Nurse’s Professional Role in Advocating for Others

Using the 4 Ps to underpin your essay and using legal, ethical and professional issues discuss the nurse’s professional role in advocating for others and how personal knowledge, skills, values and beliefs contribute to your professional identity and development.

The aim of this assignment is to research legal, ethical and professional issues in order to discuss the nurse’s professional role in advocating for others, and also to look at how personal knowledge, skills, values and beliefs contribute to a nurse’s professional development and identity. Firstly, it will consider advocacy and how legal, ethical and professional issues shape the nurse’s role.

Advocacy has been argued to be a fundamental aspect of nursing, it is reinforced by the current codes of conduct, as well as codes of ethics and competency standards that govern nursing practice. Advocacy has been defined as the ‘means by which individuals can be empowered to express their opinion’ (Gallagher et al. 2012, p. 71). There are three main models of advocacy that were discussed by Fry and Johnstone (2008), these are the ‘rights patient protection’ model, the ‘value-based’ decision model and the ‘respect-for-persons’ model. Each of these models interprets advocacy in a different way, but one key similarity is that each model looks at the best interest for the patients in their individual ways. The ‘rights patient protection’ model is where the nurse defends the patient’s rights, the ‘values-based’ decision model looks at the nurse helping the patient to discuss their needs, interests and choices without the nurse imposing their own personal opinions on the patient, and finally the ‘respect-for-persons’ model, here the nurse looks at the patient as a fellow human being who is entitled to respect. 

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Being an advocate on behalf of a patient can mean many things, it could be helping a patient make an informed decision regarding their health, translating medical jargon and assisting them to understand complex systems and conditions or it could be helping them come to ethical decisions. It is important to remember that ethical principles are standards of conduct that constitute an ethical system (Johnstone, 2009) and that a nurse must understand the cultural differences may exist for the people in the care of the nurse. Different beliefs and values mean that advocacy will be different for each individual, two people will not require the same level of care and support. Advocacy is highlighted throughout the Nursing and Midwifery Code (NMC, 2018), in all four sections. Under ‘Preserving Safety’ it is stated that a nurse should be “raising concerns immediately whenever you come across situations that put patients or public safety at risk”. This helps to shape a nurse’s role as an advocate as it highlights the importance of raising concerns in the best interest of the patient, this could potentially refer to Safeguarding or a range of other policies when necessary, always ensuring that the patient’s safety and needs are put at the forefront. Furthermore, within the NMC there is a section for ‘Prioritising People’. Prioritising people shapes the nurse’s role in being an advocate as it is all about putting the patient first, ensuring that their care needs are met and that their safety is of the upmost importance. It also mentions that nurses are to challenge any discriminatory attitudes and behaviours that are aimed towards the people receiving care, this helps shape the nurse’s role in advocacy as it is another guideline of what a nurse should speak up against.

The nurses’ role of being an advocate has changed over the previous years, this is due to a number of reasons, including legal issues. Both criminal law and civil law affect the nursing profession in their individual ways, on the one hand criminal law focuses on conduct that would cause harm or damage social order, this refers to criminal acts. Criminal law is very rarely used against nurses in a professional manner, as it refers to committing crimes such as theft from a patient, assault or murder. On the other hand, there is civil law, which deals with actions in “tort” which means civil wrongs. Dealings of civil law are much more common than criminal law dealings in nursing practice, disputes of civil law can occur between two individuals, an individual and an organisation or two organisations, the most common form of “tort” in a healthcare setting is negligence, which may arise due to failure to gain consent or a breach of confidentiality. It is due to the cases that exist from both types of law that have altered and caused the need for new policies and legislation. Some legislation that has been developed due to legal issues and cases include the Human Rights Act (1998), Mental Capacity Act (2005), Equality Act (2010) and many more. These legislations have resulted in a change in the way nurses practice and how they advocate for their patients, the legislation sets out standards that should be upheld and met, and provide a type of guideline that can be used to show what is expected of a nurse.

Professional identity could be defined as including both personal and professional development and involving the internalisation of the core values recognised as essential to the nursing profession. Many factors contribute towards a nurse’s professional identity and development, these include, but are not limited to knowledge, skills and values. Throughout their career, a nurse is expected to continue expanding their knowledge and professional development, this is done through the requirement of lifelong learning for nursing. Lifelong learning is used in order to promote and deliver the best possible care that is based on the most updated and best available evidence. Continuing Professional Development (CPD) is a requirement of the Nursing and Midwifery Council (2018), in order for a nurse to revalidate and remain on the register they are expected to complete a minimum of thirty-five hours every three years in order to increase the nurses level of knowledge and skills, this is a critical tool in order to deliver improved patient outcomes and a high quality of care. Furthermore, Eason (2010) stated that lifelong learning supports critical thinking which in turn is able to enhance a nurse’s satisfaction with their professional role and encourage the nurse to research and apply the newest evidence into their practice, this highlights the importance for a nurse to continue to develop their knowledge and learning new and more up to date information.

The NMC (2018) also expects nurses to keep their skills up to date throughout their working career by participating in relevant learning activities, this is to ensure that the nurse is fully competent and to ensure that they are using the most recent practices, ensuring patient safety and high standards of practice. The NMC Code of Conduct (2018) asserts that a nurse is to provide care to the best of their ability, using the basis of the best available evidence and also expects nurses to reflect and act on any feedback given in order to improve practice, this is highlighted under ‘Practice Effectively’ in the code (2018), and it emphasises the importance for continued learning throughout a nurses’ career, this is because in order to provide the best care, a nurse must be up to date with the most recent evidence. In addition, reflective practice is used in order to help to learn and develop practice in order to optimise learning and improve a nurses’ abilities, it enables the nurse to consider what they did, why they did it and allows them to consider what knowledge they can take from the experience.

A nurse should embrace fundamental values in every aspect of their practice, professional values are likely to be influenced by a nurses’ personal values, Badcott (2011) suggested that personal values and beliefs should have a minimal effect on professional values for practice, he further states that when certain values are required for a profession they must become integral for both personal and professional aspects of the nurses’ life. Professional values are seen to be rooted into personal values and are seen as a necessary aspect to nursing that reinforce a nurses professional and personal identity, as well as a nurse’s performance. The use of values in nursing practice is considered to increase the quality of patient care and are a source that aid in promoting nurses’ ethical competencies in a clinical setting and dealing with ethical concerns.

To conclude, this assignment has researched the legal, ethical and professional issues in order to discuss the nurse’s professional role in advocating for others, and has also looked at how personal knowledge, skills, values and beliefs contribute to a nurse’s professional development and identity. It is clear from research that legal, ethical and professional issues have all influenced the nurses’ professional role in advocating for others, there have been a range of legal issues that have resulted in new legislation which have in turn altered the nurses’ role as an advocate for patients. Furthermore, from the discussion it is evident that there are many contributing factors to a nurses’ professional identity and development, one of the most significant ones from the discussion would be a nurses’ personal and professional values, both personal and professional values are considered as essential for a nurses’ identity and professional development as they are viewed to increase the quality of care that a patient receives and are a way of promoting nurses’ ethical competencies. Also, it is apparent from the discussion that knowledge and skills are of the upmost importance for professional identity and development, this is to ensure that a nurse remains able to give the most up to date care, based on the best and most recent evidence available, ensuring that they remain fully competent throughout their career and always provide the best quality of care.

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Reference List

• Badcott, D. (2011). Professional values: introduction to the theme. Medicine, Health Care and Philosophy, 14(2), 185-186. Available from: https://link.springer.com/article/10.1007/s11019-010-9282-z [accessed 10 December 2018]
• Baillie, L. and Black, S. (2015). Professional Values in Nursing. Boca Raton: CRC Press, Taylor & Francis Group, 88-89.
• Eason, T. (2010). Lifelong Learning: Fostering a Culture of Curiosity. Creative Nursing, 16(4), 155-159. Available from: https://search.proquest.com/openview/68b934aca12d1c613836414b4e9db781/1?pq-origsite=gscholar&cbl=30045 [accessed 05 December 2018]
• Fry, T. and Johnstone, M. (2008). Ethics in Nursing Practice: A Guide to Ethical Decision Making. 3rd edition. Oxford, UK: Blackwell. [accessed 08 December 2018]
• Gallagher, A. and Hodge, S. (2012). Ethics, Law and Professional Issues. A Practical-Based Approach for Health Professionals. Basingstoke, UK: Palgrave Macmillan. [accessed 07 December 2018]
• Johnstone, M. (2009). Bioethics: A Nursing Perspective. 5th ed. Chatswood, Australia: Elsevier. [accessed 05 December 2018]
• Nursing and Midwifery Council (2018) The Code for nurses and midwives. London: Nursing and Midwifery Council. Available from https://www.nmc.org.uk/standards/code/read-the-code-online/#fifth [accessed 06 December 2018]

Bibliography

• Badcott, D. (2011). Professional values: introduction to the theme. Medicine, Health Care and Philosophy, 14(2), Available from: https://link.springer.com/article/10.1007/s11019-010-9282-z [accessed 10 December 2018]
• Baillie, L. and Black, S. (2015). Professional Values in Nursing. Boca Raton: CRC Press, Taylor & Francis Group.
• Eason, T. (2010). Lifelong Learning: Fostering a Culture of Curiosity. Creative Nursing, 16(4). Available from: https://search.proquest.com/openview/68b934aca12d1c613836414b4e9db781/1?pq-origsite=gscholar&cbl=30045 [accessed 05 December 2018]
• Fry, T. and Johnstone, M. (2008). Ethics in Nursing Practice: A Guide to Ethical Decision Making. 3rd edition. Oxford, UK: Blackwell. [accessed 08 December 2018]
• Gallagher, A. and Hodge, S. (2012). Ethics, Law and Professional Issues. A Practical-Based Approach for Health Professionals. Basingstoke, UK: Palgrave Macmillan. [accessed 07 December 2018]
• Johnstone, M. (2009). Bioethics: A Nursing Perspective. 5th ed. Chatswood, Australia: Elsevier. [accessed 05 December 2018]
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• Human Rights Act 1998 (c.42). London. Available from: https://www.legislation.gov.uk/ukpga/1998/42/contents [accessed 15 December 2018]
• Mental Capacity Act 2005 (c.9). London. Available from: https://www.legislation.gov.uk/ukpga/2005/9/contents [accessed 15 December 2018]
• Equality Act 2010 (c.15). London. Available at: https://www.legislation.gov.uk/ukpga/2010/15/contents [accessed 15 December 2018]