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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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,
Provision 3.1 of the ANA’s Code of Ethics states that the nurse will promote, advocate, and protect patients’ privacy and confidentiality (American Nurses Association, 2012). The protection of our patients’ privacy is fundamental. The ANA Code of Ethics is not a suggestion; it is a mandate to all nurses. The code calls for nurses to act when the rights of the patient or the nurse are violated through the actions of others (Edmonson, 2010). Even under FERPA guidelines, it is difficult to make an argument for the release of the student’s personal information in the manner of the large staff
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,
Without these principles and guidelines, I am not able to grow as a nurse. Everyday decisions about the care I give to my patients will be guided by basic philosophy and ethical standards. I feel that in my four years of nursing my practice has been consistent with these standards. As an RN, I feel it is important to always seek improvement in all aspects of my career. Taking a step back and self-reflecting will allow me to find areas of improvement necessary to improve the care that I give to my patients.
As a result, she breached the standard 6 which states that “registered nurse should provide a safe, appropriate and responsive quality nursing practice” (NMBA, 2016). In line with this standard, nurses should use applicable procedures to identify and act efficiently to potential and actual risk such as unexpected changing patient’s condition (NMBA, 2016). Through early identification and response by the nurse, this will ensure that the patient’s condition is recognised and appropriate action is provided and escalated (Australian Commission on Safety and Quality in Health Care, 2011). Moreover, the nurse did not immediately escalate the patient’s deteriorating condition to the members of the health care team. Therefore, she also disregards the standard 4.3 stating that nurses should have work with the interdisciplinary health care team and to collaborate, communicate and discuss the patient’s status (NMBA,2016). The purpose of collaborating and communicating with the team is to provide a comprehensive plan of care for the patient and to facilitate early treatments needed by the patient (Cropley,
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
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.
Nurses face various and exhaustive number of dilemmas and conflicts in their line of duty. Dilemma can come in various forms for a nurse, be it from family, colleagues and/or supervisors. To handle such situations, there have to be a framework of ethics and law that have to be considered before any decisions are made. According to (Hall, 1996, p.2), “Good nursing practice is good ethics is good law”. With this statement in mind, one can practice with confidence as what they do is within the guidelines of ethics and legal under the eyes of the law. An example of a dilemma in a clinical setting would be in the decision making process of a patient who is unconcious. Sometimes the physician would want the best for the patient but the family thinks otherwise or vice versa. This will be explored in the essay on the proper way to handle such dilemma faced by a nurse.
Nursing takes on a different form of learning that reflects several different aspects and abilities that encompass a wide range of skills and forms the ways of knowing in nursing. The article, “The Fundamental Patterns of Knowing in Nursing,” incorporates multiple theories associated with the learning patterns in nursing. It is a review of literature that helps identify and understand the knowledge practiced by nurses and to better understand the nursing profession. The purpose of the paper was to evaluate the expectations of learning within the nursing realm based on the four areas of nursing that include, empirics, esthetics, personal knowledge and ethics.
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 best way to look at nursing theories is like the foundational block. Nursing theories are important set the tone of how a nurse will practice. A nurse will use intuition, practice, past expertise and events, and couple with learned theories to work every day in order to give the best patient care. it is all the more important to appreciate what first advanced nursing beyond mechanisms of practice to becoming a knowledge-based force in healthcare: That force is nursing theory and the theoretical thinking and research that generate theory. The complexity and depth of nursing are reflected in its structure of knowledge, which includes discipline-specific components such as philosophies, theories, and research and practice methodologies”( Reed, 2006). Patient care is a wide topic, but a key role in a patient’s care is the patient themselves, an educated patient is vital to their well being and higher level of care.
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.
Nurses use evidence based practice and research to develop knowledge needed to practice in the nursing profession. Nurses use practical knowledge and theoretical knowledge in the many roles that nurses perform. As a provider of care and manager of care, nurses should use evidence based practice, research, and theoretical knowledge to ensure the best possible outcome for the patient. Lifelong education in nursing is necessary to keep up with the changes in nursing practice and to reinforce ethical knowledge and the core values that nurses use in their everyday practice. The professional value of caring as a nurse is one of the most important values. The caring attitudes of nurses will carry over to all other values that nurses should possess,
A norm in society is when an individual sees danger they are supposed to report it to the authorities, therefore preventing any further damage. Breach of confidentiality is when a nurse shares information about a patient to others who are not authorized to know about the patients personal information. Due to this, patients are afraid to be honest with their physicians and nurses that are treating them. In order to assure pati...
This profile adheres to the School of Health and Social Care’s guidelines set by Teesside University’s code of conduct in relation to confidentiality and consent. The profile also adheres to the NMC guidelines referring to consent and confidentiality as a real person has not been used; therefore consent did not need to be gained.