Ethics and Law for the Health Professions - Essay Example

?Nursing Assignment A comprehensive understanding of the regulations that guide nursing practice is essential for the successful handling of all types of patients. According to Brammer (2008), it is important for student nurses to be paired with registered nurses when they perform their first care responsibilities towards their assigned patients in order to benefit from the advice given by the more experienced nurses. When there is less access to such learning experiences and therefore little if any opportunity for taking part in shared learning experiences, the confidence of the student nurse in matters such as caring for patients is diminished (Deegan 2013). The fundamental ethical principles and their meanings and whether they were upheld or breached in the Case Study In this case, the key stakeholders are the patients. It is important for nurses to learn of the ethical principle of autonomy and how to implement it in the nursing situation (Midgley 2006). The right to autonomy is one of any patient’s ethical rights in a situation where they are under the care of medical personnel (Somerville and Keeling 2004). In this case, the registered nurses had the responsibility of overseeing or supervising the work of their mentees while also ensuring that their professional responsibilities were fulfilled. Another ethically based nursing principle, beneficence, holds that nurses should act with kindness, charity, and mercy towards their patients (Myrick and Yonge 2005). This basically means that nurses should not bring additional harm to their patients. A third ethical principle, nonmaleficence, has to do with avoiding a situation where a patient is caused unintentional harm (Curtin 2005). Another ethical principle in nursing practice is veracity (Dalton 2005). Veracity basically refers to truth telling in all situations. As far as the ethical principle of advocacy is concerned, it would appear that not all student nurses were satisfied with the skills and relations given to them by their mentors. The principle of confidentiality basically has to do with respecting a patient's right to privacy. This is particularly important for patients who have illnesses that carry social stigma such as A.I.D.S (Cuevas 2008). WERE THERE ANY ETHICAL CONFLICTS? Autonomy According to Brammer, there are different ways in which the student nurses and mentors may interpret what it means to function in a supervisory role (Brammer, 2008). This may bring different problems in cases where nursing students are expected to ease the burden of the mentor by indicating that the mentor was present during the examination of a patient or in writing notes on the physical conditions of patients that they might not have personally examined as a favor to their overworked mentors. This also breaches the ethical principal of autonomy. Another situation that brings into focus issues concerning with autonomy has to do with the ministrations of student nurses towards their patients (Jansson, Pilhammar, and Forsberg 2009). Beneficence From the reactions of some of the student nurses in this case study, not all the mentors were diligent in practicing the ethical principle of beneficence in their dealings with their mentees. It is not uncommon for training nurses to claim that they do not feel respected by their supervisors or seniors. This does not merely have to do with being ignored, but also the allocation of extra work with little supervision. Given that the registered nurses function as ‘gate keepers’ who wield enormous power over the future careers of their mentees, it can become quite disheartening for their mentees when they are not treated with the charity and kindness that are part of the ethical principal of beneficience (Yildirim, Ozkahraman, and Karabudak 2011). Nonmaleficence For student nurses, it is very important for them to have enough time with their mentors when looking after patients. Moreover, it would appear from this case that the student nurses recognized that their mentors could perform important tasks faster than they were able to when bogged down with having to supervise students. A good number of student nurses, though, were quite satisfied with the supervision and care given by their mentors. Given that there were no specific details given about the care of patients in this case study, it could be said that nonmaleficence cannot be proved or negated. Veracity In this case study, the principle of veracity was observed in some situations, though not in others. In the result of the study, it is stated that student nurses and their mentors in some cases, had different interpretations of what could be said to be adequate supervision or monitoring. In a case in which the power lies with the party that is invested with authority, it is likely that it is this party’s view that will be accepted as truth. Having understood that the assessment of their skills would be based on the findings of their mentors, they would also have been uncomfortable about letting their mentors know of their dissatisfaction about their supervisory skills. Advocacy In as far as student nursing is concerned, advocacy has to do with being encouraged to work outside one’s comfort zones and having clear communication between a mentor and a mentee (Whittaker 2009). From the case study, it was discovered that each student had a unique definition of what a quality learning experience should be. There were student nurses who felt that they had inadequate learning experiences as they did not have enough time with their mentors. According to Zarezadeh the registered nurse has a duty to ensure that he or she encourages team building skills in other members and creates relationships with colleagues that will enhance client care (Zarezadeh 2009). This is actually a legal stipulation (Dye 2006). Confidentiality In this particular case study, there was no confidentiality ethical conflict as there was no basis for the application of the principle of confidentiality as the study was based on relations between student nurses and their mentors. Were the Law and Professional Standards upheld or breached? The issue concerning the allocation of enough time by the registered nurses to the student nurses is obviously the most contentious. From an alternative ethical position, it could be said that registered nurses who do not provide their mentees with enough time or supervision are actually flouting rules that require that student nurses not be left with responsibilities they have not been officially certified to perform. For student nurses to benefit from the concentrated attention of a particular registered nurse, it might be advisable for the student nurse to ask to be assigned a registered nurse who is not on clinical rotation. Even though this may take time, it could be the only way to ensure that the student benefits from the attention and supervision of a nurse who has a lot of time and can correct or comment on each of the student’s actions. Stakeholders in the Case Study In this case, the key stakeholders are the clients. Moreover, the other medical practitioners such as student nurses and registered nurses are also stakeholders. If there is inadequate communication between student nurses and registered nurses, it is likely that the people who will suffer most are the patients. Disagreements or a lack of understanding between student nurses and their mentees could also result in the student nurses not being able to succeed in meeting their objectives as the registered nurses overseeing their practice may feel that they are as yet not ready to take over the responsibilities of regular nurses. Decisions that need to be made to rectify the Situation Hospitals are left with the responsibility of ensuring that they do not hire inept people who may then be accused of gross negligence, or who neglect to monitor student nurses adequately. This is particularly important in light of the nurse shortage being experienced at present. Responsible oversight has become harder for hospitals as they tend be more dependent on independent contractors such as fee-for-service clinicians to supplant registered nurses. Independent contractors usually only spend a few unevenly scheduled hours every week in the hospitals in which they are hired. This may result in a situation such as that in which some student nurses in this case complained of not having adequate supervision from their mentors. In addition, the lack of continual contact with other administrative workers hampers any indirect or direct supervision from the hospital authorities themselves. The only way for this to be dealt with is if hospitals can identify institutional dynamics that help in supporting malpractice on the part of nurses while also helping the registered nurses who serve as mentees to make helpful changes in re-addressing those dynamics. Such efforts will increase the effectiveness of registered nurses as mentors while also generating creative uses for their training and individually varied skills. The Case Study from a Different Perspective In this case study, the relationship between student nurses and mentors appears to be good, with only few of the student nurses registering dissatisfaction with the time that their mentors allocate them. According to Price (2004) mentorship actually benefits both the mentee and the mentor. Moreover, he observed that there can also be a darker side to the relationship. The skewed power structure that forms the basis of the mentor-mentee relationship can make the mentee vulnerable to exploitation. Some of the students in this case study spoke of feeling that their mentors expected them to fulfill all their responsibilities but did not give adequate time o supervise them in their performance of these duties. This could be termed as exploitation of a kind (Kerridge, Low, and McPhee 2005) In some cases, mentors can even take on multiple numbers of mentees, which merely results in each of the mentees not having adequate time with the mentor even though they are each compelled to perform duties that ease his or her workload (Mantzoukas and Jasper 2004). Problems may also crop up if the mentor actually does not have the necessary skills needed to supervise the mentee or does not take the role of mentor very seriously. Conversely, mentors can become very controlling or show undue favoritism when they have more than one mentee. Another area of ethical concern which comes about as a result of the strong mentor-mentee connection is the blurring of personal boundaries. While this is not common, it still happens when mentors and mentees develop friendships outside the workplace (Jerico, Peres, and Kurcgant 2008). Some mentors develop a paternalistic approach when dealing with their mentees, and their mentees also develop emotional connections to the mentors (Chabelli 2007). In such cases, it is not uncommon for mentors, particularly if they are all affiliated to one institution, to discuss their mentees and their individual problems among themselves. This is actually a breach of confidence and goes against nursing ethical principles. Respecting the privacy of mentees actually maintains the integrity of the mentoring process. References Brammer, J. (2008) ‘The RN as gatekeeper: gate keeping as monitoring and supervision’, Journal of Clinical Nursing, vol. 17, no. 14, pp. 1868–1876. http://ezproxy.usq.edu.au/login?url=http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2702.2008.02376.x/abstract Chabelli, M.M. (2007) ‘Facilitating critical thinking within the nursing process framework: a literature review’, Health SA Gesondheid, vol. 12 no. 4, pp. 70- 88, viewed 30 Jul 2013. Cuevas, H. (2008) ‘Using reflection as a nursing intervention’, Clinical Nurse Specialist - Wolters Kluwer Health |Lippincott Williams & Wilkins, vol. 22, no. 3, pp. 122-123, viewed 30 Jul 2013. Curtin, L. (2005) ‘Ethics in informatics: the intersection of nursing, ethics and information technology’, Nursing Administration Quarterly, vol. 29, no. 4, pp. 42-46. Dalton, L. (2005) ‘Use of clinical space as an indicator of student nurses’ professional development and changing need for support’, Nurse Education Today, vol. 25, no. 2, pp. 126–131. Deegan, J. (2013) ‘A view from the outside: nurses’ clinical decision-making in the twenty first century’, Australian Journal of Advanced Nursing, vol.30, no.4. Retrieved from http://www.ajan.com.au/Vol30/Issue4/30-4.pdf Dye, D. (2006) ‘Enhancing critical reflection of students during a clinical internship using the self-S.O.A.P.’, The Internet Journal ofAllied Health Sciences and Practice, vol. 3, no. 4, pp. 1–6, viewed 30 Jul 2013. Jansson, I., Pilhammar, E. & Forsberg, A. (2009) ‘Obtaining a foundation for nursing care at the time of patient admission: a grounded theory study’,The Open Nursing Journal, vol. 3, p. 56, viewed 30 Jul 2013. Jerico, M.C., Peres, A.M., &Kurcgant, P. (2008) ‘Organizational structure of nursing services: reflections on the influence of the organizational power and culture’, Rev Esc Enferm USP, vol. 42, no. 3, pp. 559-66, viewed 30 Jul 2013. Kerridge, I., Low, M. & McPhee, J. (2005) Ethics and law for the health professions, The Federated Press, Annandale. Mantzoukas, S. & Jasper, M. (2004) ‘Reflective practice and daily ward reality: a covert power game’, Journal of Clinical Nursing, vol. 13, no. 8, pp. 925-933, viewed 30 Jul 2013. Midgley, K. (2006) ‘Pre-registration student nurses perception of the hospital-learning environment during clinical placements’, Nurse Education Today, vol. 26, pp. 338–345. Myrick, F., & Yonge, O. (2005) Nursing preceptor-ship: connecting practice and education, Lippincott, Williams & Wilkins, Philadelphia Price, A. (2004) ‘Encouraging reflection and critical thinking in practice’, Nursing Standard, vol. 18, no. 47, pp. 46-54, viewed 30 Jul 2013. Somerville, M. & Keeling, J. (2004) ‘A practical approach to promote reflective practice within nursing’, Nursing Times, vol. 100, no. 12, p. 4, viewed 30 Jul 2013. The Canadian Nurses Association - Code of Ethics for Registered Nurses. (2008) Nursing Practice Standards, viewed 30 Jul 2013. Whittaker, R. (2009) ‘Narrative explorations in clinical health psychology’, The International Journal of Narrative Therapy and Community Work, no. 2, pp. 48-55, viewed 30 Jul 2013. Yildirim, B., Ozkahraman, S. &Karabudak, S.S.(2011) Critical Thinking in Nursing Process and Education.International Journal of Humanities and Social Science, vol. 1, no. 13, pp. 257-261, viewed 30 Jul 2013. Zarezadeh, Y. (2009) ‘A model for using reflection to enhance inter-professional education’, International Journal of Education, vol. 1, no. 1, pp. 1-9, viewed 30 Jul 2013. Read More