Study On The Guidance From The Nmc Nursing Essay

Study On The Guidance From The Nmc Nursing Essay The Royal College of Nursing (RCN, 1981) and the Nursing and Midwifery Council (NMC, 2004; 2008) described the word accountability as ones responsibility to somebody or for something, in this case nurses are accountable to the patients, the employers and the NMC principles. Responsibility is being accountable for ones action or omission to patients in our care. Whereas Sempre Cable argued that responsibility relates to ones accountability to what one does and accountability is one responsible to the consequence of what one does (2003). Nurses are accountable to the NMC which legislates and regulates all nurses, midwives and specialist community nurses in the United Kingdom and it is the responsible of all registrant to abide to its principle. Therefore, the author will weave the tapestry of this essay to demonstrate that the NMC (2008) guidance may appear simple but it is a difficult responsibility to fulfil by nurses in practice. As the guideline relates to the first paragraph of t he principles of The Code, firstly, trust in relation to caring of patients health and wellbeing will be defined and the discussion will posit around the kind treatment of the patients as individuals without discrimination, respecting their dignity and be an advocate for them whilst they are in the nursing care. Secondly, respecting their right to confidentiality as is of paramount importance and it is enshrined in the Data Protection Act (1989) and also the Human Right Act (1989) which makes it legal. Confidentiality will be defined and note that patients information cannot be disclosed without the patients consent. Thirdly, for nurses to respect the dignity of patients, to advocate for them and respect their confidentiality nurses must be able to use therapeutic communications to get the necessary information and nurses must be able to communicate with other health professionals to support the patients in their care. Nurses must be able to communicate with the patient in a languag e that is understood by the patient. Fourthly, the principle of ethics in the discharging of the roles of nurses is important to complete the jigsaw of this complex essay. Lastly, to bring theory into practice by using the five steps of nursing process model (Christensen and Kenney, 1990, 1995; Roper, Logan Tierney, 1976; Pearson et al, 2005) will be explained by using the framework of the Clinical Governance (Department of Health (DH), 1999) as the benchmark for quality practice to explain the reason that it is a difficult responsibility for nurses to balance the different agendas. Hence, before an attempt is made to answer the topic of this essay theory of nursing is explained and the definition of nursing is postulate for the reader to understand the direction that this topic will be taken. Theory provides a template for practice as it provides the embodiment of nursing philosophies, presenting the beliefs, understandings, and purposes of nursing. It also guides research and education. A theory helps the understanding of nursing by the general public (Seedhouse, 1986). Theory is also a thinking process especially when a nurse is reflecting on the nursing process (assessment, diagnosis, planning, implementation and evaluation) of a patient (Bell Duffy, 2008). Peplau (1952) argued that nurses use therapeutic communication as a way to tease out information from the patients in order that nurses gain the patients trust and they are treated with respect and dignity. (, patients most of the time are seeing the nurse for the first time,) Orems (1971) used the self- care model where he stated that nurses used the continuous self-care action to care for patients when the patients self-care exceeds their own abilities to meet their needs (self-care deficit). Though Horan et al, (2004); Rogers (1970, 1980), Neuman (1980) and Parse (1987) stated that nursing is both an art and science whereby the main aim is to help patient to achieve biological system homeostasis equilibrium after an illness and to sustain their health and wellbeing not forgetting their respect and dignity. RCN stated that the use of clinical judgement in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever the disease or disability, until death (RCN, 2003 pg 3). Respecting the dignity of patients and caring for their health and wellbeing. The World Health Organisation (WHO) stated that health is a human state of biopsychosocial wellbeing in the absence of illness. Seedhouse (1995) argued that the WHO definition is too broad and difficult to achieve and it does not take into consideration the different definition of illness. Roper et al (2000) argued that health is an important factor in the model for nursing. Therefore, one of the roles of nursing is not only caring for ill patients but the healthy clients especially when doing health promotion. Furthermore, nurses have to care for patients coming from different cultural and ethnical background, gender, sexual orientation. Firstly, nurses must treat people as individuals and respect their dignity and must not discriminate in any way against the patients in their care. Patient must be treated kindly and considerately. Nurses should act as an advocate for those in their care by helping them to access relevant health and social care information and to support them. Secon dly, patients right to confidentiality is of paramount importance and is enshrined in the Data Protection Act (1989), furthermore, it is in the Human Right Act (1989). Ethics and its moral dilemma when caring for patients health and wellbeing Ethics are standards of behaviour which nurses are expected to act on when caring for patients and others (Tschudin, 1986; Edwards, 1996; Holland et al, 2008; Kozier et al, 2008) whereas moral is ones personal standard of the difference between right and wrong in conduct, character and attitude. Ethics are found in the NMC Code of conduct and nurses are accountable for their ethical conduct (Kozier, 2008). Ethics and moral are sometimes used interchangeably in some literatures. Beauchamp Childress (1989, 2009) developed a framework stated that there are four moral principles that nurses can work under. They are autonomy, nonmaleficence, beneficence and justice as explained below. Autonomy states that a patient is an individual and his/her wishes should be respected eventhough the decision runs contrary to our own ethical issues. Nonmaleficence the patient should not be placed do no harm it could happen intentionally, placing someone at harm risk or unintentionally causing harm. Beneficence doing good implement actions that benefit patient and their supports person. Justice fairness justifying one action against another action. (Nursing theorists may say when a nurse in faced with a dilemma the decision should be based on two ethical models utilitarianism one that brings the most good and the least harm for the greatest number of people or deontological theory action is not judged on its consequences but is judged on whether it agrees with moral principles) Ethics can sometimes provide moral dilemmas that nurses face when caring for a patient especially if the patient has been diagnosed with an incurable disease whereby the family and their employer do not want it to be disclosed to the patient. In such circumstances the conflict it between ethics and moral dilemma that is enshrined in the NMC (2008) Code of Ethics their role as nurses and moral duty to the patient who wants to know the truth and the patients health and wellbeing (Benjamin Curtis, 1992; Edwards, 1996). Thompson et al (2006) stated that ethics and moral cannot work in a vacuum further added that in order to justify moral judgement nurses need prior knowledge of ethical theory. Beauchamp and Childress (2009) added that one needs understanding of moral theory to be able to justify ethical decisions. This demonstrates the extra burden imposed on nurses thereby finding themselves constrained by the difficult responsibilities placed on them to fulfil the NMC (2008) Code of E thics furthermore those of their employers. (Nurses must have professional accountability and responsibility regardless of how simple or difficult the task may, they are personally accountable for their practice and are answerable for any action and omission committed whilst discharging their role. In this case responsibility refers to the accountability or liability associated with the duties undertaken by nurses). Conclusion Definition of important words Before the essay tapestry is weaved some words definition are given to set the tone whether the NMC (2008) guidance appears simple and/or is it difficult responsibility to fulfil in nursing practice. The Essence of Care (DH, 2003) is an NHS Policy helping health practitioners to take a patient-focused and structured approach to sharing and comparing practice. Trust Bell Duffy suggested that being trustworthy is difficult as patients, peers, managers have different expectations on the definition of trust (2009). Trust is therefore defined as . Wilson argued that public has lost trust in nursing care due to the fact that they expect modern medicine could cure every possible ill and secondly someone has failed to deliver the service they were mandated to deliver (2002). Health and wellbeing health is defined as the absence of illness with complete physical, mental and social wellbeing (World Health Organisation (WHO), 1946; Seedhouse, 1986) and wellbeing being the (suggested) state of perfection (Wilmot, 2003) Dignity is defined as the way an individual perceives and acquires values (privacy, respect and trust), sets standards according to these values and from these standards judges what is acceptable influenced by the individual cultural upbringing (Haddock, 1996; Seedhouse, 2000; DH, 2000; Matiti, 2002; DH, 2004; Matiti et al, 2007). Client/patient Advocacy Griffith Tengnah (2008) stated that NMC codes places both a normative and positive rules on the registrant (Normative rule what a person should do or what they should refrain from doing and positive rule imposes a legal obligation to do or refrain from doing something). Therefore, the NMC codes pull on both the normative and positive rule to underpin a shared set of values as enshrined by the regulatory body. Apply the concept of dignity in delivering care by respecting the patient as an individual The concept of dignity A concept is a label given to an observed phenomenon In the policy documents NHS Plan (Department of Health (DH), 2000) and Standards for Better Health (DH, 2004) DH states that patients would be treated as an individual first and treated with respect and dignity by focusing on their whole health and wellbeing not only their illness. It further added that the nurses would also be treated with respect and dignity. These words are echoed in the NMC (2008) Code though it does not mention the registrant. Apply the concept of dignity Deliver care with dignity Identifying factors that influence and maintain patient dignity Challenges situation/others when patient dignity may be compromised Quality of care and clinical governance cycle Conclusion: To the author who is a novice (Benner, 1984) the NMC guidance may appear to be a difficult responsibility to fulfil in practice but to an expert nurse the process and analysis of data happens on an unconscious level. This is done as the nurse may be able to deconstruct an incident by summoning his cognitive intuition (knowledge, experience) therefore the clinical decisions appears in his/her conscious mind readily formed (Lyneham et al. 2008; 2009). So it reasonable to conclude that regimes of care should actually benefit clients, rather than simply not cause harm. Beauchamp T L, Childress J F. (1989) Principles of biomedical ethics. 3rd ed. Oxford: Oxford University Press. Beauchamp T L, Childress J F. (2009) Principles of biomedical ethics. 6th ed. Oxford: Oxford University Press. Benjamin M, Curtis J. (1992) Ethics in Nursing. 3rd Ed. Oxford: Oxford University Press Benner P. (1984) From novice to expert: Excellence and power in clinical nursing practice. California: Addison Wesley. Department of Health. (2000) The NHS plan: A plan for investment, a plan for reform. London: The Stationery Office. Edwards S D. (1996) Nursing Ethics: A principle-based approach. Basingstoke: Macmillan Press Ltd. Griffith R, Tengnah C. (2008) Law and professional issues in nursing. Exeter: Learning Matters Ltd. Hinchliff S, Norman S, Schober J. (eds.) (2008) Nursing practice and health care: A foundation text. 5th Ed. London: Hodder Arnold. Holland K, Jenkins J, Solomon J, Whittam S (eds.) (2008) Roper, Logan Tierney Model in Practice. 2nd Ed. Edinburgh: Churchill Livingstone Elsevier. Horan P, Doran A, Timmina F. (2004) Exploring Orems self-care deficit nursing theory in learning disability nursing: Philosophical parity paper. Learning Disability Practice. 7 (4) 28-37. Kozier B, Erb G, Berman A, Synder S, Lake R, Harvey S. (2008) Fundamentals of Nursing: Concept, process and practice. Harlow: Pearson Education Ltd. Lyneham J, Parkinson C, Denholm C. (2008) Explicating Benners concept of expert practice: intuition in emergency nursing. Journal of Advanced Nursing. 64 (4) 380-387. Lyneham J, Parkinson C, Denholm C. (2009) Expert nursing practice: a mathematical explanation of Benners 5th stage of practice development. Journal of Advance Nursing. 65 (11) 2477-2484. Nursing Midwifery Council (NMC). (2002) Code of professional conduct. London: NMC Nursing Midwifery Council. (2008) The Code: Standards of conduct, performance and ethics for nurses and midwives. London: NMC. Royal College of Nursing (1981) Accountability in nursing. London: RCN. Seedhouse D. (1986) Health: The foundations for achievement. London: Wiley. Seedhouse D. (2000) Practical nursing philosophy: The universal ethical code. New York: Riley. Semple M, Cable S. (2003) The new code of professional conduct. Nursing Standard. 17 (23) 40-48. Thompson I E, Melia K M, Boyd K M, Horsburgh D. (2006) Nursing Ethics. 5th Ed. Edinburgh: Churchill Livingstone Elsevier. Waights Wilmot S. (2003) Ethics, power and policy: The future of nursing in the NHS. New York: Palgrave Macmillan. Wilson R. (2002) Where did peoples trust go? Nursing Standard. 17 (2) 24-25.

Cocultural Communication :: Essays Papers

Cocultural Communication A co-cultural experience When asked to write this paper about a co-cultural experience there was one that jumped right in to my mind. My experience occurred right around a year ago while I working for United Airlines. I worked out of the Canton-Akron Airport so the planes we flew were smaller then the jets out of Cleveland and were propeller planes. One day while checking in passengers like normal for our 5:50pm flight my co-cultural experience came up to the counter to check in. She was probably in her 30’s and was with two of her friends. She was on her way to Chicago to be a guest speaker at a large conference. There was a few things that made this woman unique to me from first sight. First of all she was in an electric wheelchair. Secondly this woman was overweight. Third she appeared to be slightly retarded judging by her actions. And lastly this woman had no arms and no legs. When I found out she was flying to Chicago and not her friends, I recommended that she fly out of Cleveland and that United Airlines would provide her with transportation up to the airport. The reason I recommended this is due to the fact that propeller planes do not have jet-ways that you walk or roll out in to the plane on. But rather propeller planes have approximately 8 or 9 narrow steps that people have to climb up to get in to the plane. For people with disabilities that could not walk up the steps we had a straight back chair to carry them up the steps with. The straight back chair involved a guy at the top of the chair and one at the bottom carrying the chair while walking up the steps. A woman of her size though would be very difficult to carry up the stairs and the fact that the steps are narrow could come in to play also. After my suggestion her friends were very disgusted with me and walked away upset I could tell. No less than a minute later I had a phone call from a represenative of the Americans with Disabilities Act telling me that it was discrimination what I was doing. I explained to him the situation with the steps and that in Cleveland she would be able to roll right onto the plane through a jet-way. Cocultural Communication :: Essays Papers Cocultural Communication A co-cultural experience When asked to write this paper about a co-cultural experience there was one that jumped right in to my mind. My experience occurred right around a year ago while I working for United Airlines. I worked out of the Canton-Akron Airport so the planes we flew were smaller then the jets out of Cleveland and were propeller planes. One day while checking in passengers like normal for our 5:50pm flight my co-cultural experience came up to the counter to check in. She was probably in her 30’s and was with two of her friends. She was on her way to Chicago to be a guest speaker at a large conference. There was a few things that made this woman unique to me from first sight. First of all she was in an electric wheelchair. Secondly this woman was overweight. Third she appeared to be slightly retarded judging by her actions. And lastly this woman had no arms and no legs. When I found out she was flying to Chicago and not her friends, I recommended that she fly out of Cleveland and that United Airlines would provide her with transportation up to the airport. The reason I recommended this is due to the fact that propeller planes do not have jet-ways that you walk or roll out in to the plane on. But rather propeller planes have approximately 8 or 9 narrow steps that people have to climb up to get in to the plane. For people with disabilities that could not walk up the steps we had a straight back chair to carry them up the steps with. The straight back chair involved a guy at the top of the chair and one at the bottom carrying the chair while walking up the steps. A woman of her size though would be very difficult to carry up the stairs and the fact that the steps are narrow could come in to play also. After my suggestion her friends were very disgusted with me and walked away upset I could tell. No less than a minute later I had a phone call from a represenative of the Americans with Disabilities Act telling me that it was discrimination what I was doing. I explained to him the situation with the steps and that in Cleveland she would be able to roll right onto the plane through a jet-way.

Creative Writing †Darkness Essay

I suddenly awoke. It was three in the morning. It seemed like the whole world was sleeping but me. The silence, sinister. I felt the weight of the darkness pushing on me. My mind darted from one nightmare scenario to the next, the fear of the unknown overwhelmed me and I was paranoid about vicious intrusionsMy bedroom door was wide open. My eyes darted around the room, hunting for anything different, any dark silhouettes lurking in the darkness. I failed to find anything out of the ordinary. This only increased my paranoia even more. I felt as though I was fighting a war with the darkness, darting from one trench to the next, fleeing for my life. I groped around the darkness to find the light switch on my bedside lamp. I flipped the light†¦ Light†¦ Safety. I immediately felt relieved. I listened carefully for any noises. I could only hear the buzz of electricity in the light above me that gave me a sense of safety, and the beating of my terrified heart. Just as I began to calm down and convinced myself that everything was alright, I remembered that I left the back door unlocked and the window gaping open, inviting in the strangers that lurked in the shadows. I soon found myself once again paranoid and quickly turned back to the light†¦ Light†¦ Comfort. I knew the only way I could get to sleep was to lock that door and the window. The darkness weighed on me. Even with light streaming throughout my room, I still felt a little uneasy, like the darkness pressed up against my window trying to attack me. I encouraged myself that all I had to do was quickly go down the stairs and down the hallway to the back door and the window that was splayed open. Who was I trying to kid? I was freaked out. As I nervously stepped out of my room, the floorboards creaked underneath me as if it was a warning not to go out of the safety of my lit up room and into the horrifying darkness. I cautiously looked down the stairs in to the inky blackness below. Biting my lip, I started to make my way down the stairs. The light switch is at the bottom. I looked behind me, one last peek of light before I carried on descending the stairs into the unknown. I stepped down from step to step cautiously. Each step dragged me further into the darkness and further away from the safety of the light. I reached the bottom of the stairs. I ran my hands along the wall, my fingers sought the light switch. Flick! Light†¦ Reassurance. A quick few strides across to the door. I hastily bolted the door. I turned to the right, facing the open window. A gust of wind swirled around me, enveloping me with cold air making the hair on my skin stand on end under protruding goose bumps. I abruptly latched the window shut. I sighed with relief and turned and walked back to the staircase. I reached the base of the stairs. My hand hovered over the light switch. I took a deep breath and turned the light off. I was forced to plunge myself back into the darkness. I began to count down the steps as I ascended the stairs. Twelve†¦ Eleven†¦ Ten†¦ Nine†¦ Eight†¦ Seven†¦ Six†¦ I momentarily paused. Halfway†¦ Five†¦. Four†¦. Three†¦ Nearly there†¦ Two†¦ One. I stepped back into the welcoming arms of the light in my room. I leaped back into the warmth of my bed. I reached my arm across to turn my bedside lamp off, my hand suspended in mid air as my mind raced back to the events of a few moments ago. I withdrew my arm and hand, returning them to the warmth beneath my covers. I decided that tonight, the light would stay on†¦ Light†¦ Security.

Demonstrative Pronouns of Spanish

If youve already learned the demonstrative adjectives of Spanish, youll find it easy to learn the demonstrative pronouns. They serve basically the same purpose, acting as the equivalent of this, that, these or those in English. The main difference is that they (like other pronouns) stand for nouns rather than modify them. List of Spanish Demonstrative Pronouns Below are the demonstrative pronouns of Spanish. Notice that they are identical to the adjectives, except that most traditionally use accent marks, unlike the adjective forms, and that there is a neuter form. Singular masculine à ©ste (this)à ©se (that)aquà ©l (that, but further away in time, sentiment, or distance) Plural masculine or neuter à ©stos (these)à ©sos (those)aquà ©llos (those, but further away) Singular feminine à ©sta (this)à ©sa (that)aquà ©lla (that, but further away) Plural feminine à ©stas (these)à ©sas (those)aquà ©llas (those, but further away) Singular neuter esto (this)eso (that)aquello (that, but further away) The accents do not affect the pronunciation, but are used merely to distinguish adjectives and pronouns. (Such accents are known as orthographic accents.) The neuter pronouns do not have accents because they have no corresponding adjective forms. Strictly speaking, the accents arent mandatory on even the gendered forms if leaving them off wouldnt create confusion. Although the Royal Spanish Academy, a semiofficial arbiter of proper Spanish, once required the accents, it no longer does, but neither does it reject them. Use of the pronouns should seem straightforward, as they are used basically the same in both English and Spanish. The key difference is that Spanish requires use of the masculine pronoun when it substitutes for a masculine noun, and use of the feminine pronoun when it substitutes for a feminine noun. Also, while English does use its demonstrative pronouns standing alone, it also often uses forms such as this one and those ones. The one or ones shouldnt be translated separately into Spanish. The difference between the à ©se series of pronouns and aquà ©l series is the same as the difference between the ese series of demonstrative adjectives and the aquel series. Although à ©se and aquà ©l can both be translated as that, aquà ©l is used to refer to something further away in distance, time, or emotional feelings. Examples: Quiero esta flor. No quiero à ©sa.  (I want this flower. I dont want that one. Ésa is used because flor is feminine.)Me probà © muchas camisas. Voy a comprar à ©sta. (I tried on many shirts. Im going to buy this one. Ésta is used because camisa is feminine.)Me probà © muchos sombreros. Voy a comprar à ©ste.  (I tried on many hats. Im going to buy this one. Éste is used because sombrero is masculine.)Me gustan esas casas. No me gustan aquà ©llas. (I like those houses. I dont like those over there. Aquà ©llas is used because casa is feminine and the houses are distant from the speaker.)A mi amiga le gustan la bolsas de colores vivos. Voy a comprar à ©stas. (My friend likes colorful purses. I am going to buy these. Éstas is used because bolsas is plural feminine.) Using the Neuter Pronouns The neuter pronouns are never used to substitute for a specific noun. They are used to refer to an unknown object or to an idea or concept that isnt specifically named. (If you would have occasion to use a neuter plural, use the plural masculine form.) The use of eso is extremely common to refer to a situation that has just been stated. Examples:  ¿Quà © es esto? (What is this [unknown object]?)Esto es bueno. (This [referring to a situation rather than a specific object] is good.)El padre de Marà ­a murià ³. Por eso, està ¡ triste. (Marys father died. Because of that, shes sad.)Tengo que salir a las ocho. No olvides  eso. (I have to leave at eight. Dont forget that.)Quedà © impresionado por aquello. (I left affected by that.) Key Takeaways The demonstrative pronouns of Spanish are the equivalent of English pronouns such as this and these.The demonstrative pronouns must match the nouns they refer to in gender and number.Neuter demonstrative pronouns are used to refer to concepts and situations, not named objects.