The role of the nurse in providing professional, compassionate care
The nursing profession is dedicated to the delivery of primary health care to families, communities, and individuals with compassion and professionalism. As a critical element of nursing, it is important for health care providers to understand the various roles of nursing in relation to the six C’s of nursing. While students and individuals providing nursing care may have diverse opinions on the role that nurses play in the society, there are a number of principles that are identifiable to all nursing professionals as important to their position, such as care, compassion, competence, communication, courage, and commitment (McSherry, Pearce, Grimwood, & McSherry, 2012, p. 10). Nurses are expected to provide health care to patients and offer support to their families during difficult times. They are also supposed to be mentors, advocates, educators, and promoters of change while providing care to patients.
The Health Departments in the UK and the US require nurses to offer quality care and ensure that the safety of patients is protected while offering them treatment that is characterized by respect, dignity, and compassion. The patients should also be treated in a safe environment in order to prevent accidents and the spread of infections. Interventions offered to the patients should be therapeutic and not harmful or counterproductive. Professional nursing care also requires respect for patients’ sexual orientation, race, religious beliefs, and disabilities.
NHS values and principles
NHS is principles were made in order to ensure that quality health care is available to all regardless of their social status. Core principles for the code state that ideal health care should be available to all, based on need, on the patient’s ability to pay and lastly, at the point of delivery it should be free. The aim of NHS is ensuring that the health and well being of people is improved and it also supports people’s welfare, both physically and emotionally. NHS binds patients, public, communities and staff who work in hospitals. The code of conduct sets the rights to which the staff, public, and patients are entitled and is also committed to ensuring that patients are treated effectively and fairly. NHS also has the duty of promoting equality by paying attention to groups and societies through paying attention to improving health and life expectancy in areas that are raging behind compared to the rest of the society (Apker, Propp, Ford, & Hofmeister, 2006, p. 182).
According to NHS there should be high standard of excellence and professionalism. Dignity, respect, care and compassion should always be the core of how patients are treated. This should not be done only because it is the right thing but because the patient’s safety and this can only be achieved if nurses are empowered, supported and valued. Additionally, NHS insists that patients are the heart of all its activities. NHS also works in collaboration with other organizations with the interest of making the life of local communities and patients better.
Professional, legal and ethical aspects of nursing
Ethical codes are the guidelines that determine the behavior, values and beliefs that are morally accepted. Professional codes in nursing are useful in providing directions in providing professional health care. These moral codes are useful to professionals who act morally out of self-motivation. The ethical and legal guidelines suggest that sick people should not be regarded as clients but rather should be called patients. Nurses are required to apply ethical guidelines, not only to the clinical roles, but to all roles that they perform inside and outside the medical centers. Nursing code was revised in 2001 and it insists that nursing should be focused on the patients. Additionally nurses should always be loyal to patients. Due to growth of advanced nurses and administrators, nurses should recognize the conflict of interest that has a negative impact on the relationship between caregivers and the patients (Melvin, 2012, p. 609). The codes of ethics are applicable to all nurses regardless of the roles that they play. Nursing is not about the position or degrees that one posses, but rather commitment to patients is crucial. Nurses are also given the responsibility for advocacy and planning and making ethical decisions when delivering care to the patients. The nursing profession is governed by six main principles that include, respect for people, beneficence or doing good, non-malfeasance, which is avoiding harm, justice, veracity or telling the truth and fidelity which is about remaining faithful to nursing commitment. These principles act as guidelines for nurses when making decisions. The nurse’s code of ethics is supported by American Nurses Association Code of Ethics (ANA) (Nancy & Deborah, 2009, p. 183).
The ANA code of ethics emphasizes the importance of values and ethics in nursing. The ANA code of ethics appreciates what is important to both patients and nurses, which also includes the importance of moral respect for human beings and for the nurses. In this context, self-respect is the regard for personal life, which includes paying attention to caring for one’s needs. It is quite clear that nurses who regard themselves as unworthy cannot take good care of the patients (Boyle, 2011). The ANA code of ethics insists on the importance of good character as a whole whereby a nurse is required to understand the values in the nursing profession and express them appropriately. Nurses should also maintain integrity by being consistent with personal and professional values.
ANA and ICN Codes of ethics
ANA and ICN have a common theme of alleviating suffering through compassionate nursing care. This is based on the fact that nursing should be the main focus for nursing work. Nurses should be determined to protect the patients and the environment in which care is provided. The interests of the patients should always be above those of the nurses. Although nurses do not have a unique environment for working, they must agree to work communities and patient when they join the profession. The central responsibility for promoting and preventing illnesses but the spirit of the profession should always be caring for the patient who are going through different degrees of psychological, spiritual and physical suffering (Sabo, 2006, p. 138).
Legal implications for nursing care and practice include licenses, practice scope, state and federal laws and the expectations from the public. License, education background and nursing standards are the backbone of the expectations of the nurses. Nurses are regarded as unprofessional in cases where their standards of care are below the acceptable standards. This can lead to litigation of the nurse. Litigation is caused by negligence or failure to exercise reasonable care, professional malpractice or negligence which translates that the nurses are not committed to their professional role. As result the nurses license can be reviewed. Review of professional license and litigation can lead to lose or reprimand of the license. Correctional nurses are susceptible to litigation since they deal with correctional patients who according to constitution have the right to nursing care. Nurses are the only medical practitioners who spend more time with in-mates. Therefore, failure to offer them access to adequate medical care to meet their needs can lead to litigation. This is based on the eighth amendment which view it as deliberate indifference or 14th amendment which sees it as a form of civil rights violation (Melvin, 2012, p. 607).
According to the ethical and legal standards, nurses should always keep the private information of their patients confidential at all times. Confidentiality is a way of establishing a trustworthy relationship between the patients, nurses and the families of the clients. Nurses could be tempted to disclose confidential information to the families of patients under vulnerable situations. The legal standards also require nurses to have moral courage by overcoming the fear of confronting the issue at hand. Moral courage also requires nurses to do the right things and to speak out even when other forces state otherwise. Having moral courage enables nurses to prevent hurtful situations and prevents pain that could be caused by wrongdoings.
Regardless of the work station, nurses have a legal and ethical obligation for responding to request for care. Generally, nurses are required to review their patients and determine the care level needed based on the health needs. Communication is the key to nursing care either through face to face conversation or by phone and ensuring that they ask the right questions. The law also protects nurses through statutes that are different depending on the State (Yam & Rossiter, 2000, p. 295). In some States, protection of nurses is under Statute of limitation. Since nursing practice is expanding and nurses specializing in different areas of their profession and the standard care of nurses by the state is widening.
Caring, as defined by Simone Roach, is the intrinsic human nature of being. Accordingly, people in the nursing profession care for others, not because of the requirements of their jobs, but principally because of their human nature, a trait that is common in all individuals. Caring, therefore, forms the core of nurses’ work. Roach identified six C’s that form the fundamental attributes of caring, which determine the specific behaviors required of nurses in the process of providing care to patients, including compassion, competence, confidence, conscience, creativity, and comportment. In this regard, compassion implies being with others throughout their suffering (Fields et al., 2004, p. 83). It implies the sensitivity and empathy towards other people’s joy and pain, which allows people to participate in the experiences of their patients. The nurse-patient relationship should be characterized by a deep understanding of the person to whom care is being provided.
Further, nurses are required to be competent in their practice. They should endeavor to acquire and use humanistic knowledge and skills as well as evidence-based practice in their therapeutic interventions as per the current requirements of nursing practice. Nurses’ competence, therefore, includes the affective, cognitive, and psychomotor learning domains, which allow nurses to comprehend their roles in the health care system within the hospital and community. Caring also involves one’s self-assurance in his or her capacity to provide quality care. Nurses should be confident that their mere professional presence can positively impact on their patients. This assurance allows nurses to adequately dispense their roles as teachers, caregivers, leaders, managers, advocates, and researchers, which also facilitates change within the healthcare system. It also helps in defining and achieving goals, and is created through the combination of and effective use of experiences and knowledge (McQueen, 2004, p. 106).
Another aspect of caring as outlined by Roach is conscience, which plays a significant role in legal, ethical, and moral decision-making, as well as in the adherence to the established standards of professional practice. Nurses should be inspired by their conscience to expand the skills and knowledge necessary for appropriate response to legal, ethical, and moral matters faced by patients. According to Roach, conscience entails the increased consciousness to social injustices, health concerns, and trends in the industry at the local, national, and global levels, which facilitates responsibility, leadership, and accountability in patient care. In addition, nurses should be committed to upholding and enhancing the obligations and standards of professional nursing practice and ensuring that the delivery of excellent services to patients (McQueen, 2000, p. 728). Nurses should be loyal and devoted to the wellbeing of their patients through a deliberate effort to develop within the profession by being dedicated to life-long learning, incessant education, and increase in skill sets.
With regard to creativity, nurses should have a vision of the ideal nursing profession and aspire to make it better. As a result, nurses should think critically, imaginatively, and reflectively to improve the care giving practices and to create healing environments. Nurses are, therefore, required to nurture qualities such as risk taking, openness, envisioning, and resourcefulness, which in turn result in the incorporation of innovative insights into the existing nursing awareness and knowledge. In addition, it aids nurses in the individualization of care and acceptance of change. Finally, Roach defined comportment as the professional manner in which nurses present themselves with regard to attitudes, behavior, dressing, language, and appearance so as to present a caring environment. Accordingly, this facet includes the need for the acknowledgement of one’s effect on other people and the acceptance of one’s responsibilities.
According to Jormsri, Kunaviktikul, Ketefian, and Chaowalit (2005, p. 587), the caring aspect of nursing entails the utilization of a holistic perspective. Research shows that stressing the significance of holistic care, such as compassionate care and the art of nursing, particularly during orientation, improves results and boosts patients’ satisfaction substantially. This study found that nurses should complement the science of nursing with the art, empathy, and communication so as to impact positively on patients and form helpful relationships. Indeed, the relationship between patients’ outcomes and nurses’ compassionate care was reported in The Online Journal of Issues in Nursing. In his study, Boyle (2011) found that the addition of curriculum that focused on patient-centered care models to the normal training schedules ultimately had a significant effect on patients. This model primarily focused on compassionate care, valuing patients through active listening, and being there for them. Accordingly, nurses are requires to possess critical skills, including attentive body language, listening skills, concern, communication, concern for others, empathy, and honesty.
Compassion, empathy, and attentiveness to patients’ needs can potentially produce some tangible benefits because they address one of the primary needs of patients, that of being listened to and cared for, which depends largely on the actions of nurses. Compassionate care gives patients the feeling that their needs are being addressed and their concerns and condition are being recognized and taken care of. Subsequently, patients who develop bonds and trust with their nurses may start offering bits of information that may either lead to a diagnosis or help the nurse in improving care for the patient. Further, research has shown that relaxed patients often stay for shorter periods in hospitals, experience less pain, less anxiety, and more positive opinions concerning their health and recovery. Apker, Propp, Ford, and Hofmeister (2006, p. 186) argue that nurses who practice compassionate care often take steps to mitigate any hazards that may cause unnecessary suffering to patients, such as infections and falls. Patients themselves often reciprocate this compassion by reaching out to nurse who seem to take interest in them and avoiding behaviors that may cause additional problems.
The goal of holistic nursing, according to the American Holistic Nurses Association, is to heal the entire person. As a result, nurses are required to care, not just for the physical body, but for the patient in entirety. The current healthcare environment, specifically the increased time constraints and high patient load, makes it difficult for nurse to engage with patients on a personal level. Nevertheless, nurse practitioners have a moral duty to view patients as complete human beings as opposed to mere patients so as to heal their minds, bodies, and souls simultaneously. Accordingly, holistic nurses have a duty to help patients to heal physically, mentally, emotionally, and spiritually. They should pay attention to cultural and social disparities and customize care accordingly.
Patients themselves have their own understanding of compassionate care. The study conducted by The American Association of Critical-Care Nurses (2005, p. 191) revealed that patients’ association of caring and compassion is so strong that they could hardly differentiate the two concepts. In the research, patients described compassion as nurses’ presence and touch, as well as caring for them as human beings. Evidently, nurses should provide encouragement in times of adversities, spend time with their patients, portray positive attitudes, and create exceptional experiences that are tailored to the needs of every patient. Indeed, the study emphasizes the need for nurses to surpass their traditional moral duty of entering into patient experiences, helping them to preserve their independence, and delivering care. McSherry, Pearce, Grimwood, and McSherry (2012, p. 12) note that compassion can be nurtured through proper planning of care and attentiveness to patient-centered models of care. Nevertheless, the present-day healthcare environment has made it increasingly difficult to integrate patient centeredness into care and compassion, particularly due to the large number of patients. The study showed that patients acknowledge that nurses today are busy than ever before and are would appreciate smaller signals of compassion as opposed to expecting nurses to spend time with them to build relationships.
Theory-guided practice is also an effective way for nurse to provide compassionate care and improve patient outcomes. According to Jormsri, Kunaviktikul, Ketefian, Chaowalit (2005, p. 591), nurses study difference theories of care during their education, which they can use in their normal duties. Indeed, the use of such theories helps in providing a logical antidote to the present-day’s largely inefficient, disorganized, and fragmented healthcare system. Accordingly, nurses should endeavor to study as many theories as possible because the reliance on one theory narrows one point-of-view and vision and causes the nurse to treat all patients as if they were alike. On the contrary, nurse practitioners should select and use the most suitable conjecture in each circumstance. Fields et al. (2004, p. 92) argue that while theory-guided practice is one of the best ways to ensure that nurses adhere to proven models of care, it also allows practitioners to modify their approaches to care to fit the unique requirements of every situation, thus allowing for flexibility in care giving. The selection of the most appropriate nursing theory should be done with reference to personal beliefs and values concerning health, patients, the environment and the nursing profession, as well as the underlying assumptions, beliefs, and values of each model.
Nurse practitioners are expected to provide superior care to individuals, families, and the community, an exercise they should dispense with professionalism and compassion. The common consensus and industry standards indicate that nurse should adhere to the six C’s, including commitment, confidence, care, competency, communication, and confidence. These tenets enable nurses to provide quality services to their patients in safe, respectful, dignified, and compassionate environments. The NHS values and principles provide a guideline on how patients should be treated with regard to the provision of healthcare. These principles provide the rights of patients as well the duties and responsibilities of health providers, especially nurses. Accordingly, nursing professionals should endeavor to enhance dignity, care, compassion, and respect in health centers.
Further, nurses are expected to adhere to the general legal, ethical, and moral guidelines of the profession. As a result, all services should be patient-centered and free of any conflict of interest. The six guiding principles as outlined by the ANA and ICN ethical codes include beneficence, non-malfeasance, veracity, justice, respect for others, and fidelity. In addition, the nursing profession calls for a holistic approach that entails the healing of the entire person, physically, mentally, emotionally, and spiritually. Studies show that patients perceive care differently. Such understanding should be utilized by nurses to customize care plans in accordance to the patients’ unique needs as well as their social and cultural dissimilarities. In view of the present day’s limited time allocations to the nurses, patients have adopted their perception of care and compassion to include only a few signs, such as active listening, presence, and touch.
Finally, a nurse’s activities should be guided by proper nursing theories, the selection of which should be based on personal views, beliefs, and values. These guidelines not only help in dispensing the best possible care, but also help nurse practitioners to structure their services accordingly. Evidently, nurses have a duty to provide caring and compassionate environments for their patients. These duties are derived from various sources, such as their ethical, legal, and moral responsibilities, the six C’s of nursing, and the different theories of nursing. By employing a holistic approach, nurses can potentially improve patient outcomes, alleviate suffering, and prevent mishaps. At the core of the practice is the need to offer encouragement, be honestly concerned for patient’s wellbeing, portray positive attitudes, and be there for patients in times of need. The resultant bonds developed between patients and their nurses may provide tangible information that may be used to improve their experiences or make diagnosis.
American Association of Critical-Care Nurses, 2005. AACN standards for establishing and sustaining healthy work environments: a journey to excellence. American Journal of Critical Care, 14(3), pp.187-197.
Apker, J., Propp, K.M., Ford, W.S.Z. and Hofmeister, N., 2006. Collaboration, credibility, compassion, and coordination: professional nurse communication skill sets in health care team interactions. Journal of Professional Nursing, 22(3), pp.180-189.
Boyle, D., 2011. Countering compassion fatigue: A requisite nursing agenda. The Online Journal of Issues in Nursing, 16(1).
Fields, S.K., Hojat, M., Gonnella, J.S., Mangione, S., Kane, G. and Magee, M., 2004. Comparisons of nurses and physicians on an operational measure of empathy. Evaluation & the health professions, 27(1), pp.80-94.
Jormsri, P., Kunaviktikul, W., Ketefian, S. and Chaowalit, A., 2005. Moral competence in nursing practice. Nursing Ethics, 12(6), pp.582-594.
McQueen, A., 2000. Nurse–patient relationships and partnership in hospital care. Journal of clinical nursing, 9(5), pp.723-731.
McQueen, A.C., 2004. Emotional intelligence in nursing work. Journal of advanced nursing, 47(1), pp.101-108.
McSherry, R., Pearce, P., Grimwood, K. and McSherry, W., 2012. The pivotal role of nurse managers, leaders and educators in enabling excellence in nursing care. Journal of Nursing Management, 20(1), pp.7-19.
Melvin, C.S., 2012. Professional compassion fatigue: What is the true cost of nurses caring for the dying. International Journal of Palliative Nursing, 18(12), pp.606-611.
Nancy Aycock, R.N. and Deborah Boyle, R.N., 2009. Interventions to manage compassion fatigue in oncology nursing. Clinical journal of oncology nursing, 13(2), p.183.
Sabo, B.M., 2006. Compassion fatigue and nursing work: can we accurately capture the consequences of caring work?. International journal of nursing practice, 12(3), pp.136-142.
Yam, B. and Rossiter, J.C., 2000. Caring in nursing: perceptions of Hong Kong nurses. Journal of clinical Nursing, 9(2), pp.293-302.
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