e: Topic 4 DQ 1

The reason for standards of practice in nursing is to promote, guide, direct, and regulate the professional practice. Each province in Canada sets a standard of Nursing that every nurse has to adhere by. These standards ensure that the legal and professional standards of nursing are upheld. Hence the reason a license is issued for a nurse to practice so the public can be protected and safeguarded.

In Ontario, The College of Nurse’s of Ontario is the body that sets standards and practice guidelines for nurses. The main purpose of these guidelines is to provide safe and ethical nursing care for the people of Ontario.

Practice standards:
These outline the expectation of nurse contribution to public protection.
The nurse needs to be aware of the accountability to the public.
To make the public aware of what is expected of the nurse.
These standards apply to every nurse,

Practice Guideline:
In these guidelines, nurses understand their responsibilities and how to make ensure that they make safe and ethical decisions.

The other legislative body that is key to where I work is the Legislation relevant to mental health in Ontario. (RSO 1990, C.M.7-Ontario.ca).
The Mental Health Act sets out the guidelines for when a person is admitted to a specially designated psychiatric facility. The admission designation should be voluntary, involuntary or informal.
The health care consent act which states the rules determining capacity are in three areas, treatment decision, admission, and personal assistance care.
The Substitute decision Act allows for the individual who is capable to appoint another person to make decisions for them in case they become incapable.
Then there is the Health Information act of 2004. This legislation was enacted to ensure that health care providers understood the unique demands of providing mental health care for individuals and that there is no disclosure of information without the consent of the client or a substitute decision maker.
In the mental health setting, I work it is imperative to establish the status of the client immediately on arrival. Meaning if the client is voluntary, involuntary, or informal. Treatment decisions are made with this in mind. Adherence to the College of Nurses guidelines and the mental health legislation is important because depending on the capacity of the client, some immediately request a lawyer on admission who is routed through a Rights Adviser. A Rights Advisor is one of the hospital’s employees and can be reached through an extension. This information is usually posted so the client can have easy access. While trying to ensure that that client is safe and needs are met, it’s within the patient’s right to be treated immediately, and have access to an attorney. This is also a very important aspect of their lives.

 

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2 postsRe: Topic 4 DQ 2

To be professionally accountable in nursing is necessary and vital for patient care and safety. According to The American Nurses Association Code of Ethics, the definition of accountability “ is to be answerable to oneself and others for one’s own actions.”
The nurse has to ensure that while delivering care, accountability is owed to themselves and the client, the client’s family, colleagues, the workplace and the profession.

An example of professional accountability is during the admission process of a client to a psychiatric unit for the first time. The client is involuntary and is not sure what this status means for them. With professional accountability, the nurse explains the involuntary status and also ensures that the family understands what this status is in a psychiatric facility. Due to the fact that the hospital is a teaching facility and nursing students are always present, each opportunity must be seen as a teaching moment, so nursing students can understand how professional accountability impacts the care of clients from the time of admission.

A senior nurse knows that establishing a therapeutic relationship allows the client to feel safe and being professionally accountable impacts both client and student especially during the assessment phase. Here the nursing process is key to clinical expertise and using the nursing process demonstrates that quality of care must start from the point of admission to discharge. This nursing process is kept in mind by a highly educated nurse who also uses evidence-based practice to deliver safe and effective care.

Evidence-based practice in professional accountability allows the nurse to have a better understanding of the practice and how accountability influences her to make decisions that fully impacts patient care.(Brower & Nemec,2017) An example of evidence-based practice in mental health is to form a client-centered plan of care to ensure all decisions are shared-decision making. The care team and the client seeking help with mental health issues come together to have client-centered care and self-directed care. 

With accountability to the client and self, the nurse is an advocate for the client and ensures that the latest evidence is used to drive change for better patient outcomes. ( Brower & Nemec, 2017).

Professional Accountability is one of the best ways for a nurse to self regulate, be conscious of the care and their impact when imparting knowledge to the future generation of nurses.

 

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1 postsRe: Topic 5 DQ 1

Through championing the nursing profession, nurses give a voice to the essential role that they play in advancing access to high-quality, affordable care. With energetic participation in advocacy, every nurse can help the profession to improve and move to higher levels. The American Nurses Association (ANA) believes that advocacy is a pillar of nursing. Nurses instinctively advocate for their patients, in their workplaces, and in their communities; but legislative and political advocacy is no less important to advancing the profession and patient care. The ANA serves to amplify the voice of nurses by advocating directly with decision-makers on Capitol Hill as policies are conceived, debated and implemented. The ANA provides support for state nurses associations as they advance their own advocacy agendas and help federal agencies and elected officials propose and enforce new laws that will advance the nursing profession. The ANA creates long-lasting relationships with nurses and their representatives, working to establish a health system where care is accessible, of high quality, and recognizes the nursing profession as an integral component. Registered nurses represent the largest segment of health professionals, with more than 4 million nationwide. Nurses not only represent an incredible force by sheer numbers, but policymakers rely upon their expertise as they work to improve our nation’s health system. Through participation in professional organizations, nurses can actively contribute to legislative changes that can affect patient care and the way they conduct their work. Nurses are continually looking for and exploring new ways to provide patients with quality care (GCU, 2018).

 

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 Nationwide there is different kind of professional nursing organizations are working for nurses to provide them safety in the health care system. The ANA (American Nurses Association) is the only full- service professional organization representing the nation’s 2.9 million registered nurses through its 54 constituent member associations. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, a positive view of nursing. As a value professional nursing organization the help to let regulatory agencies know about public health issues that affect the nursing profession. (Kathleen .2014) Every day nurses are facing new challenges in the health care system. So these nursing organizations support the rights of nurses and the public. From advocating at the highest levels of policymaking to setting the optimum credentialing standards to funding the best nursing research – with the ANA Enterprise championing nursing interests across the board, every nurse is encouraged to become the best nurse that they can be. (ANA Website) These nursing organizations work as an advocate for nurses and patients according to their needs. I think we all nurses nation wise need to join nursing organizations to get more benefits like continuing education, certification, educational conferences 

 

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Patients who are ill depend on nurses to help them return to an optimum healthy state.Utilizing the nursing process allows nurses to take an active role in a patient’s care.According to Oliveira and Tariman (2017), nurses spend more contact hours with the patient than any other member of the healthcare team. Therefore, nurses have an important role as a patient advocate.It is the duty of a nurse to speak up on behalf of a patient to protect their basic rights and safeguard their safety (Oliveira and Tariman, 2017). Advocating for patients may be difficult for some nurses because the patient may want or decline treatment and it is the nurse’s responsibility to make sure their wishes are met. Patient advocacy also entails speaking to other members of the healthcare team to maintain the best interests of the patient. Standing up for patient’s rights, no matter how difficult it is, is a nurse’s responsibility (Grand Canyon University, 2018). Barriers that nurses may encounter are lack of support from administrators, acuity of patients, not using evidence-based practice, lack of assertiveness or confidence (Oliveira and Tariman, 2017). It is important for nurses to remember that one must practice according to the guidelines set by the nursing practice act of their state and advocate for their patient within their scope and standards of practice.

In my experience as a labor and delivery nurse I have had several opportunities to advocate for my patients. In one instance I had a laboring patient who was very adamant that she did not want an epidural. She wanted to experience a labor with minimal interventions. When her physician came to evaluate her, he was upset that she did not have an epidural. He started to try to intimidate and scare her into getting one.There was no medical necessity for it and she looked at me and started to cry. I verbalized to the physician that she did not want an epidural and I was going to be sure that whatever her wishes were, we were going to respect them, no matter how inconvenient he felt it was for him, as long as there was no medical contraindication. My patient delivered with no epidural and was so thankful and appreciative that I helped her not get bullied into an unnecessary procedure when there was no medical indication for it.

 

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