B740 Adult Nursing : Culture Assessment Answers

Answer:

Formative assessment:

The principles of nursing practice explain what is expected from the nurse for the welfare of the people. The In this assignment, I will be giving a reflection on one of the principles of nursing. The principle of nursing I am choosing for the reflection is principle A, which states that every nurse should take care of the patients with respect and humanity (Chadwick,  2012).

The statement of the Principle of Nursing practice A is- the primary work of every nurse is to take care of all the patients with dignity and equality. The nurses have to understand the personal needs of the patient. To do that, the nurses first have to understand the patient’s concept about respect (Lin et al, 2013). Respect is something we all expect in our daily life. To give a patient complete care, it is very important for the nurses to know the patient personally.

I have observed during my tenure that there are three key aspects of privacy, which are, personal space, privacy of the patient’s body and the confidentiality of the information. As a nurse, I can do many things for the patient to secure the basic dignity of the patients, such as, while dressing a patient, I have to close the door of the room. When the patient is using the bathroom, I have to close the door to maintain the privacy of the patient. Keeping confidentiality is also a concern. It is my responsibility as a nurse to maintain that any confidential information regarding the patient is not discussed without the permission for the patient.

I have to make sure that the patient feels that they have full control on their life. It is the basic right of the patient to decide their eating habits, if the doctor permits. It is very important for the nurse to have respect over the choice of the patient’s life. It is among the duties of a nurse is to treat the patient as a different individual. The key point of respecting and maintain the dignity of a person is about getting to know a person and development of a relationship with that person (Card, Ward, and Clarkson, 2012). From the cases I handled, I learnt that the non-verbal communication has the same importance as verbal communication. As a nurse, I have to properly interact with the patients (Gastmans, 2013).

The NMC guideline also echoes the nursing practice principle A, as it clearly directs the nurses to treat the patient with empathy, respect and kindness. It also directs the nurses to listen to the patients about their concerns and keep the practitioner-patient information confidentiality (Oosterveld-Vlug et al., 2013). The NMC guideline provides detailed instructions to the nurses about how to maintain a patient’s confidentiality, basic dignity and physical privacy (Sabatino et al, 2014). There are many policies in healthcare, which the nurses also have to follow. These policies also support and promote respect and dignity in healthcare. All these policies and guidelines support the basic principles of nursing.

Summative evaluation:

The principles of nursing describe what the patients and the society expect from a competent nurse. There is an importance of having a clear vision about this holistic measure, which would serve the expected purpose of nursing (Abraham, and Moretz, 2012). There are many measures about the principle of nursing, which are being followed throughout the world, RCN has chosen the most frequently used measures as the principles. This assignment is about the analysis of two of the RCN principles of nursing. I choose the nursing Principle C and D as the center of the analysis. To discuss about both of the principles into practical context I have to relate it to my personal experience (Casey, and Wallis, 2011). This will also detail my understanding about the person-centered, safe and effective care related to principle C and D. The principle C states about the risk management measure of nursing which is needed for effective and safe nursing practice. The principle D states that the main key of competent nursing practice is the person-centered nursing (Duke, 2012). According to this principle, the nurses have to include the patient and their family into the decision related to the patient. The reflection model I am choosing for this context is the Gibbs reflection model. Through an incident from my previous experience, I would like to discuss the nursing principle C and D (Giltinane, 2013).

Description:

Last month, I was working in the general ward under a nursing supervisor. I was at the duty of a 62-year-old man, who returned from an abdominal surgery to remove his appendix. My supervisor asked me to remove his dressing so that the attending physician could check the dressing during the round. The incident happened during the visiting time. The wife of the patient was also present with the patient. The wife of the patient is suffering from early-onset Alzheimer’s, which I did not know that time. My supervisor was present when I first undressed the surgery cut by non-touch procedure. When I was cleaning the wound, my supervisor was examining another patient and told me to come with her, as she needed my help. Meanwhile, the wife of the patient who is an Alzheimer’s patient touched the wound. I came to the patient immediately and asked the wife of the patient to remove her hand from the wound. She removed her hand immediately. I asked my mentor about the situation and she told me to clean up his wound once again. I was afraid that the wife of the patient would contaminate the area with her unwashed hands. She was also wearing a full-sleeved shirt. I was afraid that the shirtsleeves are also contaminated. I immediately told her not to touch the wound with unwashed hands. I called her an irresponsible person. After the doctor came and assessed his would site, I dressed the wound up and called the wife of the patient for an intervention. Until then, the patient’s son also arrived. Just before the intervention, the patient’s son informed me that, his mother is actually a patient of early onset Alzheimer’s. I was feeling sorry after knowing this. I still decided to continue the intervention with the son and the wife of the patient. During the intervention, I demonstrated to both of them how to properly dress these kinds of wound also reminded me to wash their hands before they touch the wound. I told his son personally to take care of his father, as his mother is somewhat incapable of taking care of it. After the intervention, the doctor and my mentor called me there and told me not to talk with the family of the patient with such a manner. They told me it is also my duty to take care of the patient’s family.

Feelings:

I was afraid and angry when I saw the wife touching the wound in unwashed hands. I might have talked with her too loudly and spoke rudely to her about the wrongdoing. As a nurse, I thought the safety of the patient is my first choice and this person is intervening with the safety. I should have talked to her patiently. After knowing that, she is an Alzheimer’s patient, I felt worse about the whole incident. I was guilty that I spoke very rudely with her. After the intervention, I told the patient’s wife that I was sorry and I should not have talked to her like that. Both her and her son was very understanding, so they did not mind of that incident. Her son told me that it was good that I did that because I am responsible towards my patient and they thanked me to taking their patient’s safety seriously. They also told me to teach them the proper way to take care of the dressing and told me to continue the intervention. I continued the intervention with their consent and told them how to take care of the surgery wound near future. Both the wife and son of the patient told me to visit their home sometimes to check on the patient. I again expressed my sorry to the patient’s wife.

Then my mentor and the doctor took me aside and told me that it is good to see that I am taking the safety of my patient seriously, but I should not have the right to talk to her or the any other person in such ill manner. I told them I was sorry about the whole incident and I asked for their forgiveness personally. They also forgave me. I also told the doctor and the supervisor that they are right, and I will never talk to anybody in such a manner within my workplace. I was feeling very guilty about the whole incident and I promised to my mentor and myself that I would never repeat such an incident in my life.

Evaluation:

The whole incident was a revelation for me. I regret that I could not come sooner to the patient to save the incident from happening. In addition, I regret the fact that I talked to harshly with a family of the patient. It is a duty of a nurse to treat the patient and the family members with respect and the way I behaved with the patient’s wife, is not respectful at all. I should not behave like that with her. I still feel very guilty that I spoke to her that way. However, I am happy that the patient’s family members took it positively and did not mind anything. They also insisted me to teach them the exact procedure of dressing such surgery wounds. They took the intervention seriously and thanked me after that. I had observed that, whenever they came to see the patient after that day, the patient’s son made sure that he and his mother has When I was studying the nursing principles that day, I realized that I have breached many of it during that incident. This incident has taught me the importance of the risk management and the importance to include the patient’s family into the plan of care. As any patient needs him / her families by his/her side after getting discharged from the hospital. It is very important for the nurses to include them into the wholesome point of caring (Good, and Officer, 2012).

Analysis of the incident and its relation to the RCN principle of nursing (C and D):

The Royal College of Nursing along with the Nursing and Midwifery council has made a framework called the principles of nursing. The Principle C states the role of a nurse in risk management. Few days after the incident my mentor told me to take a risk management course after the course, so that I can work further as a risk- management nurse further in my career. In the above incident, the family member of the patient has touched the wound of the patient with unwashed hand unconsciously (Holt, and Convey, 2012). The Nursing Principle C clearly states that a nurse have to be “Vigilant” about the risk (Lambert, Barry, and Stokes, 2012). It is also the duty of the nurse to keep everyone safe. I think I have fulfilled the nursing management criteria of being vigilant. I also took the intervention thinking that it would further make the patient safe as the family members of the patient would be aware of the risks associated with the patient. Everyone involved in the patient centered healthcare, including the patient, doctors, nurses, midwives and the family members of the patient have to be aware about the basics of risk management while taking care of such patients who has a chance of catching any infection easily. The RCN/ NMC themselves acknowledges the importance of washing the hands before handling any patient. It is among the duty of the nurses to measure the risk (the likelihood of something bad happening and how severe should be the outcome) (Ingram, and Lavery, 2005). As I did, all of the nurses would also have to try to mitigate the risk. During the intervention, I also explained the risk of a bad fall to the patient’s family. I told them to modify the minor things at home, which can lead them to fall badly. If they do not take care of this minor modification, it can affect the patient’s health as well as their health (Kaufman, and McCaughan, 2013).

The basic of the nursing is patient centric. For patient centric care, the nurses have to include the patient and the family of the patient into the whole curriculum of nursing strategy (Kuo et al, 2012). The RCN/NMC principle D states that to give the patient the best possible care, it is important to keep the patient at the center and then the families, the caregivers, and the service users in the planning (Foulds, Timms, Barwell, and Gunning, 2015). In the above-mentioned case, I chose to involve the family of the patient to the care. The patient’s family was also supportive about this. The patient’s son was alert about the basic hygiene after that incident. They also learned how to dress the wound properly (Messano, 2013). I also taught them the procedure of undressing the wound without touching it. They also learnt the proper procedure of cleaning a surgery wound (Groves, 2014).

In my brief nursing career, I have seen many cases, in which the patient and the family are ignored about the choice of the care procedure. I feel which is wrong. They should be treated as a different individual and they have the basic right to choose what is based for the patient. The basic of the patient-centric care is to involve all of the members of the care team, which includes the nurses, doctors and the patient along with the family members on board for making the right decision. Involvement of all is needed for understanding what is best for the patient.

Action Plan:

In near future, I would never talk to the patient and the family of the patient in ill manner. The incident was purely accidental and it the patient’s wife did it unknowingly as she is herself suffering from the disease. I could have acted patiently with her. As a nurse, I have to keep my calm during my duty hours. I also have to be careful about mitigating the risk of the clinic for the welfare of all the patients (Warren, 2012).

Conclusion:

While looking at the nursing principle C and D, I think I breached it without realizing it that time. I think that I could have acted sooner to prevent the main incident. Now I think that, I should not have left the patient alone during the care. Whilst, my supervisor was not present at the situation, I should have been present there. Now I can see that, I put the patient at risk by leaving him alone. As a nurse, I was supposed to think that leaving him alone could put him at risk. Now I promised myself that I would never leave a patient like that alone and always look for the hygiene of the fellow people. I would also always involve the patient’s family in the care giving process. It was my duty to involve them in the process sooner, but I also failed to do that. I talked to my mentor about this and think that with her help, I can plan out a few strategies to make sure that I follow this principles for the next time.

References:

Abraham, M. and Moretz, J.G., 2012. Implementing patient-and family-centered care: part I-understanding the challenges. Pediatric Nursing, 38(1), p.44.

Card, A.J., Ward, J.R. and Clarkson, P.J., 2012. Getting to Zero: Evidence?based healthcare risk management is key. Journal of Healthcare Risk Management, 32(2), pp.20-27.

Casey, A. and Wallis, A., 2011. Effective communication: principle of nursing practice E. Nursing standard, 25(32), pp.35-37.

Chadwick, A., 2012. A dignified approach to improving the patient experience: Promoting privacy, dignity and respect through collaborative training. Nurse Education in Practice, 12(4), pp.187-191.

Duke, N., 2012. Exploring advanced nursing practice: past, present and future. British Journal of Nursing, 21(17).

Foulds, L., Timms, K., Barwell, J. and Gunning, A., 2015. Incorporating the Principles of Nursing Practice and the 6Cs. British Journal of Nursing, 24.

Gastmans, C., 2013. Dignity-enhancing nursing care: a foundational ethical framework. Nursing ethics, 20(2), pp.142-149.

Giltinane, C.L., 2013. Leadership styles and theories. Nursing Standard, 27(41), pp.35-39.

Good, L. and Officer, C., 2012. Developing the culture of compassionate care: Creating a new vision for nurses, midwives and care-givers.

Groves, W., 2014. Professional practice skills for nurses. Nursing standard, 29(1), pp.51-59.

Holt, J. and Convey, H., 2012. Ethical practice in nursing care. Nursing Standard, 27(13), pp.51-58.

Ingram, P. and Lavery, I., 2005. Peripheral intravenous therapy: key risks and implications for practice. Nursing Standard, 19(46), pp.55-64.

Kaufman, G. and McCaughan, D., 2013. The effect of organisational culture on patient safety. Nursing Standard, 27(43), pp.50-56.

Kuo, D.Z., Houtrow, A.J., Arango, P., Kuhlthau, K.A., Simmons, J.M. and Neff, J.M., 2012. Family-centered care: current applications and future directions in pediatric health care. Maternal and child health journal, 16(2), pp.297-305.

Lambert, K.M., Barry, P. and Stokes, G., 2012. Risk management and legal issues with the use of social media in the healthcare setting. Journal of Healthcare Risk Management, 31(4), pp.41-47.

Lin, Y.P., Watson, R. and Tsai, Y.F., 2013. Dignity in care in the clinical setting: A narrative review. Nursing Ethics, 20(2), pp.168-177.

Messano, G.A., De Bono, V., Di Folco, F. and Marsella, L.T., 2013. Past and present of risk management in healthcare. Igiene e sanita pubblica, 70(4), pp.423-430.

Oosterveld-Vlug, M.G., Pasman, H.R.W., van Gennip, I.E., Willems, D.L. and Onwuteaka-Philipsen, B.D., 2013. Nursing home staff’s views on residents’ dignity: a qualitative interview study. BMC health services research, 13(1), p.353.

Sabatino, L., Stievano, A., Rocco, G., Kallio, H., Pietila, A.M. and Kangasniemi, M.K., 2014. The dignity of the nursing profession: a meta-synthesis of qualitative research. Nursing ethics, 21(6), pp.659-672.

Warren, N., 2012. Involving patient and family advisors in the patient and family-centered care model. Medsurg Nursing, 21(4), p.233.