Traditionally, the field of nursing is viewed as a vocation which provides divine services to others with its roots in some religious beliefs (Hall and Ritchie, 2009). The nursing is considered a caring profession and it is a challenge for nurses to maintain this image. Nursing has been defined as “an integral part of the health care system, encompasses the promotion of health, the prevention of illness, and care of the physically ill, mentally ill, and disabled people of all ages, in all health care and other community settings”. Nurses are expected to be competent, trustworthy and caring and in order to maintain this image, nurses have to act professionally. This essay will describe the concept of professional nursing and the role of compassion by a professional nurse in the life of patients. Moreover, it will also discuss the four principles of ethics and their contribution towards developing a professional nurse.
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Professional behaviour in nursing
Professional nursing may be defined as, “to recognise, analyse, as well as give advice and assistance with regard to actual or threatening consequences of physical and/or mental courses of diseases, handicaps, disorders and their treatments for the benefit of the fundamental activities of daily living of an individual. Nursing also means influencing individuals in such a way that human potential is used for maintaining and promoting health.” (RCN, 2010).
The registered nurses are bound to behave in a professional way to achieve certain standards of behaviour as laid down by regulation. Nurses can be removed from the register if they fail to protect patients by providing them a safe environment (Fullbrook, 2007). However, the Department of Health or the regulatory bodies have not given a single definition of professional behaviour.
The professional behaviour in nursing includes honesty, integrity, compassion, altruism, listening skills, excellence and multidisciplinary working. Professionalism in nursing refers to a set of values, behaviours and relationships that are integral to the regulation of the profession (http://www.learningmatters.co.uk/sampleChapters/pdfs/9781844451586-2.pdf).
According to literature, professionalism in nursing encompasses five C’s: compassion, competence, confidence, conscience, commitment.
The significance of compassion to the professional behaviour in nurses will be discussed here.
As indicated by the definition of nursing, the basis of nursing lie on compassion, care and respect for the frail and sufferers. Hence compassion is described as the moral obligation imposed on nurses as a result of vulnerability and their dependency of patients on health professionals (http://folk.uio.no/marithem/publikasjoner/compassion.art.pdf
The role of compassionate behaviour has an effect on patients belonging to different age groups.
Compassion is an important aspect of pediatric nursing (Fradd, 2007). It is important that the paediatric nurse is compassionate and trustworthy in an effort to provide a safe and comforting environment for children. The genuine love of children and compassion are two qualities of nurses involved in paediatric care to have a positive effect on all stages of child development.
Adolescents may show behaviours that challenge the nurses due to high level of stress due to hospitalization (Funnell et al, 2008). Adolescence is a transition phase and a time of physical and psychological adjustment and as individuals are very sensitive about body image due to recent change in the body. Moreover, the threat of body exposure is also disturbing for them. If nurses deal them with compassion and understanding, they can reduce the stressors and therefore make their sickness less painful.
Provision of nursing care with compassion to adults can be highlighted by a UK study by Attree (2001) which suggests that war, friendly, sociable and friendly staff is perceived as good practitioners by patients. In addition, patients’ perception of compassion in nursing care pertains to respect to patients’ rights, dignity and involvement in decision making.
The Department of Health (2008) in the UK have issued some best practice guidelines which are based on feedback from patients. The feedback suggested that if nurses care ‘for’ the patient rather than caring ‘about’ them, they can play a compassionate role in nursing care as required by professional nursing practices.
Ethical Principles and the Code
Nurses need to follow the same four ethical principles as other health professionals do (Silva and Ludwick, 1999). These are:
Respect for autonomy:Â this implies a respect for patient’s decisions and providing them information about the treatment options etc. so that they can play a major role in choosing their own treatment. Hence, it enables individuals to make reasoned informed choices.Â
Beneficence:Â this means that nurses should do their best to maximize the benefits for the patients and choose what is best for them. This also includes a balance of riskd and benefits of a treatment being given to patient.
Non maleficence:Â nurses should avoid harm to their patients at all costs. If this harm is related to treatment, it must be weighed against the benefits of that treatment.
Justice: The fourth ethical principle justice, means giving each person or group their due. It includes fairness, equality and focuses on equal access to care and an equal distribution of resources to all patients.
A fifth principle has also been added by some which focuses on privacy and confidentiality.
The code for the standards of conduct, performance and ethics for nurses and midwives by Nursing and Midwifery Council is the corner stone of nursing practice. It is a key tool for protection of public that the nurses are caring for as all the nurses are required to follow it. The principles of code follow the ethical principles for nursing practice so that both can be given equal importance.
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Among the above described principles of ethics, beneficence will be discussed in relation to the code. The first principle of code is that the nurses must make the care of people as first concern and treat them with dignity and respect (NMC, 2008). This follows the beneficence as both consider patient well-being as the foremost concern. The second principle of code involves a teamwork for protection and well-being of your patient and the involved friends, family and community. This principle is also directly related to beneficence which focuses on patient benefit at every cost. On a wider scale, beneficence involves issues such as the effect of a new program on the benefit of their patient. The same is reflected by third principle of the code which states that nurses should provide a high standard of care at all times which involves in all settings of the health care system.
Communication in Nursing
Communication is the transfer of information between or among people.Â The practice of nursing involves continuous communication between the nurse and the patient, family, the nurse’s co-workers and colleagues (Sully and Dallas, 2005). Hence, communication in nursing be a complicated process and can have barriers that the nurses need to overcome. An effective communication is essential as the nurses will not be able to empathize with patients and therefore will not be able to form a rapport and understanding between themselves and the patients. Such trust and understanding is required by the nurses to practice their professional behaviour.
It is the ethical and professional responsibility of nurses to build an effective communication not only with the patient but also with the colleagues at work place for patient safety (Anthony and Preuss, 2002). This also involves identifying and overcoming the barriers in effective communication.
Communication skills need to be adapted depending on the age group of the patient. Communication in pediatric nursing is essential as caregivers/parents are under high level of stress and uncertainty about their child’s health (Day, 2010). Positive communication is a vital nursing responsibility in this case and nurse training and written documentation can help. Both openness and positivity help in an effective communication in a language that could be easily comprehended and understood. Nurses should avoid the use of medical terminology and answer all the queries of patients to build trust and confidence in the parents. Parents of pediatric patients prefer types of communication that are easily understood and processed. Pediatric nurses should communicate using normal language instead of medical terminology, and communicate a sense of trust and confidence in the caregiver.
Communication with the elderly can be a challenge due to barriers present (Caris-Verhallen, 1997). First is that they might have a sensory defect such as hearing which makes communication difficult. Secondly, they might want to prolong conversation due to decreased social contact now. Thirdly, there might be a generation gap which makes communication more troublesome. Effective communication in such cases involves a lot of patience and explanation to maximize an effective rapport between the nurse and patient.
This can be highlighted by the fact that there were potential pain-reducing implications and increased recovery rates when patients were provided with additional information/communication about their diagnosis, prognosis, care and treatment (Hamilton and Martin, 2007).
From the above discussion, it can be concluded that professional nursing practice encompass a range of properties and need to follow various codes and principles. All of them contribute towards a professional behaviour in nursing practice. The properties and principles discussed here were compassion, beneficence and communication. According to author’s understanding, all these factors are inter related with each other and are required to provide care to the ill patient.
I feel that an understanding of the ethical principal of beneficence will be most helpful for me in my future practice. This is the foundation of nursing and many others factors contributing towards a professional nursing practice are related to this principle. Therefore, a conscious effort to keep this principle as the key to my practice will help me to behave as a professional nurse.
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