Health Law and Policy: the Health and Disability Commissioner Act - Essay Example

Health, law and policy Insert of Introduction The Health and Disability Commissioner Act which came into being in the year 1994 has several provisions enabling the consumers of health care to access such services in a suitable and respectable manner. The main reason behind the enactment of the act stemmed from the vulnerability of the disabled heath care consumers to exploitation and biases in terms of health care provision by the providers. The Act commissions the rights of every health care consumer across the globe and protecting them from exploitations of any nature. The code informs that every consumer has the right to be protected by the provisions stated therein. Moreover, ever health care provide is as well subjected to adhere to the stipulations stated therein. According to the provision, where a consumer has no knowledge of these rights, the Act directs the care providers to inform the consumers of their rights and besides, allow the consumers to exercise their rights while receiving treatment from them. The approach put forth in this act is to induce ethics in the health care industry. Divergences in the definition of ethics have raised issues as the term is subject to debate. The HDC Act provides a lucid direction based on the same by giving the ethical issues to be observed by the health care providers while providing such services to their consumers. Laverack, (2005) defines ethic as a set of laws and rules guiding the conducts people or professionals in a given field while executing their duties in line with their profession. Psychiatric nurses deal with psychologically vulnerable individuals who are in most occasions not able to make sound judgments concerning the various issues affecting their lives. Precautionary measures, therefore, must be taken to avoid the manipulation and abuse of such consumers. HDC Act provides exactly this intervention mechanism to health care consumers. The act has a set of ten regulations stating the rights of all consumers seeking health care attention from various providers in New Zealand. The Act accords the following rights to consumers which are subject to adherence by the care providers, these are: the right to be treated with respect, fairly, without pressure or discrimination, the right to dignity and independence, right to access for relevant information and to receive a quality service and to be treated with care and skill. The other rights accorded to the consumers by the HDC Act are the right to making independent decision about care services received, and to change mind whenever desired and the right to complain and the complain taken seriously. A practicing psychiatric nurse is, therefore, expected to adhere to these rules and regulations at all times, when on duty as well as while off duty. This is meant to preserve and conserve a process of a dignified provision of nursing care to all patients without biases irrespective of their physical, appearances, racial orientations, religious alienations, etc. (Boseley, 2008). A breach in any form to these laws and rules is subject to prosecution or termination of practice contract. In this paper, I will critically examine the process of psychiatric nursing practice within the accord of adherence to the set codes of conduct, rules and regulations of the profession. This I will illustrate based on the rights provided in the HDC Act of 1994 the rules and regulations for adherence stipulated in the nursing practice code of the state of New Zealand. In doing this, I will make references to the Health and Disability Commissioner’s application of relevant rights and the legal outcome in 12HDC00027. Health, mental health, and well-being The article 12HDC00027 presents a court case in which Ms A, a psychiatric patient had her rights under HDC Act 1994 violated by RN B, working in one of the hospitals in New Zealand. The act recognizes that the connection between psychiatric conditions social relationship is key for close observance by a psychiatric nurses (Health & Disability Commissioner, 2011). It defines mental disorders as those disorders that influence the mind of a person hindering there level and process of reasoning (Health & Disability Commissioner, 2011). The Act also recognizes the fact that it is usually difficult for the mentally ill patients to make sound judgments about certain important matters of in the human society (National Council on AIDS, 1990). Strict guidelines, from the HDC Act therefore, define the conducts of the medical practitioners in this field making sure that they offer their services in a careful and professional manner. The code states a registered psychiatric nurse should take into consideration the following; Recognize the complex relationships between emotional, developmental, physical, and mental health and the influence of social factors on physical and mental health and illness (Health & Disability Commissioner, 2012: 16). This Act calls upon RN B to observe the mutual relationship between the emotional conditions of the patients about their relationship with other people in a social context. Psychiatric nurses including RN B are instructed to note their patients vulnerability to the emotional incapacitation (Ho, 2000). RN B was, therefore, required to consider making Ms A recover in a free and uninfluenced way by making sure that her emotional conditions are not escalated by any other social, psychological, political or any other factor which may hinder the patients’ recovery process. The complex condition as is recorded in a document by the Registered Psychiatric Nurses of Canada, (2010) should be handled with great care and concern to avoid increasing the patient’s vulnerability to the influences he or she experiences. RN B was, therefore, expected to display the highest degree of competence in offering his services to Ms A and ensure proper recovery. In a bid to uphold these requirements, the New Zealand nursing council strictly scrutinizes the student nurses at every level making sure that their qualification requirements are in line with the set standards. This is to ensure that any hired or registered nurse in the country should have fully satisfied the set requirements before qualifying to begin practicing in New Zealand. The HDC Act has been developed by the council to help inform health care consumers of the expected conducts of the nurses as well as guide the professional nurses while executing their duties. The Act requires them to observe utter care and keenness in order for them to avoid the breach of their professional ethics (College of Registered Psychiatric Nurses of British Columbia, 2012). The laws provide a faithful ground for accountability by the nurses besides effective evaluation of the nurses’ performances while executing their duties. Any nurses being registered into the nursing team is often taken through these regulations to which he or she is required to adhere. RN B must therefore have been evaluated before registration as per the HDC’s requirements hence had no grounds to claim ignorance. The exercise of giving ethical education and orientation to the nurses as HDC, (2009a) stipulates begin during college training. Student nurses are taken through the ethical codes to be observed once registered as psychiatric nurses (Labonnte & Laverack, 2008). RN B, having undergone the nursing training in nursing school must have been informed of the expected professional behaviors during his administration of services (Rabinovich & stream, 2004). Qualifications for registration as practicing nurses require full adherence to the established rules and regulations. Any action contrary to the proper guidelines provided during and after training is considered a breach of the set laws, rules and regulations in the nursing profession. RN B, luring Ms A into sexual affair while attending to her is considered a breach of the laws and is, therefore, required bearing full responsibility. This may range from being deregistered or prosecuted before a court of law (HDC, 2009b). Breaching the law as Cooney, (1994) puts it is an act of going against the requirements of the set laws after one has been made aware of them or after their publications to provide guidance and care to the concerned parties. Having been taken through the nursing guidelines and care provision mechanisms, it is assumed that nurses fully understand and are able for adherence to the set rules. The fact that RN B took advantage of Ms A and manipulated her out of her vulnerable consent can, therefore, be considered a breach of the law and is punishable under the set rules. Deregistration that forms the immediate against a psychiatric nurse would be the initial stage RN B would have suffered given his full awareness on the required ethical requirements (Health & Disability Commissioner, 2011). The code of ethical practice according to the New Zealand Nursing Council’s regulations records that psychiatric nurses should; Be in a position to recognize and understand that perception, lifestyle, and expectations influence physical and mental health (College of Registered Psychiatric Nurses of British Columbia, 2012: 14). Going against this act, by seducing Ms A into sexual submission while mentally incapacitated, is, therefore, a great breach of the laws as defined by the ethical standards stipulations. RN B was, therefore, very liable to prosecutions and deregistration as a practicing nurse under (Health & Disability Commissioner, 2012). The ethical codes spells that should be geared towards finding relevant solutions to the patients in the right and accorded manner (HDC, 2009b). Ms A would as well find favor in the criminal laws which stipulates that a person is liable to stand serious charges upon committing an offence. Having been crowned as a ruling source of the laws, the criminal laws would supplement the HDC’s Act in a bid to seek sufficient justice. Regarding this affair the Canadian code of ethics and standards of psychiatric nursing practice states; Psychiatric Nursing values all aspects of health. The profession recognizes the complex relationships between emotional, developmental, physical, and mental health; the influence of social factors on physical and mental health and illness; and the role of culture and spirituality in health promotion, illness prevention, and recovery. Psychiatric Nursing values equality and believes that persons with mental health and developmental challenges deserve access to high quality health services. As a profession, Psychiatric Nursing strives to respond to and influence a complex and changing health system (College of Registered Psychiatric Nurses of British Columbia, 2012: 14). Doing the contrary, as a trained nurse, through manipulating the patients is, therefore, considered unprofessional as well as unethical. It was a breach of the coded rules and regulations. As Cooney, (1994) records the practicing nurses are supposed to be assigned supervisors during their early days in practice. The supervisors are supposed to oversee the various events unveiling in the lives of psychiatric nurses and address these in time to avoid mess ups in the future times. The fact that RN B was asking for a different allocation of a supervisor is a clear indication that the prior one never did a good job on him or was uncooperative during the supervision. The feelings and problems such as the occurrence of depression that RN B was undergoing should be taken into consideration before nurses are allocated duties to perform (Health & Disability Commissioner, 2011); these were not taken into consideration and addressed at the appropriate time despite the allocation hence the mess up. Moreover, we can as well argue that the incomplete supervision on RN B by the supervising nurses was the main cause of the later problems he committed based on the fact that his supervision and orientation documents were missing out from his file. These facts only helped further to unveil the shoddy job done during the supervision period the shoddy job done during the supervision period. Poor training as Laverack, (2004) notes are the direct cause of poor performance in the nursing field. A practicing nurse is supposed to be fully tested and approved for qualifications as an authentic source of help to the patients. This is because, of all forms of lives on earth, human life is held most important and any advances towards protecting the lives of human beings is regarded with serious intentions. It is very clear from the observations as DHB one confirms in his statement that the orientation documents related to RN B were missing out in his employment records, a matter which raises many questions as per the authenticity of the orientation, if at all it was undertaken. This continues to raise many questions and concerns as per the status of the on- job training. This guaranteed RN B no room for practicing as a psychiatric nurse having not clear documents to prove his training as a psychiatric nurse rendered fit for the job yet employed and accorded duties. Coupled with the fact that RN B had not attended any nurse study fairs organized by the institution, he lacked the necessary on- job training to help him attain the outright requirements as required in the nursing code of ethics hence the breach of the contract codes. On the contrary, we can argue that RN B tried to apply the absolute knowledge he leant during his study as a nurse only to slip during practice due to lax supervision on him. The nursing code states that psychiatric nurses are allowed to use a wide array of mechanisms to make sure that their patients recover to the levels required of them. This involves the use of several techniques ranging from psychotherapy to clinical administration of speech therapies and self care activities. The code records; Psychiatric/mental health nurses use a wide variety of interventions to prevent mental and physical illness and to promote, maintain and retain health. The Registered Psychiatric Nurse selects interventions according to their level of practice. The basic level nurse may select counseling, case management, self-care activities, group therapy, health teachings, and a variety of other approaches to meet the mental health needs of clients. The advanced level nurse may engage in psychotherapy, and act as a consultant in addition to the basic level interventions. All mental health nurses create therapeutic environments in diverse practice settings (Registered Psychiatric Nurses of Canada, 2010: 6). Concerning these facts, therefore, the nurses are required to employ every professionally proven methodology to bring their patients back to normalcy, a fact that RN B tried to employ but failed due to incompetence. The official discharge of the patient Ms A before the recommended duration elapsed was a clear indication to this incompetence and unawareness on the code regulations (Boseley, 2008). However, as Laverack, (2005) notes, changes are expected to happen anywhere in the world and that learning is a process that takes place in stages. Making mistakes to Cooney, (1994) is not a guarantee to lack of adequate knowledge and training in a given field of specialization but the in every profession, hands on skills and on- job experience are learnt with time as one continues to practice in his or her field of specialization. The fact that RN B failed in his initial trials and the failure on the part of the institution was a mere lesson learnt and a repeat for the same (though not encouraged in the medical field) is a clear indication of a routine behavior. RN B can, therefore, according to Laverack, (2004) arguments be pardoned given the fact that he had realized his mistakes and written apology over the same. Conclusion In conclusion, we can deduce here that psychiatric nursing is one of the very crucial sectors in human health provision which needs utter care and attention on the part of the care providers. Proper training is, therefore, of great importance to the nursing team in order to be able to observe the ethical standards required of them. Any misconduct in the field of professional nursing should be treated with utter care to avoid any form of irregularity in the administration of any form of medication to the patients. Medical practitioners are expected to display an adequate understanding of the principles underlying their profession by reflecting these requirements in their practice. About this issue, we can relate the affairs raised in 12HDC00027 as of prime concern to any practicing nurse an should be keenly observed to avoid such irregularities. References Boseley, S. (2008, December 8). Herception costs put other patients at risk. Guardian Weekly , 12- 23. Columbia, C. o. (2012, November). Professional Standards for Psychiatric Nursing , 3- 14. Cooney, C. (1994). A comparative analysis of transcultural nursing and nursing safety. Praxis , 8 (1), 4- 15. HDC. (2009a). FAQs - consumers. Retrieved April 2, 2013, from http://www.hdc.org.nz/about-us/faqs/faqs---consumers HDC. (2009b). History. Retrieved April 2, 2013, from http://www.hdc.org.nz/about-us/history Health & Disability Commissioner. (2011). Administration of medication to mental health patient. Retrieved from http://www.hdc.org.nz/decisions--case-notes/commissionersdecisions/2011/09hdc01408##recs Health & Disability Commissioner. (2012). General practitioner, Dr C, after hours clinic: A report by the Health and Disability Commissione. Retrieved from http://www.hdc.org.nz/decisions--case-notes/commissioners-decisions/2013/11hdc00871 Ho, J. (2000). self empowerment and professionalism: conversations with Taiwanese sex workers. Inter- Asia cultural studies , 1 (2), 283- 299. Labonnte, R., & Laverack, G. (2008). Health promotion in action: from local to global empowerment. Lonodn : Palgrave Macmillan. Laverack, G. (2004). Health promotion Practice: power and empowerment. Thousand Oaks, California: Sage. Laverack, G. (2005). Publick health: power, empowerment and professional practice. New York: Palgrave Macmillan. National Counmcil on AIDS. (1990). The New Zealand Strategy on HIV/AIDS 1990. Wellington, New Zealand: Ministry of Health. Rabinovich, J., & strega, S. (2004). The PEERS story: effective services sidestep the controversies. Violence against women , 10, 140- 59. Registered Psychiatric Nurses of Canada. (2010, March). Code of Ethics and standards of Psychiatric Nursing Practice. Psychiatric Nursing in Canada , 2- 8. References Boseley, S. (2008, December 8). Herception costs put other patients at risk. Guardian Weekly, 12- 23. Columbia, C. o. (2012, November). Professional Standards for Psychiatric Nursing, 3- 14. Cooney, C. (1994). A comparative analysis of transcultural nursing and nursing safety. Praxis , 8 (1), 4- 15. Ho, J. (2000). Self empowerment and professionalism: conversations with Taiwanese sex workers. Inter- Asia cultural studies , 1 (2), 283- 299. Labonnte, R., & Laverack, G. (2008). Health promotion in action: from local to global empowerment. London: Palgrave Macmillan. Laverack, G. (2004). Health promotion Practice: power and empowerment. Thousand Oaks, California: Sage. Laverack, G. (2005). Publick health: power, empowerment and professional practice. New York: Palgrave Macmillan. National Council on AIDS. (1990). The New Zealand Strategy on HIV/AIDS 1990. Wellington, New Zealand: Ministry of Health. Rabinovich, J., & strega, S. (2004). The PEERS story: effective services sidestep the controversies. Violence against women, 10, 140- 59. Registered Psychiatric Nurses of Canada. (2010, March). Code of Ethics and standards of Psychiatric Nursing Practice. Psychiatric Nursing in Canada, 2- 8. 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