The field of professional nursing has evolved tremendously over the last century. Nurses have turned the habit of caring into a well established, and respected occupation representing the largest field in health care jobs, with over three million registered nurses in the United States (Cherry, 2014). Through the development of professional nursing, regulatory agencies such as the National Council of State Boards of Nursing, represented by board of each state, have been established to monitor and regulate the responsibilities of, and scope, in which registered nurses and other nursing disciplines may practice their skills. Also, the licensure requirements have been set by the Boards of Nursing of each state. These boundaries of responsibilities and scope of practice given to professional nurses are products of the Nurse Practice Acts.
Other professional nursing organizations such as The American Assembly of Men in Nursing, does not play a role in direct rules and regulations within the field of nursing, but affects conveys studies and researches to improve my professional nursing practice. Their mission is to affect the men in nursing to breakdown the gender bias in the nursing field (Cherry, 2014).
The American Nurses Association (ANA), another professional organization related to the nursing field, establishes principles and standards in which nurses should abide by, such as the Code of Ethics for Nurses. The ANA standards are clearly stated in their provisions. In Provision I, and perhaps the most important principle I carry with me throughout my practice is the respect for human dignity (ANA, 2015). I recognize on a daily basis that I am treating a person, that due to an illness became a patient, but first of all, he or she is a person. Everyday when I show up to work, one of the first things I do as I am assessing my patients, I ask them to tell me more about themselves, I want to know the person laying in the hospital bed. By getting to know my patients, I cannot help but to treat them as a person first, with respect.
Another provision laid out by the ANA, is the nature of health, where it states that nurses should respect the patient’s dignity and human rights, by not judging the reason they may lay ill in a hospital bed (ANA,2015). Such is the case when I work with patients who are dependents of illicit drugs or prescribed medications. I do not let myself think at any time that their vices shape who they really are. I care for them the same way I care for an elderly patient. I educate my patients, without insinuating at any time, any judgment, or lack of appreciation towards them as a person.
The ANA Code of Ethics also sets principles for professional traits to be honored by nurses in their daily processes, with both the patients and interdisciplinary team for best patient health outcome. First and most important, patient safety; nurses must comply with standards of healthcare and management to ensure a safe environment and appropriate practices are in place to treat each patient individually (ANA, 2015). As a nurse, I cannot condone any behaviors by my patients, or colleagues and other members of the healthcare team, that may put my patients at any risk; the risk being to their immediate health, or risking their privacy and dignity. I must verbalize concerns and take actions to ensure the safety of my patients.
According to the code of ethics of the American Nurse Association, under Provision 2, another professional trait a nurse must always have while practicing is the need to avoid any conflict of interest when caring for a patient (ANA, 2015). Nurses must be attentive, and recognize any arising conflict of interest surrounding them, and remember that the patient’s safety and health always comes first, while maintaining the integrity of the nursing profession, and assisting the other members of the healthcare team. These issues may arise in both direct and indirect patient care, and nurses must learn to identify and verbalize any concerns.
Nevertheless, professional boundaries must also be set in place in the work environment. As a nurse, we get to know our patients and colleagues very well, at times on a very personal level. Nurses must acknowledge and maintain personal relationship restrictions. According to the code of ethics, the ANA, 2015, illustrates that “Nurse-patient and nurse-colleague relationships have as their foundation the promotion, protection, and restoration of health and the alleviation of pain and suffering. Nurse-patient relationships are therapeutic in nature but can also test the boundaries of professionalism.” As nurses we must recognize when boundaries are being crossed. At times, when dealing with stressful situations, the patients may confide in us personal details, or treat us as a close friend making it hard to deviate from professional boundaries. It is important to maintain professionalism while still providing emotional support for patients and families.
Throughout the history of nursing as a profession, many historical figures have made huge impact in shaping the knowledge base of modern day health care. Known as nursing theorists, many names are frequently referred to leaders of their times in patient care and patient advocacy, setting nurses as a respected member within the healthcare field. Through scientific studies in interest areas in the nursing field, many theorists have proven methods to better achieve optimal patient outcomes. One theory that resonates with me is Betty Neuman’s Systems Models. Betty Neuman promotes the wellness-illness continuum, where nurses acts as a collaborator in aiding the patient to adapt to an illness by educating them on the cause and effect of the condition, thus promoting stress reduction (Cherry, 2014). I understand this theory as promoting patient centered care, and by educating the patient on the condition and proper prevention methods, and interventions, will provide comfort to the patient, which in turns increase compliance with care.
Furthermore, no one can deny the affect Nightingale had and still have on the healthcare system. Now a household name, she once took upon herself to care for critically ill patients under the unhealthiest conditions in battlegrounds. Her documented methods of preventing infections in the patient care setting still echoes in modern day hospitals and healthcare facilities. I am a believer in cleanliness in patient care environment, and through education of my peers and patients and families, I strive to reduce the risks of hospital-acquired infections. Thanks to Nightingale, we now have a specialized nursing spectrum dedicated to infection prevention, which follows the basis of her theory, with more in depth research and knowledge acquired by nursing education in our modern day society.
As a nurse, we face challenges routinely. Some of these challenges may present as an ethical dilemma between the patients, and us although we feel as if we know the right thing to do, according to our principles, we encounter people with different views. One of the dilemmas I have faced in my career was when I had a Jehovah’s Witness patient in need of a blood transfusion, but due to religious purpose refused it. As a patient’s advocate, I explained the risks he faced if the transfusion was not administered; yet he refused. All I could do was educate, and sit back and watch him deteriorate, but I had to honor his wishes, and honor his autonomy to make such medical decisions for himself.
Autonomy and Beneficence are two nursing principles that sometimes, as in the example I cited, clash with one another. Us, as healthcare providers, serving as a patient advocate, we always want what is best for the patient, and sometimes the patient may not feel the same way, and perhaps make different choices than what we wish for. As nurses we must honor the patients autonomy to make his own decisions as long as he is competent to do so, while still wanting and presenting the best options and treatments to their ailments, and sometimes that is all we can do.
The Dude Nurse
Klaus Campos, BSN-RN