Apprenticeship Learning Log
Date of Learning:16/10/2024
Time: 9:30 – 16:30
Title of learning activity: Ethical and legal aspect in Nursing.
Mental Capacity Act.
Vital Signs and New’s
Diary of Learning activity
(itemise learning activity and reflect on the main points of learning from each. You should identify for each entry the relevant KSB)
Reflection on Learning Activity (include model of reflection e.g. Driscoll or Gibbs):
Today, we were discussing three mentioned above subjects.
All Nurses are legally obligated to provide care to their patients. They have higher duty of care, rather than someone who has limited or has no medical knowledge at all.
If Nurses fail in their duty of care and the result of the failure is harm, which patients experienced. Patients can legally require or expect redress for caused harm.
We discussed four Ethical Principles:
- Autonomy
- Beneficence
- Non – Maleficence
- Justice
Autonomy – in nursing means, that patients have the right to make their own decisions based on their beliefs and values if they have capacity to make decisions.
Beneficence – means, that Nurses should be kind, providing positive “force” actively doing good for a patient. Putting patients in Centre Care.
Non – Maleficence – means to avoid or minimalised the harm. This principle is the most difficult to uphold. Where life support is stopped, or patients has chosen to stop taking medication, which can save their life’s. The Nurse has been put in morally challenging position.
Justice – fairness or an equal distribution of benefits. In nursing relates to impartiality regarding the patient’s age, ethnicity, economic status, religion or sexual orientation. This includes impartiality when assigning clinical or prioritising patients care.
Second subject discussed on today’s session was a Mental Capacity Act
The Mental Capacity Act 2005 is a direct decision – making on behalf of adults who may not be able to make their own decisions.
Having mental capacity, means being able to understand and store information and to decide based on that information.
DOLS – Deprivation of Liberty Safeguards has been intended to protect people who are lack of mental capacity from being detained when it is not in their best interest.
In the afternoon we were discussing Vital Signs and News’s
Vital Signs are the measurements of the most basic body functions. They are useful in detecting and /or monitoring health.
They consist of:
- Blood pressure
- Heart Rate
- Respiratory Rate
- Oxygen Saturation (pulse oximetry)
- Temperature
Normal values for a healthy adult:
- BP (Systolic: 100 – 140, Diastolic: 60 – 90)
- Pulse: 60 – 100 per minute
- Respiratory Rate: 12- 20 per minute
- Pulse oximetry: 94% – 98 %
- Temperature: 36 – 37.5 (low grade pyrexia 37.6 – 37.9’C, pyrexia 38’C +
Pyrexia or fever is the elevation of an individual’s core body temperature above a set point regulated by the body thermoregulatory centre in the hypothalamus.
The hypothalamus – an area of the brain that produces hormones that control:
- Body temperature
- Heart rate
- Hunger
- Mood
We were also discussing National Early Warning Scores NEWS2
National Early Warning Scores NEWS2- is the system for scoring the physiological measurements, which are routinely recorded at the patient’s bedside. First produced in 2012 and updated in 2017 Its purpose, is to identify acutely ill patients, including those with sepsis, in hospitals in England. The NEWS2 scoring system measures 6 physiological parameters:
- Respiration rate
- Oxygen saturation
- Systolic blood pressure
- Pulse rate
- Level of consciousness or new – onset confusion
- Temperature
A score of 0, 1, 2 or 3 is allocated to each parameter. A higher score means the parameter is further from the normal range. Appropriate clinical responses are given for threshold (trigger) levels, with a recommendation to review and agree these locally:
Low risk (aggregate score 1 to 4) – prompt assessment by ward nurse to decide on change to frequency of monitoring or escalation of clinical care.
Low to medium risk (score of 3 in any single parameter) – urgent review by ward-based doctor to determine cause and to decide on change to frequency of monitoring or escalation of clinical care.
Medium risk (aggregate score 5 to 6) – urgent review by ward-based doctor or acute team nurse to decide on escalation to critical care team.
High risk (aggregate score of 7 or over) – emergency assessment by critical care team, usually leading to patient transfer to higher-dependency care area.
In the afternoon we went to the simulation room, and we learned how to check the blood pressure manually.
Today’s session helped to develop my knowledge, regarding subjects which are already do on the daily basis on the ward.
On my next shift at hospital, I will be able to confidently present it gained and developed knowledge, saving patients life’s.
Session helped me to understand the importance of Ethical and Legal aspect of my occupation.
Mental Capacity Act and DOLS helped me understand, how important is to consider patients capacity and always act on the behalf of the patient, reducing harm in patients care.
Each session at Roehampton University makes my work more interesting.
Helping me to develop confidence, that my future occupation is important for the nation and for the future development of the organisation. With high confidence I can state that, there is always room for improvement. Every day is a lesson and is always beneficial to develop our knowledge to put patient in centre care.
KSBs
K1: Understand the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and how to fulfill all registration requirements
K6: Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice
K18: Understand and apply the principles and processes for making reasonable adjustments
K19: Know how and when to escalate to the appropriate professional for expert help and advice
K26: Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld
K40: Understand own role and contribution when involved in the care of a person who is undergoing discharge or a transition of care between professionals, settings or services
S10: Provide, promote, and where appropriate advocate for, non-discriminatory, person-centred and sensitive care at all times, reflecting on people’s values and beliefs, diverse backgrounds, cultural characteristics, language requirements, needs and preferences, taking account of any need for adjustments
S19: Recognise when capacity has changed recognise and how a person’s capacity affects their ability to make decisions about their own care and to give or withhold consent
S35: Accurately undertake risk assessments, using contemporary assessment tools