The mission of a nurse is to help patients achieve their physical, mental, and social health in their environment. Recently, the view on the practice of a nurse is changing. If the earlier emphasis was placed on caring for sick people, now the nurse, together with other specialists, sees the main task as maintaining health, preventing diseases, restoring health, and facilitating coping of a person in accordance with his individual abilities. The professional competence of a nurse is the ability to enhance the knowledge and skills necessary to provide nursing care. Professional nurse embraces their core knowledge and qualified skills principle from different domain such as anatomical, physiological, psychological, sociological, and spiritual sciences. Moreover, encompasses critical thinking and clinical reasoning to integrate all these domains into one holistic approach and implement them in a specific situation. In the professional field, nursing personnel develops new behaviors like asking questions, developing intuition, awareness, creative thinking, qualitative analysis, seek for knowledge that integrates into the evidence-based practice shaped in life-long learning skills (American Nurses Association [ANA], 2015).
From all my experimental learning practice classes, I understand that as a nurse my own values, beliefs, and cultural heritage in which I grew and live are reflected in my behaviors and relationships with the patients. Each experimental learning practice has highlighted the need for cultural acculturation in order to provide quality health care appropriate to the community in each practice. I need to remember that the environmental factor affects the constitution and character of people and therefore their diseases and health. In my first teaching and learning experience I elaborate my teaching plan of care based on the recognition of the individual values and beliefs, and spiritual needs of my patient. In doing that I tried to demonstrate culturally congruent practice and advocate for my patient in order to prevent the under-served quality of care (ANA, 2015).
Ethical Practice
The basic ethical principle of nursing is respecting the human dignity and rights of the patients “unrestricted by considerations of nationality, race, creed, color or status” (Fowler, 2015. p. 10). The ethical responsibility of a nurse in the process of delivering health care to a patient is essential to implement skills such as: respecting the patient's right to autonomy and self-determination, identifying his will regarding anything and advocating for them, do not cause harm and promote safety (Fowler, 2015).
Risk
Patients can identify themselves differently related to their gender, age, nationality, specialty, social status, and health status. However, they all have the right to have a nurse that provides care to them as a person who deserves respect, attention, and compassion. Special attention is given to the importance of the self-determination of the patient in the care process, protected by consent to treatment, which he gives after receiving information about his health.
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One of the lab experiences that affect me the most was a case study about delivering care to patients with different backgrounds that are in contradiction to my moral and ethical values. That assignment denotes my ethical dilemma regarding some groups of patients such as a patient who committed child abuse, a patient who belongs to fascist groups, and a patient who belongs to racial segregation groups. Despite, knowing that the “values of a professional nurse include altruism, autonomy, human dignity, integrity, and social justice” as a human I cultivate my own ethical principles of what is right and wrong, what is good and evil and this system of values are opposite of my patient actions (Taylor, 2018, p. 105). Being aware of this situation, I reflect on it, and after depth analysis, I realized that judging and refusing to provide care I committee discrimination, stagnation, and marginalization towards them. These patients have a need for nurses that will provide respect, advocate and provide safe care regardless of their system of values and beliefs. Nurses need to identify the boundary between the personal practice of ethics and the professional code of ethics.
Another experimental learning example that open the ethical dilemma subject was regarding nurse’s advocacy. The economic system in health care that contribute to the shortages of nurses and require double shifts work, is a big concern in the health care system. The nurses lack meeting their personal needs such as food, showering, recreation, and sleep there are compromises to make errors. According to Fowler, “Some errors occur because the system of factors contributes to their creation” (2015, p. 51). In this situation, the nurses express the ethical dilemma of nonmaleficence -to prevent harm to patients and fidelity to their patients and not abandon them before another person will be assigned. The nurses must demonstrate and carry out their professional duties, by advocating for themselves to maintain their physical and mental health in order to provide qualitative and safe care to patients. As well, it is required that a nurse speaks up, especially about the safety or advocacy of their patients. In doing that, they will create a safe hospital environment and minimize potential risk factors that can compromise the safety of patients.
All these situations denote the ethical risks that nurses deal with in their practice. Each nurse should heed the code of ethics for nurses designed by the American Nurses Association (ANA) and apply them to their practice. Additionally, the nurse can contact the ethical committee and the code of conduct in their work units.
Reflection
To be a professional nurse is required to provide the best quality of care that include intellectual education such as critical thinking, professional behavior, and skills as well ethical and moral principles (Ayla et al., 2018). The first challenge I had was the need to integrate theory learning, lab skills, and experimental learning practice into one holistic approach and implement them in my daily practice. I have had to realize that a nursing program is a lifelong learning process and how important is to implement research evidence-based concepts in my own behavior in order to provide safe care. As a nurse, I will play an important role in promoting public health, preventing illness, restoring health, and improving the life quality of my patients. With each experimental learning practice, I was able to learn and grow in my ability to perform qualitative care. I learned how important is to reflect on each skill and experience that I have had so far. By applying critical thinking to my reflections, I was able to assess my professional level and evaluate them. This practice assesses the strong and weak skills that I need to be aware of.
I followed moral, ethical, and legal behaviors in my experiences. In each assignment, I paid attention to professional boundaries with which the client and made sure not to go beyond of my scope of practice. I tried to protect patient privacy and confidentiality of patient records in each setting in which I perform my practice. I did not share my patient’s information beyond the professional environment. Being aware of my weak skills I seek the assistance of my partners and work as a team. Before each action, I coordinate my steps with the patients and with my partners. This action allows us to synchronize our actions and maximize the safety of our residents. I understand that recognizing weak skills and asking for help and working on them in order to improve my performance reflects my awareness to provide care based on the ethical code of nurse.
References
- American Nurses Association (2015). Code of ethics for nurses with interpretive statements. Silver Spring, (3rd ed.), MD: America Nurse Association.
- Ayla, I., A., Ozyaziciogly, N., Atak, M., & Surenler, S. (January-April. 2018). Determination of professional values in nursing students. International Journal of caring sciences, 11(1), 254-261. Retrieved from www.internationaljournalofcaringsciences.org.
- Fowler, M., D., M. (2015). Guide to the code of ethics for nurses. Silver Spring. MD: America Nurse Association.
- Taylor, C., Lillis, C. & Lynn, P. (2018). Fundamentals of nursing (8th ed.), Philadelphia, PA: Wolters Kluwer.
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