Veracity & Fidelity in Nursing: Personal and Professional Values
Not only is it important to know our own personal values set when it comes to providing nursing care, it is also a valuable skill as a preceptor or trainer of nurses to notice and assess, as well as potentially report, issues of ethical concern. There are standards of care as well as ethical components established by the American Nurses Association (ANA) that assist nurses in this process. Models of care and nursing theories utilized in our individual health systems can also point us in the right direction with regards to proper care of patients with truth telling and promise keeping. Communication is a key factor in not only the nurse patient relationship, but also the relationship we have with our fellow nurses and the institution in which we practice. After all, it is nurses who are responsible for maintaining the integrity of our profession.
Truth Telling and Promise Keeping: Foundations of the Nurse-Patient Relationship
The right thing to do was obvious, when put into the perspective of the patient and the nurse-patient relationship. Tele-nursing involves a special sort of nurse patient relationship, one that must be developed with an immediate rapport and understanding of trust with a caller (Nagel, Pomerleau & Penner, 2013). Patients enter into a relationship with the provider and by extension, the after-hours nursing staff, and place their trust in their provider at a potentially vulnerable time (Carter, 2009).
While training a nurse who was new to telephone triage, it became evident to me through several calls and transactions that the nurse was not honest in her interactions. There is no room in this sort of nurse-patient relationship for attempting ...
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Nurses are central to patient care and patient safety in hospitals. Their ability to speak up and be heard greatly impacts their own work satisfaction and patient outcomes. Open communication should have been encouraged within the healthcare team caring for Tyrell. Open communication cultures lead to better patient care, improved outcomes, and better staff satisfaction (Okuyama, 2014). Promoting autonomy for all members of the healthcare team, including the patient and his parents, may have caused the outcome to have been completely different. A focus on what is best for the patient rather than on risks clinicians may face when speaking up about potential patient harm is needed to achieve safe care in everyday clinical practice (Okuyama,
In the nursing profession, communication is a tool to be used effectively in shift-to-shift report to ensure continuity of care and patient safety (Matic, Davidson, & Salamonson, 2010, p. 184). Benson, Rippin-Sisler, Jabusch, and Keast (2007) explain “for a report to be meaningful, the information passed along to the receiver must be done in a way that is effective and efficient; otherwise, the point of communicating the information may be lost” (p. 80). The Joint Commission (TJC) defines barriers in communication as a leading threat to patient safety (Matic et al., 2010, p. 185). Patient safety and continuity of care can be maintained by implementing a handoff communication tool and bedside nurse-to-nurse handoff.
Patients expect instant response to call lights due to today’s technological advancements. This can negatively impact nurse stress and cause contempt toward the patient. However, the expectation to respond promptly improves safety and encourages frequent rounding. Also, aiming for high patient satisfaction scores on the HCAHPS/Press Ganey by fulfilling patient requests can overshadow safe, efficient, and necessary healthcare. Although patient satisfaction is important, ultimately, the patient’s health takes precedence over satisfying patient and family requests, especially when those requests are unnecessary, harmful, or take away from the plan of care (Junewicz & Youngner, 2015). The HCAHPS/Press Ganey survey focuses on the patient’s perception of care. The problem with this aspect of the survey is that the first and foremost goal of nurses should not be to increase a patient’s score based on perception. According to an article in Health Facilities Management, the nurse’s top priority is to provide the safest, most quality care possible for patients with the resources they are given (Hurst, 2013). Once this has been accomplished, the nurse can then help the patient realize that the most
Ethics has been a popular topic in nursing for a long time. Nurses are expected to demonstrate ethical decision-making as well as professionalism. I believe that in order to accomplish this, they need to use the ANA Code of Ethics as framework for their decision-making. It is also imperative for nurses to have a strong understanding of ethics, because they will be faced with many difficult ethical decisions that do not always have a straightforward solution.
Technological advances enable nurses to provide accurate, timely care for a patient. This is due to the fact that these advances enable doctors and nurses to quickly diagnose, explain and predict the health-illness status of a patient, thus allowing health care professionals to spend less time finding answers, and more time providing quality care. For nurses, this includes spending time with the patient establishing rapport, communication and a trusting relationship for optimum clinical care.
Furthermore, there should be enough trust between the nurses and physicians where they can easily put aside their egos and ask for a second opinion when they have any doubts concerning a patient's safety. This was clearly exemplified when the nursing staff attending to Lewis Blackman failed to contact the physician when various side effects arose; instead they tailored the signs to fit the expected side effects. Even after Blackman’s health was deteriorating, the nurses remained in their “tribes” and never once broke out of it to ask for help. The entire hospital was built on strong culture of remaining in their tribes instead of having goals oriented towards patients care and safety.
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In this essay, the interactions of the nurse, doctor and patient in the video clip will be discussed from a communication perspective. Supported by the Australian Nursing and Midwifery Council (ANMC) standard and scholarly articles, the essay will also highlight how communication can affect the quality of patient care, health outcomes and the ability to meet individual patients' needs.
The Code of Ethics for Nurses was created to be a guide for nurses to perform their duties in a way that is abiding with the ethical responsibilities of the nursing profession and quality in nursing care. The Code of Ethics has excellent guidelines for how nurses should behave, however; these parameters are not specific. They do not identify what is right and wrong, leaving nurses having to ultimately make that decision. Ethics in nursing involves individual interpretation based on personal morals and values. Nursing professionals have the ethical accountability to be altruistic, meaning a nurse who cares for patients without self-interest. This results in a nurse functioning as a patient advocate, making decisions that are in the best interest of the patient and practicing sound nursing ethics.
One of the most poignant statements that I have heard during my tenure in nursing school is that “Nurses are often the first person that an infant sees at birth and the last person that a patient sees upon death.” Nurses have contact with patients recurrently along this continuum of life, now more than ever. This is due to the world’s aging population and the correlating factor of higher patient acuity (Larson, 2013). This frequent and close contact with nurses has fostered a sense of trustworthiness in the minds of U.S. citizens. This is evidenced by a recent Gallup Poll which listed nurses as the most honest and ethical professionals in America (www.galluppoll.com, 2015). Nurses have the challenging task of providing this trust-worthy,
“Ethics is a systematic study of principles of right and wrong conduct” (Taylor, Lillis, Lynn, & LeMone, 2015, p. 96). The American Nurses Association Code of Ethics has nine provisions to it. All nine are important to the nursing field in their own way. There are two provisions that I find most important in helping my career as a nurse. Provision one, The nurse, in all professional relationships, practices with compassion and respect of the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal, attributes, or the nature of health problems. Secondly provision two, the nurse’s primary commitment is to the patient whether an individual, family, group, or community.
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
The four fundamental nursing responsibilities of promoting health, preventing illness, optimizing health and alleviating the ill are represented in the code of ethics. (Arnold & Boggs, 2016) One can say that the code of ethics are rules that a nurse needs to follow in order to effectively communicate and protect the patients. The American Nurse Association provided the code of ethics to guide nurses to ensure that patient’s care, safety, rights and health are well cared for and well managed. Models like Utilitarian, deontological, and the human rights-based all contribute in answering dilemmas that can arise with a patient. Thus, explaining what some of the code of ethics are, and how the code of ethics influence our responsibilities as a nurse will impact the overall care of the
The American Nurses Association created guidelines for the profession including, a set clear rules to be followed by individuals within the profession, Code of Ethics for Nurses. Written in 1893, by Lystra Gretter, and adopted by the ANA in 1926, The Code of Ethics for Nurses details the role metaethics, normative ethics, and applied ethics have within the field (ANA, 2015). Moral obligation for an individual differs within professions than it does within an individual’s personal life, so the code of ethics was written to establish rules within the profession. The moral obligation to provide quality care include the fundamental principles of respect for persons, integrity, autonomy, advocacy, accountability, beneficence, and non-maleficence. The document itself contains nine provisions with subtext, all of which cannot be addressed within this paper however, core principals related to the ethical responsibilities nurses have will be