A
The nursing profession is characterized by dynamism, precision and disciplined due to the delicate nature of care- giving that it primarily involves. Different organizations have different goal and different strategy to guide their healthcare staff to deliver the better quality of service to the patients. The organizations aim to instill the organizational goals into their staff in different phases of their life i.e., during their education, practice and evidence- based research. The set of goals and strategies helps them function effectively in the organization. The nursing boards play a major role in the regulation of the nursing workforce and practice and their certification process such as licensing, accreditation, abiding by the standard rules and regulations, which helps in accomplishing the nursing practice. The State Nursing Boards are responsible for conducting the NCLEX- RN and NCLEX- PN exams, which are mandated for the nursing staff to qualify to move ahead in their ranks and enhance their specialization. The Nursing Boards performs this act in collaboration with the National Council of State Boards of Nursing (NCSBN) which is the national body that forms the umbrella for all state boards of nursing (American Nurses Association, 2010). On the other hand, the healthcare organizations act as an umbrella body that provides a platform to their nursing staff using which they can access valuable resources necessary for their career. Such organizations allow them to advocate for their rights during their education, practice and research. These organizations help in developing the code of ethics as well as provide the scope of practice to the nurses and thus providing a platform for practicing professionalism. Nurses are required to be members of at least one professional organization, which serves as their voice at the state and national levels in times of advocacy. Therefore both the statutory bodies are important for a nurse during their professional practice. The regulatory agencies guide me on how to perform their practice in the professional organizations. The Nurse Practice Act certifies me after qualifying the examinations to practice and use our skills in professional organization and treat illness. Along with the regulatory agencies bylaws, this act provide me a scope to practice based on my approved license and also guides me about the nursing laws, which I am to follow based on the type of license I have been approved. Contrastingly, the professional organizations provide a platform to nurses from different nursing backgrounds and allow the nurses to stay informed. They also keeps me up- to- dates on different issues in the field and helps me to become a political voice to such issues that hamper’s ones professional life. It also helps me to stay up- to- date about the new researches and inventions in the medical field so that I can increase my knowledge and apply those in my practice. It also encourages me to keep studying and gain extra credits or license at a discounted rate.
B
The ANA code of ethics is built of nine provisions which address the roles and expectations that are bestowed on the nurse. The first provision insists on the need to show compassion and respect their work, dignity, and uniqueness of the attributes when treating a patient or a client. During clinical practice, a nurse needs to take care of patients who come from a diverse background with different cultural beliefs and different social and economic background. During practice, provision 1 helps us to treat patients from different backgrounds equally, advocate their needs and provide them with quality care. It teaches us to reason with the patient and understand their specific needs, preferences and perceptions about wellness and health and using this information, they develop a patient- specific care plan. The second provision emphasizes the importance of a nurse to set patients as their primary commitment. We as nurse work in a highly regulated environment that is dictated and influenced by many internal and external policies such as cost- effectiveness of the treatment for both patient and the organization, which is solely market driven and which tends to influence the quality of care delivery process. However, many a time we cannot limit our care to our patients based on these provisions or policies. This provision helps us to maintain the standard of our care delivery and at the same time provide the best suitable treatment to the patient at a cost that is affordable for them and the organization .
C
The ANA Code of Ethics regards nurses as highly prepared individuals to meet the needs of the patients. Based on a generalized format of the patient needs, the four major traits that nurses have to demonstrate in their day- to- day activities includes health promotion, treating illness, reduce patient sufferings and health restoration. In my daily practice, I come across patients from diverse backgrounds with different cultural beliefs. Many- a- times, these patients are unaware of the diseases they suffer from or ignore their illness because of their culture beliefs and faith on traditional medicines. Therefore, during my practice when I encounter such situation, these provisions help me to interact with my patients and understand their needs. This further helps me to plan interventions to educate and treat and help them recover from their illness. Proper planning and educating patients in a way (by providing examples) in which they can understand the seriousness and the need for the treatment for their sufferings helps me in promoting health by increasing awareness among the patients. Thus understanding one's needs help me in treating the illness while interaction helps me to educate my patients and promote their health. Such situations I Have witnessed especially with elderly population and with patients coming from conservative backgrounds or remote areas were awareness is very little. Patient's issues ranges from purely physical problems, physiological problems to emotional and psychological issues. During accident cases or trauma cases, I have witnessed most of my patient fail to adhere or respond to my medications/ treatment because of these emotional and psychological issues. Stress plays a major role in failure of treatment, therefore, it is important to understand the patient’s emotional and psychological needs and accordingly plan interventions. These problems increase patient's suffering, which directly influences their quality of life. Thus, as a nurse I chose to work collaboratively with other professionals (physiotherapist, psychologist, counselors, social support groups, etc.) to plan sound interventions for my patients and thereby reduce their sufferings. The nursing provisions help me to understand to choose which resources to use and when to use during my practice. Many- a- times, even after following the guidelines developed by state boards to manage a disease, fails. I have come across such situations many- a- times during my practice, where I get clueless on what to do next to treat my patient. This especially occurs with elderly patients who are unable to communicate well. The provision of the nursing codes helps me to identify the root cause of the problem my patients’ faces during such an event. The analysis of one’s issues on the personal front and understanding the exact needs and dilemmas regarding one’s health helps me in reaching the root cause of one’s problems. This is how applying this professional trait in my practice helps me in reducing the patients’ sufferings. Furthermore, this identification helps me to identify and plan care interventions targeting the issues and thereby help patients in restoring their health status to the previous state of being healthy and prevent further deterioration in their health conditions (American Nurses Association, 2010). Health restoration, not only needs effective interventions but also needs me as a nurse to understand what is best for my patient and according educate him/ er about self- management techniques and restore their health. These provisions help me in become a better nurse and provide a better quality of service to my patients.
D
During professional practice, it is essential that the needs of each and every patient are properly addressed. This can be only achieved when their needs are appropriately identified by us and we accordingly plan strategies to help them recover and perform their tasks independently. Thus, in my daily practice, I highly value the ethics and tenets of the Dorothea Orem's Self-Care Theory. This theory emphasizes the need for the nurse to address patients as a distinct individual who at any time can fully accomplish self-care activities independently in the absence of any limiting factors. According to this theory, we as a nurse should be able to facilitate the patient to meet those needs and goals that they could not previously accomplish independently. The theory helps me to achieve skills using which I can educate my patients by informing them about the seriousness of their illness or the illness they could acquire in the future. I can further teach ways to deal with it independently. This also helps me to encourage them to learn techniques using which I can promote their health practices and help them in performing their self- care activities independently (Alligood, 2013). I believe illness is an indication of unmet needs, and patients have to take a primary role in meeting those needs with the nurse acting as a facilitator. The aspects of patient-centered care focus on increasing the patient role in managing their health and provide a platform on which the patient can proactively determine the care and care- planning process. I feel that when patients are empowered to take responsibility for their health, there is likelihood for more long-term self-care behaviors thus minimizing the need for frequent visits to the healthcare facilities. Therefore, this theory helps me in my day- to- day practice in restoring patients who come with serious illness who have lost their self- managing potential.
E
Madeleine Leininger is one of the inspirational figures whom I think has impacted my professional nursing practice. Madeleine Leininger has played a key role in the evolution of the nursing profession and the impetrate of the nurse within the health care sector. Her achievements and her way of practice during her nursing days have helped me understand the importance of the "care for patients" in one's daily practice. One of the best traits of her practice is that she identified care as the primary goal of a nurse, as without this attribute one cannot accomplish his/ her goal in providing the best care to his/ her patient (Alligood, 2013). She has inspired me to view myself as a caregiver especially in an environment where the day- to- day emerging technology is increasingly breaking the relationship between the patient and the nurse. Her practice has helped me understand the importance of "care" and thus during my practice, irrespective of the presence of the wide technology that aids in better delivery of care to patients, I always work with patient as a human in need and someone who expects me to find a solution to their problem. I work towards restoration of the health of my patients, which is only possible in the environment of care. This factor will also aid us (the nurses) to further improve ways of delivering quality services with the aid of advanced technology in the modern day.
F
When dealing with patients, their values, beliefs and preferences are likely to play a major role in the care process. These factors also influence the development of the care plan or the interventions that the care team may regard important . During our practice, the religious beliefs always act as one of the major issues, which dictate some aspects of care. Once during my practice, I dealt with a 25- year- old severely injured by motor accident patient had verbally told her boyfriend that she wants to live no matter what. However, when situation went worse with a little hope that she might recover and we had to put her on ventilators, the family objected stating that their cultural beliefs do not permit a body to forcefully survive on technology and thus wanted no further treatment. However, the boyfriend testified that she wanted to live. Therefore, it was my duty to protect my patient's wishes (right to autonomy) and thus I informed the higher authorities to take necessary actions. However, my action went against the religious beliefs of the patient's family but favored the right to autonomy of my patients. On the other hand, I had to witness a case where I had to deal with a case where an elderly patient with terminal cancer who had no chances to survive. This patient had lost his consciousness and the only way we could keep him alive was by giving him life- support. However, before losing conscious, the patient had requested to withdraw all medicines as he was tired of being sick. However, the family wished to continue the treatment. In this case, my dilemma was whether to give patient a peaceful death and abide by the principle of maleficence or to respect the family cases. In absence of patient's will, in such scenario's it is difficult to take decision. However, in the end, I considered the frustration the patient showed before losing his conscience and chose to do what is best for him. Thus, I withdrew all drugs and gave him a peaceful death by abiding by the principle of maleficence (American Nurses Association, 2001).
References
Alligood, M. R. (2013). Nursing theorists and their work. Elsevier Health Sciences.
American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Nursesbooks. org.
American Nurses Association. (2010). Nursing's social policy statement: The essence of the profession. Nursesbooks. org.
ANA. (2015). Code of Ethics for Nurses with Interpretive Statements. Washington, D.C: American Nurses Publishing.
Munyaradzi, M. (2012). Critical reflections on the principle of beneficence in biomedicine . Pan Afr Med J., 11- 29.
