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Nursing Assignment: Application Of The Code Of Nursing Practices Of NMC

Question

Task: Suzie’s Father – Grandpa Arnold
Arnold is 82 years old. He was diagnosed with dementia 6 years ago, at the age of 76, and he is a retired postman.

Arnold has recently moved in with The Family since his wife Betty died, as she was his main carer. Suzie has now taken on this role. He also receives care from community nurses team, who visit him twice per week to dress his leg ulcers.

For this nursing assignment choose a maximum of two standards taken from one theme (4Ps) within The Code (NMC 2018) and discuss the underpinning professional knowledge, values and attributes in the delivery of evidence-based care in relation to one member of “The Family”.

Answer

Introduction
According to the analysis on Nmc.org.uk. The Code, (2022), it is stated in this nursing assignment that the Nursing and Midwifery Council 2018(NMC2018) is the code of practice as per the professional standards of behavior and practice for nurses, associates in nursing, and midwives. This was considered under the London nursing and midwifery council in the year 2018 where the professional care and standards are taken care of by the midwives, nurses, and other considerable associates. Under this council, the nurses, midwives, and associates are appointed to maintain the community’s public health by assuring quality health care. They also have the power to set several registration requirements and educational standards with the establishment or nurse registration associates and other rights that appeal against their decisions. In this essay a case study has been taken where the person who needs help from the NMC 2018 is diagnosed with Dementia for 6 years whereas per the code and conducts under NMC 2018, the person has the right to get care and treatment from NMC with professional values and other practices and management teamwork. In this paper, 4Ps as per the code of nursing practices of NMC had been explained where the patient, Arnold, gets help from the team where the maximization of orientation and personal choice would take place.

Main body
For understanding the code and conducts of NMC, nursing and midwifery council 2018, there are four Ps available like prioritizing people, practicing effectively, preserving safety and the last is promoting professionalism. These four statements of revised nursing and midwifery council code of conduct are important to analyze how the nursing team helps Arnold, the patient of dementia in a true sense. In this essay, two standards have been chosen to make the discussion of underpinning the professional knowledge, attributes and values to provide help and care to Arnold who has been suffering from Dementia for 6 years. practicing effectively and its two standards chosen from 4Ps of NMC 2018 code of conduct.

Practicing effectively
Effective practice is considered one of the key standards of NMC 2018 proposed by the Nursing and Midwifery council. The professional requires to examine and deliver as well as advise on treatment. The treatment further includes the provision of help within rehabilitative and preventive care in a quick manner without any delay. The professionals must work to the best of their abilities and their treatment should be carried out on the basis of reliable evidence relevant to the subject matter. As per the opinion of Shayan et al., (2019, p. 17), best practice and use of the best evidence are expected from nursing and midwifery professionals. According to the “practice effectively” standard, the best practices involve effective communication, maintenance of accurate as well as clear records, and sharing of skills and knowledge where needed. Furthermore, reflection on the practice and continuous feedback is important to improve practice and enhance the ability to provide effective care.

Additionally, a nursing professional or a midwife must always practice in line with the most relevant and appropriate evidence. Such evidence should also include information related to the products or services that have been used for healthcare (The Nursing and Midwifery Council, 2022). The professionals should also maintain as well as improvise their acquired knowledge and skills in order to practice effective and safe care.

Communicating clearly
Communication is a key attribute that a nurse or midwife should possess as they need to interact with patients and their families directly on a daily basis. While in terms of physical illnesses the patients should be communicated about their condition and the caregiver should explain the process of diagnoses and treatments clearly so the patient can cooperate with the process, the value of communication rises tenfold in terms of psychological or neurological illnesses. As per the guidelines dictated under the “effectively practice'' standard by NMC 2018 clear communication encompasses dynamic aspects starting from the use of terms that people in the care, the public, as well as the colleagues must be able to understand completely. For instance, dementia is a disease that is critical to understand for a patient or the family. Arnold is already 82 years old and it is quite difficult for him to come up with the changes that are faced by general dementia patients. In order to treat him effectively the nurse as well as Suzie must understand clearly the concept of Dementia. Dementia is not a particular disease but it refers to the impairment of the individual’s brain’s ability to think, decide or remember that disrupts the patient’s daily activities (Centers for Disease Control and Prevention, 2019). Therefore, at foremost, both Suzie and the nurse should explain the issue to The Family in simple terms. They should further take logical steps to fulfil the needs of the patient regarding language and communication and assist the individuals whenever required. Along with oral communication the caregivers must also use non-verbal techniques of communication to enable better comprehension for both patients as well as themselves. According to the opinion of Johnson, (2019, p. 71), in terms of verbal and non-verbal communication with patients and their family’s caregivers should be culturally sensitive. Additionally, people’s understanding must be checked timely in order to mitigate any misunderstandings and keep mistakes at a minimum. For instance, in the case of Arnold’s dementia the nurse as well as Suzie needs to check on a daily basis if the patient remembers everything that has been instructed by Suzie and the nurse regarding the ulcer in legs and general activities. A dementia patient is expected to forget things and information often and needs to be reminded from time to time. Based on the country or the ethnicity the caregivers must be capable of using appropriate language. For example, Suzie and the nurse should be proficient in speaking in English with Arnold.

In the case of Arnold, Suzie must use her communication skills to talk with the patient suffering from dementia. It is often confusing for people suffering from the issue as they cannot remember the process of executing basic tasks and they are often unable to identify their friends or family members. As stated by Clark et al., (2019, p. 897), sometimes the patients also remember some memories and become restless. The caregivers must cooperate with patients during these times to calm them and help them adjust to the changing circumstances. Moreover, continuous communication is highly necessary for terms of patients with dementia otherwise they may forget a basic task that may lead to major risks. For instance, Suzie must remain present for Arnold in times of his eating to be able to guide him about the process of eating and swallowing the food otherwise he may choke on it. A patient suffering from dementia requires immense psychological support as the condition gets worse with passing days and years and the patient’s perception of the surroundings or the world changes with time (Banovic et al., 2018, p. 221). It is important for the caregiver to understand the way the patient perceives the world and provide help in accordance. Furthermore, the patients should also be encouraged by the caregiver to perform activities that stimulate memory and offer entertainment.

Keeping clear and accurate records relevant to the practice
As a caregiver assigned professionally, one must practice keeping accurate records. In order to keep clear and proper records, Suzie must incorporate the information in the record file as soon as possible to maintain a timely record with important details of the events. In the case of Arnold, the caregiver needs to identify risks or any issues that are likely to arise at any time for a dementia patient and take instant action or report to the doctor to solve the problem. Moreover, Suzie needs to study Arnold’s attributes closely to check for any changes. As postulated by Mutshatshi et al., (2018, p. 5), patients with dementia often exude changing attitudes or behavior as they undergo transformations within their brain that include loss of a particular memory or change in a specific perception. In terms of keeping a record, Suzie needs to ensure that all the input is correct and avoid falsification to carry out an ethical job. All the information should point out important details with accurate time and date so it is possible to monitor changes with time and gain understanding about the disease more profoundly. As proposed by Kerkin et al., (2018, p. 237), health records should be exclusive of the use of unnecessary abbreviations, speculations, and jargon. All the data should be stored and kept securely in order to maintain the privacy and confidentiality of the patient.

Work Cooperatively: in this standard of practice in line with the best possible as per the availability of evidence the nurses need to work more cooperatively by respecting their skills, contributions, and expertise for their team where they are able to provide sufficient care to the patient. The concerned person here Arnold needs special care and attention where the care and safety provided by nurses and midwives need to assure that their dignity is well preserved and the needs and demands which Arnold made are recognized and responded to with priority. The concerned professionals need to be more conscious whether they treated Arnold more wisely and with respect where the rights of Arnold are upheld and the discriminatory attitudes Arnold made due to the disease of forgetfulness and lack of judgemental behaviors. As Arnold is a victim of dementia where the person is unable to remember certain things and also loses the quality of judgments. special care and attention need to be considered where the person needs to feel priority and also needs special counseling. This disease has started with age in case of Arnold started facing issues of forgetfulness and loss of memory since his retirement whereas after the death of his wife it started increasing (Gajewski, 2022). As per the report (Nmc.org.uk. 2022) there is no actual treatment or cure for dementia especially when it comes to age. In the case of Arnold as dementia is caused with age it's more unlikely to get out of it until the end of life. However, as per research, the patients who suffer from this issue tend to face a number of challenges where they might feel ignored and untreated. Being a daughter Suzie when Suzie consults with the nursing and midwifery team council the first requirement is to make the patient feel accompanied and prioritized. As per the code of conduct under NMC 2018, for prioritizing the nursing interest in the very first place they need to follow some steps which are,

Maintain the effectiveness of cooperation and communication: in this step the nurses need to cooperate with one another where they are able to make a good communicative relationship with the patient as well (Openjournals.ljmu.ac.uk. 2022). For achieving, this the nurses and appointed midwives need to be more kind and give respect and compassion to Arnold where they also make sure that they are able to deliver the fundamental care in the most effective manner. The avoidance of making unnecessary assumptions with the recognition of diversity and individual choice. The treatment Arnold gets has no option to be delayed.

Keep updated with every information and change that takes place in patients’ behavior: in this phase, the team needs to work as a team and partnerships where one is able to deliver the same pace of care and attention to Arnold in place of another. Nurses need to recognize that their care and respect can uphold the mental and physical health of Arnold which can deteriorate at any time due to the elderly. The council provides encouragement and enthusiasm to the appointed nurses so that there would be no place gap in giving priority to the patient where the professionals need to be politer and compassionate where they find Arnold behaves anxious or distressed due to forgetfulness.

Work cooperatively to evaluate the quality of care and attention to patient: here paying special attention is required to promote the wellbeing and that also prevent bad health condition and also help to meet sudden challenges due to unexpected behaviors made by Arnold due to Dementia and difficult life stages. Professionals need to be more conscious so that they can be stable even in vulnerable conditions with their steady and respectful behavior by recognizing that Arnold is their first priority at that time than anyone else in life.

Conclusion
In the above study, the theme of “practice effectively” under the NMC 2018 code relating to the field of nursing and midwifery has been explained. The theme has been described in relation to the case of Arnold suffering from dementia. The study has elaborated on the values, attributes, and knowledge that are essential for the delivery of care which is based on the best evidence and practice. The NMC code 2018 demonstrates several standards and themes for executing evidence-based care in healthcare that includes prioritizing people, practicing effectively, preserving effectively, and promoting professionalism and trust. This study focuses on the theme of effective practice relating to Arnold of the Family and describes various standards that need to be met by the caregiver named Suzie. As per the standards cooperation and communication are vital to effective practices. Clear communication is necessary for terms of effective care where the caregiver should clearly communicate the health problem to the patients, their family as well as colleagues to carry out effective treatment. A cooperative environment is imperative to execute the treatment in a proper manner in cohesion with the patient. To conclude, clear communication, cooperation, and proper maintenance of records are important for effective care practice.

Reference
Banovic, S., Zunic, L.J. and Sinanovic, O., 2018. Communication difficulties as a result of dementia. Materia socio-medica, 30(3), p.221.

Centers for Disease Control and Prevention, 2019. What is dementia? Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/aging/dementia/index.html#:~:text=Dementia%20is%20not%20a%20specific,a%20part%20of%20normal%20aging. [Accessed January 3, 2022].

Clark, L.A., Whitt, S. and Lyons, K., 2019. Improving Communication Between Health Care Providers, Families, and Children with Autism Spectrum Disorder: The Linked Program. Journal of PeriAnesthesia Nursing, 34(5), pp.889-899.

Gajewski, M., 2022. People With Dementia Are Twice As Likely To Get Covid-19 And Four Times More Likely To Die From It. [online] Forbes. Available at: [Accessed 3 January 2022].

Johnson, J.D., 2019. Framing communication in health care action teams. International Journal of Healthcare Management, 12(1), pp.68-74.

Kerkin, B., Lennox, S. and Patterson, J., 2018. Making midwifery work visible: The multiple purposes of documentation. Nursing assignment Women and Birth, 31(3), pp.232-239.

Mutshatshi, T.E., Mothiba, T.M., Mamogobo, P.M. and Mbombi, M.O., 2018. Record-keeping: Challenges experienced by nurses in selected public hospitals. Curationis, 41(1), pp.1-6.

Nmc.org.uk. 2022. [online] Available at: [Accessed 3 January 2022].

Nmc.org.uk. 2022. The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates - The Nursing and Midwifery Council. [online] Available at: [Accessed 3 January 2022].

Openjournals.ljmu.ac.uk. 2022. [online] Available at: [Accessed 3 January 2022].

Shayan, S.J., Kiwanuka, F. and Nakaye, Z., 2019. Barriers associated with evidence?based practice among nurses in low?and middle?income countries: A systematic review. Worldviews on Evidence?Based Nursing, 16(1), pp.12-20.

The Nursing and Midwifery Council, 2022. Read the code online. The Nursing and Midwifery Council. Available at: https://www.nmc.org.uk/standards/code/read-the-code-online/#fourth [Accessed January 3, 2022].

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