The Issue of Paternalism in Nursing - Essay Example

PATERNALISM IN NURSING Introduction Ethical issues in the medical sector have played paramount role in the growth and development physical, psychological and socials health services. Throughout the span of healthcare services provisions in the Australian regions, a number of issues have between put forward in the endeavor of mitigating or bringing a transforming the quality of services provided to patients (Ikonomidis and Singer,1999, p. 527). The introduction of change in the system have never gone or implemented without experiencing opposing forces of transition, the paternalism policy has not been an exception. However, such paralleled forces help in streamlining the change implementation process that maintains the core healthcare codes and values and mission of health sector (Leino-Kilpi and Valimaki 2000) Paternalism in nursing The issue of paternalistic approach in the healthcare provision has been one of the issues which in the past few years and in the current times have raised heated debate. However, this affirms how humanity is diversified in opinions and thoughts. Perhaps the divisions in opinions and differences arising among the members of nursing society and the community as whole arise from the numerous interpretations of the terminology. In the broad sense, the term paternalism refers to the usual strategy of hierarchy as with family set up, that is there is application of the policy which nurtures dependence on those who are in authority, or generally those who are at a higher ranker than ones position (Osman and Perlin,1994, p. 246). Actually, the precise defining words of paternalism are “the application of the strategies whereby persons are treated and led in a fatherly mode, which implies that, the better- off and powerful have high obligations to the less privileged folks in the society, by providing the necessities without furnishing to them duties/ responsibilities as well as rights and privileges. According to the above statement, paternalism can be supported or on the other side denied for one reason or another. Roper, (1986, p. 78) established that the employment of paternalistic approach seem as though there is caring of the weak and poor by those in power/ authority. On the second narrow sense, paternalism has been used to refer to the menial approach or relationships towards women in the perspective of both expectations and behavioral codes. A paternalism application in some places of healthcare provision has been criticized for one reason or another. Whereas it has been termed as unfeasible methodology in the nursing field in some parts, there are a number of other healthcare institutions which values it as useful ways in the healthcare service provision. Thus, like many other strategies employed in the healthcare sector, paternalism is a policy which has got two facets. For instance the extension of benevolent giving by wealthier and richer persons to the needy and those individuals living in apt poverty is a plausible issue which can aid in alleviating the poverty condition within the community (Leino-Kilpi and Valimaki 2000, p. p. 90) . The process of providing such needs to the needy would mean helping to improve his health or even restoring it to the previous status. This not only demonstrates how those wealthy tycoons can help to improve the living standards of the poor through the act of charitable contributions. As matter of linking the poor and rich, social assistance is necessary as it impacts the society positively if the acts are done in form of individuals’ goodwill. Core values and Code of Ethics based on the paraplegic patient’s conditions In the nursing healthcare practices, practitioners are guided in the services provision by the four core values. These include the professionalism, caring, advocacy and holism which are nurtured through the integration of several elements in the work practices. According to paternalism approaches, it is overt that there is an intimate relationship that links it with autonomy and thus the opponent and proponent sides arise. The patient’s at our hands is a paraplegic patient whose entry in the hospice was the hope that he would receive the necessary treatment and care. In this case, the paraplegic is physically challenged. This implies that there severally activities which he cannot achieve by himself/ herself. On the other hands the victims is well recovering from other injuries which in bore during the accidents. Additionally, there is no disruption or disturbance caused to his cognitive systems meaning the he is still stable in making sound suggestions and opinions concerning various. Through the investigation of the situation as nurse, the patient is in dire need of nurse services in several ways. Inability to move around due to his/her paralytic conditions limits him/her function in many normal activities (Burnard 1994, p. 51). For instance, the patient would frequent needs to change the bed lying position to relieve fatigue or to sit down, feeding, which might greatly be challenging activities. This are some of the major activities which a paraplegic patient would require some aid, otherwise pain and suffering would not depart from him due to nurses assumption based on paternalisms. This shows that lack of the paternalistic approach in the nursing systems can affect the service delivery to the customers and patients without the recognition of the service providers. As far as the incident is concerned, the patient is like to be affected by the application of paternalisms in two main ways. Practically, if the nurses employ this strategy under such circumstance whereby the individual is unable to perform but they do assume that he/she can do itself by himself/ her, then, there will be a breach of the nursing core value of care. For a Nurse endowed with knowledge and skill, it would be a wise act to carry the patient’s burdens by offering the necessary services. This entails paying attention and being vigilant to patient needs’. Proper care cannot be extended to the paraplegic patient if there is no intimacy between the patients and the caregiver, thus, the provision of the satisfying services would not mean devoting your physical energy and physical having a concern over the patients numerous needs, but this would also require to show respect on the patient. Both respect and care are two but intertwined elements which cannot be separated into single entities in the nursing field. Generally care is viewed as the core to rapid recovery but it’s seldom attaining in a disrespectful environment (Engebretson, 1997, p. 28). Advocacy Human being are complex in nature, and in most cases making of decision especially on particular matter concerning ones life become an issue which is complicated. Hence, the relationships between patients or healthcare providers become very crucial in making specific treatment. While the principle of paternalism would permit the nurses to ignore some of acts such as let the paraplegic to do most of activities own his/her own efforts, it will be wrong as a nurse to offer a deaf ear to matter concerning his inabilities. The client’s health is much affected when suffering either physical or psychological is inflicted on them. Therefore, I would encourage and declare it unacceptable for nurses to mistreated clients. The mentality of nurses to let clients to struggle on their own for certain functions such as feeding will be renounced as unethical act. This is because it worsens the condition of paraplegic and complexes the situation through induction of malnutrition problem. Really, the chief aim in nursing is improve the health or to restore the individual’s previous health condition, which is attained through providing care needed. Despite the fact that some of the nurses are against the service being as extended to the client, and the client is weak and dire need of the service, then, cut of these services to the client would actually affected the client psychologically and also physical. It is thus my obligation to continued standing by the client by perpetuating services and enlightening the other nurses (Osman and Perlin, 1994, p. 244). Undoubtedly, this will be a deed of advocacy by which some of the staff members might be advocating for withdrawal of paternalism strategy from the patient at immature stage. Like in parenting situation where a child is let to practice what it wants, similarly in the nursing service provision, it’s of crucial importance for nurses to let patients practice whatever they are capable of doing without hurting/harming themselves. So by practicing paternalism does not imply that the patient will forever be a dependant on someone else. As the situation depicts itself, the withdrawal of nursing service would lead to suffering of the paraplegic in that he/she is yet to undergo the rehabilitating processes. Moreover, it seems that the nurses are advocating for the abolition of paternalistic circumstance without prior consideration of the recovery process and the risks embedded by within this act. In fact there is infringement of the client rights in that the nurses have not observed this progressive recovery nor have they discussed the matter with patient on his ability to perform such functions. Furthermore, the patient is very much optimistic on recovery and resuming of the normal duties. Despites this positive attitude, the nurses need the knowledge to discern emotional driven acts. Conceivably, this might be feeling of home-sick and letting the paraplegic patient to engage in functions before acquiring minimum state of ability to do so would contribute to worsening the conditions. This further blemishes the nursing codes of conduct and diminishes the respect of the individual patient. In order to put the system of healthcare service in the right track, definitely much effort must be put to salvage the clients from early involvement activities which are beyond his capability. However, by stating such it does not imply that I advocate for dependency of patients as this would be against the theory of efficacy which helps in the growth and development of one’s self-determination and confidence (Osman and Perlin 1994, p. 246). Professionalism This issue at hand of paraplegic victim is not easy to handle for most of the nurses. Actually, as demonstrated in the organization, most of the nurses whom are working in the institution feel challenged over the matter. The chief question in this how then can the healthcare providers help those individuals who are vulnerable to the community. Despite that the matter is posing challenges to the nurse counterparts; it is always wise to consult from the experts at the higher ranks for assistance. Through collaboration and co-operate working, ideas from the diverse expertise is accumulated to assist in difficult situation (Campbell 1972, p. 87). Limitations in one area or another exists in each and every institution, but success is achieved through building a network among the employees both at same level and at different levels. Under the professional factor concern, it would be unethical for clients to receive meager service from the nurses. While it is necessary for the service provider to be thoroughly screened as qualified providers of the care to the vulnerable or affected victims, it is inevitable that change in technology is bring a transition in every institution in which healthcare organization are not exceptional. Through networking with other workers both internally and external is a perspective which can be adopted to help the nurses in the developing in there profession. By practicing consultation with other workers within and without, this gives the nurses a chance to shares of their experiences with others and at the same time offers an opportunity to gain from others experience (Crow et al, 1995, p. 205). Thus, apart from the formal training that prepares nurse for their professional occupation, linking with other workers in the same profession not only provides workers supporters but it also helps in gaining the necessary knowledge and applying it practically in the right time. Creating conducive working environment with other practitioners as well as with close relationships with clients also portrays commitment and shows responsibility concern of the nurse practitioners. Perhaps, the commitment into nursing service provision is complicated in that the nurses need to make it as fundamental part of live. Hence, the rise of an opposing group of healthcare providers in the institution against the treating of the paraplegic patients in a paternalistic manner might be an indication of lack of commitment and responsibility. Additionally, it’s revealed that most practitioners in the sector of healthcare providers bears higher credentials of not less than degree level, which means that admission of practitioners with low level credentials in the nursing field is also a major contributing factor to numerous nursing challenges. Therefore, whereas the nurses feel challenged on the matter of paraplegic, there is the possibility that the client would make decision based on his/her own knowledge. Inadequate information or lack of commitment in this case is a form of infringement in respect to principle of autonomy of the patient (Engebretson, 1997, p. 29). In order to demonstrate professionalism therefore it was of significant importance to furnish the information about struggling to perform functions which are beyond his/her strength. On contrary, there is sense of professionalism in the treatment process as the nurses have shown concern over the progress of the paraplegic client. One way in which this has been shown is through the enquiry from the patient about his own strength to begin the rehabilitation program. Whereas the programs is essential before the dismissal of the client from hospice ward, the prior consultation with him/her indicates the humanistic phenomenon of creating the autonomy required for patients. The information retrieved from such individual level enhances the relationship of the client and the healthcare provider and are of great advantage to the service provide in dealing with client’s condition. The process of treatment and rehabilitation does belong to the hands of the provider; otherwise any mistake resulting from actions either taken by the patient or the provider would directly or directly affect the provider’s professionalism Henderson, 2002, p. 246). Conclusion Nursing services plays very important role in the maintaining of healthy community. Nevertheless, intricate matter arises in provision of the services to the clients. The establishment amicable nurse/client relationships and its integration into the field of nursing professionally has over the year been one of the difficulty issues, perhaps due to several parties such as family members, staff and legal staffs that involved in the program who come up with contradictory opinions. Thus, the adoption of paternalistic approach obviously results to disrespect of one’s autonomy, but for one’s own benefit. Further, paternalism is indispensable as its abolition would affect the control of nursing profession in terms nurse responsibility and accountability. Bibliography: Barker, P., Reynolds, W. & Ward, T 1995, The Proper Focus Of nursing: a critique of the "caring" ideology, International Journal of Nurse, Vol. 78 Burnard, P 1994, More humble, less mumble, Nurse Standard, Vol. 8, Issue 32, pp. 50-51 Campbell, J 1972 Myths to Live By, NY, Viking Press Crow, R., Chase, J. & Lamond, D 1995, The Cognitive component of nursing assessment: an analysis, Journal Advocacy for Nurses, Vol. 22, pp. 206-12 Engebretson, J 1997, A Multi-paradigm Approach to Nursing, Adv. in Nursing Science, Vol. 20: 1, pp. 21-30 Henderson, S 2002, Factors impacting on nurses' transference of theoretical knowledge of holistic care into clinical practice, Nurse Education in Practice, Vol. 2, pp. 244-50. 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