Nursing is governed by state boards of nursing, specific to the state that the nurse is practicing in. These boards seek to define the scopes of practice particular to a specific set of people, such registered nurses, practical nurses, home health aides, etc. The New Jersey State Board of Nursing dictates things like applications, accreditation, fees, and continuing education requirements. It is regulatory in nature. (NJ Board of Nursing, n.d.)
As a labor and delivery nurse, the professional organization that enhances my practice is AWHONN (Association of Women’s Health, Obstetric, and Neonatal nurses). As opposed to the board of nursing which provides direction to general nursing practices and procedures, AWHONN is specific to my field. It provides current research, education opportunities, and clinical resources. (Awhonn.org, n.d.)
An important aspect in delivering nursing care is the nursing code of ethics. The American Nurses Association (ANA) oversees this code of ethics. There are many ethical implications in nursing care in every specialty. In obstetrics, one of my biggest ethical dilemmas is the subject of abortion. Should a healthcare provider have the right to refuse to take part in any medical procedure? The nursing code of ethics allows health care providers to apply conscientious objection to this situation. Conscientious objection is allowed in situations where the “action would violate some deploy held moral or ethical value about right and wrong (Odell, Abhyankar, Malcom, &Rua, 2014).
Another example of how the code of ethics influences my practice is the protection of the rights of privacy and confidentiality. I am sometimes given information from patients during the admission process that other family members, even the father of the baby, may not know. Things such as previous abortions, sexually transmitted diseases, and number of sexual partners are pertinent in my treatment of the patient, but are often not things that they would like shared with the rest of the family (Code of Ethics for Nurses, 2015).
I believe one of the most important traits a nurse can possess is that of patient advocacy. People are usually at their most vulnerable when they are sick and may not be able to adequately advocate for themselves. Another important traits I would bring to an interdisciplinary team of healthcare providers is respect, respect for the patient and their choices, respect for my colleagues, but especially when I disagree with decisions made by either. Collaboration is also an important trait as a patient’s care is usually multi-disciplinary. Finally, responsibility and accountability are essential traits when part of a team. Team members need to be able to trust the people they are working with. Inevitably, mistakes are made and the true test of a professional is when they are able to own up and take responsibility for their wrongs. Code of Ethics for Nurses, 2015).
There is an element in most nursing theories that influences my practice. Dorothea E. Orem’s self-care theory most resonates with my care of the maternity patient. It encompasses physical, interpersonal, psychological, and social aspects. Since most of the labor patients I take care of are considered “well” patients with insignificant medical issues, most of my time is spent teaching and observing – making sure my patient is able to care for her child once she leaves the hospital. This includes determining not only the physical needs, but also social and psychological well being of mother and father or extended family members involved in the care of the infant.
Another influential figure in women’s health care was Margaret Sanger. She founded an organization called the American Birth Control League, presently known as Planned Parenthood. Sanger was a pioneer in the movement to improve women’s health through birth control and family planning. A controversial move at the time, she distributed pamphlets discussing birth control, menstruation, and sexuality. She was also instrumental in the founding of the first birth control clinic in the United States. Family planning and birth control continue to be extremely important women’s health initiatives (Wikipedia, 2015).
On a daily basis, I strive to create a safe, respectful environment for all of my patients. Beneficence is defined as “the doing of active goodness, kindness, or charity, including all actions intended to benefit others”(beneficence, n.d.) while nonmaleficence is defined as “the ethical principle of doing no harm”(nonmaleficence, n.d.). An example that exemplifies both of these traits is in a recent patient who presented to the hospital for induction of labor. After doing a thorough history of prior pregnancies, I determined the patient had a previous cesarean section.
This information didn’t automatically exclude her from induction but it would dictate what induction method we would use. After further research and a request of records from another institution, it was determined that patient actually had a vertical uterine incision, which is not only a contraindication for induction but also a contraindication for vaginally delivery. At the very least, we avoided an emergency cesarean section, which had the potential to impact both the mother and infant’s life. As a maternity nurse, beneficence is a part of my daily routine, but following through on incomplete, undocumented information was an ethical decision I made to make sure the patient received proper care.
American Nurses Association, (2015). Association of Women’s Health, Obstetrics, and Neonatal Nurses. (n.d.) Retrieved February 2, 2015, from https://www.awhonn.org/awhonn/content.do?name=10_AboutUs/10_AboutUs_landing.htm
Beneficence. (n.d.) Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. (2003). Retrieved February 17 2015 from http://medical-dictionary.thefreedictionary.com/beneficence
Code of Ethics for Nurses. (2015). Retrieved January 28, 2015, from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-For-Nurses.html
Margaret Sanger. (2015, February 2). In Wikipedia, The Free Encyclopedia. Retrieved 05:22, February 17, 2015, from
New Jersey Board of Nursing Laws. (n.d.). Retrieved February 1, 2015, from http://www.njconsumeraffairs.gov/nursing/nur_rules.htm
nonmaleficence. (n.d.) Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. (2003). Retrieved February 17 2015 from http://medical-dictionary.thefreedictionary.com/nonmaleficence Odell, J., Abhyankar, R., Malcom, A., & Rua, A. (2014). Conscientious objection in health professions: A reader’s guide to the ethical and social issues. Retrieved February 1, 2015, from https://scholarworks.iupui.edu/bitstream/handle/1805/3845/conscientious-objection-short- overview-20140201.pdf
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