(NMC) Regulates Standards For Health Profession

The Health Care and Profession Council (HCPC, 2014) states that a patient must first give consent for treatment, effective communication is key in gaining this

This essay will explore why consent and confidentiallity is important in midwifery practice. It will look into why it is needed and what can happen if these aspects are breeched in anyway. The National Health service was founded in 1948, this brought free healthcare to everyone. In 1902 the Midwives act becomes a law and midwifery became an established profession, fast forward to 2004 the midwives rules and standards are published and then amended in 2012 and in 2008 the code of conduct was brought into practice. These publications are legal documents in which all nurse and midwives must abide by. In these documents there are clear rules that surround both consent and confidentiality (NHS Choices 2014)

Confidentiality is a fundamental part of any healthcare profession (NMC, 2015) and as such employed midwives have a duty implied within their contract of employment stating they will respect confidentiality. Video four displays very clearly how easy it is to cross the line and break patient confidentiality sometimes, in what would seem a harmless conversation. The legal implications of this breach in confidentiality are extensive not only for the midwives in question but potentially the hospital trust they work for.

Do I have the right to refuse treatment (NHS, 2011) states that, if you hold enough mental capacity and are able to make an informed, sound decision to refuse treatment, your decision should be respected, even if the decision resulted in death.

This assignment will discuss the role of the Nursing and Midwifery council (NMC) in protecting the public of the United Kingdom. It will also discuss the NMC’s standard of conduct, performance and ethics for nurses and midwives. The author will then identify and discuss the professionalism nurses and midwives display within their and job and ‘the code’ they’re required to follow. The author will then go into detail about how nurses and midwives are tasked with maintaining a patient’s holistic health through professional judgement whilst sticking to the code of conduct. Following on the author will then discuss current issues with the effectiveness of the NMC and the current areas on concern with the regulatory body, giving their opinion on how these areas could be resolved. Finally the author will outline and evaluate the term confidentiality and how health professionals such as nurses maintain a patient’s confidentiality and when sometimes it can be justifiable to breach this. The author will then conclude the assignment by evaluating the overall effectiveness of the NMC and the Nurses and Midwives which uphold the NMC’s code.

The case study also shows an absence of professional judgement as statement five also says that “in the absence of consent, nurses use professional judgement regarding the necessity to disclose particular details, giving due considerations to the interests, well-being, health and safety of the person in their care. ”(p.3). It is evident through this fragment of the professional code of conduct that the nurse, who was not taking direct care of the patient, disregarded any professional judgment she had to access and reveal confidential medical records of a patient to a member of the public. Furthermore, the “Code of ethics for nurses” also published by the Nursing and Midwifery’s Board of Australia in 2008 states in code seven that “Nurses value the ethical management of information” (p.5), when explained, the code specifies that information can only by shared with other people with the consent of the person receiving treatment or by legal approval where the consent of the patient is unavailable (NMBA, 2008). By this piece of information it is clear that the nurse within the case study overlooked nursing codes, regulation, and laws

The rights and limitations of an individual’s decision making include, various issues like written or oral consent from patient or a representative, and patient’s mental ability to make decisions about their treatment. According to the common law right of 1891, the decisions regarding the treatment are made by individuals with decision making capacity and even after they lose their capacity their decisions do continue. An adult is said to have decision making capacity when they attain the age of 18 or when the person is not deemed incompetent by the court or when the results of the decision are well understood by the individual. In conditions of temporary incapacity, close family members can make the decision and if time doesn’t permit during emergency, the health care providers can decide about treatment to save the life. According to the right of self-determination, any competent individual who cannot handle the treatment can reject completely (Steiner, 2014).

The Conscientious Objection bill being debated in the UK would not require medical practitioners to participate in withdrawing life-sustaining treatment, among other things. Some, like Iain Brassington, consider the idea a little confusing since not withdrawing treatment is the same as continuing treatment and forcing a treatment on someone is considered to be battery by law. If the proposed law is saying that unwanted treatment should be continued, then there is no way for the bill to respect the patient’s wishes.

In a true therapeutic nurse-patient relationship, establishing trust is a key factor to promote quality and compassionate care. This trust can be easily jeopardized by a breach in confidentiality of the patient’s personal health information. This paper will focus on the importance of confidentiality as it relates to nursing and patient information and the vulnerabilities that can attribute to breaches of that information. Whether verbal, electronic, or written documentation, confidentiality must encompass all information obtained about a patient and exist only on a need to know basis among those healthcare professionals involved in that patient’s care. In today’s age of information technology and the use of electronic medical records, a patient’s personal health information may be vulnerable to inappropriate misuse. When confidentiality is broken then the ever important nurse-patient relationship is broken. The ethical dilemmas and legal issues that accompany confidentiality breaches can result in large fines and lawsuits against healthcare facilities and also end nursing careers. It is the patient’s right to have his or her personal medical information protected at all times and the nurse must understand the responsibility to protect that right is an important factor in maintaining the nurse-patient relationship.

By the 1980s, at least in the United States, additionally the Patient Self Determination Act (PSDA) in 1990 there is a consensus on that allow the patient to refuse treatment given that refusing treatment may lead to death is one of the patient’s right (Koch, 1992; Bishop, Brothers, Perry, & Ahmad, 2010).

Mental capacity is another important difference between formal and informal patients with regards to consenting to treatment. Providing the patient is mentally competent, they are in a much stronger position to refuse treatment as an informal patient. Again, however, it has been observed that patients feel coerced into consenting to treatment. Until the MCA[10] came into force this year – there was very little procedural protection afforded to those patients admitted informally and found to be mentally incompetent. Treatment could be forced upon patients in this situation on the basis of the doctors view of the patients best interests[11].

The NMC code regulates high standards of nursing and midwifery care and ensures the safeguarding of service users. The core concepts of the code is that the care of service users become the first concern and that everyone is treated as an individual with their dignity respected. High standards of care and practice must be upheld at all times and all professionals must be open and honest. Professionals must work with others to promote the health and wellbeing of those in their care, their families and carers whilst

The physician did not ensure that the patient was not able to do all the components for decision making capacity. For a patient’s decision to be regarded as right, he or she must possess the decision-making capability. Likewise, doctors are required to respect the patient’s authority to make a decision even if it is not the right one (Degner & Sloan, 1992). However, the physician is also required to act towards the client’s best interest to save his or her life (Levinson, Kao, Kuby, & Thisted, 2005). If the patient does not have good decision-making potential, because of illness and/or emotional stress like in this situation the doctor can follow state law to obtain consent.

“Legal standards for decision-making capacity for consent to treatment vary somewhat across jurisdictions, but generally they embody the abilities to communicate a choice, to understand the relevant information, to appreciate the medical consequences of the situation, and to reason about treatment choices” (Appelbaum, 2007).

Keeping the patient’s confidentiality is a nurse’s legal and ethical duty is deeply incorporated in the duty of care and maintaining patient confidentiality and privacy is of great importance in nursing to ensure that the patient’s rights are being considered (Sastow & Inman, 2008). In Melanie’s case she can be sued in civil court by the patient for breaching the confidentiality and any damage that may affect Melanie’s patient can be awarded. The use of proper guidelines and policies regarding the storage and access of patient’s history and records, along with education regarding law and ethics in hospitals are crucial to prevent a Scenario like Melanie’s (Australian Nursing and Midwifery Council, 2005; Staunton & Chiarella, 2008).