Interaction Between Registered Nurse Clientâ€Myassignmenthelp.Com

Question: Discuss About the Interaction between Registered Nurse and Client? Answer: Introducation During my clinical placement, I had witnessed an interaction between a registered nurse and a patient. The nursing introduced herself to the patient in a professional manner and explained with a pleasant tone regarding her nursing designation and her duty for the day. The nurse also displayed ethical responsibility by taking permission from the patient regarding the presence of a student nurse with them. Secondly, respect for patients and preserving the dignity for patient was seen when the nurse asked the patient regarding her need for privacy. In terms of professional responsibility, duty of care for the registered nurse was to conduct vital sign assessment of patient, assess her pain level, make the patient fill up a confidentiality and health assessment form and make arrangement for appropriate clothing for the patient to shift her to different department. Informing patient about all this made the patient comfortable with the clinical process. After conducting the vital signs and pain assessment of patient, the patient had communicated to the nurses about increased pain during movement and wanted a pain relief for it. In response to the patients concern, the nurse looked at all the patient chart to provide appropriate medication and gave option to patient regarding choice of pain relief medication. This reflected the ethical responsibility of taking consent from patient during care. When the nurse gave the option for the medication, the patient preferred Codiene and refused paracetamol. The nurse did not resist and said that she has the right to refuse. However, the nurse gave the patient the option of taking paracetamol 30 minutes after taking Codeine. Secondly, the nurse informed the patient that she needs to be given Vitamin K infusion along with anticoagulant medication because the doctor had ordered it to get the patients blood clotting level back into normal range. However, as the patient enquired about the usefulnes s of giving Vitamin K infusion as she was already taking anti-coagulants medication, the nurse hold on to the injection as she was not aware about it and she honestly said to the patient she would consult the doctor regarding it. Hence, with this action, the nurse followed all the five rules and protocol for drug administration. This also reflect legal compliance with care regimen and similar other legal obligation in care (filling confidentiality form, health assessment form and seeking ethical concerns of patient) was also completed by the nurse. Overview of the code In the nursing profession, an individual needs to follow a number of codes of professional conduct. This usually helps in achieving the best practice by the nurse, which provides the best recovery for the patients. Mainly eight important principles are introduced by the nursing council of New Zealand which ensures evidence based care for the patients where the level of patient satisfaction is the highest. The first principle mainly involves respecting the dignity and the individuality of the health consumers and advices the nurses to respect the cultural needs and values of the health consumers. Moreover, working in partnerships with colleagues and seniors and other members of the team promote the well being of the patients. The nurse should also be sure of winning the patients trust to provide the safe and competent care at the same time of maintaining the patients privacy and confidentiality. Moreover, they should act with proper integrity so that they can provide justification to the patients trust and also maintain the public and confidence on the professions of nurses (Code of conduct for nurses, 2017). For establishing effective partnership, the nurses need to establish a proper partnership with the patients on the basis of trust and respect. Independence, preferences as well as views of the patients should be taken into consideration so that the patients feel that they are included in the decision making and that their dignity and autonomy is respected by the healthcare staffs. In many cases, the patients may have limited knowledge in health literacy or may be vulnerable as well as part of the marginalized group but it is the responsibility of the nurses to balance their inherent power to handle such situations without resulting in any ethical or legal obligations. Moreover, the nurses should also instill the value of integrity, which means that they should be performing their roles actively as well as maintaining their values and actions in a way, which would assure the best health for the patients. The nurse should be committed to deliver safe practices for the patients and in c ase of any actions or omissions, she should have the ability to justify her own decisions and maintain accountability (Code of conduct for nurses, 2017. Evaluate interaction against the four principle of the code of conduct: Based on the summary of the nurses interaction with patient in a clinical setting, the principle of respecting the dignity and individuality of health consumers (principle 1), respecting the cultural needs and values of health consumers (principle 2), working in partnership with patient to promote well-being (principle 3) and maintaining the patients trust by providing safe and competent care (principle 4) is most applicable for the scenario. The evaluation of the nurses action and interaction while providing care to the patient clearly reflect applicability with the above mentioned principle of the code of conduct for nursing practice. The following is the detailed evaluation of the nursing interaction against each principle: Respect the dignity and individuality of health consumers The first principle of the code of conduct for Nursing practice is related to respecting the dignity of patients by means of kind and considerate behavior towards the patient and facilitating appropriate partnership with patient to respond to their concerns and preferences (Code of conduct for nurses, 2017). Dignity, privacy and confidentiality has been given an important priority in nursing practice because dignity is a human right for each individual irrespective of their health status and respecting patients dignity is associated with positive outcome in care such as increase in patient satisfaction with care (Baillie Black, 2014).Similar action is also reflected from the nurse-patient interaction summary as the nurse was found to ask the patient regarding her need for privacy throughout the day. The nurse treated her with kindness and used soft tone to communicate. Even when the patient denied taking certain medication, the nurse kept her cool and cooperated with the patient at all times. This made the patient comfortable too. This is applicable to the standard 1.1 of principle 1, which states that respecting the dignity of patient and treating them with kindness is an important role of nurse. The discussion of the nurse-patient interaction also showed that nurse took care of the privacy need of patient. When the nurse was preparing the patient to change into appropriately clothing for transfer into another department, the patient was given privacy by closing the curtain and door. This action has relevance with the standard 1.2 of the principle 1, which is related to taking steps to ensure that the physical environment allows the patient to maintain privacy and dignity in care. Matiti, (2015) also gave evidence regarding the importance of promoting patient dignity in health care setting. Patients dignity is often compromised in heath care setting and combination of factors like knowledge and attitude of health care staff and quality and quantity of resources helps to maintain dignity of patients. As survey has shown that mostly registered nurse are challenges by the ethical issue of protecting patients right and dignity, there is a need to make health care staffs understan d the importance of promoting patient dignity (Matiti et al., 2007). The nurse in the interaction scenario was successful in maintaining dignity of patient because the nurse had the right attitude towards care and respected the client right. Therefore, the nurse matched the clinical skill with clinical circumstances to make patient feel worthy and values. This helped to maintain cultural safety in care too. According to standard 1.3, listening to health consumers about their concern and preference is important as part of ethical and legal responsibility in care. The nurse maintained the individuality of patient by means of effective communication skill and patiently listening to patient regarding her preference for medications. Nurses skills to communicate with patient helps promote safety of patients and sharing of information too (Clarke, 2014). Respect the cultural needs and values of health consumers The principle 2 of the code of conduct for nursing practice summarizes the responsibility of nurse in respecting the cultural needs and value of health consumer. In accordance with this principle, the professional and legal requirement of nurse is to ask patient regarding their religious and cultural values while delivering care (Code of conduct for nurses, 2017). Registered nurse can also weave the principles of the Treaty of Waitangi to protect the values and needs of culturally diverse people. The three principles according to the treaty of Waitangi is partnership, participation and protection. Partnership involves engaging patient and family members in health care decision making, participation means encouraging the patient and family to be active in care plan and protection involves preserving the beliefs, values and custom of patient (Day, 2012). In the nurse-patient interaction, nurse maintained the cultural needs and value of patient by asking patient regarding if they should call him by any preferred name or the mentioned name is all right. Secondly, partnership and participation in care was seen when nurse encouraged patient to give her opinion regarding the pain relief medication and her preference for particular medication was respected by the nurse. The interaction also showed ethical and legal aspects of care because when the patient refused taking parecetamol medication, the nurse professionally said that it was the patients right to reject any care regimen. According to the standard 2.5, nurses work in partnership with Maori healthcare consumers to achieve positive health outcome of patient. The nurse also exhibited this action during the interaction when appropriate communication helped patient to enquire about the need for Vitamin K infusion even when she was taking anti-coagulant medication. In this scenario, instead of arguing with patient regarding the doctors order, the nurse preferred to hold on to this because nurse wanted to clarify about it from the doctor. This helped in respecting patient concern and preserving patient safety in care too. Day, (2012) reported that cultural safety is often inconsistently applied in practice due to lack of resource and nurses disrespectful attitude towards patients treatment choices. This attitude creates a situation where culturally diverse group like Maori experience marginalization in health system. To mitigate this barrier to providing culturally safe care, cultural safety education in nur sing practice is necessary to understand the complexities of human behavior and social realities. A nurse who can effectively understand the theory of power relations can be successful in delivering culturally safe care in any context (Nursing Council of New Zealand, 2017). Work in partnership with health consumers to promote and protect their well-being The third principle of the code of conduct for nursing practice emphasizes on working in partnership with patient to protect and promote their well being. According to standard 3.1, this may be implemented in practice setting by sharing necessary health information to patient (Code of conduct for nurses, 2017). The professional way to accomplish this standard of practice is to provide accurate and honest information to client is such a manner that they can easily understand. The positive benefit for patient is that it will make patients clear about the rational for treatment and they can enquire regarding any specific regimen too. This will enhance transparency in care, which is an important element according to ethical and legal requirements in care (Tobiano et al., 2015). The nurse in the interaction enhanced and protected the well being of patient while informing the patient about the combination of drug to give relief from pain. The patients preference of choice for medication wa s Codeine as she had the belief that paracetamol is not a strong pain reliever. In such condition, the nurse promoted better outcome for patient by suggesting about the combination of Codeine and Parecetamol to bring pain relief. The patient finally agreed to nurse suggestion because nurse had shared the information in a professional manner. This action also promoted well-being of patient as this would help to provide relief to patient from excessive pain. Another standard of the principle 3 is to respect health consumers right to participate in decision making and involving families member in planning to discuss about priorities and any specific concerns. This was also seen in the interaction when the nurse chose to ask the patient regarding the preference for medication. The nurse action demonstrated the nursing priority of respecting clients right in decision making. From the ethical and legal aspects too, the interaction is done in a professional manner and the nurse is accountable for preserving the right to autonomy and beneficence of the patient. Although patient denied taking paracetamol medication, the nurse agreed to it by stating that it is a right for patient to refuse treatment. In this way, the principle of autonomy was protected by the nurse. Secondly, the nurse also followed the value of beneficence in care by means of giving the option of taking parecetamol 30 minutes after taking Codeine. This skill to effectively con vince patient promoted well-being of patient Ethical code of conduct focuses on delivering an action to provide benefit to patients and it helps in fulfilling the professional responsibility of care (Chadwick Gallagher, 2016). The nurse accountability to protect the health and well-being of patient is also demonstrated by the action of strictly following the protocol for medication administration. Appropriate method of medication administration also helps to avoid medical error and promote patient safety. The five rights of medication administration include choosing the right patient, right drug, right dose, right route and right time to administer medication (Masters, 2015). All this was adequately done by the nurse. Maintain health consumer trust by providing safe and competent care The patient-nurse interaction also had relation with the principle 4 of the code of the practice for nurse in Australia. The principle 4 explains maintaining the trust of the customer by providing safe and competent care. This action can be accomplished by professional nurse by means of using appropriate skills in identifying the health needs of patient and taking advice and assistance when there is any doubt in treatment procedure (Code of conduct for nurse, 2017). The nurse action as witnessed in the interaction with the patient showed followed this principle very well. Instead of blindly following the doctors order to provide Vitamin K infusion to patient, the patient query raised against the rational for taking Vitamin K infusion even when she was taking anticoagulant medication provoked the nurse to delay this nursing responsibility. She was honest in her response and maintained the trust with patient by stating that she would consult the doctor regarding prescribing Vitamin K i nfusion before administering it to patient. This action reflects that professional accountability has been maintained in providing safe drug administration to patient and promoting therapeutic relationship with patients by assuring them to clarify regarding the medication choice. Building rapport with patient is influential in positive management of patient and encouraging them to comply with treatment regimen. It also enhance spiritual, psychological and physical well-being of patient (Din Gastmans, 2013). This action is in relevance with the standard 4.5 of the code of conduct for nursing practice which states seeking advice from other health care team in case of compromised knowledge regarding any care process. Impact for professional nursing From the overall evaluation of the code of conduct for nursing practice in New Zealand, it is understood that nurses have the responsibility to display professional conduct and preserve ethical values in care too. The key element of the code of conduct is also extracted from the principle of the Treaty of Waitangi, which relates to integrating partnership, protection and participation as important part of nursing service for Maoris (Orange, 2015). Hence, it reflects that cultural safety and preserving the values and beliefs of culturally diverse patient is also essential in delivering safe and quality care. Briefly, it can be said that as part of the code of conduct for professional practice in nursing, respecting the dignity of patients, meeting their cultural needs, engaging in appropriate partnership with consumer to promote well-being, respecting consumers privacy, building the trust with patient, maintaining public trust in nursing professional and acting with integrity is impor tant responsibility of the nurse (Code of conduct for nurses, 2017). The observation of the Registered nurse practice as mentioned in the interaction summary reflects that ethical, legal, professional and cultural safety values needs to be preserved. It gave an idea about the appropriate way of communication with patient, seeking consent from them regarding treatment process, involving them in decision-making, providing health care information and respecting patients right in care. In terms of nursing responsibilities, the nurse took care to maximize professional accountability in practice by following all the protocol for medication administration and seeking to clarify issues in practice by consulting with the doctor. Secondly, ethical responsibility in care was also seen when the nurse decided to hold on to the Vitamin K infusion and built trust with patient. The correct attitude of nursing practice was also seen when the nurse respected the values of patient and preserved the dignity, privacy and confidentiality of patient while providing treatmen t. Hence, the practice of the nurse is in compliance with professional nursing practice within New Zealand. Reference Baillie, L., Black, S. (2014).Professional values in nursing. CRC Press. Chadwick, R., Gallagher, A. (2016).Ethics and nursing practice. Palgrave Macmillan. Clarke, C. (2014). Promoting the 6Cs of nursing in patient assessment.Nursing Standard,28(44), 52-59. Code of conduct for nurses. (2017).Nursing Council of New Zealand [online] Available at: https://file:///C:/Users/admin/Downloads/Code%20of%20Conduct%20Booklet%20short.pdf [Accessed 11 May 2017]. Day, L. (2012). Journeying to a new understanding of cultural safety.Kai Tiaki Nursing New Zealand,18(4), 14-15. Din, L., Gastmans, C. (2013). Trust in nursepatient relationships: A literature review.Nursing ethics,20(5), 501-516. 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