Swedish Forensic Nursing Care - Essay Example

Risk Assessment Caring for the patient regardless of their disease is a complicated task to deal with. In order for the health care and medical workers to fulfill their duties in taking care and prolonging the life of sick persons, they must assess the gravity and the kind of treatment for the patient. In doing so, one cannot deny the fact that there are things to be done. However, there are risks and hazards that may come during the treatment process. A perfect example of this is those treatments that have something to do with surgical procedures especially with the disease, which are fatal if operation was not served. Also, malignant and communicable diseases are among those that should be taken into consideration. Upon knowing these things, one might ask the importance of risk assessment. On the second thought what do we mean by risk assessment. What is the connection of this with nursing These are the question that has something to do with risk assessment, which we will tackle in the succeeding part of this chapter. In this study we will delve into the definition and importance of the aforementioned subject and study in nursing. These are the things that we will look into. There are things and diseases that will be introduced that needs risk assessment in their treatment. Also, this paper would also determine if risk assessment is only applicable to some diseases of if this thing has to deal with all of the diseases. To add to this, I will also conduct a risk assessment in a patient suffering with corneal cancer. Furthermore, this study will tackle primarily of the importance of risk assessment in general. Risk Assessment 2 The term "risk assessment " is defined as " A scientific process of evaluating the adverse effects caused by substance, activity, lifestyle or natural phenomenon (www.columbia.edu/itc/hs)." It is also characterized by uncertainty and this would also establish probability in determining this kind of assessment.' Risk assessment exists to evaluate and to further test the harmful or unusual thing that is happening to one's self because of a certain change. With such a phenomenon, medical practitioners are compelled to study and further assess the weight and value of the change brought by a certain event to a patient. In such cases, change is evident whether it is physiological or psychological but in both cases, change affects the life of he patient. In the earlier sentences of this page, uncertainty (on the part of the patient) has something to do with change. There are things that are done in order to know and conduct risk assessment to further cater the needs of the patient as well as to know the next step to achieve the betterment of the patient. In order to make risk assessment, probability is also important. It deals with probable cause (on why change is evident to the patient) and how can we formulate for possible solutions to the patient for the treatment and normalizing the change brought by the factors stated above. This practice is also important as it contains the vital information of the cause and effect to the patient, which brought change to his life or to be more particular, disease on these people. Risk Assessment 3 To further know the procedure of risk assessment, instrumentation is vital. Also, protocols with regards to standard operating procedure (SOP) of the hospitals as well as knowing the legality of risk assessment in order to prevent problems in the future, which is beneficial to both the patients and nurses. It is an established fact that nurses are the one who took over caring for the patients in the absence of a doctor. They are expected to intervene and determine/execute the needed tasks which was given to him/her by the doctor. In addition Kreplick (1995) stated that " Any nursing intervention that requires independent, specialized nursing knowledge, skills or judgment cannot be delegated." If we are to further look into it, it seems that nurses do have the call when risk assessment came into picture. After having and recording the risk assessment and it would be studied and in order to realize it, risk management is essential in order for them to know the next step and what they should do to manage and assists the treatment for the patient because the liability should untoward incident happens would boil down to nurses. Jaeger D. (1993) also added an example of Kansas law stating " An important aspect of mandatory laws is the definition of reportable incident as an act by a health care provider which 1) is or maybe below the applicable standard call and has a reasonable probability causing injury to patient 2) May also be grounds for disciplinary action by the appropriate licensing agency." Risk Assessment 4 In achieving the "risk assessment", sometimes the hospital wanted to aide nurses and with this, they tend to get healthcare providers, which offer services such as risk assessments. Although there are a quite number of people and company who avail this, it is also important to know them as well as to analyze their credibility since risk assessment has something to do with the vital information which was forwarded to them by some medical practitioners in order to provide them the needed information. Upon knowing this, risk assessment and management is important in taking care and giving medical attention to people with illness. The website www.violentrisk.com (2004) has also attest to the importance of risk assessment in the nursing practice stating that "Risk assessment and management have become increasingly important in forensic psychiatric nursing, as nurses work with patients who have a high probability of displaying violent behavior. However, as an emerging practice, no standardized universal training or instruments exist, and there has been much recent research into the development of risk assessment and management models." Risk assessment models are indeed a beneficial tool not only for the nurses to be guided while doing their tasks but also for the patient for them to have the needed treatment. Upon realizing this, careful analysis of the situation as well as the changes that took place to the patient's life is an important element to determine the betterment of the patient. In realizing this, there are a variety of methods and steps that are needed to be done in order to realize and provide risk assessment on a certain patient. Risk Assessment 5 It is also an established fact that, medical practitioners, including medical attendants such as the nurses can sometimes commit errors and blunders while doing their tasks. In this case, most of them are penalized in just a simple blunder that would cost something to the life of the patient. The issue of ethical and professional dilemma in nursing practice using risk assessment now takes place. In dealing with this, arguments are now laid on how the nurses and medical practitioners in general on how will they be penalized considering the fact that risk assessment is a no-joke phenomenon if we are to deal with the premise and definitions stated above. Also, one cannot delete the fact that sometimes; under qualified personnel is the ones who call the shots for risk assessment on patient, thus, Maeve, M. K., & Vaughn, M. S. (2001) implied that "Ethical problems: maintaining confidentiality, using chemical restraint for security rather than medical purposes, working with under-qualified personnel providing care outside their scope of practice, caring for addicted prisoners, caring for the mentally ill, caring for incarcerated mothers and their newborns, managing for the visitation rights of children whose parents are incarcerated, dealing with violence, coping with prolonged isolation/ segregation of inmates, and providing appropriate planning for released prisoners" Therefore, one cannot deny the fact that risk assessment is indeed an important tool in order to further know the details and treatment of the disease that a patient has to undergo and for the doctors to do. While doing these tasks, one should bear in mind that proper assessment and anticipation is indeed vital. In relation to this, the care for patients who have acute illness is indeed vital in determining the qualification of the nurse who will attend to the need of the patient. Risk Assessment 6 The skill of the nurses is indeed vital in risk assessment in order for them to perform the task that they ought to do. In doing such things, it is important that they know what they are doing, assess things that they ought to do because risk assessment per se, is a preparation for the worst case scenario in the treatment of the patient s with the aforementioned diseases that needs extra care and evaluation on how their duties as well as their tasks should be done. Particularly in risk assessment, one should know the bounds of their intervention in order to cater the needs of the patient. Rask, M., & Aberg, J. (2002) also agreed that "The types of competence rated most important by nurses: effective communication, the maintenance of security, the performance of the nursing process, and the maintenance of a professional role" and "The skills nurses stated they needed most often include: to initiate relationships, to listen effectively, to document in a clear and concise manner, to maintain confidentiality, and to cope with institutional and environmental stressors" To further asses the situation and the risk during the treatment process, abstract is needed to know the framework of the assessment. This includes the purpose and objectives, the design that is used, the settings, the sample, the method and the likes indeed play a major part in determining the risk assessment of the aforementioned diseases which would affect the performance of the treatment process. In the same way, the issue as to whether a specialization in nursing while conducting risk assessment is required creates another question to be answered. Risk Assessment 7 However, the ICN or the International Council of nursing prescribed that "specialization in nursing as a level or knowledge and skill beyond basic nursing education; in 1992, the National Council of State Boards of Nursing further defined the requirements by stipulating that in addition to basic nursing education, advanced practice nursing requires a graduate degree in nursing with a concentration in the identified area of practice (Sekula, K., Holmes, D., Zoucha, R., Desantis, J., & Olshansky, E. (2001). If we are to deal with the succeeding part of risk assessment, one could have the idea on how to answer the question. Risk assessment also includes Main research variables such as the findings that have been made, comparison with other types of a certain disease and the likes are also important in order for one to know the specific treatment and the medical specialist who will attend to the needs of the disease. The findings based on the research variable are also vital in determining the next step needed for the treatment of the patient. In doing such, the basis of the experiment and the likes are indeed a force to reckon with in order to fulfill the tasks of the said assessment. The findings would also help to determine the outcome of the assessment. To add to that UK encourages leadership among nurses in providing health care which is also vital in determining as to whether the specialization is indeed vital. Pullen, M. L. (2003) also stated that "UK: Need for strong leadership within the NHS: The NHS Plan (2000) states that nurses need to take a lead role in the running of local health services" Risk Assessment 8 In addition, Scheick, D. M. (2002) stated that " Learning how to lead a group begins by being in a group; each year nursing students are given more of a leadership role accompanied by journal writing to internally process and self-evaluate - students self-teach and expand the therapeutic repertoire of responses" Upon analyzing these premises, we might conclude that specialization in nursing is indeed vital in order to execute the risk management. The remaining part of the risk assessment is the conclusion; it is where you will characterize the nature of the changes in one's life, particularly disease, the needed attention and steps for medical practice as well as the important tasks that should be done in attaining the steps on how one would be able to execute the needed treatment. Also, this is where one could see the risks that would come along the way and the needed remedies to lessen, if not eradicate this thing. In attaining these things, a therapeutic environment is essential however it is limited on the basis of "The balance in providing a therapeutic environment and maintaining security can be difficult to achieve and often present the nurse with stressful dilemmas. Clinical supervision should aim to assist the nurse in objective decision-making at all times" and "Developmental and managerial approaches to clinical supervision are focused on relationship issues alone, or service issues. A problem-oriented approach to supervision was developed to ensure both a pragmatic and flexible means of working (Rogers, P., & Topping-Morris, B. (1997)." Risk Assessment 9 Also in determining risk assessment, particularly for nurses, it is important to remember and take note of the "Key Points" that are to be done in order for one to know the probability and the comparison of risks among the variables in the study. A concise and accurate information and analysis is indeed vital in realizing this issue. Also, the comparison of the treatment, to determine whether the treatment for one disease can be applied to another is also a thing to consider. The realization of such things cannot be limited to a certain premise but rather, a variation of examples done in an accurate and delicate manner is needed for the realization of this. In relation to this, nurses work in order to determine the needed remedy of the patient as they are the people with whom the patient spends with more time during the treatment process. This claim was also supported by Lorbergs, K. A. (2001) stating that "The nurse works with the patient to draft the terms of supervision in the form of a contract; the patient is aware of the consequences of violating the contract, which include implementation of the risk management plan, outlining care/ management, formulated by the nurse" and "The nurse is faced with the responsibility of balancing patients' rights to treatment in the least restrictive and least intrusive environment while minimizing public risk. Community acceptance of the patient is difficult to achieve at times, but is possible through education and demonstration of successful rehabilitation." Risk Assessment 10 The last thing to deal with is the implications for nursing and the how would this thing affect in the future. Primarily, the goal and the objectives of risk assessment are to deal with the patients needs in order for the betterment of him with the consideration of the risks that one might encounter. In the earlier par of this report the vital part of risk assessment was stated and there are things which are introduced. If I am to deal with risk assessment the process would be same thing as I have stated above. This thing would help me a lot in determining different premise in nursing and how both the nurses can and the patients can be benefited with this assessment. After all, Webster defined risk as "possibility of suffering a loss" but however, it open doors for essential progress and failure which is an integral part of learning." Reference: 1) www.columbia.edu/itc/hs/nursing/m4225/2004_02/lect03Slides.ppt " Definition of Risk Assessment" 2)www.fao.org/docrep/meeting/005/X1855E/x1855e05.htm 3) courses.tox.ncsu.edu/tox415demo/Lectures/Content/risk_assessment.htm 4) www.niwotridge.com/PDFs/RiskAssesmentTemplate 5) http://www.violence-risk.com/risk/literature_nursing.htm 6) Maeve, M. K., & Vaughn, M. S. (2001). Nursing with prisoners: The practice of caring, forensic nursing or penal harm nursing Advances in Nursing Science, 24(2): 47-64 7) Rask, M., & Aberg, J. (2002) Swedish forensic nursing care: nurses' professional contributions and educational needs. Journal of Psychiatric and Mental Health Nursing, 9: 531-539 8) Sekula, K., Holmes, D., Zoucha, R., Desantis, J., & Olshansky, E. (2001). Forensic psychiatric nursing: Discursive practices and the emergence of a specialty. Journal of Psychosocial Nursing & Mental Health Services, 39(9): 51-57 9) Pullen, M. L. (2003). Developing clinical leadership skills in student nurses. Nurse Education Today, 23: 34-9 10)Scheick, D. M. (2002). Mastering Group Leadership: An Active Learning Experience. Journal of Psychosocial Nursing, 40(9): 30-9 11) Rogers, P., & Topping-Morris, B. (1997). Clinical Supervision. Nursing Management, 4(5): 13-15 12) Lorbergs, K. A. (2001). Framing nursing practice within a forensic outpatient service. 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