Engaging with Vulnerable People - Case Study Example

Engaging with vulnerable people Case Study Mrs. Manning. Introduction: This essay addresses a single case study of Mrs. Manning who is an octogenarian and has been hospitalized for the treatment of a fracture on her arm. In this assisted home, she is vulnerable and the actions of the care takers distress her immensely. This type of case is not a rare one but in fact older people get hurt easily. The vulnerable people succumb to the will of others, who are superior to them, physically and mentally. Vulnerability exposes the frailty of the human beings who are inferior and so. It also creates a mental disturbance which has deleterious effects. This essay represents the case of Mrs. Manning to highlight about the grave effects of being vulnerable. Here, Mrs. Manning has developed a problem of mental distress and the root cause of her problem lies in the staff that did not follow the NMC Codes of Conduct properly. Her condition proves to be a case of cognitive vulnerability. The fact that her daughter brings sin her favorite clothes shows her looks conscious nature which is the main cause of her vulnerability here. Therefore, we shall discuss about the concept of vulnerability, NMC codes of conduct and also the anti-discriminatory practice which could curb the ill-treatment of such patients. Vulnerability of Mrs Manning The definitions of vulnerability is multidimensional, for instance, according to Gabor, "vulnerability has been referred to as a threat to which a community is exposed, taking into account not only the properties of the chemical agents involved but also the ecological situation of the community and the general state of emergency preparedness, at any point of time." (Ashbindu, n.d., 2). This definition by Gabor in 1979 has been summarized by the author, Ashbindu Singh. The other definition by Cutter in 1993 has also been observed as "Vulnerability as the likelihood that an individual or group will be exposed to and adversely affected by a hazard. It is the interaction of the hazards of the place, risk and mitigation with the social profile of the communities". (Ashbindu, n.d., 2). The concept of vulnerability deals with the social system and indeed it becomes a threat to human beings particularly the ones who are weak mentally and physically. Here, in this case study it focuses on an older woman who is susceptible to injuries and hence she needs a good supervision of a nurse. The mental distress which she is going through refers to the fact that more women are affected by mental disorders compared to men. (Agenda for research on women's health for the 21st century, n.d. p 47). Mrs. Manning is vulnerable because it seems she is now being compelled to adapt herself in the environment of the hospital. The hospital staff has made her wear a uniform, which she does not like. She finds it uncomfortable about her hair being tied up in a ponytail gives her a different look. Here, psychologically she is challenged. She is depressed and not happy with her present appearance. She confides the fact to her daughter. Mrs. Manning suffers from depression and it has been revealed that women who undergo discrimination are depressed seven times more than men. (Guidelines for Psychological Practice with Girls and Women, n.d.) The mental health problems are evident in the patients who are aged and they can confide their problems to the staff or any available service. (Ryan, & Pritchard, 2004. p 287) Mrs. Manning had not given her consent which highlights the fact that the staff had not mentioned to her about their decision. Consent of an individual is important as it involves decision making of an individual. (Bielby, 2008) Mrs. Manning cries and this proves that she was reluctant to wear that dress and she was forced to wear it. Appearance is an important factor but for some it also contributes to one's self-esteem. The fact that she was so sensitive about an issue as trivial as wearing a dress shows that she is in a very vulnerable condition and one has to be extremely careful in dealing with her. She also fears the staff members which ultimately leads her to suffer from anxiety disorder. This anxiety disorder has affected millions of people in America. (Agenda for research on women's health for the 21st century, n.d. p 47) NMC Code According to Nursing and Midwifery Council, there are three basic principles and they are as follows - promoting good practice, preventing poor practice and intervening in unacceptable practice. Certain rules are specifically formed in the Guidelines for Mental Health and Learning Disabilities Nursing which have to be followed by the nurses or nurses. (Tilley, & Watson, 2004, p 119) In an institute where care is given to the needy people, the following codes of conduct must be obeyed. Firstly, the nurses have to respect the patient as an individual. The patient does owe a respect from their nurses as they are also human beings who have feelings, emotions, preferences, etc. Secondly, the patient has to be informed about his or her treatment. It is the right of the patient to know about everything that involves him. Thirdly, the nurses have to co-operate with each other so that their skills are used appropriately. Fourthly, information about the patients is to be handled in a confidential manner. Fifthly, nurses have to update their skills throughout his or her working period. Sixthly, the nurses have to be trust worthy and lastly, the responsibility of the nurses is also to be aware of the risk involved in dealing with the patient and minimize it by protecting the patient. (Sellman, n.d.; NMC code of professional conduct: standard, n.d.; NMC Code of Professional Conduct, n.d.; Tschudin,2003. p 79). As we have discussed the codes of conduct, the case of Mrs. Manning shows that the staff did not follow the codes of conduct. Since they are trained and are responsible for the patient, they should have been more careful while treating Mrs. Manning in this way. She was not informed about the dress and she was left in a distressed situation. She was helpless in front of the staff members and it is clear that she was afraid of the nurses. The hospital staff did not win her trust but rather forced her into doing something unappealing. This hurt Mrs. Manning's self-esteem and she could not control her tears. The nurses could have followed the codes of conduct in order to persuade Mrs. Manning to wear that dress. She would have complied with their instructions if only they had won her trust and explained to her why she needs to wear it. The staffs according to the codes of conduct have to acknowledge the patient's interests and respect her dignity. The patient should not be discriminated on the basis of gender, age, class, race, religion, lifestyle and status. (NMC code of professional conduct: standard, n.d.). Mrs. Manning's fracture has been healed but here, it has been projected that mentally she is very disturbed. Staying away from home and being under such staff caused a mental disorder. Thus, for such cases, Mental Capacity Act (MCA) 2005 has been implemented in April 2007. (Jacoby, Oppenheimer & Dening, 2008. p 219.) IMCA represents the patient's feelings, preferences and interests. The anti-discriminatory practice in UK means that no one can be discriminated on the basis of creed, color, race, religion, and disability of physical or mental. (Millam, 2002, p 29) The same applies in all the working environment of the world. The anti-discriminatory practice is a concept that can change the perspective of the patients as well as of the nurses. The codes of conduct have never encouraged abusing the patients or harming them in any way. Therefore, this code of conduct primarily favors anti-discriminatory practice. (Penhale, & Parker, n.d., p 12). Discrimination might be on any ground and it basically involves personal likes and dislikes of the caregiver. The anti-discriminatory practice is not just meant for the inmates but also for the workers who are the nurses. These nurses or nurses might have also experienced abuse from the patient or from the patient's family or from their own agency. This results in more abusive situations. The nurses are like social workers and they are doing a social work by taking responsibility of the vulnerable adult people. Anti-discriminatory practice should be encouraged as it ends prejudice. (Grant, n.d.). Therefore, it promotes equality for both the staff and the patients. Care Standards Act, 2002 has been implemented for the Protection of Vulnerable Adults. Another set of code ensures the safety of the vulnerable people by not employing unsafe workers in their agencies. The British Association of Social Workers has established its Code of Ethics, BASW, which deals with the role of the social workers who work for the protection of the vulnerable people who are abused. (Penhale & Parker, n.d. p 12) in this case Mrs Manning has been discriminated on the grounds of her age. The staffs working there perhaps were too busy to consider the sensitivity of n old woman about her looks. She had come here to heal her arm. If the nurses were observant enough they could have realized that taking her consent before dressing her up was important mainly because she was a woman conscious about appearance related matters. The common concept that older people are experienced and dressing up according to the environment is normal should not always be taken for granted. Without any discrimination, the nurse who was attending to her should have queried about her likes and dislikes and she should have known that even if Mrs. Manning is old, she has the right to be conscious of her appearance. Mrs. Manning could not defend herself and was helpless. She thus, obliged to the staff's orders, as she feared them. The staff should realize that the interests and needs of an individual have the same rights and to comply with the patients preference is their primary duty. The anti-discriminatory practice could be promoted by valuing all the differences and recognizing the good virtues and also by accepting the person as he is in a society. The anti discriminatory practices play a key role in the movement of social work. (Wilson, & Beresford, n .d.; Davies, 2008, p12). The nurses or the staffs should have an aim of practicing good rather than doing what is required by the rules or laws that have been implemented. (Millam, 2002. p 29) anti-discriminatory practices may be promoted by time to time training given to the nurses, careful and constant monitoring of the staffs and taking continuous feedbacks from the patients through anonymous polling. After reflecting on this case study, I have understood the consequences of being discriminated especially if one is vulnerable and this discrimination can produce negative effects. The discrimination done here in this case has mentally disturbed Mrs. Manning. It can also be severe as it has affected her deeply. The various laws that have been put into effect deals with the protection of the vulnerable people and these laws guarantee them security and non- discrimination. Recently, some convicted men working in a nursing home in Illinois abused the residents. (Abels, 2009) The case study has taught me that a nurse needs to be sensitive towards every patient she treats irrespective of any personal grudges against color, gender or age. Also, a nurse should be especially sensitive to a patient who is vulnerable by age and gender. The professional codes of conduct for the nurses have also been revealed here. A dress is a petty issue but the fact that the woman in this case is reacting so strongly to this issue shows her overexposure to the surroundings. The case reveals that an older patient especially female is hypersensitive about issues like looks and giving her opinion about any minor issue. References 1. Agenda for research on women's health for the 21st century. (n.d.) Available at: http://orwh.od.nih.gov/research/report.pdf. (Assessed on 29/10/2009). 2. Abels, D. (9th October 2009). Convicted felons in Illinois nursing home. Available at: http://www.illinoisnursinghomeabuselawyerblog.com/ (Assessed on 29/10/2009). 3. Anti-discriminatory. (n.d.) Available at: http://uk.answers.yahoo.com/question/index'qid=20070402035926AAVRBNm (Assessed on 29/10/2009). 4. Bielby, P. (2008) Competence and Vulnerability in Biomedical Research. Springer Netherlands. 5. Davies, M. (2008). The Blackwell encyclopedia of social work. Wiley Blackwell, p 12. 6. Grant, H. (n.d.) The issue of discrimination and anti-discriminatory practice. Available at: http://www.helium.com/items/709009-the-issue-of-discrimination-and-antidiscriminatory-practise. (Assessed on 29/10/2009) 7. Guidelines for Psychological Practice with Girls and Women. (n.d.) Available at: http://www.apa.org/about/division/girlsandwomen.pdf. (Assessed on 29/10/2009). 8. Jacoby, R. Oppenheimer,C and Dening,T. (2008). Oxford textbook of old age psychiatry. Oxford University Press, 2008. 9. Millam, R. (2002) Anti-discriminatory practice. Continumm International Publishing Group. 10. NMC Code of Professional Conduct. (n.d.) Available at: http://portal.surrey.ac.uk/pls/portal/url/ITEM/20B2BC3C38B37302E0440003BA296BDE (Assessed on 29/10/2009). 11. NMC code of professional conduct: standard. (n.d).Available at: http://www.encyclopedia.com/doc/1O62-NMCcdfprfssnlcndctstndrdT.html. (Assessed on 29/10/2009). 12. Penhale, B & Parker, J. (n.d.) Working with Vulnerable Adults. Routledge, 2007. 13. Ryan, T & Pritchard, J. (2004). Good Practice in adult Mental Health. Jessica Kingsley Publishers. 14. Sellman, D. (n.d.) The Importance of Being Trustworthy. Available at: http://nej.sagepub.com/cgi/content/abstract/13/2/105. n.d. (Assessed on 29/10/2009). 15. Singh, A. (n.d.) Assessing human vulnerability to environmental change, Hertfordshire: UNEP 16. Tilley, S and Watson, R. (2004). Accountability in Nursing and Midwifery. Wiley-Blackwell. 17. Tschudin, V. (2003) Ethics in nursing: the caring relationship. Elsevier health Sciences. 18. Wilson, A. and Beresford, P. (n.d.) Anti- oppressive practice: emancipation or appropriation. Available at: http://bjsw.oxfordjournals.org/cgi/content/abstract/30/5/553 (Assessed on 29/10/2009). Read More