Description of the event:
A patient was admitted to the general ward after he was identified with cardiovascular disorders and poorly managed diabetes type-2 during the time of my placement. After the provision of care, I had to undertake the discharge responsibility of the person as the nursing professional who was attending the patient throughout the care of the patient. While discharging the patient, I was quite distracted as I had to repeatedly visit another patient who was suffering from appendicitis and was having pain due to peritonitis. I had to continuously assess her pain and prepare her for the surgery. Therefore, I tried to quickly complete the discharge procedure. Instead of communicating with the patient and teaching his the modifications in his lifestyle that were important to overcome the risks of the disorders, I handed him a pamphlet. He asked several question but I was in a hurry to attend the patient who had to be taken for surgery and so I stated him to follow the pamphlet as everything was written within it. Later, my mentor stated that the patient had complained stating that I had not discharged him properly and did not answer his questions. He had stated that he had felt humiliated, disrespected and uncared. The mentor was severely upset with my professional conduct.
Feeling:
The entire incident made me very upset. I felt bad that I could not provide the best care to the patient and I could not ensure patient satisfaction. The professional codes of conduct put forward by the NMC, advises nurses to provide care which respects patients’ dignity and autonomy and ensures patient satisfaction (Rowe 2017). I breached a number of professional conduct standards and this made me lose confidence over my skills and knowledge. I was severely embarrassed in front of my mentor as she expected best effort from my side. I lost confidence from my practice as the feeling of guilty was continuously bothering me. However, I did not let it affect me and I decided that I need to be more polished in my professional conduct, take trainings and other initiatives and emerge out as bets nursing professional in the future.
Evaluation:
The bad part of the event was that I could not follow the professional codes of conduct effectively. Studies are of the opinion that every nursing professional need to maintain the professional codes of conduct as they are directly linked with increased patient satisfaction, development of therapeutic relationship and formation of bond based on trust and respect. It also prevents nurses from getting involved in different legal obligation (Oshodi et al. 2017). Effective communication, maintenance of bioethical principles, providing culturally competent care and enhancing the patient’s participation, empowering the patients, marinating professional boundaries are some of the aspects that nurses need to maintain besides clinical expertise (Griffith and Tengnah 2017). In the incident, I neither completed my duty of educating the patient about the lifestyle modifications he needs to undertake for development of his health conditions like diet, exercises, community services, changing of habits, smoking and drinking modifications nor communicated with him properly to resolve his concerns. In that way, I breached the standards and codes of professional conducts that affected the patient’s self esteem and dignity and resulted in poor patient satisfaction. Such practices also increase the chance of readmission of the patient as he was not properly educated about the dos and don’ts important for his health condition (Kennedy et al. 2015). In a way, I did not maintain my responsibilities completely. The only good part was that, this incident helped me realise that I do not have skills and knowledge in maintaining professional conduct and that I need to work on this aspect to develop my expertise and move forward in the career.
Analysis:
By closely analysing this incident, I realised that I had not followed many of the professional codes of conduct that had been provided by the NMC codes of conduct. The first code of conduct states the importance of treating each patient as individuals and upholding their dignity (Nursing and Midwifery Council (Great Britain) 2015). The standard was breached as I could not provide treatment and care, assistance and support as required by the patient during the discharge. Patient education is one of the most important components that ensure safety and prevention of the recurrence of the disorders that the patient was suffering from (Snelling 2017). I could not ensure the best assistance as I did not educate him properly. The second code states the importance of listening to patients and responding to their preferences and concerns. It is important for nurses to listen to concerns of the patient to ensure quality care of the patient and help the patient to lead better quality life and helping them to overcome their confusions (Kangasniemi et al. 2015). I did not listen to the concern of the patient that he had during the discharge time and did not work in partnership with him in supporting his queries and answering them. The third principle is making sure that the physical; social as well as psychosocial needs of the patients are assessed and addressed. Researchers support providing holistic care to the patients ensuring best health outcomes (Bryce et al. 2017). However, I did not allocate any time for such initiatives to the patients and complexity overlooked these professional codes of conduct. Another code of conduct that I also breached is effective communication. It is important for nurses to communicate with patients in ways by which they feel respected, meet up to their health literacy level, utilise proper verbal and non-verbal communications which are respectful and prevent any misunderstanding (Hayes 2017). I did not listened to the patient actively, was fidgety in my approach and did not show empathy and compassion to the patient. This made him feel disrespected and dishonoured making him feel that I was not interested in his care. Therefore, all these codes were breached in the incident.
Conclusion:
From this incident I learnt that I should always ensure that I am following the NMC codes of professional conduct while caring for patients. In my future as well, I might have to tackle many such situations in busy shifts. In such situation, I should critically analyse the situation and take decisions. In this incident, I should have handed either of the cases to another nurse who was free so that each of the patients would have received comprehensive care expected by them. I would provide proper education to the patient while discharging the patient following the professional codes of conduct. This would reduce the chances of patient dissatisfaction and ensure quality and safe care with lessened chances of readmission.
Action plan:
I need to develop more skills and knowledge to follow the professional codes of conduct effectively while caring for patients. Therefore, I would be joining workshops and training sessions where nurse mentors would help me develop such skills and expertise. I would also discuss issues with my mentor so that I can learn from her advice and experiences. I will also undertake reflective practice so that I can learn from my practice. I will also undertake evidence based practice to develop expertise of following professional codes of conduct by NMC.
References:
Bryce, J., Foley, E. and Reeves, J., 2017. Conduct most becoming. Australian Nursing and Midwifery Journal, 25(6), p.25.
Griffith, R. and Tengnah, C., 2017. Law and professional issues in nursing. Learning Matters.
Hayes, J.A., 2017. Values-Based Nursing and Fitness to Practice Issues. In Key Concepts and Issues in Nursing Ethics(pp. 175-189). Springer, Cham.
Kangasniemi, M., Pakkanen, P. and Korhonen, A., 2015. Professional ethics in nursing: an integrative review. Journal of advanced nursing, 71(8), pp.1744-1757.
Kennedy, C., O’reilly, P., Fealy, G., Casey, M., Brady, A.M., McNamara, M., Prizeman, G., Rohde, D. and Hegarty, J., 2015. Comparative analysis of nursing and midwifery regulatory and professional bodies’ scope of practice and associated decision?making frameworks: a discussion paper. Journal of advanced nursing, 71(8), pp.1797-1811.
Nursing and Midwifery Council (Great Britain), 2015. The Code: Professional standards of practice and behaviour for nurses and midwives. NMC.
Oshodi, T.O., Crockett, R., Bruneau, B. and West, E., 2017. The nursing work environment and quality of care: A cross?sectional study using the Essentials of Magnetism II Scale in England. Journal of clinical nursing, 26(17-18), pp.2721-2734.
Rowe, G., 2017. Values And Ethical Frameworks In Health And Social Care. The Handbook for Nurse Associates and Assistant Practitioners, p.20.
Snelling, P.C., 2017. Can the revised UK code direct practice?. Nursing ethics, 24(4), pp.392-407.
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