Vulnerable_People

This essay will outline the case study of Miss Jaya who is a private, 74 year old Hindu lady. Miss Jaya is alone in the world and previously had an upsetting experience in hospital, and was constant in pain. If Jaya was a real patient her name would be changed to comply with respecting patient’s right to confidentiality under the Nursing and Midwifery code of conduct (NMC, 2008). Secondly, I will discuss the concept of vulnerability and explained the reasons why Miss Jaya vulnerable. I will examine the ways in which I can demonstrate professional values with reference to the Nursing and Midwifery Council code of conduct (NMC, 2008) and consider the ways in which I can maintain Miss Jaya dignity, demonstrating respect and empower her. I will then consider how I can promote anti discriminatory practice including the definition. Finally, reflecting on what I have learnt and what I could do differently to make Jaya stay in hospital more comfortable. On her last admission to hospital, a male nurse entered the bathroom unannounced while she was having a bath which was assisted by a female nurse this experience has made her upset and embarrassed. She is also worried that the prescribed medication not relieving the pain she is experiencing. Vulnerability is defined as “susceptibility to physical or emotional injury, susceptibility to attack open to censure or criticism, assailable, liable, to succumb, as to persuasion or temptation” (American Heritage Dictionary, 2000, p.1, cited by deChesnay and Anderson, 2008, p, 16). Vulnerability could apply to most people at some point in their lifetime. According to Pritchard (2001), there are many reasons why people will become vulnerable. People are unique individuals and will respond to certain situations for example ill health differently; however vulnerability can also apply to factors like race/ethnicity, gender or age. However, being vulnerable is not always regarded as a negative involvement; according to deChesnay and Anderson (2008) being vulnerable can be a positive inference that increases the quality of development and change. Consequently vulnerable people can be supported to become less dependent and encouraged to be independent. The Department of Health (2000) defined a vulnerable adult has a “person aged 18 years or over, who is in receipt of or may be in need of community care services by reason of mental or other disability, age or illness; and who is or may be unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation.” However, not all governing bodies hold the same views as The Department of Health. For instances the Police Act provided further clarification of the definition of a person who is vulnerable as “someone who has either a dependency upon others in the performance of, or a requirement for assistance in the performance of basic functions” (Police Act 1997 (Enhanced Criminal Record Certificates) (Protection of Vulnerable Adults) Regulations 2002, regulation 2, cited by Griffith and Tengnah, p, 262). Miss Jaya is vulnerable because she is an elderly lady without relatives or family and lives alone in a small bungalow, however, while she was admitted to hospital a male nurse entered the bathroom without knocking. According to the NMC code of conduct (2008) nurses should treat patients as individuals, respecting their dignity and privacy and also to provide morally good practice and care at all times. Clearly this did not happen in Jaya’s case; therefore Jaya was in a position of reduced control over her wellbeing. In order for the nurses to protect Jaya’s dignity and privacy, the male nurse that entered the bathroom should have knocked and waited for a reply before entering. This would protect Jaya’s privacy and dignity and she would not have been embarrassed or upset. If the male nurse had followed the NMC code of conduct (2008) this clearly would not have happened. Dignity is a fundamental part of what it means to be human (SCIE, 2006). When dignity is present people feel in control, valued, confident, comfortable and able to make decisions for themselves. When dignity is absent people feel devalued, lacking control and comfort (RCN, 2008, cited by Potter, p, 430). Dignity continues where patients are care for as individuals, where care is centred on the whole person and not merely the illness or the physical need and where appropriate balance of control between the nurse and the patient. However, patients are ignored and can be distressed by lack of privacy, on a regularly basis within hospitals that they cannot regarded as remote cases. “The main components of care are maintaining the patient’s dignity, treating the patient with respect and giving the patient privacy.” (Field and Smith 2008, p, 28). The second problem identified that was highlighted, the pain reliever she’s been prescribes not relieving the pain. By ignoring the pain could result in missed opportunities to enhance her life and decreases the disease and neglect. However, not treating the acute pain can lead on to chronic pain, which will be more difficult to overcome. Evidence shows that the elderly receive different care than young people resulting in satisfactory pain management (Bruce and Kopp, 2001, cited by Gregory and Haigh, 2007, p, 3). The nurses need to acknowledge the pain Jaya is experiencing and reassure her that you are trying to do something about it; this will reduce the level of anxiety and repair the relationship with her, after all every patients are individuals and sometime different cultures have a poor threshold. Jaya is a Hindu lady and because of her ethnicity she is considered to be vulnerable, and she is not communicating and eating. However, because her ethnic origin, religious and spiritual beliefs her needs are not been fulfilled and this could be the reason why she has become uncommunicative and not eating. Ethnic was defined by Baxter as a class of people who have certain tradition trait such as language, culture and religion in common, which will provide the community with a unique distinctiveness (Baxter, 1997, p17, cited by Holland and Hogg, 2010, p, 11). However, The Department of Health has accepted that nurses need to make sure that religion and cultural beliefs of patients are met (Department of Health, 1996, cited by Holland and Hogg, 2010, p, 43). Hinduism is not only a religion but a way of life for people from India. They believe that all living things are sacred, and will not eat meat or meat products. This could be the reason why Jaya is not eating because she was not given any choice; according to the NMC code of conduct (2008) patients must be given choice and listen to the patients in your care and acknowledge the patients concerns and preferences. The nurses did not take the time to see whether she could read English in order to understand the menu, or explain to her that there are vegetarian dishes available. They could have been other reasons why she is not eating for example having a shower instant of a bath. It is essential for Hindu’s to wash in running water to maintain purity. The nurses did not give her the choice of whether she wanted a bath or shower. Until Jaya has washed in this way, she will not eat or drink. Hindus will not eat any food that is prepared by the hospital; they may refuse to eat or drink in hospital because they are unable to find out definitely that the food or drink is not polluted in some way and have food brought in from home, but, Jaya cannot do this so the nurses need to explain to her the ingredients of the dishes and answered any questions she may have to the best of their knowledge and truthfully. Under the Human Rights Act (1998) includes an individual’s right to freedom of thought, conscience and religion and clearly this did not happen in Jaya’s case. Empowerment defines as “enabling process through which individuals or communities take control of their lives and environment” (Doctors and Society, 2002, p, 372). It is also to promote autonomous so that the patient’s health and wellness can increase. Empowerment can be seen as a positive concept, which focuses on strengths instead of weaknesses, rights instead of needs, and abilities instead of deficiencies. Empowerment aims to encourage personal growth by developing assertiveness and self-esteem. According to Kenworthy, Scowled and Gilling (2002) patients who feel they have little or no control over their condition or experiences in their lives have higher rates of illness and mortality, the nurses should provide Miss Jaya with information, educating her about her illness and involving her in the decisions regarding treatment. Nurses must be aware of patient’s values, views and opinions, and realises that Miss Jaya is an individual who has personal values and opinions which must be recognised and respected. The NMC code of conduct (2008) stated that nurses need to be aware of diversity and respect the cultural differences, values and beliefs of others, including their patients and colleagues. It is clear that the nurses let Miss Jaya down by not providing a menu that catered to Miss Jaya cultural needs and allowing the male nurse to enter the bathroom without knocking while she was taking a bath because they were short staffed. However, the NHS Executive recognises that shortage of staff can lead to poor or unsafe care (NHS Executive, 1999 cited by wells, 2007, p, 3). Nurses need to learn from each other in order to develop their own understanding of diversity, rights and equality. Individuality, dignity and respect all patients should have, nevertheless, the nurses did not give this to Jaya. However, as nurses it is crucial for them to acknowledge diversity, rights, dignity and equality in order to provide patients with acceptable level of care. According to deChesnay and Anderson (2008) empowering the patient is best achieved by supporting them to be involved in their care. With any patient it is essential to empower them to be part of their own care and to make decisions about what happens to them. Not listening to Jaya’s the nurses had indicated to her that she was unimportant and inferior, this will risks the feelings of worthlessness and inequality. The NMC code of conduct (2008) stated that “you are personally accountable for ensuring that you promote and protect the interests and dignity of patients and clients, irrespective of gender, age, race, ability, sexuality, economic status, lifestyle, culture and religious or political beliefs”. According to the N MC code of conduct (2008) I would demonstrate professional values and empower Miss Jaya by finding out if there are any language barriers and if there is a need for an interpreter. Provide a menu that catered to Miss Jaya cultural needs and explain to her the ingredients of the dishes. I would give Miss Jaya Individuality, dignity and respect by offering the choice of taking a bath or a shower. Making sure the door was locked whilst under my care in the bathroom so no one could enter the room, this would prevent the male nurse from entering. Request the pain management team and doctor to review her and the pain reliving medication, and try to understand and meet her culture and religious needs. This would encourage feelings of self-worth and control therefore empowering Miss Jaya. However, if these decisions are taken away from Jaya she will feel uncontrollable and that she is unimportant and worthless. Discrimination means to treat one particular group of people less favourably because of their age, gender, race or disability. However, anti-discriminatory practice is about taking positive action to counter discrimination by not judging or making assumptions but promoting and protecting, laws has been passed to protect the vulnerable but, you do not have to be vulnerable to experience discrimination. Miss Jaya was discriminate against because of her age. She is an elderly patient that the government perceive as bed blockers, this term is disrespectful and unavoidable which leads to the views that the elderly in need of health care are potential problems, but not a group in need of care. The nurses did not offer the choice of going to the chapel nor a quite place where she could prayer because Hindu’s pray at less three times a day. According to the NMC code of conduct (2008) nurses are accountable for ensuring that they promote and protect the interests and dignity of patients and clients, irrespective of gender, age, race, ability, sexuality, economic status, lifestyle, culture and religious or political beliefs. Studying this unit and undertaking this essay about vulnerable adults has taught me that anyone can become vulnerable. Nurses are trusted to care for the most vulnerable people in society, it is argued that the way we treat the vulnerable in society is an indication of values, ethics, compassion and standards of that society (Seedhouse 1998, cited by Cuthbert and Quallington, 2008, p, 242). Nevertheless, it is essential that we treat patients with the utmost respect, dignity and offering choices. Undertaking this essay has given me some knowledge of how to care for the vulnerable within a hospital or community settings and to treat each patient as individuals. . References Brown, K. (2010) Vulnerable adults and community care. 2nd ed. Exeter: Learning Matters. Bulman, C. and Schutz, S. (2004) Reflective practice in nursing. 3rd ed. Oxford: Blackwell. Burbank, P, M. (2006) Vulnerable older adult: health care needs and interventions. United State: Springer. Curtis, A, J. (2000) Health psychology. London: Routledge. Cuthbert, S. and Quallington, J. 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