The The results of the Gallup’s Annual Honesty and Ethical Standards poll (DEC20, 2016) showed that nursing the most trusted profession for the 15th year all way. Trust is a firm belief, of the character, strength or truth of someone of something according to Merriam-Webster (1828). For a person to be trusted by anyone, he must have portrayed a particular character, trait, or individual strength. The character is also built on some personal characteristics or principles governing your way of reasoning or responding to the situation (Johnstone, 2016). We can also deduce from that poll, that for the nursing profession to be ranked as the most trusted profession, it had achieved quite a milestone in its service delivery. This might have been achieved by acting in a particular manner and been guided by a certain set of standards and principles governing the code of conduct and the provision of services regulatory frameworks. Therefore this essay examines the relevance of two guiding documents produced by the board of nursing and midwifery of Australia in clinical practice. These materials include the code of ethics for nurses in Australia (2008) and the professional boundaries (2010) nurses’ guide. The essay will also seek to address the relevance of these documents in clinical practice.
Code of ethics can be defined as a statement of binding principles supported by explanations and position papers according to Gormley (2015). Therefore, the code of ethics for nurses refers to a statement of binding principles which have been developed to provide a framework for accountability among health care professions and promote responsible practices by nurses in all clinical, educational, research and managerial areas related to health care. They outline the commitment of the nursing practitioners to promote respect while protecting and upholding the fundamental rights of both the users and the nursing health care providers. And therefore these code of ethics act as competency standards for nurses practitioners.
The Nursing and Midwifery Board of Australia (NMBA) has developed the codes of ethics governing the practice of health care professionals about health care provision. The first code of ethics developed stated that, nurse’s value quality nursing care for all people (Holt & Convey, 2012). In assessing the quality of nursing, it implies that the nurses will take full responsibility and accountability for the standards of health care they provide and also help in the promotion of the standards of nursing care. Therefore, it will be helpful in ensuring that the interest of recipient of the health care is taken care of or considered. It will also guide the relationship with fellow colleagues by making sure that unethical behaviors from their members are reported and support those who comply with the set standards.
The second code of ethics developed stated that nurses value, respect, and kindness for individual and others help in assessing the moral value and dignity of an individual and others (Korhonen, 2015). Therefore this is important in that it will promote the virtue of self-worth especially by respecting colleagues, respecting you, the patients or recipients of health care and the community as a whole. It takes into consideration the communities standards and values they uphold about health care provision. Kindness on the other side ensures that your activities are done with gentleness, care, and consideration.
Thirdly, as provided in the code of ethics, nurse value the diversity of people. According to Gormley (2015), it is important as it contributes significantly to understanding different cultural backgrounds and languages of an individual. It will also help in understanding and appreciate the cultural similarities and differences, and therefore it is important for the nurses to develop cultural knowledge and awareness. For this will enable the evaluation and better understanding and effective response to the concerns of recipients of health care and those of the people in their care during that health encounter.
Gardener (2016) also denotes that nurses value informed decision-making as this provides a platform for one to express their interests towards an inevitable issue of concern during the health encounter. In so doing, one can also value the moral right of an individual as found in the human rights. It is also helpful in respecting the rights of his or her colleagues. It enables the health care providers to value the contribution of the community to health care decision making. The health care providers will hence be in a position to advise the community on any impending health issues.
Lastly, it is an ethical code that nurses value ethical management of information as denoted by Henderson and Dahnke (2015). It is essential as it enables the health practitioner in the medical career to operate under the nursing obligations and set principles. For instance, it helps in keeping medical records and documents as any alteration to them may have significant health implications. Therefore, professionalism should be demonstrated while capturing or recording of health data or information.
This document was developed in Australia and New Zealand as a complimentary text to that of nurses’ code of ethics and that of nurses’ code of ethics. It, therefore, refers to minimum standards that nurses need to uphold internally and externally within the professional domains in ensuring good standing of the profession (Australia and New Zealand: 2010). Korhonen (2015) denotes that these boundaries act as a mechanism to control the behavior of health care providers about set the ethical standards. For instance, the nurse’s behavior should be consistent within the codes of professional conduct and ethics. It should also meet a clearly identified therapeutic need for the person requiring care. Also, it should be within the scope of practice of the nurse and hence will help the nurse to be competent enough to perform certain tasks.
As per the NCSBN, professional boundaries are the gaps between the nurse’s power and the patient’s vulnerability. Therefore it calls for nurses to respect power imbalances and promote or ensure a patient-centered relationship. Any violation of the boundaries bears some consequences or implications to either the nurse or the recipient of health care in one way or the other (Paschke, 2017).The conventional professional boundaries in nursing professional include; border crossing, boundary violations, sexual misconduct or the use of media to make comments on any incident of health concern (Gardner, 2016). In this case, boundary crossing is purposeful, and it’s allowed for some time while attempting to meet a particular therapeutic need of the patient. Although, any repeated boundary crossing should be avoided.
On the other hand, Henderson and Dahnke (2015) denote that boundary violations may happen when there is confusion or a misunderstanding between the needs of the nurse and those of the patients. For instance, when privacy and secrecy terms are not upheld as agreed. These violations can cause distress to patients, and in most cases, it may not be observed or evident until harmful consequences occur (Korhonen, 2015). Relating to this is the use of social media to comment or post anything during a health encounter without the consent of the recipient of health care. It is also distressing and a breach of professional boundaries.
The other form of a professional boundary is sexual misconduct which falls under the extreme forms of boundary violations (Gardner & McCutcheon, 2015). It is a criminal offense since in this case, sexual misconduct may refer to any seductive behavior, harassing, sexually demeaning or reasonably interpreted as sexual by the patient (Lachman, 2015). It is, therefore, important for the health practitioners, whether in clinical, management, education or research to keep these boundaries in mind. These will ensure that the nurse is working within therapeutic relationship and that they will be aware of any boundary crossing, its implications and avoid repeated border crossings.
Conclusion
From the findings in the research above, health profession is very vital and sensitive. To improve its performance and effectiveness in health care provision, the code of ethics and the guide to professional boundaries must adhere. Both the health care providers and recipients of health care services need have an awareness or knowledge and understanding to the issues raised in either of the documents. And therefore in my opinion as a health student, these two papers will be vital in my clinical practice as they will provide guidelines and directions to the code of conduct, code of ethics and above all professional boundaries. All this will provide a better understanding of the patients’ needs and improve my service delivery. It will also ensure that health profession stands out as the best and as the most trusted profession.
References
Gardner, A. (2016). Experiences of nurse practitioners and medical practitioners working in collaborative practice models in primary healthcare in Australia — a multiple case study using mixed methods. BMC Family Practice, 171-16. doi:10.1186/s12875-016-0503-2
Gardner, A., & McCutcheon, H. (2015). A constructivist grounded theory study of mental health clinicians’ boundary maintenance. Australian Nursing & Midwifery Journal, 23(6), 30-33.
Gormley, E. (2015). A process-based framework to guide nurse practitioners integration into primary healthcare teams: results from a logic analysis. BMC Health Services Research, 15(1), 1-11. doi:10.1186/s12913-015-0731-5
Henderson, M., &Dahnke, M. D. (2015).The Ethical Use of Social Media in Nursing Practice.MEDSURG Nursing, 24(1), 62-64.
Holt, J., & Convey, H. (2012). Ethical practice in nursing care.Nursing Standard, 27(13), 51-56
Johnstone, M. (2016). Key milestones in the operationalisation of professional nursing ethics in Australia: a brief historical overview. Australian Journal Of Advanced Nursing, 33(4), 35-45.
Johnstone, M. (2016). Key milestones in the operationalisation of professional nursing ethics in Australia: a brief historical overview. Australian Journal Of Advanced Nursing, 33(4), 35-45.
Korhonen, A. (2015). Professional ethics in nursing: an integrative review. Journal Of Advanced Nursing, 71(8), 1744-1757. doi:10.1111/jan.12619
Lachman, V. D. (2015). The New ‘Code of Ethics for Nurses with Interpretative Statements’ (2015): Practical Clinical Application, Part II. MEDSURG Nursing, 24(5), 363-368.
Paschke, S. M. (2017). American Academy of Ambulatory Care Nursing Position Paper: The Role of the Registered Nurse in Ambulatory Care. Nursing Economic$, 35(1), 39-47.
Pratt, D. (2015). Advanced skills for enrolled nurses: a developing classification. Australian Journal Of Advanced Nursing, 32(4), 40-46.
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