This week I spent time at Kings College hospital in order to understand the ethical considerations of a nurse’s job. “As a nurse at Kings College Hospital you have to take into account Ethical Considerations…”in my interview with Sister Malcolm we will be discussing ethical considerations like right to life, social justice, person-centred approach, the expectations of individuals receiving the service, empathy, honesty and adherence to codes of practice and policies and seeing how they impact her job.
Right to life means the right to live, as a nurse right to life means preserving some one’s life for as long as possible even if they want to die. For example, all nurses and doctors at Kings College hospital should do everything they can to keep a person alive if it’s possible. But things like a ‘DNR’ (do not resuscitate) form make it impossible for a doctor to save someone’s life No doctors would help a person die because it is illegal to have euthanasia in the UK. Some people who wish to end their lives have gone to Switzerland to end their lives in utter peace.
A person-centred approach means an approach to assessment of need that puts the individual at the centre of the process and is based on their views and wishes. For me as a nurse a person-centred approach or as we say ‘patient-centred approach’ means making sure my patient comes first, that they are comfortable system that creates a fair, honest and equal society. As a nurse this means treating all your patients equally as well as colleagues no matter of their ethnicity, religion or culture. For example all patients are included in decisions about their health, such as which hospital they receive their treatment at.
Empathy is the ability to understand and share the feelings of another, in my line of work we have to be sympathetic and have empathy towards all our patients no matter our opinion on the situation, whilst being empathetic. At King’s College Hospital the staff must remain professional at all times but they say that it’s hard not to empathise with some patients especially when you see that they are distressed and don’t know how to deal with a situation.
Honesty means the quality of being honest this means at every point and aspect of my job I have to be honest. Doctors have to be completely honest with all their patients as not giving them all the information could put them in danger they have to tell them what the problem is exactly and explain it and they have to inform them of what treatments are available.
Adherence to codes of practice and policies this is the foundation of nursing, they are the rules we abide by in order to keep ourselves and our patients safe, this is called safeguarding, the codes of practice are; make your patients your first concern/priority, provide a high standard of practice and care at all times and you must be accountable for your actions, these are the key tools in my profession if I couldn’t abide by these rules then there would be no hope for me.
The expectations of individuals receiving the service these are the expectations of which the service provider should deliver as a service user to be treated with respect, to be treated as an individual, to not be discriminated against, to be allowed access to information about themselves, to be able to communicate using their preferred method of communication and language, cared for in a way that meets their needs and takes into account their personal choices.
However all patients need to be treated as an individual. This means that they want to be treated as a person and have their needs seen to and not feel like their part of a mass operation, and that their needs aren’t being met. For example making sure a patient receives a meal option suited to their diet. For instance if their vegetarian they are given a vegetarian option.
At Kings College Hospital, all service users are allowed to access information about themselves. The Freedom of Information Act states that all patients are allowed access to their personal health records. For example, if a service user is applying for a job, their GP may be asked to provide details to their new employers to see if they are eligible for the job.
All patients are entitled to privacy this is to ensure that they are comfortable at all times, for example if the patient has to change into a gown for examination the nurse/doctor should leave the room to so to protect both the patient and the nurse/doctor, this is also a sign of respect for the patient and it makes them feel like their needs are being met.
Communication is another key point between the service user and the service provider patients should be communicated with in their preferred language this will make sure everything runs smoothly and for example if you had someone come in that was hearing-impaired then there should be someone on hand that can sign this make the service user feel like he/she is being cared for and that they have equal opportunities.
Both service users and service providers have the right to be in a safe environment and to be protected from any harm; this means that King’s College have an enforced health and safety policy. This outlines the rules and regulations, and the actions that need to be taken if there is an accident.
At Kings College hospital support in a way that meets their needs and takes account of their choices is when the service user has enough confidence to express their feelings or share information with the service provider. It is important for service providers to provide active support to help people communicate what their needs are. In order to overcome this, they could provide a questionnaire, for the patient to fill out and give feedback about how the service/treatment they received was and if they received the amount of care that they needed.
At Kings College they believe that all patients have the right to be treated in a dignified way this is because they have the right to feel respected and taken care of, if they feel disrespected or vulnerable then they may not want to open up about their medical problem and this may stop them from receiving the treatment that they need.
Disclosure is the passing of information between healthcare professionals, for example your GP passing on information to your hospital doctor so they can give you the right treatment. However if the patient disagrees with this and the nurse still shares the patients information, this is known as breaching confidentiality. This can have a negative impact on not only the service provider but the health care service as a whole. For example as a precaution GP’s are no longer a loud to leave messages on your phone regarding your health.
Confidentiality is keeping information private and not disclosing it to anyone else apart from those involved in the patients care. It is key when working with service users within the health and social care sector. However if the doctor/nurse gives out private information about the patient, then there will be serious consequences. This refers to The Requirements of the Freedom of Information Act. This is a legislation that patients have the right to look at information about their selves. Another part of confidentiality is If a person comes to the hospital with bruises and marks on their skin, then the service provider knows that their something wrong. However if the service user tells the nurse/doctor what has been happening and they say that the service provider shouldn’t tell, they will need to tell social services and this can cause tension between rights of patients and the responsibilities of the service provider.
Information of patients is kept on computers as well as on paperwork and files. Whichever way the information is stored, it needs to be stored in a safe place, where no one has access to it, that way it remains confidential. They need to make sure that the file can be retrieved when needed.
The use of communication to support diversity, inclusion and promote equality of opportunity is important when working in a hospital; this allows the hospital to accommodate for people of all ethnicities, ages, sex etc… this could be posters and signs in different languages to providing food to cater for vegans. This promotes equality amongst the service users because they feel like their individual preferences and needs are being met.
The requirements of the Data Protection Act 1998 that all information is securely kept so that that only those that need to access it can because otherwise it would conflict with the requirements of the Freedom of Information Act 2005 this is the freedom for service users to have access to their medical notes if requested at any time, they cannot be withheld.
Dealing with tensions between rights and responsibilities is a tough decision to be made by a medical professional; because if a patient comes into the hospital with bruises and tells you that they are being abused and they ask you to keep it a secret then as their healthcare provider you cannot do this even though it’s a breach of patient doctor confidentiality but as a healthcare provider you have to inform the correct authorities so they can take action and this can cause tension between rights and responsibilities.
The Importance of accurate recording, storage and retrieval of information (including electronic methods), filing correctly and securely is important in the healthcare service because this is confidential information about individuals, and they have entrusted you with this information, so it should be stored in safe place and be able to be accessed easily by the right individuals if needed. These documents should be filled in a secure facility preferably in more than one place so that if one set is destroyed there is another. It is Important that workers make sure they make accurate recordings and Information on patients is kept on computers as well as on paperwork and files.
Provision of active support to enable people who use services to communicate their needs, views and preferences away in which the patient can put their views across is buy putting suggestions in a suggestion box, filling out a questionnaire or posting a complaint if the problem is serious and needs to be dealt with straight away, and offer a resolution for the problem. The hospital will promote equality of opportunity. This means they give everyone the opportunity to voice their opinions in hospitals they have posters and leaflets all around the building in many different languages.
Another part of being a nurse means respecting, and treating patients equally and not being discriminated against this is important because we want patients to feel comfortable and like they trust the nurses and doctors who are caring for them, all patients no matter the gender, sexuality, race etc… will be treated equally and receive the same care and support.
Courtney from Study Moose
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