The Code of conduct for practicing nursing
The Code of conduct for practicing nursing sets out the expectations, professional behavior, and legal requirements for all nurses in Australia. This Code encompasses a clear outline of how nurses should conduct themselves in the workplace and the community. It also gives guidelines for safe practice and principles of professional behavior. Individual nurses have personal values and beliefs, but they have to play by the rules of ethical standards. Students who are still under training are also covered in the Code of conduct because they are set to be the practicing nurses of tomorrow. The Code is also set to meet the standards and expectations of the National Law. There are eight guiding principles that are grouped into domains and backed with an explanatory value statement. This Code of conduct will form the background for discussion in this essay. This essay will provide a comprehensive analysis of three case studies in nursing practice and draw its allegiance to how professional nurses conduct themselves.
Case Study One – Sam
Ethical Implication
This case study’s ethical implication is that this lady requires counsel and financial help in her decision. Sam is tired and elderly and has decided to stop going for dialysis. If she stops coming for medication, her chances of surviving are dangling mid-air. From a caring perspective, I would wish to influence the patient to take heart and continue coming for dialysis. Given the financial capacity, I would support her to get to the hospital for her checkups. Whether she accepts it or not, I have the moral sense to see the good things she deserves.
Link with Relevant NMBA Codes
The prevalent link of this case study with NMBA codes is respect for patients’ autonomy (NCLX-RN, 2020). Patient autonomy is the aspect of accepting a patient as a person with the innate rights to follow her beliefs, decision, perspectives, and opinions. Sam had decided to stop her regular dialysis sessions based on the idea that she was tired of the process. Nurses are required by the Code of conduct to encourage the patients to make their decisions without coercion or judgment. The reason is that a patient has the right to accept or reject any treatment on them.
Critical Discussion of the Ethical Principles
However much I feel obliged to advise Sam; otherwise, I am limited by ethical NMBA code of conduct. If I try to implore her to change her mind, I will be breaking the Code of conduct (ANA, 2015). A patient is entitled to the decision concerning their health. It does not matter how much a nurse feels it is the wrong decision. Besides, the patient has justifiable reasons to stop the dialysis sessions because she claims she is tired and has to walk for three hours to access medication.
Ethical Conflict
There exists conflict regarding patients’ decision-making attributes and nurses’ ethical principles regarding the value of measured accessibility and availability of healthcare services. Nurses are expected by the Code of conduct to value informed decision-making practices (NMBA, 2005). In our case study, nurses have a conflict of options. They are expected to ensure that patients are in a position to get treatment and in a convenient way. As it turns out, Sam was a weary patient who was tired of making to-and-fro visits to the hospital. It would be a better option if the nurses advised the patient to stay in the hospital and provide her a bed and food to eliminate the inconveniences. However, other underlying factors, like lack of financial facilitation, may have influenced the patient to decide not to visit the hospital anymore. Nurses have no choice but to overlook the first principle of enhancing the accessibility of healthcare and respect Sam’s decision as viable.
Course of Action
This case study was inclined more on the patient’s side than on the nurses’ side. The nurses did not, by any chance, influence the patient’s decision to stop her regular dialysis. However, the most viable intervention would be to organize counseling sessions with patients undergoing life-sustaining treatment to understand their challenges and perspectives about treatment. Based on the second statement in the guide to the decision-making framework, nurses are allowed to make decisions beyond their scope. They can see organization support and authorization to start counseling sessions to patients undergoing life-sustaining medication (NMBA, 2019). Patients like Sam may have a second thought if they undergo counseling sessions and are told about the benefits of making regular doctor visits. Besides, healthcare institution boards and stakeholders may start a foundation to help people undergoing life-sustaining medications to get basic facilitation like transport and food to help them through their medication journey.
Case Study Two – Sarah
Ethical Implications
This case study focusses on breach of Code by Sarah. Sarah is a nurse I have been assigned to work with, but her practices are marred with unprofessionalism and lack of respect for the patient, me, and the relative’s patient. She is very unethical in her operations, which may lead to a lack of trust from the patient she is to treat and me. Besides, she handles the patient inappropriately, which is unlikely for a professional nurse. In contrast, Jo is expected to have a sober mind and desist from taking alcohol before she comes to work. She also has to have some respect for colleagues and patients in her practices. These are mere expectations of general ethics rather.
Link with Relevant NMBA Codes
Sarah’s portrayal of behavior is linked to the breach of two vital principles of operation in Australia’s nursing scope. Firstly, Sarah devalues the aspect of respect for herself and others. This principle encompasses the value for dignity and moral value for oneself and other people, including colleagues, patients, and patients’ accompaniments. The aspect of kindness entails the act of being caring, gentle, and considerate to other people. Secondly, this case study portrays the lack of a culture of safety and in healthcare and nursing (NMBA, 2005). This Code requires that a nurse understands how crucial safety is to contemporary practice in the nursing environment.
Critical Discussion of the Ethical Principles
From the very beginning, Sarah comes to work while drunk. This act is a show of lack of respect for work because when someone is drunk, they may not have the mental capacity to make rational decisions. As a colleague, this affects me because working with someone who is rationally distorted due to drunkenness. She goes further to whisper to some patients that she enjoys drinking in the morning. This is to mean that other patients who will be treated by Sarah have lost their trust in her. As if this is not enough, Sarah goes ahead to ask the relative of the patient she treats to go and place a stake on her behalf. This is a show of a lack of dignity for other people. Onto the matter regarding lack of kindness and care, Sarah inappropriately handles the patient as she gets her out of bed. Since the patient was unable to get out of her bed on their own, she was vulnerable and deserved to be handled carefully. However, this seems not to be part of Sarah’s DNA.
Ethical Conflict
In this case study, there exists a conflict of ethical Code in nursing practice. Practicing nurses are expected to behave ethically and with respect toward their colleagues. On the other hand, student nurses and even practicing nurses must collaborate with their colleagues in every aspect of the practice (Pecorino, 2002). However, the Code does not provide the limits of collaboration. In this case study, Sarah is disrespectful to the patient, the patient’s relative, and me as the student nurse. As per the Code of conduct, I have to go by her rules to foster collaboration regardless of my disregard for her behavior.
Course of Action
It is proven that disrespect chills collaboration and communication. Per the decision-making framework and guidelines, nurses should be made accountable for their actions and behaviors (NMBA, 2017). Such individuals should also be reported to the authorities and disciplinary action taken against them (Grissinger, 2017). This action can be implemented through policy to curb such behaviors and conflicts. In most cases, when disrespectful individuals are questioned about their behaviors, they may become aggressive and escalate. A task force must be created to manage conflict in such occurrences and resolve differences.
Case Study three – Jack
Ethical Implications
This case involves medical negligence and lies in nursing practice. Jack is handing over the responsibility of taking care of 16-year old James, a diabetic patient. He confides to me that he forgot to give James an insulin dose at 9 am. While forgetting to administer the dose may not be due to incompetence, the idea of signing for it is misguiding and unethical (Boney, 2014). Jack even lies to James’ mother to keep her anxiety in check. In general ethics, Jack is expected to be transparent. If he had not administered the medication to James, he needed not to sign for it.
Link with Relevant NMBA Codes
This case draws a connection to two NMBA codes, which were unfortunately breached rather than observed. Firstly, Jack did not honor the value of fostering the safety culture in healthcare and nursing practice. This principle requires that a nurse uphold high safety standards for patients, colleagues, and themselves. This is the only way to build trust between nurses and patients who come seeking medication. Secondly, Jack made little consideration to the Code that entails valuing ethical management of information in nursing practice. This Code requires that information (including healthcare records and documents) be generated and handled with utmost integrity and professionalism. Any information being recorded should be non-judgmental, accurate, and relevant in the treatment process of patients. A healthcare record cannot be altered by any means. The only allowed action is to add relevant information. The reason is that healthcare records are often used later for reference to a patient’s medical history to determine the type of treatment that suits them.
Critical Discussion of the Ethical Principles
Jack forgets to administer an insulin dose to James, and this, in its fashion, puts the health conditions of James at stake. Since James was on the prescription, he had all the right to be given the dose. Unfortunately, Jack committed a medical error in this case, and this is an error that was now shifted to me as the new caregiver. Jack later commits a heinous crime by signing for the dose, yet he had not administered it. By doing this, he has misinformed whoever would look at James’ medical records either for research or medical treatment purposes in future. This is a show of lack of integrity. Besides, he lies to James’ mother about administering the dose to James. Conclusively, this is a case of lack of integrity in nursing practice, which is fatal.
Ethical Conflict
There are ethical provisions in nursing practice that allow nurses to lie about vital information regarding a patient’s healthcare. These lies include reassuring a patient’s care, covering up for prognosis, and medical errors (Paton, 2019). This occurrence tends to contradict the expectations of ethical Code where a nurse is required to be integral with medical information and records. The law also allows some medical personnel to lie about patients’ health information (Odell, 2020). This is a rare practice, but it does happen.
Course of Action
Based on the National Decision-Making Framework, nurses are required to be accountable for their actions. It is allowed to lie about some medical information but with limitations (Martin, n.d.). This is to means that any other instance of lying that is not justifiable is punishable by relevant parties in the nursing fraternity.
Conclusion
In conclusion, the Code of conduct in nursing practice is the guiding principle that draws a boundary between what should be done and what is not ethically accepted. Based on the case studies discussed above, there is a prevalence of negligence of these guiding principles. Though not statistically proven, the number of ethics in the above cases is about two-thirds. This shows that there is a high probability that many nurses are reckless and uncaring about these codes. Luckily enough, the decision-making framework is already put in place to curb such occurrences.