Nursing: Scope and Standards of Practice - Essay Example

? Critic 28th Feb, Bekemeier, B. & Butterfield, P. (2005). Unreconciled Inconsistencies: A critical Review of the concept of Social Justice in 3 National Nursing Documents. Advances in Nursing Science, 28 (2): 152-162. In this article, Bekeimeier and Butterfield give a detailed critic of the American Nurses Association Code of Ethics for Nurses with Interpretive Statements, Nursing: Scope and Standards of Practice and the Nursing's Social Policy Statement. According to these authors, the mentioned documents fail to provide a sufficient basis on which nurses can broadly provide quality health care and be able to solve the root causes of emerging health issues. They refer to the documents as those that only focus on individual relationships between the nurse and the patient, but fail to sufficiently focus on the wider sectors and sytems whose improvements are likely to have a major role in the improvement of health and health provision. The documents do not satisfactorily promote social justice according to the authors, an area which they deem as fundamental to the nursing practice. Bekeimeier and Butterfield feel that the documents need to have placed more focus on political action and on ways through which nurses can be able to address all underlying factors in the eradication of emerging health problems. With this, the three documents help in ensuring quality healthcare for individual patients that nurses come into contact with, rather than ensuring the quality health of the entire population. From the arguments presented by the two authors, the three documents bring about various social aspects but only mention this at some instances. The weight given on issues related to social justice cannot be compared to that given to issues related to individual patient care. The phrase social justice is reported to have only been used one time in each of the 3 documents, an indication of the value this has been given as compared to aspects related to nurse-patient relationships (Bekeimeier & Butterfield, 2005). Based on the arguments presented by the two authors, I strongly agree with their view and believe that more should have been done to promote the role of nurses as political and social leaders as well as advocates. Though the Scope and Standard for Practice document defines nurses as those who play these two roles of leadership and advocacy and in the promotion of social change and reforms towards the improvement of health, the document, just like the other two documents does not focus on how this can be effectively done (ANA, 2010). Having gone through the three documents by ANA, any one would see the evident focal point for the three documents. The amount of information given as guidelines for the nursing practice and that relate to the care and services provided to a patient is overwhelming. There are parts of the documents that touch on public health and the nurses’ involvement in the promotion of public health, but have only been briefly stated (ANA, 2013). I am in complete agreement with the authors on the issue of collaboration as brought out in the three guide documents. In most cases, collaboration has always been taken to mean different groups of persons working together with one mission, and where each member makes a contribution towards the group. This is however not the concept brought out in the Code of Ethics, where collaboration during patient care would be taken to mean nurses working with patients and other related parties such as families and the surrounding community to promote quality care and treatment as well as overall promotion of complete health for all. The Code of Ethics, in this case brings out collaboration to mean the involvement of the patient in being part of the decision making process (ANA, 2013). This definition shifts the focus of the document from the social aspect to what most parts of the documents focus on; an individual patient. I also concur with the two on their view that the generalization of the term patient to refer to the entire population in the Code of Ethics is ambiguous and not appropriate at all (Bekeimeier & Butterfield, 2005). The reason given for this is the amount of information that clearly focuses on one particular patient and most especially in relation to the various case scenarios presented (ANA, 2010). The three documents by the American Nursing Association (ANA); The Code of Ethics, The Social Policy Statement and the Scope and Standards of Practice have evidently played a great role in promoting quality health. The documents provide a guideline through which nurses are able to effectively carry out their assigned duties and tasks through ways that promote safety and well being of the patients. The focus of the three documents has mainly been identified as being more on patient nurse relationships, with very little information being given on issues related to social justice and social reforms. This as has been observed by Bekeimeier and Butterfield is a major weakness with the three documents from the organization. Despite the fact that ANA is one of the leading organizations that is supporting numerous programs, many of which are also focused on promoting public health through the identification and control of underlying issues that may affect the quality of health, the three documents have a played a very insignificant role in doing this (ANA, 2010). The three documents have provided a framework through which nurses have over the years used it in their day to day processes of decision making as well as undertaking of assigned roles and duties. These have helped them to effectively practice their duty towards the patients they serve. To deliver their complete potential, however, and to be able to effectively take up their profession, nurses also need to be aware of the social and political responsibilities bestowed upon them. This can best be done if they have a framework through which they can be guided and encouraged to take the lead in promoting social justice and in addressing the fundamental issues that may affect the health and stability of not just one individual patient, but of the general population. At this point, the three documents by the ANA do not provide that framework. The promotion of social justice calls for the promotion of equality in the distribution of both health and wealth, and nurses need to be aware of the huge role they can play in attaining this. References American Nursing Association. (2010). Nursing: Scope and Standards of Practice. Silver Springs: ANA. American Nursing Association. (2010). Nursing's Social Policy Statement. Silver Springs: ANA. American Nursing Association. (2013). Code of Ethics for Nurses with Interpretive Statements. Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsfor Nurses/Code-of-Ethics-Review.html. Bekemeier, B. & Butterfield, P. (2005). Unreconciled Inconsistencies: A critical Review of the concept of Social Justice in 3 National Nursing Documents. Advances in Nursing Science, 28 (2): 152-162. Insert your name Address 01.03.2013 Del. Shirley Nathan-Pulliam, R. Maryland House of Delegates,  Lowe House Office Bldg., Room 309 Annapolis, MD 21401  Dear Sir, Ref: Heath Policy Related to Bipolar Disorder Mental health disorders have continued affect the social, political as well economic aspects of the country, and in turn necessitating the need for proper control measures to be put in place. Such control measures have included policy formulation and implementation. This letter addresses the issue of bipolar disorder, also referred to as manic depression. This is a mental disorder that leads to changes in a person’s moods, ability to work or undertake numerous activities as well as shifts in energy (Goodwin & Sachs, 2010). The illness is mainly characterized by numerous mood swings, irritability, feelings of hopelessness and sadness and suicidal thoughts and attempts (NIMH, 2012). Statistics obtained from the National Institute of Mental Health in 2002 indicate that over 2 million adults in American suffer from bipolar disorder (NIMH, 2002). By 2005, the number had increased to 5.8 million adults (Kessler et al., 2005). The employment sector is one area that has been highly affected by the increased number of people suffering from bipolar disorder. Employers and their affected employees have also reported a lot of conflicts with some employers opting to fire their employees for poor productivity and output. Such is the case with a patient I handled some time back. Paul (name changed for confidentiality) had been brought into the hospital showing a number of behaviours that led to the diagnosis of the disorder. The abnormal behaviours were characterized by pacing up and down, incoherent fast speech, suicidal thoughts and increased irritability. Further inquiries from his sister indicated that Paul was having problems at work as a result of his frequent mood changes and irritation that were as a result of his illness. The man had been issued with a suspension letter by his boss a few days prior his coming to the hospital. The patient was reported to have missed work for many days and his productivity reported to be very poor. This patient represents so many other patients who have lost their jobs on the basis of their illness. Bipolar disorder has been regarded as a disability and the patients are therefore protected by the Americans with Disabilities Act (ADA). The law serves towards protecting persons with disabilities. According to the act, an individual is regarded as disabled if he or she has a mental or physical impairment that prevents him or her from engaging in one or more activity (EEOC, 2011). Upon assessment, bipolar disorder has been found to always limit the normal functioning of the brain as well as the normal undertaking of the various day to day activities. Having an accommodation as a bipolar disorder patient allows one to freely acquire reduced hours of work, get moved a working area that is more peaceful and quieter, break off from the job once in a while, get a job that is not strenuous and modify the various roles and responsibilities at work. According to the Equal Employment Opportunity Commission (EEOC), the discrimination of an employee or a potential employee on the basis of his disability, color, race, family or class among other factors is unlawful (EEOC, 2011). Through the ADA act, therefore, bipolar patients are protected from getting fired or unfairly dismissed on the basis of their illness. From the case of my patient, it is clear that employers do not recognise bipolar student as those protected by the ADA act. This prompts for more action to be taken by all relevant stakeholders; nurses, patients and various government agencies. It is important that the rights of employees suffering from bipolar disorder are upheld. Employers need to be aware of the rights of such employees and need to be prepared to respect those rights. The patients need also to be made aware of those rights, and in turn call for their provision. The government needs to ensure that employers who do not act in accordance with the Act are prosecuted. Such strict measures will help in reducing the increased discrimination of the bipolar disorder patients. It is my wish that you office will work towards ensuring that the rights of this group of patients are upheld at all times. Thank you. Yours Sincerely Name References Equal Employment Opportunity Commission (EEOC). (2000). EEOC enforcement guidance on the Americans with Disabilities Act and Psychiatric disabilities.  http://www.eeoc.gov/policy/docs/psych.html Goodwin, G. & Sachs, G. ( 2010). Fast Facts: Bipolar disorder. Oxfordshire: Health Press Limited Abingdon. Kessler, R., Chiu, W., Demler, O. &Walters, E. (2005). Prevalence, severity and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62 (6): 617-27. National Institute of Mental Health. (2002). Bipolar disorder.  http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml Read More