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Accountable Practitioner- Consent

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Introduction

Accountable Practitioner- Consent Caulfield's (2005) Four Pillars of Accountability provides a good overview of the elements that need to be addressed in relation to the professional role. This assignment will look at three of the pillars: relevant legal, ethical and professional issues that impact on the role of a nurse. Other areas that can inform professional judgement and decision-making practice include clinical guidance from the Department of Health (DoH), the National Institute for Clinical Excellence (NICE), alongside information from the Nursing and Midwifery Council (NMC) and the General Medical Council (GMC). All of these have been looked at by my group throughout the module and will be considered when forming this essay. This assignment will discuss my leaning throughout the module and analyse my development as an accountable practitioner. I will also discuss the accountability of student nurses and reflect on my branch of nursing which is Mental Health. Towards the end of my assignment I will write a critical incident report which will reflect on an event which happened on a past placement regarding my chosen topic. Hendrick (2004) interprets accountability to be about justifying your actions, omissions and decisions. And in order to be accountable you must have the necessary knowledge to explain the motives behind your action (Dimond, 2005). In the School of Nursing, this module has looked at the scenarios of Pamela and Eddie. From the Pamela scenario our group queried her ability to give consent when she was in a confused and agitated state. Even though consent may have been gained prior to the original operation date some changes were discussed in the scenario and therefore I believe these changes should have been discussed with Pamela and further consent should have been gained. So the concern that I have raised I have decided to base my assignment on the subject matter of consent. CONSENT It is a general legal, ethical and professional principle that valid consent must be obtained before starting any treatment or physical investigation, or providing personal care for a patient. ...read more.

Middle

Although as a group (and class) we had many discussions around the different courts and which cases would be looked at in these courts, I am still not confident in this area and need to continue to educate myself about this. PROFESSIONAL ISSUES Hunt (2005) states nurses are downwardly accountable (primarily) to patients and upwardly accountable to management, the National Health Service (NHS) and the NMC. Doctors are responsible for prescribing treatments and medication and are answerable to the patient, the General Medical Council (GMC) and the NHS. But nurses are responsible for providing the treatments and are answerable to the patient, the NMC, the employer and the NHS. The NMC (2008) Code of Professional Conduct gives advice on standards of practice and gives ethical guidance to nurses. Secondly, it is the body, which can punish a nurse for professional misconduct. It is outlined in the Code of Professional Conduct (NMC, 2008) that one of the overriding responsibilities of nurses is that they must obtain patients consent before treatment is given. The NMC (2004) guidelines state that the information must be given in a sensitive and understanding way, and that enough time should be given for the patient to consider the proposed treatment and be able to ask questions. It is not safe to assume that the patient has enough knowledge for them to make an informed choice without explanation. The code outlines that the nurse must respect and support people's rights to accept or decline treatment and care (NMC, 2008). Patients may well be vulnerable and unable to protect their own interests, so by providing information and making the patient feel confident to make their own decisions will guarantee the professional role. The nurse must be able to account for any decisions made. Accountability is concerned with weighing up the interests of patients in complex situations by using professional knowledge, judgment and skills to make that decision. ...read more.

Conclusion

unless these are discussed at the early stages of the disease then the patients' wishes would not be known to healthcare professionals. The Mental Health Act 1983 sets out circumstances in which patients detained under the Act may be treated without consent for their mental disorder, but it has no relevance to treatment for physical disorders (DoH, 2008); which in Sally's case (although she was not detained anyway) the treatment was physical. So looking back at what happened, from Sally having a diagnosis of Vascular Dementia in the later stages when rational thinking is not good, imposing physical treatment on her was 'in her best interest' so no law breaking was conducted. Conclusion There are many different things that must be considered when gaining consent from a patient. Nurses must always remember to give enough information and explain the risks as well as assessing the patient's ability to give consent. Nurses are obliged to accept patient's wishes even if we may disagree with their decisions. The main point I have learnt from this module is that whatever decisions are made the nurse must always be able to justify her actions. I feel my knowledge of being an accountable practitioner and taking responsibility for all of my actions has enhanced dramatically through undertaking this module and this assignment but I still feel that my knowledge needs to continue to expand for the current time as there are still many more things to learn within this area. My diary sheets which were completed each week show some of my learning but most of it was through discussions in my group, which I found difficult to express on paper, but through writing this assignment I hope I have expressed my recent understanding of the subject well. I will ensure that I keep up to date with relevant Accountable Practitioner policies to ensure my professional role as a nurse is never challenged when a complex situation may arise. ?? ?? ?? ?? Words: 3494 Page 1 of 3 ...read more.

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