A patient tells their charge nurse in confidence that they have had thoughts of harming themselves and others, even though the patient told them in confidence it is the nurses obligation to report this before the patient or somebody gets hurt.
Cultural and Religious Values
One religious and cultural value, which would clash, would be with the beliefs of a Jehovah’s Witness. They would refuse to have a blood transfusion, but the consultant would explain that having a blood transfusion is needed in order to survive. However they could still refuse and medical staff may have to challenge this in court. This topic was portrayed in an episode of the American Comedy Scrubs.
There was a recent case I remember from the news a couple from this faith were having a baby and the doctors knew from tests that the baby would be born with an illness which would need a transfusion they went to court to get the judge to allow them to do this against the parents wishes I don’t know what the consequences of this will be, could the parents or the church reject the baby in some way.
Resource allocation
Patients who require daily exercise or have daily activities, In mental health patients need stimulation and motivation so the ward may spend money on a pool table or a treadmill while others would say that going walking costs no money and is exercise and could also be other daily activities for patients organised which cost no money, so the money could be spent on better equipment around the ward.
Discriminatory issues in healthcare such as racism have brought about various pieces of legislation, such as, Race Equality Act and Human Rights Act. Below are 5 discriminatory issues that have caused dilemmas for staff and patients, and how these issues have been challenged.
Cultural Values
If a Jewish person came onto a ward for treatment it is important that the hospital providers kosher meals, so that their cultural values are met, the hospital may not be able to provide this ,this would be discrimination the staff would have to think of ways to address this ,could a private company bring this in ,would the hospital allow the family to bring in food to abide by the law the hospital has to show that they have taken all reasonable steps to reduce discriminatory practice.
Safety and Protection
During my work placement at the psychiatric wards in the Mater hospital, a polish man was admitted onto the ward. During his stay he refused any treatment and food for 3 weeks, he only had a small amount of water each day. Health care professionals find it hard to let this happen but it is the patients right to deny treatment. Health care workers have to respect the patient’s decision, as if the patients rights are not respected, they are being discriminated against. Eventually the approach of staff and bringing a member of his family from Poland encouraged him to eat and have treatment which was good as the staff were having meetings about detaining him under the Mental Health Order and going to court to get a judge to agree to him being forced to treatment and food to save his life.
Competence and Risk
On the ward during my placement, a 17-year-old boy was admitted to the ward, suffering from severe depression. It was an ethical issue whether the patient should receive ECT (Electro Convulsive Therapy). The patient’s doctor, nurses and carers debated whether the patient was old enough to receive this treatment or if they had to find an alternative method of treatment until the patient is 18.
Resources
As we all know the NHS does not hand money over to various departments very easily. They have cut hundreds of jobs to save money. So when departments are given their annual budget they have to spend the money wisely on equipment they really need this has to be based on a risk management approach.
Issues around discrimination do exist in healthcare especially with those who live in socially deprived areas, those who are unemployed, the elderly the chronically ill or those with a disability these people have low incomes can have limited access to healthcare and education and can easily fall into a cycle of disadvantage. One group of patients this can affect is the mentally ill. They can feel socially isolated, misunderstood and they are often unable to work because of their illness, they may loss their home if they have no money or if it is rented because of their behaviour caused by their illness. In my placement I saw how staff and a pressure group for patients called Lamp were challenging this they helped patients by providing good information on their condition by looking for accommodation for them on discharge and encouraging them to join local help groups.
Ethnic minorities have had to deal with discrimination in health care for many years, especially in mental health, a study showed that black men are 6 times more likely to be detained than white men. A new policy in England was brought in called Delivering Race Equality in Mental Health Care, this was brought in to stop health professionals treating and diagnosing black patients improperly. This piece of legislation came about because of the unnecessary death of David Bennett a black man who was a patient in a mental health ward in Norwich. David Bennett was diagnosed as schizophrenic, and died when being brutally restrained by staff.
Reference: Class Handouts
All nursing staff will now go through Race Equality Training in a bid to cut out racism and discrimination against ethnic minorities in healthcare. Staff will learn about cultural differences and how patients should be diagnosed, treated and managed.
I feel that with all these laws and staff training, anti-discriminatory should be a thing of the past, however there will always be small-minded people in all walks of life and in healthcare. At least things are moving forward in healthcare as these discriminatory issues are being challenged and during my time on my work placement there was no sign of racism or discriminatory practice, which is a positive step towards equality in healthcare.