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Exam on Ethical Practice and the NMC Code

1. What is the function of the Nursing and Midwifery Council (NMC), and how does this relate to the professional role of the nurse?

Nurses and Midwifery Council (NMC) has a control over nurses and midwives who provide services within the United Kingdom Great Britain and North Ireland. Before NMC, there was United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) which ceased in 2002 after its transition to NMC. Most of the functions or rules of UKCC are still operational in NMC (NMC, 2010). The functions of NMC include:

NMC maintains a register of all nurses and midwives as well as health visitors who are qualified to work in the UK. They also make provision of leadership to registrants, and settling of cases that arise as a result of professional misconduct (NMC, 2010).

NMC monitors the quality of educational courses and skills levels on nursing and midwifery, and keeps students records in different training courses. This ensures that nurses and midwives have proper qualifications and they are competent to do their job in the UK (NMC, 2010).

They ensure that nurses are kept up to date of their profession through continuous professional development courses and training in order to acquire more knowledge and skills to meet the standard of the code of the profession as well as keeping up-to-date on new technologies (NMC, 2010).

NMC, also, makes sure that midwives in the United Kingdom are safe to carry out their profession by setting up rules for their practice as well as supervising them (NMC, 2010).

In addition, NMC has an investigatory function, to investigate an allegation of improper conduct of all professional midwifes and nurses who fail to meet the standards for education, skill or conduct and take appropriate action such as supervision or permanent removal from the register if justified (NMC, 2010

2. Briefly describe how ‘fitness to practice’ relates to the personal and professional lives of the nurse.

NMC (2008) describes ‘fitness to practice’ as required standards that both students and nurses must undergo to test their suitability in terms of competence and character either before starting their educational programmes or starting their medical job duties.

It also ensures that nurses are fully aware and prepared for the chosen career which aims at life-saving. Nurses are required after their graduation as well as working life to take Continual Professional Development (CPD) to help update themselves while carrying out their professional work and to deliver effectively without fear and with full practising skills ( Lynn 2011, NMC).

Furthermore, the Nurses and Midwifery Council in the U.K., requires Criminal Records in addition to Occupational Health checks procedures to be carried out on every nurse at the beginning of their training and tracks frequently their good character and health throughout the whole period of education of students and career of a qualified nurse (NMC, 2008).

According to Lynn (2011), fitness to practice helps to safeguard the lives of the public through nurse assessment without restrictions by enabling the investigations of complaints or allegations levelled against nurses, if at all committed. This empowers and strengthens the issues surrounding nurses’ professionalism and competencies in carrying out their duties. Competence of nurses helps to increase patients ’safety, safe clinical practices, reduction in clients’ abuses, which ultimately reduces litigation and legal conviction. Finally, it helps to curb and remedy the nurses’ misconducts and prolong peoples’ lives (Lynn 2011, NMC).

3. You are working on a care of the older person ward where one of your friends worked recently. Whilst chatting on a social networking site, she asks how Mrs Jones is getting on. Describe how you deal with this situation with reference to your professional responsibilities.

Firstly, patient’s confidentiality is most paramount and must be respected always. A social networking site is an inappropriate area to discuss any such information (Burnard and Chapman 2006, P.67-68; NMC code, 2008). Even though my friend may be the caring type and not meaning harm, I would remind him/her about the code of conduct that we must at all times adhere to in our practice. This is because patients always put their trust in the medical staff and that any disclosure of all or part of their personal details, or talking about them outside work would be harmful to the client as well as jeopardise our professionalism (NMC code 2007).

Section 5.1 of the code of conduct states that, having accessing to relevant information is very important for every member of the nursing team. It does not say that anyone who once worked within the health premises still have access to information after leaving the premises (Burnard and Chapman 2006, p.68).

Discussing her on a social networking site would be inappropriate, unprofessional, unsafe and disrespectful for her. For data protection purposes, as a nurse, patient’s safety must be taken seriously and any inference of such disclosure must be weighed and critically be considered before a decision is made (Burnard and Chapman 2006, P.70). Above all, the patient’s wishes must be respected and followed at all cost (Burnard and Chapman 2006, P. 72). Finally, I would organise a debriefing with the friend and the senior in charge to reaffirm the issue of confidentiality.

4. Describe what is meant by ‘consent’. What does the nurse need to consider to ensure that consent given is informed consent?

Consent is provision of information when a person or an individual gives their permission before receiving any treatment or allowing a third party to give authorization on their behalf either verbally or in a written form (Age Concern 2006, p.1).

It is the responsibility of the nurse to provide information about the health condition of the patient and be supportive to patient’s rights to agree or refuse treatment. Nurse must make sure that information given is precise, trustworthy and must be given in a manner that the patient would understand easily. It is also the nurse’s duty to be sensitive to the information being given out and ensure that patients/clients’ needs and wishes are respected (Burnard and Chapman 2006, p.45; NMC 2008).

Nurses also need to take into consideration patient’s autonomy. They must make sure that consent is only given or refused by a client who is legally capable and should be in writing for evidence purposes (Burnard and Chapman 2006, P.48).

However, should the patient be incompetent (i.e. mentally incapable) to make up an informed decision, then nurses must ask the relative of the client and involve them in the decision making process regarding the consent. Nurses must have full knowledge of what consent is all about as consents are not always all about living. The knowledge of consent to be given is vital to both the client and the nurse. To ensure “informed consent”, nurses must explain the whole truth without any reservation whatsoever while keeping in mind that at the end of the explanation and discussions, an understanding between the nurse and client can be arrived before actually signing the documents (Burnard and Chapman 2006, p.48-49).

5. What is ‘ethics’ and how does it relate to nursing?

Ethic is a part of philosophy which is concern with determining whether what the individual decides is right and wrong for her/ him relating to how people decide and behave (Chaloner, 2002 p.42).

Nurses should be able to identify moral rules; this can help them to decide on doing the ‘right’ thing. For instance, if telling the truth is believed to be a ‘rule’ subsequent action would have to be considered which should be determined with adherence to these regulations (Chalonar, 2002, p.43). Although, ethic is relative and influenced by personal and societal values, Burnard and Chapman (2006), warned that people have to behave in “a good, right and just” manner so that their act do not harm or cause pain to others morally. Ethics have different aspects such as ‘personal ethics in which people often make judgments by their moral intuitions without any justification (Numminen et.al, 2009, p.391; Burnard and Chapman 2006, p.7; Chaloner 2007, p.44).

Crucially, ethics helps nurses to know the degree of their autonomy and whether they may be held accountable for given care to the patients (Burnard and Chapman 2006, p.13). According to Burnard and Chapman (2006, p.12), even though it is not easy coming up with a law in which all circumstances might be judged, the nurse should ascertain that every client should be treated as an individual, however, everybody have to be treated the same, although, every patient is different.

6. Briefly describe the skills necessary to enable the nurse to practice as part of a multi-professional team.

Team work within the professional circles refers to as the coming together of qualified health professionals with different skills who work together to ensure that every feature of caring are sufficiently covered for the patient (Burnard and Chapman 2006, p.55) Team work is also about looking after each other’s welfare and safety in the work environments.

A good team member must be loyal to the team and ready to cover for any member within the multidisciplinary team in his/her absence. Being loyal does not mean not reporting inconsistencies within the team. Reporting any incompetence of a member within the team must be done empathetically and ethically to the hospital authorities. Regular team debriefing is also essential so that members of the team would feel that they are learning new things within the team and not otherwise. This would help authorities to ensure patient safety at all times (Burnard and Chapman 2006, p.107).

Again, the nurse must be “appreciative”, that is, must work together in the team and respect the skills, knowledge as well as involving other colleagues because each contribution is vital for total patient care (Burnard and Chapman 2006, p.58; NMC 2008). Furthermore, nurses should help students and other members of the team in developing their skills and knowledge (NMC 2008).

Nurses are usually the first point of contact for any person seeking help and since team work involves clients and their close relatives, nurses must play a patient-role-model so that the patients would be able to trust them. This helps to establish good rapport between the patient and the nurse (Burnard and Chapman 2006, p.59).

7. Identify and briefly describe three aspects of nursing which might be considered to signify its status as a profession?

8. Describe what is meant by reflective practice and its role in the development of the nurse.

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