EXPLORING ADULT NURSING

This essay is about humanising values framework and holistic care of service users. The paper will explore the value framework portrayed by Todres, Galvin & Holloway (2009) making links to practice presenting how it could be used to develop nursing care. The essay analyses the theoretical influences on nursing practice and applying discipline knowledge, philosophical approaches to articulate the skills required to deliver person-centred care. The essay discussed the code of conducts and linked to essential aspects of how it is to be human. The essay is also based on nursing assessment and daily planning for patient and explore how nurses could treat an individual in the way they would like to be treated and how they may work in the best interest of the individual. Firstly, the essay discussed and compared humanising and dehumanising values in definitions. The conclusion of the paper will represent an overview and explain the nursing model, care pathway and evaluate the risk assessment involved.To humanise means to recognise the individual’s human characteristics and to address the presented health care issues with dignity and respect however dehumanising is to ignore human characteristics implying of dignity, empathy, respect and autonomy (Howard, 2015).In the video, the two nurses were not adequately applying their roles as professional nurses to the vulnerable dementia service user. Communication skills were lacking because the nurses were just focusing on the task to be done rather than showing a sense of dignity and respect to the patient. Therefore, this is dehumanising because the fact that service users are still treated like this is just wrong. Communication was not appropriate because in the video, there were no choice of preferences given to the service user for example some patients may prefer bed bath rather than basin bath. Applying care without asking for preferences and choice may lead to low self-esteem and poor relationship between a service user and the nurses (Ackley, 2019). In addition, when feeding the patient, the nurse was only making sure the job is completed but there was no sign of empathy or compassionate quality to nourish the care in feeding the dementia patient thus leading to dehumanising care. Dignity and compassion should have shown by the nurses by taking time and being patience to listen, explain and communicate; demonstrating empathy, kindness and warmth; care centred on the service user’s needs, involving the patient in the decisions about their healthcare, care and support (Department of Health, 2012).According to Nursing and Midwifery Council (NMC, 2015) code of conduct states that, nurses should treat people as individual and uphold their dignity, respect and autonomy. Code of conduct is a set of rules which makes sure nurses provide safe, guaranteed care and support appropriately and how nurses must act to promote equality and diversity in practice. The code of conduct ensure that everyone is treated with respect, dignity and equally by making service users feels valued and making sure their concerns are important to promote high quality care that patients receive (Department of Health, 2018).Concurrently, person-centred care facilitates people with dementia to take part in the things they enjoy. From a person-centred perspective, nurses should take their time to know their patients personally. In addition, improving life for people with dementia eventually varies on the individual relationship and attachment that progresses between patients and nurses. This can be done by understanding their cultural preferences, history, hobbies and interests (Wylie, 2003). For instance, developing a care plan right for dementia patients should be based on person-centred care by involving families of the patients when appropriate. The nurses might have learned that the patient prefers taking shower instead of a bath, and that her regular routine was a hot shower before bedtime, and therefore her bath time will have been shifted to the evening. This tool for checking assessment plan for patients can be effective way of managing behavioural signs of dementia according to the video. Furthermore, objectification has been distinctly defined as the dehumanisation of service user subsequently from concentrating extremely on how they fit into analytical methods or technique, part of any other approach by which they are categorised and characterised with does not completely take justification of their insiderness (Todres et al. 2009). Objectification is also understood by Kitwood (1997) as a form of communication or contact by nurses that gives growth to reduced people with dementia. To be human is to have knowledge and understanding of life in relative to your feeling, mood and emotion through which you understand humankind. A methodology which does not emphasis on patient’s difficulties and complications, but their knowledge and skills are required to safeguard that we do not treat people like objects. Nightingale (1859) advocated for better and improved hygiene conditions, hospitals should do the patient no harm and ensure a safe care environment to patient. In the video, the nurse feeding the patient did not actually ask the woman when and what time she would like to eat, listening to her responses whether the food was too hot for her is a de-humanising care however, considering her feelings and allowing her choice can result in positive relationship with the client. As a nurse it a responsibility to ensure not to make people in care feel like objects. Actively involved in feeding the patient without her consent and preferences de-humanises care and thus a poor decision making by the nurse. Nursing and Midwifery Council code of conduct (NMC 2015) states treat people as individual and uphold their dignity and respect someone else suffering.Consequently, to be human being is to be product of a society as the same time acknowledging individual’s uniqueness. For instance, social isolation can have a negative influence on health and people in care whereas s negative relationship can also lead to maltreatment and injury. Social isolation influence adversely because of physical and psychological impairment such as patients suffering from dementia disease (Drennan et al, 2008). Working within any health and social care settings, need to be intensely alert of the essential social interaction between patients and nurses or family. In addition, the improvement and safeguarding of trust between service users and nurses are supreme, and a fundamental characteristic of that is the up keeping of the patient’s dignity. It is important to ensure that nurses provide support and care to patients available to build good relationships and friendship. Ensuring that service users are treated as individuals is also essential to recognise that companionship are primary source to individual holistically. However, in the video the relationship and bonding between the nurses and the patient was unsuitable and inappropriate, particularly when caring for older people with severe cognitive decline (Howard, 2015). Moreover, individual uniqueness as human on no account can be diminished within care settings because of human characteristics comprising of gender, age and race. In relation to individual, patients are unique, and they should not be de-humanised because of certain capabilities such as sickness and disease. Extreme emphasis on how individual uniqueness is not highlighted to empower patients to fit into a society including dementia, and obese patients which result individual from the context of their life (Kitwood,1988). Any de-humanised behaviour within care environment to notify should constantly reflect the patient’s context, family and friends, so that it can balance in contradiction of generalisation that conceal the exact individualities that make them who they are. The difficulties of individual life as a dementia patient may affect their capability to transform their wellbeing and behaviour as this is essential for nurses to put into consideration to be able to provide care effectively. Nurses need to know the patients they deliver care to and their context to build a strong and trusting relationship and know what is vital for the patients. According to Kitwood he suggested that all these approaches may lead to reduced stress, concerning memory loss and, thus improved holistic care, quality of life, and reduced difficult behaviours. Kitwood (1988) stated that to feel alive, individuals should be considered and must be understood and acknowledge by others. Beck and Heacock (1988) also testified that valuing communication is survival and is vital if the outcome is not just physical but a virtual state of holistic wellbeing.However, as humans we make preferences and are normally held accountable for our conducts. Individual do not usually see their selves as completely passive or absolutely focused but as a substitute having the capability to live within limits to be linked to social, mental health and physical (Stansfeld et al. 2002). Patients suffering from dementia are passive recipients as a problem to be treated as this may result in individual to become disempowered. Nurses ensuring to maintain that service users sense of agency suggest different approach of observing individuals, as this assist nurses to make sure that justification and choice are interlaced into communication and relationship. Nurse may reflect what potentials and options exist to enable individuals to self-manage their care plan (Hairon, 2007). This could be done by ensuring that nurses offer and assist individual choice and freedom for patients. Also, the capability to make individuals personal choices is vital to personal freedom and agency. For example, with the dementia old woman, individual choice was taken away by the nurses as a form of de-humanised care provision. This is habitually important, particularly individual with cognitive deterioration. For instance, in the video where the patient was trying to express agency, but becoming more unsatisfied, was proved in her unwillingness to eat the food she was been fed. The patient was exceptionally upset when she was been fed because it might be something that she does not like but her choice was not taken into consideration as the nurse did not asked why she did not want the food after two spoons. The problem may be that she did not wanted anymore because the food might be too hot or very cold.To conclude with, as trained and competent nurses, upholding the most excellent values and ethics of care in health and social care settings is individual nurse collective accountability and responsibility to provide high quality of care to patients. Most nurses believe that focusing care on what is essential to service users as human beings supports them to identify and know and more fully value the individual’s personal knowledge of infirmity and therefore nurses can have advance understanding of how to deliver care appropriately to patients. In doing so, nurses believe that this could ensure a patient first approach to care which would mitigate against the criticisms that have been placed at nursing of late and improve humanity of care (NMC,2018). Competent nurses have an individual and co-operative accountability to uphold the most excellent standard of care. Focusing on holistic care is essential to individual as human as it allows nurses to comprehend and more wholly value the individuals personal understanding of infirmity, so they can enhance their support. Applying these could safeguard a dignified and respectful method to treat and puts service users first (Todres,2009).Bibliography Drennan J, Treacy MP, Butler M, Byrne A, Fealy G, Frazer K, (2008) Support networks of older people living in the community. Int J Older People Nursing 2008; 8:234e42.Department of Health, 2012.compassion in practice Nursing. Midwifery and care staff our vision and strategy. The stationery Office. HMSO.Egger, G. and Swinburn, B. 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