Law, Human Rights and EthicsChloe MarrinerHSC211B1301674When a practitioner working within a health and social care setting is assigned the task of mentoring students on placement, the practitioner, for example an experienced nurse, must be well tutored in the knowledge and skills required to advise the student to optimum capacity. It is stated in the Professional Code of Conduct, published by The Nursing and Midwifery Council (NMC), that nurses should share their knowledge, skills and experience with their colleagues for the benefit of their patients and co-workers.
This is not to say that all nursing professionals will be mentoring students. Typically, nurses whom have undertaken additional training through an NMC approved mentoring course will be able to register as a mentor for future nursing and health care professionals. Many organisations follow strict policies and procedures which are strongly linked with government legislation and law. To correctly advise and lead the tutee, the mentor must exhibit professional role modelling and be fully learned in the set profession they are required to mentor in.
When applying policies, legislations and codes of practice in adult social care, such as in hospitals and nursing and residential homes, it is essential to discuss with the student the importance of professional accountability. This branches out in to legal and ethical accountability also; accountability translates as taking responsibility’ or answering for one’s action or inaction.An important component of professional accountability is record keeping. Records must be kept demonstrating the practitioner’s involvement with the service user and is vital to monitoring progress and patient welfare, along with treatment and support the patient may be receiving.
Good record keeping also enables health care providers to learn about the patient’s history, to better tailor person centred care. (Kline and Preston-Shoot, 2012. p126)Poor record keeping has consequences for both staff and service users. Practitioners may face disciplinary action, or being struck off’, if they have been found to have been negligent in documenting information relating to a patient who may then go on to develop a serious condition or injury due to remissness of care. By failing to keep records adequately and in a timely manner, the professional risks making errors concerning their patient’s treatment, which in the direst of circumstance, may result in fatalities, and the health professional facing litigation. (Kline et al, 2012. p132)Another facet of professional accountability is competency. Being able to carry out specific tasks one has been assigned to with efficiency, proficiency and successfully; showing that they are competent in what they are doing, and in doing so, they take professional accountability for their conduct. Competency is one of the Six C’s’ of Compassion in Practice; an e-learning resource launched via the Department of Health and the NHS Commissioning Board 2012. Legal accountability refers to ensuring the health care providers conduct meets legal requirements within the remits of the law, and thus are held accountable to the criminal and civil courts if their conduct is called into question. Dependent on the practitioner’s role or status within the institution, moral accountability can also be called to address. Although the practitioner may not be directly responsible for an action, if they are considered professionally responsible for the one committing the act, they too may also become accountable. What is meant by ethical accountability in health and social care is practitioners and professionals are morally obligated to adhere to codes and policies for the betterment of their patients. Confidentiality is a salient part of working in health and social care and must be exercised wherever possible; except in extreme circumstances where a breach in confidentiality is necessary for the patient’s welfare, or concerns are raised for the safety welfare of others.Confidentiality is one of the key values prominently held by professionals in the health and social care vocation. Without confidentiality there cannot be trust between client and practitioner, and it is difficult, if not impossible, to build a trusting and professional relationship with a service user without veneration for their right to confidentiality. In order to give appropriate and effective care, health care workers must have access to personal and private information. To do this there must be an element of trust that the individual’s information is kept confidential, and through this assurance, patients are more likely to divulge personal details to their health care practitioners. (Cuthbert and Quallington. 2017, p167)However, it is important that professional trustworthiness is not confused or extended beyond the confines of the practitioner/patient relationship. A common hazard of any role which involves one to be in close personal proximity with their service user, is the misconception that professional relationships equals friendships. Avoiding an over familiar’ relationship with a patient comes through understanding one’s role in delivering patient centred care and building an appropriate rapport with the patient. An individual must feel that the care they receive is specific and tailored to their unique needs. Feeling valued, emotionally and physically safe, and having the care giver available and accessible, are all prerequisites of maintaining a trusting relationship’. (Belcher, Cited in Cuthbert. 2009, p158) Care practitioners, particularly nurses, achieve a higher level of patient trust, which is then either strengthened or weakened by preconceptions of personal trust. The reality of the trust however, consequently influences the congruence of the true relationship. Patients may become confused or attached to their care giver on an unprofessional and emotional level, thus limiting the quality of care the practitioner is able to give. (Din and Gastmans. Cited in Cuthbert et al. 2013, p155)All health and social care practitioners are bound by law to maintain patient confidentiality. The revised Caldicott Principles’ provides the framework that guides practitioners in deciding whether patient information should be shared and on what grounds. The General Medical Council (GMC) are the regulating body responsible for ensuring that practitioners are accountable should confidentiality be breached. In the case of nurses, though answerable to the GMC, they are most notably held in account by the Nursing and Midwifery Council (NMC) alongside the NHS Code of Practice. The NMC states that it is a nurse’s duty to uphold confidentiality and privacy to all whom are receiving their care. Practitioners must exercise professional judgement and be accountable for their work. The code goes on to state that confidentiality should continue even after the patient’s death. (NMC, 2018, p7)Nurses who delegate tasks and duties to others must be confident that the person they are delegating to is competent and fully able to carry out the task. The nurse is accountable for deciding if the set tasks are within the other persons scope of ability. (NMC, 2018, p12)For a registered nurse delegating tasks to less qualified colleagues, professional responsibilities continue. The nurse must ensure that the delegee understands the task they have been given and are efficiently schooled in the principles of confidentiality and company policies. The practitioner must ensure that records are kept to a reasonable standard, contemporaneously and are expected to countersign those records too. (Kline et al, 2012, p127) Furthermore, the nurse in question must also be able to recognise their own limits in competency. The professional must be able to ask for assistance from one of their peers should they themselves not feel confident to carry out a duty. (NMC, 2018, p13)The Francis Inquiry Report of 2013 identified major failings of suboptimal care in the health care system after investigations in to reports of serious lack of care and managerial leadership at an NHS hospital. The report found that patients and their families were not being afforded satisfactory care, with reports of patients being neglected and left in appalling conditions, (Mid Staffordshire NHS Foundation Trust Public Inquiry, 2013. p13)The report raised questions about the accountability of staff following the failings and brought professional accountability firmly on the agenda. Specifically, the report identified the failure of staff to responsibly provide safe and effective care; failing to meet expected standards or ensuring that standards were met. (Cuthbert, 2017. p 211) The focus of legal and professional accountability and competency ultimately leads to ethics. Professional accountability, competency and the legal aspects of health and social care, merge together under the ethical umbrella’. Ethics, in the medical sense, involves the task of making decisions with all factors taken into consideration. Ethics is not so much focusing on what a patient wants, but more what a patient needs. For instance, a patient suffering from cognitive conditions, for example dementia, will not necessarily want treatment; however, their condition may be so severe that they may need to be treated, for their benefit and the benefit of others.This is measured through the four principles of the medical ethics framework; Autonomy, Beneficence, Non-maleficence and Justice, the four pillars of Biomedical Ethics’. Also known as the principle-based approach, it is an expansion on the three principles of the Belmont Report published in 1978, concerning ethics and healthcare research. The report, conducted and published in the United States, was founded on the basis of respecting human rights; patients or subjects having autonomy over their bodies and giving informed consent.Autonomy refers to an individual’s right to make their own choice; their role in decision making on their own care and treatment. Beneficence translates into balancing harm from good; relieving insult or injury. Non-maleficence makes to protect from and prevent harm, while justice is gaining the appropriate result in response to misdemeanours.Autonomy, or self-determination, is always at the forefront of any decision making or sharing of information in health care. However, there are exceptions to this rule. For instance, in patients diagnosed with cognitive malfunctions, for example dementia, a patient may be incapable of making a decision for themselves that is in their best interest. The Mental Capacity Act of (2005) states that there must be a presumption of capacity unless a person is proven to lack the capacity to govern themselves.In the event that a patient is proven to lack capacity, commonly a Deprivation of Liberty Safeguards (DoLS) will be put into place to allow practitioners to make choices for the patient’s bests interests. This is where non-maleficence and beneficence can be applied. (Mental Capacity Act, 2005. p2)This principle-based approach is useful in allowing the progress of better health care services and its deliverance in contemporary society. Society is gaining a better understanding of complex human issues; with the emergence of gender recognition, differing faiths and beliefs, and a greater empathy for mental health. Health care must adapt to a more person-centred care approach, and by doing this, it ensures that each person is treated both equally and fairly.However, equality does not mean to treat all patients in the same way. Different patients require different care for their needs, and so to treat patients with equality, practitioners must treat patients fairly. (Cuthbert et al, 2017)By applying the medical ethics approach when delivering health care, one is ensuring that they are displaying competency in their work and giving the best possible care to the service user. They are showing reverence for the service users rights and following the legal framework