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This piece of creative writing will center upon an experience on placement. Confidentiality will be maintained as per the Nursing and Midwifery Council (NMC) Code of Conduct, 2018.
My first day on placement was exciting but daunting. It was mid of October, cold and windy when I walked up the stairs, into my assigned ward and met a beautiful lady sitting in an office directly in front me, with her head facing downwards reading a newspaper. She was my ward manager; Anita. As I went closer to introduce myself, she briskly stood up and responded with a kind and charming voice, greeted me, and offered me a cup of tea. Two minutes later, walked in a slim, tall lady with blue eyes and blond hair tied up.
She was Sara, the nurse on duty. She glanced at me with an unwelcoming attitude when I was introduced to her. I was nervous and overwhelmed with grief and was frozen where I was sitting like a fish in water. The manager noticed that something was not right and asked me; are you, all right? I said, “yes, yes” nodding my head. When she left, I said to myself; “this is the nurse”. She verbally abused a patient in front of me a week ago causing me to intervene. Section 20.3 of the NMC explains the awareness of how the behaviour of nurses could affect and influence the behaviour of other people. The book; safeguarding adults in nursing practice explains how the NHS has adopted the term ‘safeguarding’ and explain in depth.
The following day, Sara was introduced to me as my team leader. Even though I was uncomfortable, I had to reflect on the skills and knowledge gained in class. I said to myself; “this is the time to exhibit my qualities and apply theory into practice”. It was breakfast time and I was assigned to aid an elderly Asian man in his 80s with visual impairment and dementia. I walked closer to his bed and introduced myself explaining what was to be served. He replied reluctantly, ok. He ordered egg on toast and beacon without the awareness of the fact that bacon was from pork as he was a Muslim. He asked; what is bacon made of? I replied; from pork. He said. No, no, no, no, eating pork is against my religion. I cannot see but can hear. The ladies that came here did not explain the way you have done. However, I could inform my daughter to bring me food from home but in the meantime, I would be pleased if you could buy me something from the canteen because I am very hungry. I went to nurse Sarah and explained all that happened. Even though the Nursing and Midwifery Council (NMC) code explains that professional standards of practice and behaviour for nurses, midwives and nursing associates must be applied within our professional scope of practice, Sara did not follow the code before approaching the patient. The code further explains that nurses must uphold the reputation of their profession and be inspiring models of leadership and integrity to enable the public, people under their care and other health care professionals to have trust in them.
Sara approached him and said; Rashid, Rashid, listen to me, we are not here in a Muslim country. When you are in Rome, do what the Romans do. According to our policy, we do not allow food brought from home. As he bent his head down, tears ran down from his eyes. He went further and said; ‘I want to die’. Give me something to die so that I can meet my wife. If she did not die of cancer, I could not have been here today. The nurse replied; “And so, what”? She went further and said that; no choices here, Mr Man. The Brazilian National standard of advanced nursing, June 1991 via a Perceptions of the Nurses’ Workplace Questionnaire (PNW) states that the way nurses feel about themselves is fundamental in the care they deliver to patients. It further explains that the strongest predictors of overall satisfaction with nursing were based on self-perception and recognition of work, meaning that, her attitude at that point in time may have been influenced by unknown factors.
It was quite touching and emotional. I thought to myself; it is time to speak up now or never. I invited Sara for a dialogue, but she despised me. I called her again with a deep voice filled with grief; Sara, Sara, excuse me please, I would be delighted to have a word with you in silence. while I was insisting, the manager walked to us and asked, what is going on here? She said nothing, she looked straight into my eyes and asked again, what is going on here? In less than no time, I unfolded everything to her. She was displeased with Sara’s attitude and instructed her to email the kitchen for a meal replacement and refer Rashid to a dietician for extreme weight loss. In less than no time, a nice warm bowl of porridge and a cup of coffee was brought by his bedside which was served to him with respect and dignity. At the end of the shift, she received a suspension letter from the manager for misconduct because it was the second event that month. The next day, Rashid passed away and a week after, the daughter made a complaint against Sara and allegations against the establishment claiming that Rashid died of starvation and dehydration after just two days of admission. It was a Monday morning, nice and sunny, when Anita, the manager invited me for a detailed explanation about what happened. I walked into her office with a calm and gentle look, filled with grief and horror. Rashid’s social worker was in the office with Sara, a member of the nursing and midwifery council (NMC), a member from unison, the ward manager, a safeguarding officer, and Rashid’s daughter. The dignity in health campaign in the book; Dignity in Healthcare explains how care for the elderly should be improved. Although there were food and fluid charts in place. She was suspended at the end of the meeting for professional accountability and misconduct.
In conclusion, Sara received a final warning letter for her recurrent attitude and for not making the environment a fair place for her patient. She resumed work after two weeks and committed to working following the six Cs. She set up relationships with patients, understanding their attitudes, personality, and maintaining a dignified person-centred care as per The British journal in community nursing. The journal further explains how nurses should avoid letting professional responsibilities interfere with their personal lives. Sara won the nurses award of the year and was promoted to a more senior role. May Rashid’s soul rest in peace!
There are several policies and procedures today which underpins the principles of nursing practice. The Royal College of Nursing (RCN) explains what everyone, from nurses to patients should expect from nursing including safe and effective nursing care, not forgetting attitude, behaviour and approach that underpins excellent care. Principle A explains how dignity and humanity should be supported when delivering care and to understand the needs of individuals, respecting people equally, showing sensitivity and compassion.
? Brooker, C. and Waugh, A. (2007) ‘The NMC Code of conduct and applied ethical principles’ in Foundations of Nursing Practice, Fundamentals of Holistic care. Cert Ed. LONDON: Elsevier, 163-166.
? Dodds, AE. (1991) ‘What makes nursing satisfying’: A comparison of college students and registered nurses’ views. Journal of Advanced Nursing 16 (6), 741-753.
? Hall, C. and Ritchie, D. (2013) What is nursing? 3rd ed. London: Learning Matters, pp.123.
? Matiti, M. and Baillie, L. (2011) Dignity in healthcare. Cert Ed. London: Radcliffe Pub. pp.37-42, 145.
? Mendes, A. (2017) ‘Nursing care and maintaining professional boundaries’. British Journal of Community Nursing 22(8), 407-408.
? Northway, R. and Jenkins, R. (2013). Safeguarding adults in nursing practice. 1st ed. London: Learning Matters, pp.90-97.
? NHS (2018) Leading change, adding value online Available from https://www.england.nhs.uk/leading change/. 8 November 2018.
The Person-Centred Care Theory and Practice explain how the WHO ‘s global goal is to humanise healthcare by making sure that all health care is rooted in universal principles of human rights and dignity, participation and empowerment, non-discrimination, access and equity, and a partnership of equals. This overall information provides us with a profound judgment on Sara’s unprofessional attitude in paragraphs three, four, and five. The six Cs were not implemented in her practice and furthermore, she did not behave as expressed in the professional code of conduct. (LO1, LO3, LO4).
? Nursing and Midwifery Council (2018) Guidance on professional conduct for nursing and midwifery students. online Available from 8 November 2018
? Royal college of nursing (2013) Response of the Royal College of Nursing to the Francis Report online Available from 8 November 2018
Paragraphs two and three provide us with a wider knowledge on how legislation and policies have influenced the nursing practice today. This is a true reflection on some of the issues raised at the Mid Staffordshire NHS Foundation Trust due to concerns raised by Julie Bailey leading to the Francis report with one of the most outstanding themes which were the impact of culture on the practice of organisations and staff. Sir Francis’ intervention came up with 290 recommendations in relation to what is expected from the NHS and the independent sector in order to maintain an outstanding level of care with the aspect of person-centred care being fundamental so it is our duty to highlight all that we could do to improve care, follow the NMC constitution. The Francis report is a great source of information which has brought forward laws, policies and procedures based on the way care should be delivered today. (LO 1, LO2, LO4).
? Seedhouse, D. (2018) Valuesexchange. online Available from 8 November 2018
This story is like the story published in value exchange whereby, Ahmed enjoyed eating his wife’s curry conundrum with his hands as part of his culture. Secondly, it was pointless referring the patient to a dietician because he enjoyed his curry and loved eating it in the way he grew up. In this case, the patient’s values and choice must be respected and a private area arranged for him to enjoy his meals. Sara’s reaction to her patient was unprofessional and presented some signs of racial discrimination (LO1, LO3).