NUR345 The ICN Code of Ethics for Nurses Assignment Sample

Transition To Practice

Table of Contents

Introduction..

Critical analysis of the incident occurred.

3 challenges faced whilst transitioning from novice to registered nurse and strategies to overcome challenges.

Definition of resilience and its application and strategies to foster resilience.

Conclusion.

Reference List

Introduction to The ICN Code of Ethics for Nurses

Nursing and Midwifery practices require maintaining a high degree of professional standards to ensure that the care delivered to the patient is safe, appropriate, responsive and respectful to the patients. However, the transition from student nurse to registered nurse may create different difficulties and bring stressful events that might create uncertainty though the nurses are required to maintain the standard protocol of practice for every single patient. The current study will analyze Kelley’s story drawing on the literature. Additionally, it will discuss 3 challenges that student nurses face while transitioning into registered nurse and strategies to overcome it along with the application of resilience in nursing practice.

1. Critical Analysis of The Incident Occurred

3 Applicable Nursing and Midwifery Board AHPRA (NMBA) nursing practice standards

There are seven standards of nursing practices among which one is Comprehensive conduction of assessments (Standard 4). Under this standard, it is required to consider that the RNs will conduct assessments in a holistic and culturally appropriate manner. However, In Kelley’s case, the responsibility for assessment has been provided to a student nurse, which is against this standard. The nurse also did not work in partnership with the student nurse. Additionally, Standard 2 of practice include engaging in therapeutic and professional relationships. Nurses are required to develop, sustain and conclude relationships differentiating boundaries between professional and personal relationships. However, in the hospital setting the patients were following the nurse for drugs which can be considered against the professional relationship of the nurse with the patient. As per Standard 6, nurses are required to provide safe, appropriate and responsive nursing services where nurses will implement an appropriate method to find out the actual risk. However, the current nurse failed to accomplish the task according to this standard as she was not actively involved in the assessment process (Nursing and Midwifery Board of Australia, 2020).

2 principles of the NMBA Code of Conduct

One of the major principles of Nursing and Midwifery Board of Australia’s Code of conduct is person-centred practise (Principle 2). Nurses are requiring recognizing and reflecting upon what has happened and report the same the concerned persons. However, Kelley did not take an active part to find out the area of concern considering the absence of pain. Another sub principle under this is to recognize that care will be provided to the person at different times by other healthcare providing members (Nursing and Midwifery Board of Australia, 2020). This has not been considered in the current case where Kelley decided to recheck the patient despite the presence of other team members and at the end of her duty. Therefore, it is required to consider effective decision making with the team members for avoiding conflicts regarding care.

As per the principle 3, nurses have required to development respectful relationship and cultural practice where effective communication with the patient has been considered inevitable. However, in the current case, the nurse did not communicate effectively with the patient which has increased the chance of overlooking significant alarming signs. This has led to the deterioration of the health condition of the patient.

2 elements of the International Council of Nurses (ICN) code of ethics

One of the elements of the code of ethics by the International Council of Nurses is nurses and practice. According to this element, nurses will be responsible for maintaining personal health so that the ability to provide care is not compromised. Apart from that, nurses are also required to judge the competence of a person before giving any responsibility (International Council of Nurses, 2020). In the current scenario, the competence of the student nurse to assess the patient was not determined through immediate action has been taken after the confirmation of the student nurse about the health condition. Kelley also required maintaining her health so that these issues could be easily handled. As per the element 4 Nurses and co-workers, collaborative and respectful relationship is required to be established with co-workers. However, in the current case, adequate respects to the co-workers have been demonstrated by Kelley where she handover the task of rechecking the patient as responsible persons in the morning shift has arrived.

2 ethical principles

As per the guidelines of Australian nursing practise, a nurse is required to adhere to the principles of justice and beneficence. According to the principle of justice, the nurses are required to be fair while they are distributing care to the patients they are taking care of. Care must be justified, equitable and fair for every patient (Esmaelzadeh et al. 2017). However, in the current case, Kelley did not provide importance to assessment or other required services that the new patient required which can be considered as an unethical act. However, the condition of the patient has been quickly informed to the doctors, which can be considered as an ethical practice by the nurse. Another principle is beneficence or doing the right thing for the patient. In the situation described in the current scenario, the new patient was required to be adequately accessed and communicated properly to find out her requirements and health needs which have not been performed by the nurse (Oguisso et al., 2019). Therefore, these two ethical principles as not been followed in the current case scenario.

Discussion and application of 2 National Safety and Quality Health Service (NSQHS) Standards relevant to the case that now seek to protect the public from similar events

One of the NSQHS standards is communicating for a safety standard. According to this standard, effective communication is mandatory at the time of clinical handover. However, due to the lack of information regarding the patient, Nurse Kelley could not communicate with the care members working in the morning shift. Apart from that, critical information and risks are required to be documented and effectively communicated with the concerned health professionals, which could not be performed in the current case. This has increased the proneness of the patient to be affected by a serious health condition. Another NSQHS standard is “Recognizing and Responding to Acute Deterioration Standard” (Australian Commission on Safety and Quality in Health Care, 2020). The criteria for these standards is detecting and recognizing acute deterioration so that care requirements can be escalated for patient safety. In the current case scenario, this standard has not been maintained and importance has not been given to the assessment of the patient due to which escalation could not be performed at the time of requirements. However, the nurse showed adequate responsiveness while she detected acute deterioration of the condition of the patient.

2. 3 Challenges Faced Whilst Transitioning from Novice to Registered Nurse and Strategies to Overcome Challenges

Experiences of a nurse are highly valuable in clinical practice which is gathered within the journey to novice to registered nurse. Many challenges can be faced by the individual pursuing this career among which, three challenges will be discussed below:

One of the major challenges in caring for increasingly critical patients with several co-morbidities. The novices can get some realities of practice from their academics. However, that cannot be considered as complete preparation for actual practice (Murray, Sundin & Cope, 2018). Increased communication and skills for considering different aspects along with switching attention to different important responsibilities can only be achieved through experience. The transition from a student nurse to registered nurse is a gradual process and it takes time to become competent in handling critical cases. One of the main strategies to overcome this challenge is to take part in the collaboration of academia and hospitals that will help in finding the gaps and taking the appropriate approach to fill those gaps. Another strategy is to allow a transition period so that promotion and retention can be performed in nursing (Wang et al., 2018)

Another challenge that is commonly faced by the nurses in the mentioned transition period is patient assessment skills. The patient assessment methods and processes can be learned through the process of academics. However, different strategies and verbal tactics are required to be used for obtaining relevant information about the health of the patient (Bartels et al., 2017). For instance, it can be difficult for a novice to identify the points where a patient is needed to be cross-questioned. On the other hand, developing a therapeutic relationship or rapport also requires situation and person appropriate skills which ease out the process of developing meaningful and trustworthy relationship. One of the effective strategies that can be used to overcome this challenge is to develop effective communication skills and practical understanding the values, beliefs, motives and their influence upon the behaviour of the patient.

Clinical decision making is another challenge which can be a barrier to the patient’s health and safety. The clinical decision requires clinical judgement about making conclusion regarding the health status of the patient and choosing an effective method through which the patient needs can be effectively met and wellbeing can be effectively restored. However, making an effective decision requires the collection, collation and clustering a huge number of cues which comes with practice and experience. As mentioned by Höbler et al. (2018), as compared to a registered for the expert nurse, the novice may face greater difficulty to identify, collate and implement the cues in understanding the patient condition and needs which are required in effective care planning. Therefore, the strategy of in-depth training of the novice nurse along with workshops is required to be attended to increase attentiveness to the clinically significant cues.

3. Definition of Resilience and Its Application and Strategies to Foster Resilience

Resilience can be defined as the survival of an individual from loss or any disease or it can be considered as a skill to survive (Yılmaz, 2017). It is also considered as an individual characteristic or a developmental process. In a simpler term, the ability of an individual to undergo any difficult situation through successfully adapting with it can be considered as resilience.

As identified in the current case study stress is one of the major barriers for the nurses to provide adequate and appropriate care to the patient. Nurses are dealing with different patients among which dealing with terminally ill patients can be depressive for the nurses. These depressive factors are responsible for different physical and mental health problems, lack of concentration, emotional exhaustion and others affecting the ability to maintain practice standard. Therefore, resilience works as an important protective factor against the draining of energy and emotional exhaustion. It can also be considered as a supportive factor that helps nurses to adapt to the physical, emotional and mental nature. As a nurse, it is important to be confident about the tasks performed and decisions made. A nurse will always have a sense of control over their actions and competence. Zafarnia et al. (2017) identified a significant association of these factors with the resilience of the nurses. Therefore, resilience among nurses provides them confidence and sense of control which improves their capabilities to handle difficult situations. However, Brown, Wey & Foland (2018) argued that the age, years of experience and expertise does not determine the level of resilience of the nurses.

Resilience also plays an important role in enhancing job satisfaction (Kašpárková et al., 2018). It can be stated that the higher level of job satisfaction is important for the nurses to perform required tasks with more perfection and accuracy which is also dependent upon the resilience. Higher resilience level is also associated with the application of effective problem-solving approach into practice and higher level coping efficiency among the nurses. One of the highly effective strategies to foster resilience is to arrange mentorship and orientation programs along with supportive educational activities that help them increase competence, hope, job satisfaction, sense of control and others. Improving social network by developing meaningful and trustworthy professional relationships will also help them create life balance, thus fostering resilience.

Conclusion on The ICN Code of Ethics for Nurses

In conclusion, it can be stated that work overload, handling critical patients, the uncertainty of situations are different factors that highly contribute to professional stress among the nurses. As observed in Kelley’s case, despite being a careful and sensitive nurse, due to work overload and reduce physical and mental capacity has led to face a difficult clinical situation which was against the practice standard. Challenges that novice face in the transition period of being a registered nurse can be overcome through developing effective communication skills and joining workshops. Additionally, resilience is important for the effective practice of the nurses which can be gained through improving the sense of control, greater job satisfaction and others.

Reference List for The ICN Code of Ethics for Nurses

Nursing and Midwifery Board of Australia, (2020), Registered nurse standards for practice, Retrieved 10 October 2020, from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

Nursing and Midwifery Board of Australia, (2020), Fact sheet: Code of conduct for nurses and Code of conduct for midwives, Retrieved 10 October 2020, from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/FAQ/Fact-sheet-Code-of-conduct-for-nurses-and-Code-of-conduct-for-midwives.aspx

International Council of Nurses, (2020), THE ICN CODE OF ETHICS FOR NURSES Retrieved 10 October 2020, from https://www.icn.ch/sites/default/files/inline-files/2012_ICN_Codeofethicsfornurses_%20eng.pdf

Esmaelzadeh, F., Abbaszadeh, A., Borhani, F., & Peyrovi, H. (2017). Ethical sensitivity in nursing ethical leadership: a content analysis of Iranian nurses experiences. The open nursing journal, 11, 1.https://doi: 10.2174/1874434601711010001

Oguisso, T., Takashi, M. H., Freitas, G. F. D., Bonini, B. B., & Silva, T. A. D. (2019). First international code of ethics for nurses. Texto & Contexto-Enfermagem, 28. https://doi.org/10.1590/1980-265x-tce-2018-0140

Australian Commission on Safety and Quality in Health Care, (2020), The NSQHS Standards, Retrieved 10 October 2020, from https://www.safetyandquality.gov.au/standards/nsqhs-standards

Murray, M., Sundin, D., & Cope, V. (2018). New graduate registered nurses’ knowledge of patient safety and practice: A literature review. Journal of clinical nursing, 27(1-2), 31-47. https://dx.doi.org/10.1111/jocn.13785

Wang, L., Tao, H., Bowers, B. J., Brown, R., & Zhang, Y. (2018). Influence of social support and self-Efficacy on resilience of early career registered nurses. Western journal of nursing research, 40(5), 648-664. https:// DOI: 10.1177/0193945916685712

Schmidt, C. S. M. Are semantic and phonological fluency based on the same or distinct sets of cognitive processes? Insights from factor analyses in healthy adults and stroke patients. Neuropsychologia 99, 148–155, https://doi.org/10.1016/j.neuropsychologia.2017.02.019

Bartels, D. J., van Laarhoven, A. I., Stroo, M., Hijne, K., Peerdeman, K. J., Donders, A. R. T., ... & Evers, A. W. (2017). Minimizing nocebo effects by conditioning with verbal suggestion: a randomized clinical trial in healthy humans. PLoS One, 12(9), e0182959. https://doi.org/10.1371/journal.pone.0182959

Höbler, F., Argueta-Warden, X., Rodríguez-Monforte, M., Escrig-Pinol, A., Wittich, W., & McGilton, K. S. (2018). Exploring the sensory screening experiences of nurses working in long-term care homes with residents who have dementia: a qualitative study. BMC geriatrics, 18(1), 235. https://doi.org/10.1186/s12877-018-0917-x

Yılmaz, E. B. (2017). Resilience as a strategy for struggling against challenges related to the nursing profession. Chinese Nursing Research, 4(1), 9-13. https://doi.org/10.1016/j.cnre.2017.03.004

Zafarnia, N., Abbaszadeh, A., Borhani, F., Ebadi, A., & Nakhaee, N. (2017). Moral competency: meta-competence of nursing care. Electronic physician, 9(6), 4553. https://doi: 10.19082/4553

Brown, R., Wey, H., & Foland, K. (2018). The relationship among change fatigue, resilience, and job satisfaction of hospital staff nurses. Journal of Nursing Scholarship, 50(3), 306-313. https:// doi: 10.1111/jnu.12373

Kašpárková, L., Vaculík, M., Procházka, J., & Schaufeli, W. B. (2018). Why resilient workers perform better: The roles of job satisfaction and work engagement. Journal of Workplace Behavioral Health, 33(1), 43-62. https://doi.org/10.1080/15555240.2018.1441719

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