Nursing And Its Professional Guidelines: Ethical Implications For Depression And Suicidal Tendencies In Nurses

Depression in Nursing Profession

Question:

Discuss about the Nursing and Its Professional Guidelines.

Nursing is all about delivering treatment and care for individual, and beyond this it is related to care for family and community irrespective of sex, age, race, language and culture. This professional has to maintain a code of ethics and professional conduct while ensuring the quality of care delivered by them (Grace, 2017). However, nurses sometimes might face occupational hazards like depression or anxiety.   

Unfortunately, the rate of depressive symptoms is almost double among nurses than the general population. However, the nurses study about maintaining their health in their training courses, but often they are unable to identify the symptoms occurring to them and eventually this may lead to suicide (Mikkonen, Kyngäs & Kääriäinen 2015). It seems that mental illness like depression and other related symptoms is a subject of shame for nurses as they treat patients to recover from illness and by not addressing this, it could directly affect the profession and work, which they deliver (Parahoo, 2014).   

In this case-based study as one nurse is showing the symptoms of depression and suicidal tendency, there is a question of responsibility from witnessing nurse within the code of profession and ethical implications relating to this (McCarthy & Gastmans, 2015). Analyzing the case study situation and making appropriate recommendation, this essay will address the co-nurse’s immediate action and responsibility, the way the depression affects on the work, the reasons for fitting this situation in the sections of the Australian Registered Nurse Standards for Practice and the possible ethical connection in this context (Vynckier et al., 2015).   

Depression is very common and extensive in nursing. Here, in this case study a nurse is continually showing symptoms of depression and has spoken of thinking about suicide. This situation should accept as a normal situation, a nurse who treats people could fall sick, physically or mentally. The main cause inherent in this case has implanted mostly on the job-related hazards and the shortage of the number of nurses globally and locally (Jahanpour et. al, 2014). The effect of depression in the nursing profession could lead to hazards in the workflow. The depressive nurse could be less motivated in her work and the depression could affect her work in a large extent. The profession seems to be challenging for nurse who is suffering in depression as in this profession one has to handle many responsibilities. This profession is related to life care services. The well-being and positive attitudes of the nurses and healthcare professionals helps the patients effectively to recover from illness. However, if a nurse constantly poses depressive attitudes it would definitely affect the mental conditions of the patients, which eventually influence his physical health, as it is known that recovery depends upon the mental health too. The depressive symptoms and attitudes of the nursing professionals could make her forget about the schedules of applied medication for the patients, as one of the major characteristics of depression is anxiety. The night shift seems to be very difficult for them who suffer in depression, as sleep disorder is the common outcome of depression. Even the depressive nurse cannot provide full concentration on her work and any kind of damage or accident could happen in her working environment (Stuart, 2014). The life is on the hand of nurses. The depression leads to discouragement in the nursing profession and other nurses could easily be influenced by it. However, as the depression rate is very high among nurse, the influencing factors could normally affect the others. The nurse suffering from depression could show any kind of disability in her profession. It might that she could not handle the stressful condition, which is very common in the profession. The depressive nurse could lose the productivity of her work and that will directly affect the care and service, which she expects to provide. It is shown in the study that there is also a high rate of occupational burnout among nurses, almost 18%, which also increases the rate of depression (Simmonds, 2013).

Responsibility of Witnessing Nurse

The nurse suffering in the case study is affected by occupational stress. There is a high chance that her reason of depression is related to her job. This happened for most of the nurses or else she has other personal reasons or may be both, which continually dragging her to the mental illness like depression and suicidal tendencies. If a colleague nurse shows the symptoms of depression and mentions thinking about suicide to a co-nurse, the immediate action of the witnessing nurse is to make her convinced for consulting a mental healthcare professional and take actions accordingly. It is part of responsibility of the witnessing nurse to pay attention to other co-nurses problems and offer help (Simmonds, 2013). The witnessing nurse even helps the sufferer to identify the factors behind her depression by providing her proper counseling and medical help. If her reason of depression has been evolved from her occupational hazards, the witnessing nurse should suggest her to undertake some stress management program if offered by the hospital or any private institution. Otherwise, the depression could directly affect the quality of care-centric service and the capacities of practice of the job. It is the responsibility of the witnessing nurse to provide relevant information and way out regarding depression to the co-nurse (Masters, 2015). Otherwise, the depression could damage the work of a nursing professional and it would affect the working environment where depressed nurse and witnessing nurse both are involved.

According to the Registered Nurse Standards for Practice in Australia, the registered nurses are bound to provide clinical care to any health related disability to any individual, family, group, community, co-workers and other healthcare professional (O’connell, Gardner & Coyer, 2014). This can be both physical and mental. In this particular case, as the witnessing nurse is observing the symptoms of depression to a co-nurse, the witnessing nurse has the responsibility to respond to the problem. Nursing is not only about providing treatment to the patients who has come to a health care; rather it is also caring for the co-workers. The purpose of this standard is that. It communicates the realm of nursing exercise within and outside the profession. Even it is published more importantly for the overall benefit of the Australian community, which consists of diverse range of culture and language groups (Cashin et. al, 2015). As the Australian Government is highly interested to provide health care service to every individual in Australia irrespective of economy, culture, gender or language, the standards are composed like that. It aimed at the wellbeing of multicultural population of the country. If the witnessing nurse guides the co-nurse to overcome depression instead of overlooking the matter, it will contribute to the community’s welfare. The standards for practice admit and communicate it to the nurse, which is followed strictly in Australia (Jeffery et. al, 2014).

Australian Registered Nurse Standards for Practice

Specifically, in Standard 3, titled as Maintains the Capacity for Practice, states that the responsibility of a registered nurse is to ensure her safety and the proficiency for practice first and then respond when there is necessity for concern about the capability of practice of other healthcare professionals (Ossenberg, Henderson & Dalton, 2015).

Registered nurse should contribute to the professional development of herself as well as the growth of others. They not only look after her health and professional progress, but also contemplate and reciprocate the same for the other professionals in practice (Nursingmidwiferyboard.gov.au, 2017). Therefore, in this case, as the witnessing nurse is observing the chance of incapability of practice in a co-nurse due to depression and other fatal tendencies and which ultimately affects the job role of the nurse, the witnessing nurse should look into the matter with great concern (Cashin et. al, 2017). As the depression and related problems could affect the work of a nursing professional and cause great barrier to the development in her profession, it is a serious matter of concern.

The reason for choosing this specific standard in this context is particular to the situation. The immediate action of the witnessing nurse has to respond to another co-nurse’s problem and provide necessary information about mental health issue to the sufferer. If the witnessing nurse responds to the specific problem of the colleague nurse, it will enhance the capacity of the work delivered and patient care and that ultimately help the wellbeing of the Australian community (O’connell, Gardner & Coyer, 2014).    

Nurses have to face a number of ethical issues in their service. In the present case study, the nurse was faced with the ethical challenge of whether to inform other members of the team. Depression is an under-rated disease. The nurse should deal with care with such patient. It is the ethical duty of a nurse to think about the well-being of the people both physically and psychologically (Cashin et. al, 2017).  However, it is also the duty of a nurse to inform the senior doctors about the condition of the patient. Nurse faces with the ethical dilemma of obtaining consent from the sufferer nurse. Mostly, the sufferer nurse feels hesitant to inform others about the condition (Nursingmidwiferyboard.gov.au, 2017).

Another ethical implication is that the sufferer nurse should be careful about his own well-being. In the nursing training, there is a section where the mental health issues are addressed, however, the sufferer nurse could forget about this and is unable to identify this. Even she could be shy as people facing such issues are looked down with contempt and are not accepted by the society. The sufferer nurses might not want to acknowledge the fact that she is suffering from depression (Kleinpell et. al, 2014). The sufferer nurse should be aware of her health as she is responsible to work in a healthcare centre and provide treatment of illness to the other. As long as she would be unaware of her mental health condition, she projects an unethical notion in her profession (Nursingmidwiferyboard.gov.au, 2017).

Ethical Implications

It can be concluded that the standard for practice in Australian nursing system is built in the context of multicultural society and it promises to deliver the health care to the every individual of the Australian community. A nurse should take care for other nurses along with the patients in the community and as well as her own health condition. It is like self-help and providing help to others as well. In this case, the sufferer nurse, who provides treatment to the other patient, is suffering from an illness. This matter should not be overlooked. It is the duty of the witnessing nurse to observe the fact and take actions immediately as this is the responsibility of every nurse (Kleinpell et. al, 2014).

The standard will help the working professional to develop a healthier society. Therefore, every individual in the profession should contribute by doing her job perfectly. Therefore, the nurse who is showing the symptoms of depression and has talked about the suicide should be treated as a helpless patient. The responsibility of the witnessing nurse is to acknowledge the fact and treat her accordingly. The standard for practice has been developed by stating that. It will base on the care for individual nurse and co-nurses. By giving help to the co-nurse, the witnessing nurse contributes to the Australian society as well.

References:

Cashin, A., Buckley, T., Donoghue, J., Heartfield, M., Bryce, J., Cox, D., … & Dunn, S. V. (2015). Development of the nurse practitioner standards for practice Australia. Policy, Politics, & Nursing Practice, 16(1-2), 27-37.

Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Cox, D., … & Fisher, M. (2017). Standards for practice for registered nurses in Australia. Collegian, 24(3), 255-266.

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

Jahanpour, F., Khalili, A., Pouladi, S., Zoladl, M., & Dehghanian, H. (2014). Construction and evaluation of nursing ethics questionnaire.

Jeffery, C. A., Mitchell, M. L., Henderson, A., Lenthall, S., Knight, S., Glover, P., … & Groves, M. (2014). The value of best-practice guidelines for OSCEs in a postgraduate program in an Australian remote area setting. Rural and remote health, 14(3), 2469-1.

Kleinpell, R., Scanlon, A., Hibbert, D., Ganz, F., East, L., Fraser, D., … & Beauchesne, M. (2014). Addressing issues impacting advanced nursing practice worldwide. OJIN: Online J Issues Nurs, 19(2), 5.

 Masters, K. (2015). Role development in professional nursing practice. Jones & Bartlett Publishers.

McCarthy, J., & Gastmans, C. (2015). Moral distress: A review of the argument-based nursing ethics literature. Nursing Ethics, 22(1), 131-152.

Mikkonen, K., Kyngäs, H., & Kääriäinen, M. (2015). Nursing students’ experiences of the empathy of their teachers: a qualitative study. Advances in Health Sciences Education, 20(3), 669-682.

Nursingmidwiferyboard.gov.au. (2017). Nursing and Midwifery Board of Australia – Registered nurse standards for practice. Nursingmidwiferyboard.gov.au. Retrieved 23 August 2017, from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

O’connell, J., Gardner, G., & Coyer, F. (2014). Beyond competencies: using a capability framework in developing practice standards for advanced practice nursing. Journal of advanced nursing, 70(12), 2728-2735.

Ossenberg, C., Henderson, A., & Dalton, M. (2015). Determining attainment of nursing standards: The use of behavioural cues to enhance clarity and transparency in student clinical assessment. Nurse education today, 35(1), 12-15.

Parahoo, K. (2014). Nursing research: principles, process and issues. Palgrave Macmillan.

Simmonds, A. (2013). Nursing ethics in everyday practice.

Stuart, G. W. (2014). Principles and Practice of Psychiatric Nursing-E-Book. Elsevier Health Sciences.

Vynckier, T., Gastmans, C., Cannaerts, N., & de Casterlé, B. D. (2015). Effectiveness of ethics education as perceived by nursing students: Development and testing of a novel assessment instrument. Nursing ethics, 22(3), 287-306.