Essay: Effective nursing, personal and professional values

The Atkins and Murphy model of reflection, from 1994, will help frame this essay. This model is made up of 5 different sections. This essay will follow these sections which are; identify a case study, briefly describe the situation, review the evidence, evaluate the evidence and summarise any new learning. The case study which has been chosen is based on Ms. T. Ms. T. is a woman who is diagnosed with paranoid schizophrenia and there are also growing welfare concerns surrounding her. She is also type 2 diabetic which is poorly controlled. The communication between the different services that cared for Ms. T. was below standard, this ultimately cause Ms. T. to go unseen for a long period of time. The care received was dis-integrated due to the lack of communication, meaning that Ms. T. fell under the radar of some of the services. This essay will focus on learning outcomes ones and four. Learning outcome one refers to personal and professional values which underpin compassionate, person-centred care. Learning outcome four is based on the importance of working co-productively with other people to support health and well-being. Person centred care is proven to need worked on as growing dissatisfaction from service users shows that more attention is needed to ensure the patient’s wishes for their own care needs are met. (Parse, 2004). I feel the case study is a prime example of dis-integrated care and provides evidence that in some cases, integration and professional values can be the cause of some serious flaws in the system.
Research has been carried out to back up the points made in the introduction. These articles have been critically analysed in the following paragraphs with my thoughts and feeling on them and how they relate to my chosen case study included. For the first searches carried out CINAHL was used, this included words like, values, professional, personal, compassionate care and communication. These are all listed in the search strategy table, appendix 1.
The communication in the case study chosen was not at a high enough standard to effectively care for Ms. T. Bailey., C. et al in 2011 stated that communication is a key role for a multi-disciplinary team to be successful. In the case of Ms. T. the communication was not a main priority for the services involved. This could be due to them having different value bases. The strengths of having good communication in a multi-disciplinary team is that each expertise can share their thoughts and feeling on the situation and everyone knows who is dealing with what. This means that each service will know that the correct person has been contacted and spoken to when necessary. In the case of Ms. T. the care she was receiving was dis-integrated as the communication between the different services was not strong enough for any essential information regarding Ms. T. to be passed on to the correct professional. This lead to there being a substantial amount of time of Ms. T. not being heard from which ultimately led to a long period of time until her body was found. This proves that communication and values were a very major part in the dis-integrated care that Ms. T. received in the time leading up to her death. Jane Jones in 2014 stated that to meet the needs of the patients in our care we must be familiar with our own values, attitudes and beliefs but also not to infringe these on patients, although, we also should embrace the professional values of the workplace. The senses frame work underpins relationship- centred care. The senses framework consists of 6 factors that acknowledge the nature of the determinants of care for an individual. These were developed by Nolan. M in 2006 and still stand today. They consist of; a sense of security, a sense of continuity, a sense of belonging, a sense of purpose, a sense of fulfilment and a sense of significance. The feelings described in the factors are essential for any person to feel valued and safe. The care received by Ms. T could have been improved if the different services had more communication with each other as this would have impacted the care by making sure the early warning signs of Ms. T.s wellbeing was spotted and the correct help being given. The values of the different organisations have not been stated in the case study, so to assume what they are is unfair and unjust.
The second search I conducted was on similar search terms as the first as I felt that I had not found enough evidence to back up my argument. A quantitative study was carried out by Riklikiene, O., Karosas, L. and Kaseliene, S. in 2017, to explore and compare personal and professional values in undergraduate nurses and nurse educators. Nursing requires clear values as there are many ethical dilemmas which will arise in their profession. Students acquire essential values for the nursing profession through the appropriate training from their educators. Nursing students aim to become confident in providing ethical and professional care to patients while their educators aim to model desired behaviours of a nurse. A comparative study was carried out in 2011 which involved 408 people, 316 of these undergraduate nurses and 92 nurse educators. The study was carried out by using a 57-question questionnaire completed by the nurse educators and student nurses. The results from this study show that nurse educators rated honesty and intellectualism higher than that of the students and admired truth-telling. The study reveals the differences in professional values between the nurses and the nursing students. Findings show that personal and professional values in both students and educators were, as it seemed, interrelated, which proved the link between the values. Person centred care is defined as ‘care that respects others as individuals and is organised around their needs’. (Department of health 2001). This is an appropriate article for this essay as it shows that personal and professional values can be interlinked to each other and that through the nursing course, professional values will be widened and altered into the value base for their career. Zamanzadeh, Vahid et al in 2018 backed up this point by stating that compassionate care was made easier by having a personal system of values and a professional one and being able to separate these, but at times, go between both sets of necessary. I feel that these articles link to the case study as it shows that learning outcome one is a very relevant statement. Compassionate care and values go hand in hand with each other as your value base outlines the care you give. As different services may have different value bases, this can at times, make multi-agency working difficult, this will be explained in the next section.
This search was conducted on ASSIA and used terms like; multi-agency, inter-agency, teamwork, collaboration, United Kingdom and co-productivity.
Collaboration stands for working together while respecting one’s autonomy (D’Amour et al 2008). The National Health Service aims for all health care professionals to understand the differences between personal and professional values that underpin person centred, compassionate care. Integration and person centred care can interlink as Clarke and Fawcette in 2016 stated that the priority of person centred care is the individual who is receiving care. By having all members of healthcare working together and collaborating with one another means the concept of person centred care is easier. There is also a focus on co-production and integration between different services. Co-production is a new term to be used in health and social care services. It has been defined as public services being delivered in an equal way and professional relationships between professionals, service users and their families being created. ‘By acting like this both services and service users will become more effective for change’ (Williams, 2010). The nursing times in 2017, stated that they felt collaboration should be a core value in nursing. They stated that collaboration is crucial to nursing practice and that it should be part of the 6 C’s.
The 6 C’s were drawn up by NHS England in 2016, they are part of a three-year strategy called ‘compassion in practice’ and an important value base for any nurse. The 6 C’s consist of; Care, Compassion, Competence, Communication, Courage and Commitment. (NHS England, 2016). Hanneke Wiltjer stated in 2017, that as best practice in nursing currently, is founded in person centred care, shared decision-making and multidisciplinary teamwork. Care based on these principles requires a broad amount of collaboration between different professionals or professionals with patients. This is important as the NMC code 2015 states that communication and cooperation within the one team are two separate factors, albeit, closely linked aspects of nursing. Considering the principle of person centred care, it is clear to see that collaboration between professionals and patients or families is an important part of sufficient nursing care. It is a requirement of a nurse to collaborate with other professionals to always to ensure care is carried out the best way possible for the patients. This fits with my chosen case study as the communication between professionals were not at a standard which is required for an effective multiagency team. The 6 C’s in this case have not been followed as one of the C’s stands for communication which there is clearly a lack of in the case study. If there was more of an emphasis on communication between services in relation to Ms. T the care she received would have been more integrated and effective.
The senses framework, mentioned above, is also an important factor in effective nursing care as it can go hand in hand with the 6 C’s. The Public Bodies (Joint Working) (Scotland) Act 2014 is a legislative framework for the integration of health and social care in Scotland. The act will bring, outcomes which have been agreed nationally, which will apply across health and social care, and NHS boards and local authorities, A requirement for health and social care budgets to be integrated by local authorities and the NHS and the requirement on partnerships to make sure the role of clinicians and professionals is strengthened. The act is strictly for the integration of adult health and social care. The National health and wellbeing outcomes were first produced in 2014. They are important affidavits of which health and social care partners are aiming to reach through integration. There are nine outcomes in the document, some of which are being able to look after and improve your own health, reducing health inequalities, ensuring service users are safe from harm and making sure that the staff of the health and social care services are engaged in their work and are regularly supported to improve their knowledge.
To conclude, personal and professional values are vital for any nurse to be able to provide compassionate care to all patients involved and helps them to become the best nurse they can be. Co-productivity has also been proven to be an important aspect of care, although there is some room for improvements, which will hopefully be addressed in the near future. This essay provided me with new learning that will help me in my career. Communication is a vital part of any health and social care processionals career. It is crucial that it is used correctly for the care given is to a high standard that is expected from health and social care. Co-productivity is a new term used in the health and social care context, it is important as it helps the Government’s plan to have health and social care work co-productively. I learnt how important the national health and wellbeing outcomes were and that the 6C’s are more influential in nursing than I originally thought while producing this essay. I feel that communication between different services must improve as in the case of Ms. T, the lack of communication among some other factors, resulted in serious outcomes.