Reflective nursing, ethics, dementia care, ethical nursing, patient safety, legal obligations, autonomy, dignity, fall prevention, clinical practice, healthcare
Providing high quality, ethical nursing care requires strict adherence to professional standards, legal obligations, and moral principles. This reflective essay will critically assess a dementia patient's fall and its professional, ethical, and legal ramifications using Gibbs' Reflective Cycle. I aim to improve my clinical practice by examining this event using the NMC Code, ethical decision-making frameworks, relevant legislation, and dementia care literature.
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The NMC Code of Professional Standards, which sets ethical principles and behaviors for safe, effective nursing care, will guide my reflection on Nichole's fall. This code protects people's dignity, autonomy, and well-being and sets high standards. Nichole's preventable fall and sad aftermath raise nurse duty concerns. In this situation, I will review the Health and Safety at Work Act 1974 and patient handling and restraint guidelines. The complex moral difficulties in this episode can be seen by applying Beauchamp and Childress' four biological ethics principles (respect for autonomy, non-maleficence, beneficence and fairness). I think systematic reflection is crucial for new nurses devoted to learning and growth to turn unpleasant clinical experiences into competency.
[...] (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park, CA: Addison-Wesley. Cahill, S. (2018). Dementia and human rights. Routledge. Charters, E. (2019). Person-centred care in everyday nursing practice: An analysis of current policy and practice guidance. Journal of Dementia Care, 24-27. Chater, K., & Hughes, N. [...]
[...] The on-call physician was immediately notified while we continued trying to properly position and immobilize Nichole to prevent further harm. Given Nichole's refusal to cooperate and resistance to our interventions, it took the combined efforts of all three staff members to carefully roll her onto a transfer board and lift her back into bed using a mechanical hoist. Throughout the process, Nichole remained highly distressed, occasionally lashing out at us and requiring gentle restraint of her limbs to ensure safety. [...]
[...] Dranove, D. (2020). Dementia and patient autonomy: Using the four principles of biomedical ethics in the nursing home setting. Nursing Ethics, 116-124. Dykes, P. C., Dumenco, L., Feliciano, Z. R., & Webster, T. F. (2018). Patients' falls in the acute care setting: maintenance of momentum. JONA: The Journal of Nursing Administration, 283-288. Fazio, S., Pace, D., Flinner, J., & Kallmyer, B. [...]
[...] (2018). The fundamentals of person-centered care for individuals with dementia. The Gerontologist, 58(suppl_1), S10-S19. Fetherstonhaugh, D., Tarzia, L., & Nay, R. (2013). Being central to decision making means I am still here : The essence of decision making for people with dementia. Journal of Aging Studies, 143-150. Health and Safety Executive (HSE). (2020). Manual handling in health and social care. https://www.hse.gov.uk/pubns/hsis4.pdf Naue, U., & Kroll, T. (2009). [...]
[...] However, this incident failed on numerous institutional levels to respect dementia care best practices and satisfy Nichole's vulnerable requirements. From environmental safety audit oversights to inadequate therapeutic communication and neglecting patient autonomy, this incident revealed my dementia care competencies needed self-reflection and development plans. Analysis The important episode with Nichole can be analyzed via professional, ethical, and legal perspectives to determine why some things occurred successfully or poorly. Our team's fast mobilization and Nichole's successful transfer back to bed followed the Nursing and Midwifery Council's Code of patient safety and prompt action to prevent further damage (NMC, 2018). [...]
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