Essay on Nurses Practice Dilemmas Acts and Regulations

There were a few practice dilemmas acts that were identified as a result of the defined incidence. I who was the immediate observer was caught up in the dilemma of whether to watch the whole incident or intervene by taking immediate action. Another dilemma was by the HCA who had to decide whether to follow the hospital's policy or allow the John to get a smoke since he had missed his previous smoke break. This was a dilemma because according to section two of the mental health care amended in 2007 a patient has the power and authority to put his case forward if he feels that he is treated against his will especially following the events that John was locked in a secluded room. John felt that the HCA was doing so and he had the right to put his case forward to the Independent Mental Health Advocate. However, the employer's rule stated that no patients should be allowed to get a break during such hours of working. This posed a great dilemma on what actions to take since there would be consequences for any made decision. Also, there was the dilemma of denying or granting John permission to take his smoke while he is being monitored so as to avoid any kind of trouble since he has a history of being violent to caregivers.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Order now

The values and ethical issues which are highlighted by this incident include pain management, human dignity, and integrity. Pain management in this incidence is evidence on how John was treated when he asked for a smoke break. John probably needed a cigarette to relieve pain he felt in his mind or whichever part of the body. His tendency remains stubborn and uses a disrespectful language dictated the way his pain would be managed (Sabella, 2014). The nurse managed this in different ways which showed the value of integrity and human dignity because the nurse began by explaining to John why he cannot be granted a smoking break. According to the Nurse Practice Act states that the ethical approach to pain management ensures that nurses are not only confident in their work but also successful in the manner which they treat their patients. Hence locking John in an isolated room resulted in the success of maintaining peace I the institution (Quinn, 1998).

The inter-disciplinary collaborations which I identified as a result of this incident included: arriving at a conclusive decision and working towards the set goal that the employer's rule is followed. A conclusive decision making is significant where the HCA and the nurse in charge made the decision to cool John down so as to control the degree of his violence. The two parties worked together and ensured that this regulation was followed as they controlled the situation themselves (Brinn, 2000).

There was a correspondence between the intervention and best practice guidelines such as NICE. The congruence in this incident where we see me the practicing student and he registered nurse being available throughout the incidence. This is in relation to NICE guidelines which state that during night hours there should be at least two nurses one should be a registered nurse as the other is a practicing nurse. This will provide availability of staff during the working hours. Moreover the intervention and best practice guideline that patients with special care such as mental illnesses is evident in the incidence where there is the availability of the Home Care Attendant. The Home Care Attendant and the ownership of a secluded room for mental patients offers special attention to the designated patient which match the NICE guidelines.

Nonetheless, the implications for the collaboration for the interdisciplinary and interagency collaborations as a result of this incident are that the HCA and the department nurse work best to solve a problem created by the patient. In addition, the availability of two nurses to cater for every patient ensures that a patient is properly attended to and the HCA can receive immediate help where need be.

I have learned that whenever am faced with a situation that is beyond my control I tend to let the specialist get involved as I watch and access the situation. I have also learned that I am still not sure of the best ways to deal with the violent type of patients because the outcomes remain uncertain. What is more is having learned that there are more advantages to having a good relationship with others. In this case both the caregivers and the patients. The reason is that having a suitable relationship with a patient can make work easier. An example is that a violent or rebellious patient is likely to pay attention to my instructions because of the good relationship we have. This is likely to occur out of respect for each other. In addition, a good relationship with my fellow care attendants helps establish interdisciplinary collaborations which promote the ability to solve issues and solve disrupting incidences.

On the other hand, the mental health nursing is a department which I have actually attained lots of information from. It has come to my attention and understanding that dealing with reluctant and rebellious patients is an act that I should get used to. This means that I should research and attend to this department as often as possible for there is much to learn from hence it will help improve my practice. Also, I have learned that each organization has its own procedures and policies hence I should always familiarize myself with them before attending to my practice.

Psychiatric and Metal Health Nursing theory has helped my understanding of this incident. The theory has helped me understand why mentally disturbed patients act in ways that suggest anxiety, depression or rebelliousness in this case. The theory highlights major causes of these illnesses and the importance of having a nursing care plan. The nursing care plan can be through the help of an HCA who offers help to both the family and the patient himself. This has helped me understand why the HCA was involved in this incident and the decision to lock John in a secluded room.

Another theory which helps me understand the various events as a result of this incident was the behavioral theory. The theory explains that behaviors normally occur as a result of conditioning. In John's case, it is possible that he formulated the behavior of being resistant and stubborn due to conditioning where he always gets whatever he demands. According to BF Skinner when an object is always conditioned or given to a person it results to behavior development. After the behavior is developed the only way one can minimize it is by negatively reinforcing the behavior. In this case the injection and locking John in a secluded room ensure that he is likely to discontinue the behavior of being stubborn and rebellious.

The research done by Sieff has helped developed my understanding in relation to this incidence which explains that mental illness can occur from the way an individual understands the information he or she gets from a source. Moreover, this relates to john's incidence since it was after his last family visit that his character changed. In relation to Seiff's research, it is probably what his family said to him that affected his mental illness. John was doing better before the visit but after the visit, he was more quite meaning that he was trying to process information which made him miss his smoke break. What is more is that according to research by World Health Organization tobacco smoking is known to give the smoker a cool effect which results to the calmness of the mind (Huang, 2016). This explains why John was reluctant to missing his roll-up.

An understanding of the legislative, organizational and policy contexts explain some aspects associated with this incident by highlighting the nursing practices. An example is the nursing and midwife guidance which states that a caregiver should act without delay if there is the risk to the public protection. Hence this broadens my understanding as to why the nurse and HCA acted in the described manner. Nonetheless, the Gibbs reflective cycle expands my understanding of most aspects in relation to this issue. Gibbs reflective cycle is a policy used by the legislative heads to help a situation. In its action plan stage, it calls upon a caregiver to take immediate action which will ensure that the faced situation does not happen again. In this case, the negative reinforcement of locking John in a secluded room is likely to ensure that John will not repeat the same mistake (Hanley, 2015).

Some of the future learning needs I have identified as a result of this incident are how to handle different type of patients. Also the need to do more research on the regulations set for the users in different states, hospitals and departments are another necessity I have identified. This can be achieved by doing maximum research via the internet and books about the nurse approaches and regulations by different institutions (Chien et al 2014). Going through research by various scholars will also help fulfill my learning needs in the nearby future. Moreover, the active indulgence in various departments which deal with different type of patients will assist in fulfilling my future acquired knowledge since through this I will be able to learn quite a lot.

The outcomes of this incident were different for each participant. My outcome as the main witness as well as the main witness was quite a number. I had learned a lot from this incident and I had to approach the hospital employer or whom it concerned and raise a concern about John ( Waugh& Gray, 2014). Johns outcome was probably different for he probably became more restful and obedient to orders given. He learned to follow the rules and avoid violence with the hospital staff. What is more is that he was now in a seclude room which was meant to help him become less violent. The HCA and the nurse outcome were to establish a better relationship with John so that they can work together towards his treatment and get him out of the secluded room.

This incident is actually influential in how I think, feel or act in particular situations judging from the fact that it resulted to locking John in an isolated room. I feel that an isolated room should not be the immediate remedy for violent patients. Despite the dangers that are likely to occur from a mentally ill rebellious patient, I feel that there should be a protocol followed while dealing with such patients (Freeman et al 2015). Thus my thoughts about this incidence are that the legislative bodies should come together and set specific rules on how to deal with different type of patients. This is because their policies are indefinite and at times they conflict with that of the employer. For instance, Johns case can be analyzed from two different dimensions that of the employers rule and that of the Human Rights of Persons with Mental Disabilities.

It is thus clear that the idea of secluding John was not the best for both John, his family and other users. Judging from the fact that the issue arose from the need to have a cigarette the caregivers should have provided a different remedy. Hence the caregivers appear to have acted slightly unprofessional the same way to how John acted. John's actions were quite un-profound based on his language and how he handled the response he got (Zuckerman, 2014).

References

Abdulmalik, J., Fadahunsi, W., Kola, L., Nwefoh, E., Minas, H., Eaton, J., & Gureje, O. (2014). The Mental Health Leadership and Advocacy Program (mhLAP): a pioneering response to the neglect of mental health in Anglophone West Africa. International journal of mental health systems, 8(1), 5.

Bastos, M. L. D. A. (2014). A research laboratory in the treatment of wounds (RLTW): nursing technological space evidenced by experimental research. Journal of Nursing UFPE on a line, 8(4).

Brinn, F. (...