1. A 15 year old girl Jessica Williams has been admitted to the Emergency Department, following an event of unconsciousness at the cross-country program at her school. The major problem in this case was related to possible pregnancy in a 15 year old girl. Teenage pregnancies are associated with severe discrimination and stigma, in addition to threats related to violence and poor health status. Jessica clearly stated her opinion of not letting others, specifically her parents know about her qualms and uncertainties. Healthcare service consumers should be able exert opinion regarding the medical care, without any influence of a third person such as, family member and/or healthcare provider (Reach 2014). Safeguarding the information shared by Jessica from her mother Mrs. Wilson is a matter of utmost concern in the case. All healthcare consumers display more probability of seeking appropriate medical care when they feel respected and secured. This makes them share an honest explanation of their torments and signs (Kourkouta & Papathanasiou 2014). Therefore, efforts taken by a nurse to foster a strong confidential relationship will possibly encourage self-assurance of the service user and strengthen her faith in the care services being delivered.
Furthermore, children who have reached the age group of 14 years should be provided with the right of exerting their informed consent and permission to any treatment or plan of care that is utmost necessary for enhancing their health and wellbeing. However, it must be ensured that the adolescent consumers have gained an appropriate understanding of the nature, benefits and adverse effects of the proposed treatment, prior to providing their informed consent (NSW Government Health 2005). Clinical events as this case study where the patient is aged less than 15 years, all healthcare staff should carefully seek the endorsement of the mother or father, unless a protest is made by the young client (NSW Government Health 2005).
Moreover, under such circumstances when the adolescent patient exerts his/her opinion regarding the treatment services, no further allegations can be drawn for assault against the medical practitioners, in accordance to the Pursuant to the Minors (Property and Contracts) Act 1970. The Family Law Act states that both parentages are entitled with equal accountability for their children who are minors or aged below 18 years. The stage that is measured suitable for an adolescent to deliver agreement to management and/or cure of a disease or ailment, without any parental supervision also hinges on on the rigorousness of the signs and symptoms for which cure requires to be executed, in contrast to the comparative maturity intensity of the patient (NSW Government Health 2005).
3. Sam can adopt two approaches:
- The ICN Code of Ethics are comprise of four basic elements that are responsible for outlining the standards of the ethical behaviour and conduct that is expected of health professionals. The code that can be used by Sam is encompassed by the first element, namely ‘Nurses and people’. The nurse has the duty of holding in assurance all kinds of personal information that are furnished by the patient and are also responsible for accurately judging the presenting complaints and needs of the patient (ICN 2012). Furthermore, her consent must also be taken prior to disclosure of any health related information to her parents, or other healthcare providers.
- Wilson should be informed about the health status of her daughter. This will be based on the nursing standards of practice that makes it mandatory to engage in a therapeutic and professional relationship with all clients (code 2) (Nursingmidwiferyboard.gov.au 2018). Furthermore, a responsive and safe care must be delivered to the patient (code 7), besides taking efforts to develop an appropriate plan of care for the presenting complaints (code 5). The NBMA code of ethics should also be followed that will provide guidance for recognising the active participation of the service user in nursing care (Nursingmidwiferyboard.gov.au 2018).
4. If I were to play the role of Sam, I would consider establishment of a confidential and close therapeutic relationship with Jessica in order to gain her trust. This would make her feel a sense of security and belonging, thus enabling her to share relevant information related to her health. Although guardians have been found to play a crucial role in providing assistance to adolescents for navigating the healthcare systems, I would not disclose Jessica’s current health stauts to her mother, in order to preserve the former’s dignity and rights (Nursingmidwiferyboard.gov.au 2018). Concerns of adolescents about maintaining confidentiality regarding their health often act as major barriers in the pathway of accessing care services (Hiriscau et al. 2014). This in turn will be enhanced by showing an adherence to the NMBA standards of practice for a registered nurse that will guide me to initiate effective conversation with Jessica.
I would always try to how respect towards her personal beliefs and values, while providing her care services. Patient advocacy is a specialised area of care where an effective advocate is entrusted with the duty of acting on behalf of the patient, in the form of a representative. Few things such as, sexuality are often considered more personal about the human body and sharing such information is frequently embarrassing or sensitive for patients (Fortenberry 2013). My duty of confidentiality would therefore require me to take all efforts to uphold Jessica’s integrity and autonomy in relation to her disclosure of medical information or treatment that she wants to be exposed to. I would also develop a nursing care plan in accordance to the individual needs and demands of the client (Nursingmidwiferyboard.gov.au 2018). Hence, all health related information would not be disclosed to her mother. In other words, I would not breach the standards of patient confidentiality and would always maintain privacy of my client.
Fortenberry, J.D. 2013, ‘Puberty and adolescent sexuality’, Hormones and behavior, vol.64, no.2, pp.280-287.
Hiriscau, I.E., Stingelin-Giles, N., Stadler, C., Schmeck, K. & Reiter-Theil, S. 2014, ‘A right to confidentiality or a duty to disclose? Ethical guidance for conducting prevention research with children and adolescents’, European child & adolescent psychiatry, vol.23, no.6, pp.409-416.
International Council of Nurses., 2012, ‘THE ICN CODE OF ETHICS FOR NURSES’, Retrieved from https://www.icn.ch/sites/default/files/inline-files/2012_ICN_Codeofethicsfornurses_%20eng.pdf
Kourkouta, L. & Papathanasiou, I.V. 2014, ‘Communication in nursing practice’, Materia socio-medica, vol.26, no.1, p.65.
NSW Government Health 2005, Consent to Medical Treatment - Patient Information, viewed 7 September 2018, https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2005_406.pdf.
Nursingmidwiferyboard.gov.au 2018, Code of Ethics for Nurses in Australia, viewed 7 September 2018, https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx.
Nursingmidwiferyboard.gov.au 2018, Nursing and Midwifery Board of Australia - Professional standards, viewed 7 September 2018, https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx.
Reach, G., 2014, ‘Patient autonomy in chronic care: solving a paradox’, Patient preference and adherence, vol.8, p.15.
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