Culturally-Sensitive Values: Pillars in Professional Health - Case Study Example

Culturally-Sensitive Values: Pillars in Professional Health The health care profession is a highly specialized professional field. Composing of multidimensional staff with expertise in particular clinical concepts, client-related information can pass from one health team to another in coordinated management. Yet, misunderstandings still occur, especially in situations where clinical facilities cater to racially diverse groups. Although professional regulations and values alone may seem sufficient for provisions of quality care, health care professionals must establish cultural awareness and sensitivity in care, for patients are holistic individuals in need of care for physical, mental, emotional, and spiritual recuperation. Cultural Values in Nursing Provision In actual clinical case, there had been one particular patient, Mrs. R.K.A, 66 years old, female widow from Scotland, who had been admitted in a general hospital for 3 days due to severe abdominal pain and vomiting of blood. Her whole hospital duration had been challenging for the health care team for a number of reasons. For one, her advancing age renders her quite difficult to handle, for she tends to stick with her herbal medications, and disregards treatments indicated for her in the medical facility. In other times, she has other racial beliefs that deviate away from medical concepts, such as reasons for her ailment, which she attributed to celestial and magical beings. Although mentally fit and psychologically coherent, such bouts of ethnic differences can indeed try the patience of any health practitioner. The situation exhibits the cultural values that the patient adapted prior to hospitalization. In retrospect, although totally different from the values nursing professionals follow in clinical practice, such personal principles by the patients serve as an eye-opener on the impact on moral and ethnically principles that each adapt. As expounded by Fry and Johnstone (2002), these categories of values are generated as an acceptable part of the norm by cultural groups, which falls in line with their belief concepts and are considered to give full justice and worth to systems of valid experiences existing cultural groups. In the client’s case, the significance placed on certain traditional beliefs of ancestral sources must be taken into professional consideration when rendering care. To relate with such reflective case, Davies and Finlay (2000, p. 83) suggested the three-stage framework in correlating experiences according to three aspects: “stage one (returning to the experience), stage two (attending to feeling), stage three (re-evaluating the experience).” On the first level, recall of the whole case episode is suggested in an objective manner. After doing so, one’s own mental and emotional reaction to such events are reviewed, internally touching on constructive emotional elements, while eliminating distracting experiences not related to the case in point. Lastly, after reactive emotions are identified, these are connected to personal situations, examining for similarities and distinctions, all the while, the newly developed ideals are incorporated on one’s philosophical knowledge and attitude (Davies & Finlay, 2000). Such procedures must be followed in every step in order to make relevant values alteration and integration on the professional level. On actual application, the import of being aware on how other cultural values operate must be monitored and identified early in nursing practice. The level-based critical reflection approach is relevant, not only for health care team, but also for clients and families as care recipients--extension of care to families is necessary for they provide support on physiological and psychological aspect of patient’s treatment and healing. As herbal and mythical dynamics are highly common in Scottish lands, these must never be dismissed as mere diversions. Although health personnel do not encourage such ideals, they must also be professional enough not to condone such practices. As pointed out by Duncan (2009), values may be a number of things, but at its core is its capacity to provide meaningful purposes to those who adapt them. By this, the cultural values of the patient served its purpose for her, and her family as part of the cultural group. Nurses should never condemn, but understand and provide values in quality care that are needed most. Professional and Ethical Values in Practice Every professional is governed by more than lawful regulations in performing clinical obligations. To a wider degree, health staffs are also ethically accountable for their indicated duties. Generally, values in health are equated to a number of concepts, including “choices and desires, attitudes and beliefs, norms...standards, visions and goals, morals, principles and commitment” (Pattison & Pill, 2004). The wide ranging roles that values preserve add to the complexity of its concept. In professional practice, a number of values are enumerated as important dimensions in identifying which are clinically appropriate actions. Grounded on common ethical principles as safety net in clinical practice, (nursing) health professionals abide to standard values in clinical management, from “autonomy, nonmalifecence, beneficence, justice, veracity, and fidelity” (White, 2004, p. 71). All of these characteristics must be molded in every health staff, where they must manifest attitude of respect for rights and autonomy of patients and their families, doing correct health procedures skillfully while preventing any form of harm from happening. There is commitment to do clinical services according to standards in nursing health practice, consistently telling the truth for the patients’ sake. These can influence how health professionals act in health settings, for the absence of a single value renders professionals temporarily incapable in rendering quality care. The values anchor health practices in various ways--as these target not only the physical side of treatment, but also the psychological and spiritual status of culturally diverse patients. Values, even culturally-related ones, must always be considered while caring for clients. Its import encompasses more than clinical aspects in care, for valuable concepts and beliefs serve to fuel the will of patients to seek health-related attention. On professional values, government policies are now veered at strengthening information campaign through autonomic values, giving them more access to their health management as independent entities in care. Moreover, the involvement of family members and the public at large are also emphasized, where their health and social status are to be protected and enhanced by virtue of governing laws and ethical considerations (Secretary of State for Health, 2010). In doing so, such legal actions that cover the providers of health care and their recipients show the great influence of holistic value inclusion in targeting improvements in health practices and services. Thereby, the partnership between families, health teams, and policymakers is crucial in the attainment of health care services that are physically, mentally, and spiritually satisfying--these must be efficient and achievable in long-term care. Regulations in General Nursing The nursing process in health care denotes a cyclical periods of health care functions: assessment, diagnosis, planning, implementation and evaluation of care plans. As indicated by Royal College of Nursing (2003), the time where nursing is more of a comforting health role had given way to more professional organization that is based on evidence-based nursing procedures and concepts. The establishment of reliable and valid body of clinical information rendered it more independent from medical functions. Thus, the ability to assess, diagnose, and intervene within the nursing scope are more competently done, yet, certain limitations are erected to safeguard the safety of health consumers. Included in the quality parameters in professional accountability is the wide coverage in ethical practice on autonomy. This principle dictates the need to honestly supply all health information related to client conditions. These actions range from respecting the dignity and rights of patients through providing treatment options, risks and benefits involved, as well possible outcomes of every treatment interventions presented. Upon doing so, patients are included in every step of clinical management and should decisions be nonconstructive, health professionals are liable to guide them to more appropriate paths, without coercion nor prejudice. Health personnel give every opportunity for patients to determine and decide the course of action they wish to take. Nurses must be professional enough to accept whatever decisions their patients choose, and secure them by way of informed consent (White, 2004). To provide valid evidence that patients have fully comprehended the health status they are in and the relevance of the decision-making they undergone, informed consent forms are always secured as attestation of their perception on treatments and possible outcomes. Without full knowledge on such processes, nurses neglect their duty to protect patients, and are failure in their functions, as well. As one of the regulatory organizations, Nurse and Midwife Council (NMC) is a credible association that caters to all regions in United Kingdom, where their priority is the safety of public health through regulatory processes. Aside from professional monitoring and screening schemes, they also scrutinize standardized functions in both academic and clinical institutions, keeping close watch against danger of going beyond indicated boundaries of health roles. Continuing trainings and educations are initiated, updating clinical concepts and skills while going after those who have displayed misconducts in the profession (Nurse Midwifery Council, 2010). Regulations, then, entail more than watching for discrepancies in health practices, it is also preventive in nature as it consistently updates care qualifications and codes to fit current generation of practitioners. Included in the benchmark is the value of maintaining integrity in consent of care and confidentiality with which full health disclosure is decided through patients’ self-determination. In general terms, consent of care will only remain valid in instances where mental capacity of signatories are sound and faculties are within legal age and psychologically bounds. Moreover, the nature of confidentiality always sides with clients, but in instances of public threats, disclosure is indicated (Nurse Midwifery Council, 2008). The regulatory is quite specific in its terms, and whoever goes out of professional limits are subject to punishment, accorded from local and universal health policy laws. All of participating stakeholders in health care (providers, consumers, and regulators) play significant roles in the check and balance of quality care, but the ultimate beneficiaries are the patients as public consumers. In cases of contrariness on their side, as in the case of Mrs. R.K.A., their safety as care recipients may be put in considerable jeopardy. Diversity in Multidimensional Health Practice In tandem with the regulatory functions exhibited by NMC, the government enacts on general and specific health issues of the citizens in United Kingdom through the National Health Service (NHS) as a public organization. As directly pointed out by the Department of Health (2010), this health body is constitutionally designed to provide health services that are rendered to all groups, regardless of their physical attributes, cultural orientation, and paying powers in society, as equity dominated such provisions. Like the NMC, the framework of the organization ensures public safety through excellent standards in health care to providers, as rendered to patients, their families and all community populations as ultimate recipients of care. Basing from the NHS service scope, it can be surmised that all health sectors, from the national to local agencies, are largely involved in delivery of quality care. Enlisting cooperation from clinical and community health institutions, the NHS framework enables potential clients from receiving care within their reach (Department of Health, 2010). As local health systems are extensively involved in national campaigns, standardized health services can actually be implemented and attained in full. At large, the informal way in dealing with clients makes definite distinctions between members of health teams. In nurses and midwifes, their roles as front liners are crucial in performing care that is both empathetic and efficient. The focus of prioritized care will always remain on the whole person, with individual human responses that cannot be defined in pathological terms (Royal College of Nursing, 2003). The professional values from each team members, then, differ, as priorities vary. Nurses and midwifes are taught to look for psychological reactions while executing clinical functions, and attend to them as part of holistic service provision. Included in such assistance is professional understanding that each patient maintain cultural concepts that are entirely different from their own. To be effective, objective neutrality may be the best approach, where health personnel promote cultural awareness while assuming a more understanding stance with values difference in others. This way, clients can place their trust on their care providers, knowing that their differences are set aside in treatment. At the same time, care providers can also bridge the communication gap between health providers and consumers, in a setting that lack cultural prejudice and values discrimination. Only at such strategy can these groups function without external influences as barriers to care. Involvements in Professional Health Service Equity in service is part of the key concepts emphasized in the professional conducts maintained by nurses and midwifes. Unfortunately, reports by Nurse Midwifery Council (2010) exhibits the reality of poor public services rendered to minority groups and indigents communities, hence, need to strengthen the Code of Professional Conduct specific in guidelines created by NMC. In general manner, trust between health providers and recipients of care must establish mutual trust. In order to obtain this, priorities must be centered on patients as unique beings of distinct characteristics. Confidentiality and collaboration of care with clients and clinical colleagues must be observed, and cemented through consent forms and legal contracts in treatment. They must be conscientious in delivering effective care, where delegations are done, depending on clinical knowledge and skills. This way, services can be fast and accurate, while managing risks to the minimum. Such tasks must always be guided through evidence-based concepts in practice, where information and skills are utilized to maximally benefit patients; all the while, accurate records of care must be kept clear for future references. All these are implemented with integrity and impartiality borne out as health professionals, in keeping the public safe (Nurse Midwifery Council, 2010). These codes of conducts are broad, but they cover the essentials with what make nurses and midwifes at safe margins in their health careers. As ascribed by Pera and Tonder (2005), nurses are more than accountable in professional level, as they are legally, morally, and administratively responsible with what happens in the work place. As discussed earlier, there are guiding principles that both students and registered alike follow all throughout their tasks in health. Failing in a single area in regulated rules and accountability exploit the vulnerability of patients as dependent stakeholders in care. If health professional exploits their functions, clients must be aware of their rights as patients in care--to understand where the nurses’ privileges end and where their rights begin. In the case of Mrs. R.K.A., her situation demands that she be given extra understanding with her advancing age and cultural orientation. Nurses, in such scenarios, must be culturally sensitive with variation in value systems and deviations from clinical health frameworks. Their influence as partners with clients in health care is tested, as well as their abilities to set aside their own values in allowance to those of their patients. As dictated by the national and local policies on service equity and discriminatory protection regulatory discussions in NHS and NMC had been clear that health professionals will always sustain neutrality as professionals. After all, they are not present in health settings to pass judgment, but to professionally intervene on clients’ conditions--both in physiological and psychological level. Conclusion All in all, most of the activities executed by health professionals are strictly governed by both national and local health sector agencies. In such scenes, diversities in cultural orientation and values largely influence how both patients and professionals react in each of their roles. On the side of patients, they are well-protected by their human and health rights, while nurses are guided by their core ethical principles on how to handle procedural conflicts in health settings. The individuality of each patient can affect the quality of care, but health organizations (NHS and NMC) ensure universality in services through equitable health provisions, regardless of physical or cultural attributes. In the long run, excellence in service are not only due to standardized benchmarks in clinical practice, ethical parameters are also necessary in creating an atmosphere that is mutually trusting, and at the same time, impartial against any forms of cultural discrimination that may largely affect how health services are rendered and received. References Davies, C., & Finlay, L. eds. (2000). Changing practice in health and social care. London: SAGE Publications. Department of Health. (2010). The NHS Constitution: The NHS Belongs to us all. Retrieve http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_114941.pdf Duncan, P. (2009). Values, ethics and health care. London: SAGE Publications. Fry, S.T., & Johnstone, M.J. (2002). Ethics in Nursing practice: a guide to ethical decision-making. 2nd ed. United Kingdom: Blackwell Publications. Nurse Midwifery Council. (2010). Our role. Retrieved from http://www.nmc-uk.org/About-us/Our-role/ Nurse Midwifery Council (2008). Strategic context report. Retrieved from http://www.nmc-uk.org/Documents/Strategic%20context%20report.pdf Pattison, S., & Pill, R. eds. (2004). Values in professional practice: lessons for health, social care, and other professionals. United Kingdom: Radcliffe Publishing. Pera, S.A., & Tonder, S.V. (2005). Ethics in health care. 2nd ed. Landsowne: Juta and Company. Royal College of Nursing. (2003). Defining nursing. Retrieved from http://www.rcn.org.uk/__data/assets/pdf_file/0008/78569/001998.pdf Secretary of State for Health. (2010). Equity and excellence: Liberating NHS. Retrieved from http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_119109.pdf White, L. (2004). Foundation in basic Nursing. 2nd ed. United States of America: Thomson Delmar Learning. Legend: Select an episode of care for an individual in which you have been involved in during practice placement AND use a recognised model (Gibbs model of reflection cycle) of reflection as a structure to describe that episode of care. Within the reflection include an examination of your own values and beliefs relating to the individual receiving care, and/or their families/carers. AND Within the reflection use theory related to values and beliefs to explore how these values and beliefs underpin your practice. I.E. Theories related to values and beliefs which underpin practice are, Attitudes, prejudices and stereotypes, Legislation - consent, vulnerable adults or children, Freedom of Information Act, Data Protection Act, confidentiality to be used mainly, Ethics - making moral decisions, autonomy to be used mainly/ rights/dignity/ empowerment/informed choice, Collaborative working- Reflection in practice Read More