The Principles of Nursing and Health

Introduction

This assignment into principles of nursing and health will explore dimensions of health; it will give an insight to a person who has a condition called multiple sclerosis. Looked at will be what determinants of health are to this person. Underpinning professional, legal and ethical implications surrounding health should the individual require nursing care is of great importance. Finally the assignment will give a reflection of what information has been gained and health concepts on a personal level.

1 Dimensions of health

‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.’ World Health Organisation (WHO 1946) cited in Naidoo (2009). Health means so many different things to different people, someone viewed as having a disease or disability can also feel like they are healthy, as can a person who is physical fit feel unhealthy. Dimensions of health determine health to each individual. There are six different dimensions of health which are; intellectual, physical, emotional, spiritual, social and environmental. Health is looked at as a whole and when being cared for, a holistic approach could be used taking into account all of the dimensions of health. Dimension in more detail are; intellectual this is when a person has the ability or inability to make decisions and judgements reasonably, understanding decisions and consequences of decisions. Physical health is what you can see the size, shape and body function. Emotional is when a person is empathetic towards other people’s feelings and has an understanding of their own, and can deal with all different types of emotions as and when they occur. Spiritual health can be having a belief in a god or religion however it has more of an impact on a person’s ethics, peace of mind and principles. Social dimension is having relationships with all different types of people for example work colleagues, family and childhood friends. Environmental can be where a person lives and works it could be a poor area or poor working conditions. Across all the dimensions if one is affected this could have a knock on effect to other dimensions or all of them, they usually all go hand in hand, Brooker (2007).

2 Person overview

To put principles of health into a reality and have an understanding an example could be an individual’s health. Chosen as an example is David Anderson; David is fifty five year old male who was diagnosed with multiple sclerosis in his early thirty’s. Multiple sclerosis is a condition which causes a defect in the central nervous system. The myelin sheath which surrounds the nerve fibres comes under attack from the autoimmune system, Corcos (2008). The disease is unpredictable and can affect different people in different ways. Usual symptoms are numbness in limbs, involuntary movements, lethargy, blurry or double vision the list goes on. Multiple sclerosis was identified by the French neurologist Jean-Martin Charcot in 1863 who worked in a hospital called Salptrire in Paris. He identified the condition as ‘aclrose en Plaques’, Burgess (2010) which mean hardening, this relates to the scaring which causes the damage to the nervous system. David has worked in the same job for over 30 years, it is an outdoor manual position where he walks for long periods of time in a country setting as well as working in a country setting he also lives four miles from his place of work and has no commuting stress. David has been married for 35 years he has three grown up children and three grandchildren. David enjoys spending time playing golf in the summer months and watching sports live and on the TV he also enjoys photography. David’s health has always been very good despite his condition; he has never been on medication other than over the counter analgesics and has never required any kind of treatment. At times the effects of his condition do show but in a very minor way which he has always coped on the surface extremely well.

3 Determinants

Determinants are factors which may affect a person’s health; this may be in a good way or a bad way, generally and in the health of the above person. Determinants are factors which influence how healthy a person is. These are socio-economic which are cultural and environmental for example where in the country the person lives, living and working conditions for example are the conditions good is there stress involved, social and community networks is there support in place in the community and socially, individual lifestyle factors for example if the person takes regular exercise and eats a balance diet, and age, sex and hereditary factors. Naidoo and Wills as cited in Brooker (2007). Determinants which affect David are difficult to identify, possibly determinants affect him in a positive way. David has a very good life style, and has had a steady job for a long time environmental factors have possibly enhanced the quality of life for David. He spends a lot of time outdoors and feels this has a positive effect as for long periods of time he lives symptom free from his condition. Social and community factors again are strong in his family who surround him and the networks of doctors in the local GP office are also strong. Around the world the United Kingdom has one of the highest rates of multiple sclerosis in the world, Rog et al (2009) cited in Burgess (2010). It has been said by Ebers et al (2007) cited in Burgess (2010). One in one thousand people in the UK have MS. It has been shown in studies that the further away from the equator the higher the volume of people recorded to have MS. This could be due to the periods of time these areas have sunshine, a vitamin related to sunshine is vitamin D, the body requires sunlight to synthesize vitamin D this vitamin is found in most immune cells and is associated functions including inhibition of the production of cytokines this is known to have a negative effect in MS, Ponsonby et al (2005) cited in Burgess (2010). Shetland and Orkney in the north of Scotland have the highest rate of cases in the world. Interestingly studies have also shown people who emigrate from country to country before the age of 15 will develop the risk from the country which they have settled in, if the move takes place after the persons 15th birthday it is said the person will retain the risk factor from the country they are originally from.

Underpinning professional, legal and ethical principles.

Nursing care may be required for David in time and there are a lot of factors to consider when any person is being nursed. Looked at are the underpinning professional, legal and ethical principles involved in nursing a patient. As a professional a nurse has to follow rules which are set by the NMC. The NMC is the Nursing and Midwifery Council they are the governing body for all nurses and midwifes, the NMC have produced a code and within the code there are rules, standards, guidance and advice. NMC The Code (2008).

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The NMC are a council who if find or have any incidents reported to them will make decisions about fitness to practice, and can discipline or strike a nurse off of the registration if the nurse has failed to follow the code or committed an offence. The main concern of the NMC is to safeguard patients and members of the public and how they are treated by nurses and midwifes. It is said in NMC, The Code (2008) Individuals must be respected and dignity must be maintained. Individuals should not be discriminated against and must also be treated with consideration and kindness. Where required a nurse must seek out help and support from relevant agencies and support networks in the health and social care setting. Respect is an essential part of protecting an individual’s confidentiality, information should never be shared other than with relevant people or professionals involved with the care of the person. It is also important that information should be shared if the person is at risk or harm. An additional part of respecting a person may be concerning their likes and dislikes, communicating is essential when caring for a person or there family to ensure the best possible care is given, this could be ensuring communication can happen without any obstruction for example language or communication requirements possibly providing some kind of aid. Consent is a large part of care giving every time a treatment is given this could be from bathing to giving medication consent must be obtained, if an individual declines consent for treatment this must be respected, as it is a person’s right to be involved in any decisions regarding treatment however there is an instance when decision making could be taken away from a person this happens when the mental capacity is compromised. there is a part of legislation which ensures a person who is incapable of making decisions regarding care is safe guarded. As a professional nurse boundaries must be maintained between patients and nurses it is unacceptable to accept gifts, loans or personal relationships from patients and their families. It is part of the role of a professional to identify risks and people who are taking risk’s, it is also a duty to report any practices that are putting others at risk. Record keeping is an essential skill which nurses must practice in an accurate way as the records include all of the patients care which has been given or is due to be given, keeping accurate records is imperative as poor records could harm a patients safety and confidentiality. In the case for David he may become ill in time and require nursing care and it may become costly to the government, it is his right to receive care as and when required and be treated with respect and dignity, he may decide he does not want his suffering to be prolonged if his life is nearing an end and any decisions he may take must be upheld.

“Be open and honest, act with integrity and uphold the reputation of your profession” NMC The Code (2008). Following the above statement ensures you comply with the code and also by following the law, being honest and able to identify problems and deal with them in the correct way if anything were to happen in practice. This will ensure care given can be without prejudice and the integrity of the nurse remains intact. NMC (2008)

Legal issues which could arise could be in two ways these are civil and criminal. A civil court of law is where an individual person can file a case against another person or organisation when a person has come to harm possibly by neglect. Criminal law is where a person has committed a crime and it is in the public’s interest for the person who committed the crime to be prosecuted by a court of law and punished.

Personal Concept

As I have studied and read more about principles of health it has had a major impact on the importance of knowing what the dimensions of health are, and understanding why a person has maybe become ill or in hospital, and what can be done to help or educate an individual to have a better life style which will lead to improved health.

Looking at an individual has also given me an understanding that determinants of health can be positive as well as negative, as having a good life style for someone who has a condition like MS can enhance quality of life. Also if someone has a very poor life style this can lead to conditions like type 2 diabetes, this is generally caused by a very poor diet and by being overweight.

Being a nursing is an extremely important role and has very strict guidelines which must be followed. This will ensure accurate information and care is given at all times. By following the NMC code it will ensure that I am respectful of individuals and value people from all walks of life, always leading by example, being accountable for my actions and will always treat people fairly.

Conclusion

This assignment has looked at dimensions of health, and how different dimensions can have an effect on all of the dimensions, there are six different dimensions which range from emotional to physical, each one is of equal importance and if any one is impaired it can often influence health. An overview of a person who has MS has been given and what determinants affect this person’s life, is it good or bad? Professional, legal and ethical principles have been looked at, also and the importance’s of how these come into play when a person is being nursed. Identifying how the assignment has enhanced a personal view of the nursing profession has also been discussed. It has been identified the importance of being accurate regarding care giving and in record keeping to ensure the best care is given at all times.

References

Brooker C, Waugh A and Watson R. Foundations of Nursing practice fundamentals of holistic care, 2007 Edinburgh Mosby Elsevier.

Burgess M, Shedding greater light on the natural history and prevalence of multiple sclerosis British Journal of Neuroscience nursing January 2010 Volume 6 number 1

Corcos J and Shinck E Neurogenic Bladder second edition 2008 Informa Healthcare.

Naidoo J and Wills J. Foundations for Health Promotion Third edition 2009 Edinburgh.

Nursing and Midwifery Council The Code 2008

World health organization. (WHO) 1948 Preamble to the constitution, Geneva. [online] http://www.who.int/suggestions/faq/en/ [13/11/2010]