Dated: 09/10/2024
Time: 09:30 – 04:30
Title: Ethical and Legal Aspect of Nursing/ Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS)/ Vital Signs and NEWS
The day started with learning about the ethical principles in nursing, mental capacity act (2005), deprivation of liberty safeguards (DoLS), concept of consent, capacity and confidentiality and the four-quadrant approach to decision making.
Autonomy – This is the right of a person to make informed decisions about their care, support and treatment.
Beneficence – This is the act of doing good; be kind
Non-Maleficence – The desire to do no harm
Justice – This is equality and fairness
Mental Capacity Act (2005)
This is an act whose primary purpose is to protect and make decisions on behalf of adults who are unable to due to lack of capacity.
Deprivation of Liberty Safeguards (DoLS)
This is an amendment of the Mental Capacity Act (2005) which protect people receiving care whose liberty has been limited. There are six assessments that needs to be completed for a decision to be taken and they include age, mental capacity, mental health, best interest, no refusal, and eligibility.
Consent
This is when a person must give permission before they receive any form of care, medical treatment or an examination. Consent can either be written or verbal.
Confidentiality
This refers to the ethical and legal duty to protect an individual’s personal information. And making sure that they are informed about their care and that information about them is shared appropriately.
Quadrant Approach to Decision Making
· Medical implications
· Patient preferences
· Quality of life
· Contextual factors
It is crucial for Nursing Associates to understand the implications of capacity assessments and decision-making processes. Capacity assessments are crucial to ensure that patients are involved in their care and that their rights are uphold. Obtaining consent ensures that healthcare professionals respect the patient’s autonomy and legal rights.
Confidentiality is not only a legal obligation but also essential for building a trusting therapeutic relationship. Breaking confidentiality could lead to serious consequences such as loss of trust, harm to the patient, or legal actions against the healthcare professional.
Moving forward, I will strengthen my communication skills to better explain treatment options and outcomes, ensuring patients fully under their decisions before they give their consent. I will ensure that’s patient information handled with the highest level of discretion. I will also stay informed about the latest legislative updates, participating in training on capacity and consent and promoting person centred care.
During the afternoon I learnt about vital signs and how to use NEWS. Vital signs are crucial indicators of how the body functions. They help healthcare providers assess the overall health of a patient and detect any changes that could indicate a problem. These vital signs include respiratory rates, pulse, blood pressure, oxygen saturation, temperature. Afterwards, we all went to the clinical area to perform manual blood pressure on ourselves with consents approved.
NEWS refers to national early warning signs and it is a scoring system used to identify patients at risk of deterioration. A higher NEWS suggests that the patient is at greater risk of acute illness, which may require immediate attention.
This learning highlights the importance of understanding and recognising abnormal vital signs early. By interpreting the NEWS correctly interventions can be made early enough to prevent further deterioration of the patient. The experience of the practical work helps to guide me on how to take manual blood pressure accurately. Additionally, it taught me how to be more observant and proactive. While the nurses often lead decision making, the Nursing Associates can play a vital role in first line detection, raising alarms when necessary.
In the future, I will ensure I remain vigilant when measuring and interpreting vital signs. I will practice using NEWS regularly to improve my confidence in identifying patients at risk. If I notice abnormal readings, and will not hesitate to escalate them immediately, ensuring the patient receives appropriate care.
KSBs addressed:
K1: understand the code: Professional standards of practice and behaviour for Nurses, Midwives and Nursing Associates (NMC, 2018) and how to fulfil all registration requirements
K6: Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical framework, including any mandatory reporting duties, to all areas of practice
S1: Act in accordance with the Code: Professional standards of practise and behaviour for Nurses, Midwives and Nursing Associates in (NMC, 2018), and fulfil all registration requirements
S10: Provides, promotes, 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 where capacity has changed and a how person’s capacity affects their ability to make decisions about their own care and to give or withhold consent
S22: Take personal responsibility to ensure that relevant information is shared according to the local policy and appropriate immediate action is taken to provide adequate safeguarding and that concerns are escalated
S23: Work in partnership with people, to ensure shared decision making, in order to support individuals, their families and carers to manage their own care when appropriate
S38: Prioritise and manage own workload, and recognise where elements of care can safely be delegated to other colleagues, carers, and family members
B1: Treat people with dignity, respecting individual’s diversity, believes, culture, needs, privacy and preferences