Patient Safety, Ethical And Legal Dilemmas, And Self-Care: A Discussion

Patient Safety and Emotional/Mental Safety

Module 1

Patient safety is a complete term which means protection of patient from all kinds of adverse effects that they may have to face during their healthcare-related procedures after admission in a healthcare organization. Safety of the patient in every aspect is the foremost thing that every hospital and healthcare organization aims to provide at its best. In today’s time patient and its family keep the safety at first before taking treatment from any healthcare centre. It may be physical or mental. Physical patient safety includes to protect patients from every kind of cross infections, microbial attacking and others. However, the patient’s mental safety includes providing an emotionally safe environment for the patients in their post-admission period (Huang et al., 2018). Lack of this emotional safety may lead the patients to indulging themselves in suicidal activities or making self-harmful activities. In medical and nursing practices, till now the emotional safety of patients is an area neglected the most. This has led to many cases where a patient’s health deteriorate and results in not a speedy recovery. Country likeAustraliais are facing a challenge for providing the hospital and medical organizations with the nurses who are certified by National Nursing Industry and have adequate knowledge about providing emotional, mental safety to their patients (Grace & DRN, 2017).

Australian Institute of Health and Welfare has included the protection system as one of the most crucial responsibilities of nurses. All of the professionals in this field are now bound to find out all the likely sources of stress depression of the patients and make patients ready to cope up with these problems (Congress, 2017). As a result of these activities, all the nurses have to deal with withunhealthy and stressful lifestyle. It leads them towards psychological illness, sleeping disorders, digestion problems, and many others physic-mental problems. Due to their own mental and physical problems, nurses lose their patience level towards their patients and do not listen to patients problems (Krautscheid, 2017). It creates a severe problem in the nursing profession of nurses. It is another leading cause of the high rate of suicide or mortality among the nurses of Australia. At the same time, the turnover rate of nurses in Australia is decreasing due to which all the medical health organizations are facing a crucial problem (Lim, Bogossian, & Ahern, 2010). Overload in the work pressure is the primary source in this case. As a result, nurses cannot provide personal cares to all of the patients. To mitigate this significant issue in medical organizations, it is highly crucial to implement legal policies in healthcare organizations(Storaker, Nåden, & Sæteren,2017).In this aspect, in the review based articles of reference provides the best way to mitigate such kinds of stresses. It includes the removal of stresses by lessening the conflictions of internal and external demands (Span-Sluyter, Lavrijsen, van Leeuwen, & Koopmans, 2018).

Ethical and Legal Dilemmas in Nursing

 It needs the cognitive and behavioral efforts to make self-esteem among all the nurses. It will provide the definite way where nurses will be able to bear out, or to reduce or to remove their conflictions (Huang et al., 2018).

In a summative manner, it can be said that, nurses of Australian countries are facing a significant problem due to their tremendous work pressure and others. In this assignment, “Stress and coping in Australian nurses: a systematic review.”The article is selected to get all of this information. Among all of the ideas to cope up with these problems the most crucial one is the avoidance of exhausting situations(McBride, Tietze, Robichaux, Stokes, & Weber, 2018). It will positively help the nursing professionals to be aware of possible areas of crisis, develop self-esteem to avoid all of these issues.

Module 2

In this module, the basic discussed theme is the ethical dilemma versus legal dilemma in the nursing profession, where context is taken from Australian countries. In the overloaded situation, nurses have to take enormous decisions where they have to go through a great confliction between the nursing ethics along with the legal code of conducts (Davidson et al.,2018). Such situations happened mainly due to informed consent related grounds, the disclosure of different types of medical conditions along with enhancing incompetence among other colleagues or peers and some other broader issues related with nursing professions. In cases of informed consent, it is observed in a high rate that, all time it becomes impossible to tell every step of the treatment to the patient’s family members. As a result, after the operation or any clinical treatment steps whenever patients have to meet with unexpected outcomes, the nurses are blamed for the grounds of informed consent (Lokker et al., 2018).

On the other hand, late in performing any special treatment may lead the patients towards mental or physical harms. In these situations, nurses become bound to take their own decisions (Sari, Baysal, Celik, & Eser, 2018). Another sort of dilemma occurred when family members of the patients ordered nurses not to tell the physical condition of a patient. According to the Australian Medical caregiving system, patients have legal rights to know about their treatment procedures, physical diagnosis, and its outcomes. In this time, nurses are facing the great dilemma where legal rule permits to tell he patients about his physical condition or diseases, but nursing ethics permits nurses not to tell patients because such information may lead them to the fearful situations, suicidal tendencies or self-harm related activities (Congress,2017). In this period, nurse’s crucial principles of fidelity along with non-malfeasance become active to come over this situation. Sometimes, insufficient infrastructure or incompetence team members create a great hindrance in the performance of a nurse. As a result, after knowing the adverse effects of wrongdoings of a team member, the user has to tolerate it silently (Sharpe , Hall, Ochije, &  Bailey, 2018). Though it is illegal from the ethical point of view, it is very much confliction creating one ((Gifkins, Loudoun, & Johnston, 2017). 

The Importance of Self-Care in Maintaining a Positive Attitude

In this discussion and research on the nursing practice based ethical dilemma and legal dilemma, it is found to be present in large web-based reports, articles and secondary information sources that, non-malfeasance and fidelity maintenance is very crucial because from this point the confliction between ethical and legal dilemma start (Jalal, Imran, Mashood, & Younis, 2018).

In this point of time, nurses take their own decisions about their activities and stay neutral to the situations. It means answering only the questions arisen generally in the course of time without making any delay (Gifkins et al., 2017). It helps them to avoid some unwanted discussion also. It is an enormous pressure creating the thing in the work g life of nurses, mainly in Australia. Quality care of nurses and medical service providers includes all of these activities, but sometimes it becomes not possible for the nurses also to adhere with the legal firewalls of professions due to their ethical considerations of nursing practices. In this aspect, it is highly crucial to maintaining the ethical working environment in the medical organizations, providing training to the nursing professions about the social justices and their activities related legal activities (Jalal et al., 2018).

In this way, nurses will be able to mitigate their mental issues along with patients. Although avoiding the situation is not the permanent resolution for nurses but at the great extinct it can help nurses to keep their health and mind in the good state. To make this a good practice different shift timing can play a role as after short time interval nurses will be changed.

Conclusion

It can be concluded from the above discussion that before expecting quality care from nurses it is highly crucial to give them a quality social life. It will take help them in decision making and quality care providing activities in a definite manner. In short, if nurses are good and well satisfied then only they will be good for their patients. Nurses should not be self-centered, they should keep their patient at first place and should sometime act like family members for the patient and should provide mental and physical support to them when needed.

Module 3

Reporting of the case study:	The accident has led her to suffer from 14 broken bones, a severe traumatic brain injury, losing of nine teeth in front and has difficulty in seeing well. The brain injury had also put her in 3 rated coma. The recovery process from the suffering that she went through has allowed me to understand the importance of self-care and maintaining a positive attitude towards life.	The given article that represents Maggie’s incredible way of getting over with the chronic illness she had been suffering through the past few years due to the fatal accident that occurred. Being in the nursing profession, I have been able to note Maggie’s situation after her accident was very crucial that required total care for her from her near and dear ones and respect from them. Even though has been criticized stating the fact that she will not be able to overcome her injuries completely and she will not be hundred percent better, she did not lose hope and her family and spouse has been a major support throughout (Butterfield & Martin, 2016).
Responding to the incident:	She was a positive affirmative person, which allowed her to gain the never losing hope attitude that helped her to recover from her injuries and leading a normal life today (Murphy, Chuma, Mathews, Steyn & Levitt, 2015).	The stated situation indicated that the emotional upheaval and anger that Maggie was going through has helped her to maintain her positive attitude in order to get quick recovery in her case which was very difficult due to the massive injuries she went through including the head injury.
Relation with the incident	According to my nursing experience, maintaining a positive attitude is highly important in order to gain confidence for the activities that are difficult for any chronic disease patient.	I believe that Maggie has been able to manifest the world around her by using the words that has been spoken by her every day. She has been positive in her terms used leading to a positive attitude towards life and recovery. The situation presented requires high level of positive attitude and re-affirmations from the society to be healthy and fit again (Marcroft, 2018).
Reasoning:	Maggie has been narrating her story in her blog, which has helped her to make effective communication with the society leading to self-improvement in terms of the confidence level she has been gaining day by day to recover completely from her injuries.	According to my nursing knowledge, I have been able to understand that Maggie went through the theory called the Spoon Theory (Liu, Willis, Wu, Shi & Johnson, 2018). This theory is based on the communication that is being carried out between an individual who has been undergoing chronic illness and the other individual who is healthy and does not have any such difficulties.
Reconstruction:	I will ensure that I learn more about the Spoon Theory so that I will be able to help the patients to cope up with their emotional instability and gain confidence for recovery (Tobiano, Bucknall, Marshall, Guinane & Chaboyer, 2016).	The given story has been able to make me understand that maintaining a positive attitude among the patients with chronic illness is highly important so that they are able to gain more confidence in order to recover themselves from the injures or the illness being suffered. I will be allowing my patients to communicate with me in future to talk about their feelings and assure them with positivity for their successful recovery.

References:

Congress, E. P. (2017). What social workers should know about ethics: Understanding and resolving practice dilemmas. Social Work Ethics, 1909.

Davidson, P., Rushton, C. H., Kurtz, M., Wise, B., Jackson, D., Beaman, A., & Broome, M. (2018). A social–ecological framework: A model for addressing ethical practice in nursing. Journal of clinical nursing, 27(5-6), e1233-e1241.

Case Study: Maggie’s Recovery

Gifkins, J., Loudoun, R., & Johnston, A. (2017). Coping strategies and social support needs of experienced and inexperienced nurses performing shiftwork. Journal of Advanced Nursing, 73(12), 3079-3089. 10.1111/jan.13374

Grace, P. J., & DRN, P. (Eds.). (2017). Nursing ethics and professional responsibility in advanced practice. Jones & Bartlett Learning.

Huang, H. L., Yao, C. A., Hu, W. Y., Cheng, S. Y., Hwang, S. J., Chen, C. D., … & Chiu, T. Y. (2018). Prevailing Ethical Dilemmas Encountered by Physicians in Terminal Cancer Care Changed After the Enactment of the Natural Death Act: 15 Years’ Follow-up Survey. Journal of pain and symptom management, 55(3), 843-850.

Jalal, S., Imran, M., Mashood, A., & Younis, M. (2018). Awareness about Knowledge, Attitude, and Practice of Medical Ethics about Patient Care, among Male and Female Physicians Working in a Public Sector Hospital of Karachi, Pakistan-A Cross-Sectional Survey. European Journal of Environment and Public Health, 2(1), 04.

Krautscheid, L. C. (2017). Embedding microethical dilemmas in high-fidelity simulation scenarios: preparing nursing students for ethical practice. Journal of Nursing Education, 56(1), 55-58.

Lim, J., Bogossian, F., & Ahern, K. (2010). Stress and coping in Australian nurses: a systematic review. International Nursing Review, 57(1), 22-31. doi:10.1111/j.1466-7657.2009.00765.x

Lokker, M. E., Swart, S. J., Rietjens, J. A. C., van Zuylen, L., Perez, R. S. G. M., & van der Heide, A. (2018). Palliative sedation and moral distress: A qualitative study of nurses. Applied Nursing Research, 40, 157-161.

McBride, S., Tietze, M., Robichaux, C., Stokes, L., & Weber, E. (2018). Identifying and Addressing Ethical Issues with Use of Electronic Health Records. Online Journal of Issues in Nursing, 23(1).

Sari, D., Baysal, E., Celik, G. G., & Eser, I. (2018). Ethical Decision-Making Levels of Nursing Students. Pakistan Journal of Medical Sciences, 34(3).

Sharpe, D. K., Hall, J. K., Ochije, S., & Bailey, R. K. (2018). Understanding forensic psychiatry in healthcare practices and collaboration between legal nurse consultants and physicians. Medico-Legal Journal, 86(1), 32-35.

Span-Sluyter, C. A., Lavrijsen, J. C., van Leeuwen, E., & Koopmans, R. T. (2018). Moral dilemmas and conflicts concerning patients in a vegetative state/unresponsive wakefulness syndrome: shared or non-shared decision making? A qualitative study of the professional perspective in two moral case deliberations. BMC medical ethics, 19(1), 10.

Storaker, A., Nåden, D., & Sæteren, B. (2017). From extreme busyness to emotional immunization: Nurses’ experiences of ethical challenges. Nursing Ethics, 24(5), 556-568.

Butterfield, A., & Martin, D. (2016). Affective sanctuaries: understanding Maggie’s as therapeutic landscapes. Landscape Research, 41(6), 695-706.

Liu, X. L., Willis, K., Wu, C. J. J., Shi, Y., & Johnson, M. (2018). ‘Better to save one life than build a seven-storied pagoda’: a qualitative study of health education for patients with acute coronary syndrome and type 2 diabetes mellitus in Shanghai, China. BMJ open, 8(8), e019351.

Marcroft, H. L. (2018). Can ‘healing’architectural elements be incorporated into current and future hospitals to create environments that aid recovery and improve patient experience?. Journal of Undergraduate Research at NTU, 1(1), 19-41.

Murphy, K., Chuma, T., Mathews, C., Steyn, K., & Levitt, N. (2015). A qualitative study of the experiences of care and motivation for effective self-management among diabetic and hypertensive patients attending public sector primary health care services in South Africa. BMC health services research, 15(1), 303.

Tobiano, G., Bucknall, T., Marshall, A., Guinane, J., & Chaboyer, W. (2016). Patients’ perceptions of participation in nursing care on medical wards. Scandinavian journal of caring sciences, 30(2), 260-270.