not want to act on duty they are ethically obligated to do so (Rich, 2008).
In order for nurses to practice ethically they must understand the meaning behind each professional value. The first value is human dignity. With each patient we encounter we must show them respect as individuals. It does not matter what the medical condition is, race, ethnicity, culture, religion or gender of the individual. The dignity of a person must be protected. As nurses we must respect the uniqueness of each individual we care for, as this is a fundamental right of all humans. A person with dignity feels a sense of self-worth and as nurses we must do our best to help our patients maintain that feeling of worthiness.
Integrity, respect for persons, justice, non-maleficence, and responsibility are all identified within the code, however compassion is not directly stated but is implied. To show compassion for others during suffering is an almost automatic response in nursing. When nurses decide to act either beneficently or non-maleficently they are doing a service to those being cared for. When dealing with human lives moral value becomes especially important, and is not situationally dependent. Ethical neutrality does not have a place in professional ethics, and an obligation to respect the moral values is necessary. The code deals with specific issues related to the nursing profession, and ensures standards are upheld. Creation of code of ethics within a profession limits misconduct, create safeguards, promote trust for the profession within society, and preserves the integrity of the profession (Soskolne, 1984) It is important for me to emphasize the difference between the nurse’s code of ethics and the Hippocratic Oath. The nurses ethical code is tailored toward the care provided to the patient, and not the involved science and diagnostic aspect of the
“The provision of good care not only means the provision of technologically competent care but also care that respects the patient’s beliefs, feelings, and wishes, as well as those of their family and significant others” (Williams & Hopper, 2015). From providing care, the staff will be able to grasp a holistic view for the patients and their families to critically think about the patient care plan and avoid harmful or undesirable results. A research stated: “the principle of beneficence, imploring us to do good and to prevent harm” (Lang, Dupree et al., 2016). Through the definition of maleficence to respect the preferences of the patients and their families, this will help the staff to give quality patient cares. Furthermore, the nursing principle of beneficence will support both patients and staff wellness from the establishment of rapport between staff and patients towards an ideal health