Nrsg370 Reflecting On Clinical Integration Assessment Answer

Clinical nurses possess immense responsibilities in order to provide appropriate patient care (Shields, 2013). While clinical nursing includes various aspects of care, there remain certain challenges in clinical nursing that need to be addressed. In the current scope of discussion three online module related discussions has been included, one related to safety issue in patient care, another issue is related to confidentiality and the last reflective analysis is related to public domain view on health care (Daskein, Moyle & Creedy, 2009). The three reflective analyses provide in-depth information related to the various challenges that are facing current scenario of health care.   

Safety Issue In Aged Care

Clinical practicing nurses possess several responsibilities and specific rights related to aged care (Fleischer, Berg, Zimmermann, Wüste & Behrens, 2009). It is the responsibility and right of nurses to keep patients/clients physically and emotionally safe. In the current scope of discussion identified safety issues specific to aged care is being discussed. Providing safety to patient and clients is the primary motive and ultimate goal for any clinical nurse. Nurses need to ensure trusts in patients by ensuring their health as much as possible. There exist several safety issues that might threaten patient’s safety. With rising costs of patient safety, hospital and their care givers need to ensure that all adverse events of patient safety can be analysed and reduced as much as possible. Nurses need to ensure patient’s medication safety concerns. Innovation in medicine management in health care is seldom used (Bauer, Nay & McAuliffe, 2009). Though hospitals and clinics need to use them however, seldom such practices are adopted. Often nurses administer inappropriate medications at inappropriate time frames. Moreover, nurses administer dosage without having prior knowledge related to the patient’s allergic or tolerance related information. This might lead to a significant challenge as patient health might suffer or he might be at risks from developing other ailments. Medication safety related issues are specifically integral in case the patient faced comorbidity (Lim, Bogossian & Ahern, 2010). At such instances clinical nurses has to take special care to ensure that medicines administered are absolutely in line with patient needs.        

Nurses aid in assisting and providing healthcare services to their patients. Medication safety is a serious concern that nurses need to take care off. I feel that clinical nurses need to possess knowledge and skills so as to render appropriate medication to patients such that they do not suffer in the long run. Only providing patient’s safety can assure them and help re-assign their trust in the medical system. Safety related issues can erode trust of patients and lead them to avoid the medical institution which has committed such errors. Moreover, such errors might lead to ethical issues. In short term period the patient might suffer and in long term period, there might arise issues related to health impacts. Therefore, clinical caregivers and nurses need to view schedules and gain detailed insight into the medical treatment being rendered to. Apart from medicine safety issues, a patient might also face dilemma related to financial insecurity and diagnostic challenges as they are inter-related (Carryer & Yarwood, 2015). Inability to maintain confidential information related to patients or not being able to provide adequate security in aged care facilities are some of the deeper concerns facing healthcare. Aged care facilities have older people hence healthcare centers need to adhere to norms such that they are able to provide best possible care. Often patients are given expensive medications and less expensive and equally effective medications are avoided. Nurses need to take care to see that patients are given a medication with correct components rather than deciding upon particular brand name for medicines. Such expensive medicines might impose financial challenges for the patient, who in turn might become defendant to face such troubles.

Confidentiality 

In healthcare every client has some rights of clients in the process of treatment and recovery. Nurses being primary caregivers to patients and clients, there remain some questions regarding ways the nursing profession views and deals with the rights of the clients (Tarzia, Fetherstonhaugh & Bauer, 2012). The need for information, particularly in the context of patients/clients who may lack insight in their care needs has to be diagnosed and attended to. Confidentiality is one of the primary duties in medical practices, where health care providers need to retain personal health information privately unless the patient provide consent to release such information. In critical cases nurses and careers might face sometimes dilemma in providing information to anyone else. Patient’s while resorting to healthcare regularly share various personal information with health care providers, especially nurses. In case confidentiality of this information is not protected they the relationship with nurses would diminish. In such cases patients would be apprehensive in sharing sensitive information that would in turn hamper their care (D’Souza, Venkatesaperumal, Radhakrishnan & Balachandran, 2013). Creation of a trusting environment for the patient is important for respecting patient privacy and it allows the patient to be honest during the time of healthcare. The trusting environment provides and encourages patients to be honest during health care visit and also allows the patient to seek care when needed. Confidentiality is particularly important in cases of sexual, public health, reproductive and psychiatric health concerns.

Health cares professionals especially nurse have the duty of confidentiality, which prohibits them from disclosing any information regarding patients to anyone else without permission. Nurses need to assist in the healthcare system which ensures that only authorized persons are able to access reports and other information related to patients.  Healthcare team members including nurses and other professionals need to undertake special care to ensure that no data relative to patients is disclosed in front of anyone who is not a member of the healthcare team. It is the primary duty of nurses to protect information of their patients and protecting such information from those who should not have access to the same (Tilse & Wilson, 2013). Healthcare systems which make use of Electronic medical records (EMR) can face significant challenges while preserving confidentiality of information. In cases only where nurses feel that they can share information of the patient with that of their family, then they can do so. In case the information related to patient has not obtained explicit permission then such information cannot be ethically justified to be shared with family members also. Only in case of a medical emergency or when the spouse is at risk of harm which is directly related to diagnosis then only he or she can be informed as in such cases ethical challenges might not appear (Por & Barriball, 2008). However, generally the issue of confidentiality possesses enormous challenge in itself. The most integral challenge in health care related to confidentiality is ethical challenge. As disclosing of private and confidential information of patient is not at all ethical and might lead to breach in ethicality. Concern for safety might arise in various cases in case the healthcare provider is unable to adhere to confidentiality concern. Providing access to medical reports or other health documents might be legally challenging and impose grave ethical concerns.   

Reflection using the Five R’s

The public domain on how people have made meaning of their health-related issues. The 5 R’s of Reporting, Responding, Relating, Reasoning and Reconstructing framework according Bain, Ballantyne, Mills and Lester (2002) has been undertaken for arriving at a reflective practice. The reflective practice has allowed changing perspectives and developing perception, morals and ethics related to health. Diagnosing illness of an individual is best undertaken by means of 5 R’s such as reporting, responding, relating, reasoning and reconstruction (Gifkins, Loudoun & Johnston, 2017). The article by Tarzia, Fetherstonhaugh and Bauer (2012) which reflected various challenges related to dementia and confidentiality in aged care facility was discussed. In order to understand the situation of patients in such conditions it becomes integral to have a systematic thinking or step by step practice through the experience or situation. The 5 R’s provide suitable framework for in-depth and meaningful analysis related to the experience. In the first step of 5 R is reporting where a brief description of account of the situation or issue is discussed. As in the current article various issues that aged people were facing at the facility was discussed, who had dementia or sexual problems. There was lack of trust and confidence amongst people residing at various aged care facilities. They did not like their stay in the facility and the situation primarily had arrived due to healthcare professionals and nurses especially not being aware of the various healths related ethical behaviours which they needed to maintain. At the second step responding to the situation is undertaken. In the current scenario it can be said that the situation is rather sad and unwanted as healthcare professionals could not provide adequate care that they should have provided. Not only were they unprofessional rather the institute did not have any code of conduct. This led to a grimmer situation and prevented patient and client of the institute from getting appropriate care.

In the next step of relating, personal or theoretical understanding of the event is undertaken (Plank, Mazzoni & Cavada, 2012). I being a professional in the healthcare industry did not like the approach that was undertaken by the nurses and health care professionals. According to Health Information Portability and Accountability Act of 1997, institutions need to have policies for protecting privacy and confidentiality of patients. All policies and procedures were breached in the current scenario and there was no adherence to any standards. The fourth step of the process involved reasoning, in this step explanation of the issue is undertaken. The theory which can be evaluated here relates to confidentiality and safety issues that need to be present in aged care. However, no adherence to any of the issues has taken place. In the last step reconstructing or drawing of conclusion and then developing a future course of action was planned. At this step a deeper understanding of the issue and reframing of future practice is undertaken. It can be said at this stage that, in future I will take possible note to avoid any such situation that might conflict with code of conduct in my practice.   

Reference Lists

Bauer, M., Nay, R., & McAuliffe, L. (2009). Catering to love, sex and intimacy in residential aged care: what information is provided to consumers?. Sexuality and Disability, 27(1), 3-9. Retrieved on 26^th September 2018, from https://link.springer.com/article/10.1007/s11195-008-9106-8

Carryer, J., & Yarwood, J. (2015). The nurse practitioner role: Solution or servant in improving primary health care service delivery. Collegian, 22(2), 169-174. Retrieved on 2^nd October 2018, from https://www.sciencedirect.com/science/article/pii/S1322769615000128

D’Souza, M. S., Venkatesaperumal, R., Radhakrishnan, J., & Balachandran, S. (2013). Engagement in clinical learning environment among nursing students: Role of nurse educators. Open Journal of nursing, 3(01), 25. Retrieved on 1^st October 2018, from https://file.scirp.org/pdf/OJN_2013031814415858.pdf

Daskein, R., Moyle, W., & Creedy, D. (2009). Aged?care nurses’ knowledge of nursing documentation: an Australian perspective. Journal of Clinical Nursing, 18(14), 2087-2095. Retrieved on 24^th September 2018, from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2702.2008.02670.x

Fleischer, S., Berg, A., Zimmermann, M., Wüste, K., & Behrens, J. (2009). Nurse-patient interaction and communication: A systematic literature review. Journal of Public Health, 17(5), 339-353. Retrieved on 30^th September 2018, from https://link.springer.com/article/10.1007/s10389-008-0238-1

Gifkins, J., Loudoun, R., & Johnston, A. (2017). Coping strategies and social support needs of experienced and inexperienced nurses performing shiftwork. Journal of advanced nursing, 73(12), 3079-3089. Retrieved on 6^th October 2018, from https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.13374

Lim, J., Bogossian, F., & Ahern, K. (2010). Stress and coping in Australian nurses: a systematic review. International nursing review, 57(1), 22-31. Retrieved on 9^th October 2018, from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1466-7657.2009.00765.x

Plank, A., Mazzoni, V., & Cavada, L. (2012). Becoming a caregiver: new family carers’ experience during the transition from hospital to home. Journal of clinical nursing, 21(13-14), 2072-2082. Retrieved on 7^th October 2018, from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2702.2011.04025.x  

Por, J., & Barriball, L. (2008). The personal tutor’s role in pre-registration nursing education. British journal of Nursing, 17(2), 99-103. Retrieved on 4^th October 2018, from https://www.magonlinelibrary.com/doi/abs/10.12968/bjon.2008.17.2.28136

Shields, L. (2013). A personal essay on the role of the nurse. Contemporary nurse, 43(2), 213-218. Retrieved on 5^th October 2018, from https://www.tandfonline.com/doi/abs/10.5172/conu.2013.43.2.213

Tarzia, L., Fetherstonhaugh, D., & Bauer, M. (2012). Dementia, sexuality and consent in residential aged care facilities. Journal of Medical Ethics, medethics-2011. Retrieved on 28^th September 2018, from https://jme.bmj.com/content/early/2012/06/01/medethics-2011-100453.short

Tilse, C., & Wilson, J. (2013). Recognising and responding to financial abuse in residential aged care. The Journal of Adult Protection, 15(3), 141-152. +Retrieved on 8^th October 2018, from https://www.emeraldinsight.com/doi/abs/10.1108/JAP-11-2012-0025