The Unique Function of the Nurse - Essay Example

Trust Introduction ‘The people in your care must be able to trust you with their health and wellbeing. To justify that trust, you must make the care of people your first concern, treating them as individuals and respecting their dignity’. NMC UK Code 2008. This guidance from the NMC appears simple, but it is a difficult responsibility to fulfill in practice. Discuss. The idea that patients are individuals is not a new one, but treating them as such rather than as part of a business plan or production is in some ways an easier option. No account has to be taken of individual needs or preferences and planning is easier. However in 1966 Virginia Henderson said ( page 15) :- The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. This idea was later expanded by Roper-Logan-and Tierney in the 1970’s into a model of nursing that encompasses the various activities of daily living. There are many ‘Trusts’ within the modern day NHS. They are local organizations entrusted with the medical care of the people in their area. Unfortunately, in some cases, the word ‘Trust’ is just seen as another word for a business, patients get in the way of business efficiency and they soon learn to mistrust the word. The code mentioned above goes on to say:- Work with others to protect and promote the health and wellbeing of those in your care, their families and carers, and the wider community. Provide a high standard of practice and care at all times. Be open and honest, act with integrity and uphold the reputation of your profession. The dictionary defines ‘Trust’ in a number of ways. These include a firm belief in the reliability or truth of a person or thing; a confident expectation; the thing or person committed to one’s care and the resulting obligation or responsibility. Trust is based to a large extent on past performance as well as present actions. If the idea of going into a hospital or other health care facility is based upon the belief, based on past experiences or knowledge, that staff are well trained, professional and caring and that the hospital maintains high standards when it comes to such things as hygiene, the correct dispensing of medication, staffing levels and vetting staff, then trust is justified, and they will presumably receive the best possible care. If however standards have slipped in some way, whatever the patient believes and trusts in, their trust is not fully justified. However all may not be in the immediate control of an individual member of staff. They may have little to do with the hiring of staff or compiling of rotas. They are obviously part of a team, but it isn’t necessarily entirely composed of members that they would choose. There may for instance be agency nurses who know little of normal routines, who however well qualified and professional, find difficulty on occasions with simply finding things or knowing which form to fill in. There may be members of staff who, although qualified and capable in many ways, have an accent that is difficult for some people to understand. There may also unfortunately be those who are not as sympathetic as they might be to a patient’s individual needs and worries, those who, when someone appears to be in pain, respond by saying things such as ‘They are only doing it to gain attention’. In such cases a nurse must maintain her own professional standards, even if this means taking more than her fair share of caring responsibility. She must also ensure that the matter is dealt with either by providing more support and training or by ensuring that her seniors are aware of the situation and the difficulties caused. Another area in which an individual health worker has little control is budgetary. Each ward or department will have an annual budget, but accountants and finance managers need to be made aware of exactly why ‘x’ amount of incontinent pads are used on one ward and only ‘y’ on another and so on. They should not just be office workers, but visit various department s regularly and listen to what staff and patients say. If there are major difficulties such as failures in supply this needs to be reported or patients will not receive the care they need. The individual may have almost no control over such things as waiting lists or the work of other departments. If however beds are regularly being blocked by patients who should be being cared for elsewhere or there are other major failures then the matter needs to be raised in the appropriate way. Each NHS Trust must provide facilities for feed back from staff at all levels. Sometimes matters can be put right easily, a phone call to the right person, but it is not always possible. The 12 activities of daily living as outlined by Roper, Logan and Tierney should not be treated lightly as a checklist on admission i.e. by asking if the patient is mobile, continent etc, but steps need to be actively taken to ensure the best possible individual outcome. If for instance a patient is immobilized by their illness then a plan should be put in place to ensure that they receive help to regain their mobility, perhaps by using the services of the physiotherapy department, but also encouraging mobility at other times. If they require nutritional help or advice this should be arranged. This may require such things as making meal times a time when other activities stop, so that full attention can be given to helping where needed, rather than meals being left on bed tables out of reach. Even if the patient is incapable of expressing trust, as may occur with senile dementia, the professional still has a duty of care, a trust. Conclusion If a nurse is asked to deliver a standard of care that they consider to be less than adequate they need to ask themselves why this is and what can be done to right the situation. If they are delegating tasks then this should only be done if they believe the task will be carried out properly. This involves checking that the required task has been carried out properly and supporting staff in their work. Such accountability is an important part of the role of any health care professional whether they are the most junior or in charge of large numbers of people. Trust equals accountability. Rodney Porter, writing in the Nursing Times in 1997, gave the results of a survey in which many respondents had complained of staffing levels in hospitals, and too much reliance upon bank and agency staff. In the same article Michael Walker, spokesman for the pressure group , the NHS Support Federation, is quoted as saying he believes issues such as pay, standards and job security as well as and gagging clauses , needed to be dealt with. We are now 13 years on and things have changes very little. Change from the top doesn’t seem to work. I t is time for the individual to stand up and accept, as a professional and as a caring individual, the trust which is theirs. References Accountability, Nursing and Midwifery Council , April 2008 available from https://manuscriptservices.digitalsecured.com/harvard.shtml , accessed 12th March 2010 HENDERSON,V. 1966, The Nature of Nursing .New York: Macmillan Publishing, The Nursing and Midwifery Code (2008)available from http://www.nmc-uk.org/aArticle.aspx?ArticleID=3056, accessed 11th March 2010 Porter, R. ,Whom do you trust with the NHS? The Nursing Times 1997, abstract available from http://www.faqs.org/abstracts/Health/Whom-do-you-trust-with-the-NHS-anger-at-staff-shortages-and-the-increasing-use-of-bank-and-agency-nu.html#ixzz0hxY580Nf, accessed 10th March 2010. ROPER, N. (1973,1982). Principles of Nursing, Edinburgh Churchill Livingstone, ROPER,N.LOGAN,W.,TIERNEY,A., editors (1983). Using a Model for Nursing,. Edinburgh Churchill Livingstone Walker, M. quoted by Rodney Porter, see above. Read More