Misuse of power by healthcare professionals

In this assignment I will discuss the potential misuse of power by healthcare professionals when working with Australian elderly people and why they may be at risk. The discussion will look at summary of situations that may arise.

However to begin the discussion the concept and idea of what is vulnerability will be described. Take for example the following statement made by the College of Registered Nurse of British Columbia (www.crnbc.ca 07/10/2010), in an article called Nurse- Client Relationships which reads, “Vulnerable is the power imbalance present in a professional relationship places the recipients of care in a position of vulnerability and of potential exposure to exploitation or abuse if that trust is not respected.”

The group nominated for this topic discussion is the elderly people, who are 60 -plus years of age. There is a number of reasons that can explain why this group are at risk. The elderly most suffer from multiple illnesses and disabilities which impacts on their treatment and care. The range of health issues can vary within this group. For example; they can include but are not limited to; depression, dementia, hearing loss, little vision, heart disease, cardiovascular disease there are a number of areas in which an elderly person may receive inadequate care. The discussion will now move to the areas that the writer finds important in the context of care and treatment. The first is that of the appropriate use of medication. Problems in the delivery of medication may occur in a number of circumstances for instance, an health professional must always follow the five rights; namely, the right patient, the right medication, right time, right route, right dosage and what as actually been prescribed for them. Taking theses steps would cause no confusion with the nurse patient relationship.

From another point of view the elderly maybe at risk because they may not always be aware of what is happening around them. The elderly tend to expect what is happening to them and not question why it might be happening. Depending on their condition they are extremely reliant and depended on their carers for both emotional and physical and social support as well as the treatment in care.

There are a number of areas in which an elderly person may receive inadequate care. I will now discuss what I believe to be the most important of these areas. The first is that of the appropriate use of medication. Problems in the delivery of medication may occur in a number of circumstances. A health professional nursing an elderly person must always follow the five rights; namely, the right of the patient to receive medication that is of the right type, at the right time, the right dosage, the right route and what is actually been prescribed for them. If this doesn’t take place the patient can get side effects such as dizziness, constipation, upset stomach, sleep changes or other reactions due to their illness or disability.

Because of their age, elderly patients are not fully aware of what is happening around them and so are vulnerable because they are accepting of what is happening to them and not questioning why it might be happening. They are extremely reliant on their carers.

In outlining possible examples of the misuse of professional power by health care professionals, the discussion will now detail cases to show how this can happen. In addressing this issue the discussion will focus on two areas of interest which include career orientated health professionals and the social political. The notion of career oriented workers is and idea that talks about self interest. Because they often put themselves before the patients and follow their own agendas. They often created more difficulties than what is needed. They created an environment that is not productive and conducive to best health care practice. Because they impact on work practices of their colleague which effects the quality of care. This is misuse of power because once they have it they will do what ever it takes to maintain their authority at all cost to the detriment of the elderly. In terms of the social and political the elderly have been for years have been under-represented and not recognised. In terms of change it as taken many years to address the imbalance of power relations between service delivery the care of the elderly. There are many cases that can be sited that show examples of maltreatment and care by health professionals towards the elderly. For instance take the article by Debra Shipman and Jack Hooten (2009), entitled ‘Staff background checks: safeguarding vulnerable adults’. This article talks about protecting and looking after the interest of older people. For example it highlights the patient abuse among other issues which include background checks on health care facilities and those they employ. Importantly the article make a reference to patient care and legislation and places health care treatment of the elderly on the political agenda. For example, Shipman & Hooten (2009, p.24) makes this point quite clear when they state that, “Studies conducted by independent investigators have been beneficial in helping society understand the magnitude of abuse”.

In term of addressing the situations which have been arise in the above the discussion will now concentrate on putting forward and suggesting possible strategies to deal with these situations. Health professional taking time off when work get stressful. For example they need to manager time and stress in the workplace. Have a mentoring programme for workers as well as regular in service training provided, which provides staff with current skills. Also there are ways for patients to stay more in contact with what is going on around them by staying socially connected, staying active and staying mentally active and maintaining independence as long as possible.

Now moving to the point of prevention, the discussion will now focus its attention on ways to address these concerns. There is a number of ways to prevent the abuse of the elderly. For example take the approach put in place by North West Melbourne Division of General Practice (2010) who present a clinic sheet regarding elderly abuse. In summarizing the article it talks about ways to prevent abuse and all its forms. It is a well present article which talks about signs and symptoms also so includes a profile of abuses and managements plans which includes counselling and other forms of support. It is a well thought out approach to the management and prevention of abuse. It is a approach I would gladly used. For reference please see attachment 1.

In deal with the issues of legislation and professional code of conduct involved with the elderly group. The discussion on this point will be based on the Australian Nursing & Midwifery Council (ANMC) document called National Competency Standards Further Registered Nurse, 4th January 2006 The ANMC list ten points regarding national standards. To keep your register nurses are to obtain capability standards of your performance, is assessment obtaining and retaining your license. Here are some of the most important points which are listed in the ten standards;

Nurses practice in a safe and competent manner.

This means that the nurses are personally accountable for the safety and care of the patient in the care for the patient, also maintain knowledge and skills clinical. Nurses know they are only to work within their scope of practice. Know to contact the nurse in charge if the quality of care towards a patient is not maintained.

Nurses and health workers have self respect for people that kept their owe cultural beliefs which come from many ethnic, groups.

Nurses have to be aware that different groups of people, have different beliefs and values. Nurses need to protect the interest of the patients which are getting care. Nurses need to not be judgemental on people’s beliefs and always have a good attitude and be professional in the work place.

Nurses provide impartial, honest and accurate information in relation to nursing care and health care products.

When nurses are providing care it is most important to tell the patient the advantages and disadvantages of a treatment or medication and let the patient make their owe chose. Nurses are here to provide a service or services of the quality of care.

Nurses support the health, wellbeing and informed decision making of people requiring or receiving care.

Nurses assist in assessing decision making on the quality care for a patient, for example talking to a nominated family member and support their wishes. Nurses can also advocate for patient if need to.

In conclusion of this assignment it is important to bring to your attention to quality of care is a must for our elderly people. And realise how vulnerable and at risk and misused by health professional to gain professional power. So we have to be aware of this and take steps to avoid this and educate our elderly about the legislation and code of conduct to protect them .