Breach of the Code of Conduct for Nurses on Person-Centered Care - Paper Example

Introduction

A person-centered care is a healthcare approach through which the healthcare providers consider the patients as equal partners in the planning and delivery of a care plan to manage the patient health (Luxford et al., 2010). Person-centered care is an essential approach of care that ensures that the healthcare intervention is tailored towards the needs of the patient especially patients with chronic problems which require long-term management. Patient problems and situations vary from one patient to another, and person-centered care can be used to improve healthcare outcomes of the patients (Cashin et al., 2017). In this case, a person-centered care is a personalized care approach which allows the coordination, cooperation and involvement of the patients. The person-centered care isan important in improving care quality and ensuring that the patient has more say and contribution towards their healthcare plan (Katon et al., 2010). Person-centered care in Australia is a universal standard that is expected of all the healthcare providers. As a code of conduct, person-centered care is recognized as an essential approach to standardize care. Patients and their families according to the code of conduct should be considered in the patient decision making which is a strategy to improve health outcomes (Jackson et al., 2013). The person-centered care occurs in an environment where there is high disclosure of information which helps the clients to open up on their values, beliefs, and families and can improve in the high involvement of patients in decision making (Mather, Gale, & Cummings, 2017). Person-centered care is used to create flexibility which promotes the ability to increasingly meet the needs of the patients (Delaney, 2017). This paper will assess and evaluate a case where nurses failed to observe the person-centered care code of conduct in providing care to a diabetes type 2 patient. The paper will use Gibb's Reflective Cycle to assess the case where nurses failed to observe the patient-centered care requirements according to the Code of Conduct for Nurses (NMBA, 2018) which sets out standards and regulations.

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Discussion

Gibb's Analysis

Gibb's Analysis is a reflection model that seeks to create an avenue for one to challenge their perceptions about experiences one has faced previously (Gibb's, 1988). The model uses six reflective steps that help develop a descriptive and experience analysis to be able to create reflections on how the events unfolded or happened and its implications (Wilding, 2008). The primary role of Gibb's reflection model is to help one to challenge their assumptions and create an environment where one can be able to explore different ideas and scenarios towards improvement and to link practice with theory.

Description

While working as a volunteer nurse at Royal Prince Alfred Hospital as an assistant nurse, I witnessed a diabetes patient who was denied person-centered care. During a Friday morning 3rd August 2018 I experienced a breach of the Code of Conduct for Nurses (NMBA, 2018) which emphasizes the importance of person-centered care. In this case, John a veteran and a diabetes type 2 patient at the hospital was admitted having high blood pressure and poor vision which are synonymous with diabetes complications. The medical records at the hospital showed that John was previously admitted at the hospital with similar symptoms treated and after the blood pressure normalized was discharged. In the second time, the nurses attended John without further assessment and creation of a patient-centered care plan to ensure that John complies with diabetes lifestyle requirements and also to establish the causal factors for his blood pressure relapse. In this case, person-centered care guidelines set in the Code of Conduct for Nurses (NMBA, 2018) were not observed which puts the life of the patient in danger due to the possibility of a more severe diabetes complication such as stroke.

In such case, the patient was poorly treated and assessed because he was previously admitted in the hospital and the nurses thought that further assessment was unnecessary. The nurses should have carried out a biopsychosocial assessment to establish the cause of John's poor diabetes management and create a person-centered care plan that could help John to regain back his health. Patient care is a delicate issue that cannot be left to assumptions that are not established without any evidence. Through their negligence, the nurses posed a higher health risk to John suffering more severe diabetes complications because of the nurse's ignorance and failure to adhere to the required code of conduct. The nurses failed to offer John a person-centered care plan that could have been initiated by a new biopsychosocial assessment that will establish the issues that are causing the patient the complications such as poor adherence to the required diet and exercise regulations. The nurses should have educated the patient on the role of dieting and participating in physical activities which can help improve the patient outcomes and conditions (Alharbi et al., 2014).

Breach of Person Centered Code of Conduct

The nurse's actions towards John were a direct violation of the code of conduct for nurses which is a framework that is established to create evidence-based practice guidance for nurses to improve healthcare outcomes. The code of conduct is a standardized approach that seeks to create a more standardized approach to care. Breaching the code of conduct for nurses regarding person-centered care led to substandard care which put the patient's life in more danger (Ross, Tod, and Clarke, 2015). The nurses in the Royal Prince Alfred Hospital should have used a person-centered care approach to reassess John's diabetes self-management capabilities which could have increased healthcare outcomes and created a more responsive care plan based on John's healthcare needs and situation both socially and psychologically.

Feelings

After witnessing the incident, I realized the importance of person-centered care. I feel that nurses denied John quality care which was detrimental to his own health and wellbeing. Healthcare organizations are designed to provide care with the code of conduct standardizing how care is delivered and guides the nurse's decision making. In the scenario at Royal Prince Alfred Hospital was against the established nursing values in Australia which denied the patient both quality and individually designed care. Before my experience of the nurse's ignorance at the Royal Prince Alfred Hospital, I believed that nurses in hospitals that are known to deliver quality use the person-centered approach to provide care. During the act, I felt that what the nurses were doing was wrong because their approach was not going to improve John's health outcomes since the major problem in the case was not attended to. From my perspective, the nurses should have used a biopsychosocial assessment to create a person-centered care plan that was going to improve John's health outcomes at the time. I felt like I could intervene but as a nurse assistant, the regulations in the Royal Prince Alfred hospital did not allow nurse assistants to interfere with care plans developed by senior nurses. I watched helplessly and wished that I was in a position to create the patient care plan myself which could have been tailored towards the special patient needs to avoid future hospitalization. I reacted to the experience by writing a note to the nursing suggestion of the need to adopt and educate nurses on person-centered care especially for diabetes type 2 disease which is a chronic disease that need long-term management and failure to implement a patient-specific care reduces the effectivity of the intervention plan which was the reason behind John's readmission in the hospital. After the experience, I felt that there is more that assistant nurses can do especially those still in school to improve the nursing experience for chronic disease patients (Disch, 2012). For instance, if Royal Prince Alfred Hospital internal policies allowed the assistant nurses to contribute towards the creation of the patient care plan could have increased the observance of person-centered care code of conduct which is a crucial nursing value that every nurse and healthcare provider should identify with when dealing with chronic care situations.

Evaluation

The evaluation section of Gibb's reflection framework creates an understanding of what went wrong during the experience (Scott, 2013). In this case, the nurses denied John a diabetes type 2 a patient-centered care approach in creating his care plan which overlooked the current patient predicament. The nurses failed to carry out a reassessment of the patient because they were already aware of the patient diabetes problem. The poor observance of the person-centered care conduct requirement according to the Australian code of conduct for nurses reduces care outcomes and leads to increased patient readmission (McMillan et al., 2013). Different patients have different care needs that should be approached individually in a more comprehensive way. In this case, a biopsychosocial assessment could have helped to identify individual and isolated patient problems that were making it difficult for the patient to implement the prescribed self-management care for diabetes which is the primary approach used in managing chronic diseases (Hanna, 2010).

Analysis

Causes of Action

In the event of John's admission, different factors caused the nurses to overlook the need for a patient-centered care plan which should have started with a patient assessment to establish the reasons for the patient readmission (Mettumpurath & Manoj, 2018). Failure of carrying out a patient reassessment played a significant role towards the failure of the nursing interventions to be in alignment with the nurse's code of conduct which emphasizes on the importance of person-centered care plan. In John's condition, a care plan is necessary to ensure that the patient needs are established and aligned with the care plan adopted by the doctors. In this case, the nurses failed due to ignorance because the patient was readmission and the disease remained constant. The nurses should have instead considered that the patient care plan was ineffective or the patient lacks self-care knowledge. Besides, the number of nurses at the hospital at the time was small compared to the number of patients in the diabetic ward which posed a significant problem in addressing the individual needs of the patients. The nurses took a conventional approach to care which is ineffective and fails to solve the individual patient's problems (Keene, 2016). A person-centered care breach in the hospital, therefore, can be tied to the low number of nurses and the high number of patients (Mettumpurath & Manoj, 2018). However, the most significant cause of action, in this case, was ignorance from the part of the nurses who failed to identify the need to reassess the patient and create a more effective care plan.

Consequences of Action

The nurse's ignorance led to the breach of the nurse's code of conduct that requires nurses to offer person-centered care especially for the chronic diseases patients who need specialized care and education to improve their health outcomes. The most predictable outcome was that John situation could only get worse due to the failure of the nurses to create a more specific care plan to address his needs. Diabetic complications such as eye damage and hypertension could lead to more severe problems such as stroke or permanent blindness which could be due to the negligence of the nurses and the healthcare organiz...