The essence of the essay is to give an in depth understanding of the idea of dignity in the care and attention system. This essay will focus on the issues reviewed in the group Enquiry Centered Learning (EBL) presentation; define and critically analyse the idea of dignity from different perspectives, in relation to its abstract and subjective dynamics. How dignity is looked after by health professionals, influenced by cultural differences, and look at some current initiatives used to promote dignity in practice.
Furthermore, I am going to give attention to my experiences in practice to illustrate the concept of dignity, using relevant ideas to aid my discussion. I shall conclude using Gibbs's construction to think about the group presentation.
I have chosen to target entirely on Dignity of id as it pertains to my chosen section of nursing. Nordenfelt identifies four concepts of Dignity: Dignity of Menschenwјrde, Dignity of merit, Dignity of moral stature, and the Dignity of personal individuality.
In my definition of dignity, I will dicuss definitions that relates to elderly people in care and attention. As a grown-up medical student specialising in the care of the elderly, who are the key users of health services, the knowledge gained along the way of this essay will be applied to every adult in my care.
Definitions of the idea of 'Dignity'
Dignity is a hard concept to specify, and has a strong association with admiration. Dignity is thought as being worthy of respect. (DH, 2003) cited from Andrew and Alison however, The Sociable Care and attention Institute for Brilliance (SCEI; 2006) remarked that although defining dignity may be difficult, 'people know when they have not been treated with dignity and respect. '
The definition of dignity from the oxford dictionary discusses the innateness of dignity in individual as it is natural. This is also embedded in Article 1 of the US General Assembly Declaration of 1948, reiterate in 1996 by the United nations International Monthly bill of Rights, which expresses, "that all human beings are blessed free and equivalent in dignity and protection under the law" (United Nations, 1996). (matiti).
From the EBL group presentation Professor Lennart Nordenfelt's theories on dignity were reviewed; first of all, Dignity of merit- based on hierarchical position in population, dependent on economical/social course can be hereditary. Second, Human Dignity gives rise to the worthiness of being human, and the Dignity of moral stature predicated on someone's moral autonomy/integrity and, finally Dignity of personality which targets individuals being's self-respect, including notions of integrity and autonomy, and could be violated when a person is avoided from doing what they would like to do or have entitlement to do, or by physical assault and humiliation. The past aspect of Nordenfelt's definition of dignity, which is the dignity of personal id, is the one which can be related to older people. Due to possible limited functions associated with ageing individuals they could be subjected to their dignity being violated, as their condition may bring about them being reliant on others for their daily activities of living, thus depriving them of the from doing what they would want or entitled these to do, which might produce physical assault and humiliation. *absent offer to be put, upon confirmation of source**
The Royal college or university of Medical (RCN) has managed to get clear that dignity is applicable equally to those who have capacity and those who lack it. Everyone has equivalent worth as human being and must be treated as human beings and must be treated as though they could feel, think, and respond in relation to their own price or value.
*lacking Dignity in Attention quotation to be put, upon confirmation of source**
It is evidenced from my research on the definition of dignity that individuals perceive dignity differently due to its subjective dynamics. Nonetheless, there is absolutely no general contract on what dignity actually means. Julie Clark, 2010. However, there is a consensus that it is a value possessed by every individual. Everyone irrespective of circumstances should be treated with dignity.
Nordenfelt argues that, "Menschenwurde is the essential platform. Each older person has his or her intrinsic value, which includes a number of privileges, among other the rights of the UN Declaration. People do not lose any of these rights because they have reached a particular time. " **(Dignity in care for aged pp)** Badcot says that, Kant I Cited in Gallagher et al 2008 holds that human beings posses dignity because "they can be rational, autonomous creatures with intrinsic value who can pursue and determine their own ends". Kant's definition of dignity with regards to 'intrinsic value' seems to rely upon ownership of autonomy.
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"Treating patients or clients with dignity is considered as part of providing them with quality good care and permitting them to experience quality of life which may be violated according to Nordenfelt because of the circumstances; disease or old age. " (Dignity in Care and attention text reserve)
PROMOTING DIGNITY IN CARE
It is of paramount importance that health care professionals promote dignity in good care at all times. There are conditioning factors and traits that have been put in location to govern dignity in health care situations.
One of the most crucial conditioning factors is designed for the nurse to get a full understanding of the idea of promoting dignity in order to provide good medical care to your adult patients.
In good care situation, dignity may be promoted or diminished by the next factors; physical environment, organizational culture and the attitude and behavior of the nursing team in the way care are completed. There are many ways that patient's or consumer dignity can be marketed.
According public institute of superiority (2010) there are 8 main factors that promote dignity in treatment. Few of which I will clarify with example.
Dignity can be promote by healthcare professionals by concerning patients in their own attention, empowering to make their own decisions and options concerning their care and attention.
Treating patient or consumer as an individual involves listening to them and also to avoid caring for them as a group, pushing independence and presenting time and choice. For instance, give patient choice of how they would like to be dressed by asking these to choose cloths with their choice.
When communicating with patient, it is important expressing respectful verbal and non verbal communication; Tuning in, responding, allowing time and use of therapeutic communication when required.
Healthcare professionals should cultivate the behavior of approaching patient within an appropriate manner thus, with value and professionally.
Providing patients with necessary data regarding their health, leads to them having sense of value.
Explain procedure to gain consent cooperation prior every treatment and including them in their attention by giving them choice and freedom to express their sense of makes them feel a feeling of belonging and this nurses are not dominating the treatment they offer. Maintaining privacy is important. For instance, during strategies, curtains should be pulled around patient's bed using peg, to ensure privacy.
Keeping the environment clean is very important. For instance, a commode should not be remaining at the patient's foundation area after use. It is figured reflection on, and improvements to, the care environment makes a substantial contribution to patients, relatives and staff sense valued and reputed. (Matiti)
"When dignity is present people feel in charge, respected, confident, comfortable and able to make decisions for themselves. When dignity is absent people feel devalued, lacking control and comfort. They could lack confidence and become unable to make decisions for themselves. They could feel humiliated, uncomfortable or ashamed.
It is of paramount important to organise and affecting seniors in rousing activities, especially those in a medical home in as this will prevent isolation.
According to 2008 Gallagher et al it expresses "that later years may intimidate dignity due to the fact that the quantity of social inclusion and participation are limited".
When patient and client are not treated with value and dignity it will gave negatives effect on their wellbeing thus impacts them psychologically and socially.
dignified treatment correlate most carefully with high satisfaction with a healthcare facility stay, thus indicating that patients who perceive they are treated with dignity are more comfortable with the overall hospital experience. (matiti) (chochinov et al, 200b) Matiti) indicated a link between loss of dignity and different unwanted effects, such as mental health and symptoms distress, heightened dependency needs and loss of will to live
It is affirmed by legislation and moral of the profession that, all healthcare professionals to at all times promote patients' dignity and esteem. (chochinov et al, 200b) Matiti) indicated a link between lack of dignity and various unwanted effects, such as mental health and symptoms distress, heightened dependency needs and loss of will to live
INITIATIVES TO MARKET DIGNITY
The desire to restore dignity to the heart of nursing can be an attempt to issue and redress a few of the delegation and overspecialisation that has took place within the last decade, which have perpetuated the identified erosion of treatment (Scott, 2000). However, (Maben and Griffiths, 2008). From dignity champion exerts that Promotions for dignity in attention may not actually bring about the change of worth, attitudes and beliefs that are perceived to be lacking in nursing
As it's been mentioned that dignity is difficult to establish and that treatment professional may not be equipped with the required skills and Knowledge required of them to treat consumer with dignity however, there are governing bodies that are in destination to help health practitioner in using initiatives to market dignity. These initiatives are plentiful as helpful information to healthcare/care provider in order to effectively and properly treating consumer with esteem and dignity. Adherence to these initiatives, consequently result in appointment clients needs as individual and providing quality health care.
Design for patient's dignity is another body that promotes dignity. They have got created a number of initiatives to help practitioners in care setting up. These includes, widespread gown which suits all sizes as well as ethnic and religious beliefs. The gown also covers all part of the patients body like the front and the trunk gives patients privacy and allows those to feel secure and many more.
http://www. designcouncil. org. uk/our-work/challenges/Health/Design-for-Patient-Dignity/Case-studies/ - 23 December 2012
My home life focuses on seniors, this is excatly why it has been chosen
my home life movement is also a governing body who formed a number of initiative which aspire for best practice includes a sense of security; this involves gaining trust and maintain confidentially unless on the need to know basis. A sense of significance permitting them to feel sense of worthy of and valued, recognising their occurrence, hearing and understanding their needs, empowering them to allow them to make alternatives and decision about their lives. A sense of continuity
All of the initiatives help to promote their dignity because they feel a sense of belonging. (Nolan et al's 'Senses Framework').
From my research it is evidenced that several research have been completed to promote dignity in treatment settings.
One of these initiatives is Dignity in Good care network create by SCIE (Sociable Treatment INSTITUTE FOR Brilliance). The 10 point Dignity Task is the framework and the 'gold standard' this initiative aims to revive dignity at the heart of medical and social good care orofessionals
Initiatives from the department of health including the National Service Platform for older people, the follow-up Next steps file and the Dignity in care and attention Campaign including the dignity obstacle, all try to promote the required changes in culture that are had a need to ensure that older people and their carers are treated with respect, dignity and fairness. The Department 's Fact of good care: Patient-focused benchmarks for medical governance offers a platform for healthcare professionals to use in measuring their practice relating to privacy and dignity.
The Healthcare Commission payment report Caring for Dignity (2007) preserves that dignity is 'a individuals rights concern' and really should be the underlying process when delivering services. However, there may be little guidance no way of measuring how well a service respects someone's privacy and dignity. Dignity is a complicated concept this means various things to different people, but is dened as being consisting of two parts: having self-respect and being well known by others.
Maintaining dignity really helps to protect our self-worth and identification; this is particularly important in good care adjustments where residents are often vulnerable, and caring procedures can make people feel undignied due to their personal and seductive nature. It is better to identify when dignity has been lost alternatively than when it is being retained.
(Medical & Residential Good care, August 2009, Vol 11, No 8)
(Privacy and dignity in continence care and attention: research review)
PRACTICE EXPERIENCE.
that devalues and will not respect the dignity of the average person should be confronted. Mrs Hussein's smiled and said "thank you". My mentor replied that "it is our job to care for patients needs.
Mrs Hussein's dignity of id was jeopardized as the care assistant needed the good thing about Mrs Hussein's condition to violate her dignity of personal information on her behalf own conveniences. Professor Wilfred exerts that "Dignity is promoted when individuals are enabled to do the best within their capacities, exercise control, make choices and feel involved in the decision making that underpins their care and attention. " I needed my clinical position in a stroke ward where i came in contact with people with different types of stroke and those on rehabilitation pathway. There were several cases where I experienced how patient's dignity had been preserved and conversely, compromised. For the purpose of this essay a pseudonym will be used in order to protect confidentiality (Medical and Midwifery Council's code of do 2009).
I cared for Mrs Hussein, a 75 yrs. old, Asian woman who was simply admitted in to the ward with ischemic stroke which left her with right sided weakness of both limbs. (Walsh 2002) defines a stroke as an interruption of the blood supply to an integral part of the mind and the development of neurological deficits.
Mrs Hussein's health condition required her to be dependent on carers has she requires help for nearly all her activities of everyday living. During the morning hours shift I backed the good care assistant to clean her. We searched for for her consent and asked if she'd prefer to have her shower, curtains were pulled around using peg and her private part covered with towel before private part needed to be washed, making certain her privacy and dignity were maintained. The Medical and Midwifery council (NMC 2009) exerts that individuals should be cared for with admiration and dignity.
After we done bathing her, I headed to her cupboard to get her cloths, but the care assistant said she is wearing the hospital Gown because she actually is incontinence of both urine and faeces. Mrs Hussein said she will not want the Gown that she prefers her own clothes because a healthcare facility gown will not cover her body properly, she described. Unfortunately, her need was ignored. Despite the code of conduct (NMC2009) that expresses that "You must listen to the folks in your attention and respond to their concerns and preferences". Also, International Journal of Medical Practice 2011; 17: 336-341 also asserts that "Hearing patients is a necessary precursor to respecting their dignity in care and in supporting their sense of their own dignity"
Mrs Hussein had not been looking happy as her wish was ignored. I intervened by moving nearer to her, held her side used the therapeutic communication skill. I presented her hands to describe to her that I will get one of the carers that will aid in changing her to her own cloth. The frame of mind and communication skills of the individual practitioner can do much to ensure these and other similar experience aren't compounded. Matiti
I reported the situation to my mentor and she was included with me to change her. ". Corresponding to Wilfred (professor in dignity of older people) Any practice
Those patients on rehabilitation pathway were all the time given the decision of what things to we specially the women were inspired to wear their personal cloths as they could need to go for physiotherapy. That is done at all times to keep up patient's dignity.
I also experienced an 82 years old man who was simply admitted into the ward and was confused. Due to his condition he always undressed himself. This led to making the decision for him to be relocated aside room. The idea of being in the medial side room alone led to him not be taken care of as he was lost and could not use the decision bell
Control of the colon and bladder is something which people develop as small children and lack of this important to preserve a person's privacy and dignity during such care. Victims to feel child-like and stigmatised. The elderly with continence problems often feel a lack of dignity in care settings (Nursing & Residential Treatment, August 2009, Vol 11, No 8
During my positioning I also noticed that when there was a shortage of personnel, the patients dignity tends to be diminished. For example, in the stroke ward where I was, patients who were unable to supply for themselves required assistance but due to the shortage of staff patients had to wait for changes to be given as a result, their food will need to have gone cold which then diminishes their dignity because if indeed they could actually feed themselves they might not have to wait for assistance. The hospital toilets particularly, those people in distributed bays are relatively small for carer to manoeuvre which sometimes subject patient's dignity being diminished.
It is assumed that you of the factors inhibiting dignity used is as result of the healthcare professionals not adequately outfitted with the required skills and knowledge required of them to have the ability to carry out their work effectively. Also, the fact that the idea of dignity is a very difficult to establish, it is difficult to give a specific definition that may be used to underpinned practice.
(Anderberg et al, 2007). Therefore, there may be need to help healthcare workers in practice to identify practical ways of promoting patient and customer dignity
Patient dignity is sensing appreciated and comfortable psychologically with one's physical display and behaviour, level of control over the problem, and the behaviour of other people in the surroundings (Baillie, 2007, p. 247). Matiti
Within healthcare settings, how patients feel they are simply viewed by personnel looking after them, or how personnel feel they are simply viewed by colleagues and patients, can affect self-confidence. If a person's own standards are found, they develop a sense of take great pride in, have high self-esteem and feel worthwhile. Matiti
Access to lavatory/bathroom facilities - There is certainly often insufficient usage of lavatory/bathroom facilities with personnel unavailable to help and alternatives, such as commodes, offered that people found embarrassing and undignified. This diminished their dignity and result in the individual not attempting to demand toilet. Tugging of curtains during strategies is crucial all the time.
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Conclusion
Dignity in care is not the only real responsibility of one professional group: all health insurance and social care pros need to be dignity champions. Nurses are usually more aware and educated of different measurements of people's Wilfred (professor in dignity for older people) medical times
REFLECTION ON EBL
Reflection is a process of reviewing an experience to spell it out, analyse, evaluate and also to inform learning of practice (Reid 1993) cited in Sully and Dallas. Gibbs representation routine process (1988) will be utilized to think about my display. This comprises of six features and listed below in chronological order.
DESCRIPTION: reflecting on the EBL process, on the first week, lead to was presented with to the group to analyse and discuss the implication for practice. We performed, strived and researched collectively as a team for a month. The process started out by electing chairperson and a scribe. Thereafter, theme was shared amidst us as subgroups to research upon, which we all came to arrangement. Matching to (Thompson et al 2006) working jointly is the type of nurse education to explore theoretical and specialized medical principle and applied them to practice.
Each week, prior to the presentation date each subgroup developed their research and we discuss on our research and asked every member of the group for a person input before the arrival in our facilitator. Finally, research completed was come up with and we made a decision between ourselves who want to present. In the long run we were all pleased with our performance and the markings honored, as the marks will be put into individual final grades.
FEELINGS: Feelings and thinking are the most essential aspect of the reflective process; therefore, great care should be taken in this process (Ely and Scott, 2007). Prior to the display, we were overwhelmed with feelings of nervousness and jittery, as well as incompatibility of the group customers. There was a concern with time management, as we'd only thirty minutes to provide. Presenters had rehearsed prior to the proper presentation was carried out to ensure that people bit enough time. In the end, enough time management was perfect and our display was wonderful.
EVALUATION: The great thing about the groups was that there surely is always a good turnout for extra conference out the normal category hour. Although, some do arrived late for classes but get the group up to date. Working as a team was a great experience; it offered me more confident and better understanding of this issue. The EBL presentation has shown me how to build up my knowledge and skill, effective listening skill was discovered during the presentation. However, on the previous meeting day before the presentation, there was problem of summarizing two different slides on the power points this helped bring somewhat of argument but it was summarised and most of us resolved amicably. The presentation provided me with an in-depth knowledge of the dignity in health care. Matching to (Elly and Scott 2007) analysis process is a level that enables someone to reflect on the performance of your experience, what was incorrect and right about your experience.
ANALYSIS: in the process of EBL analysis i developed the knowledge and skill of gathering and showing information, effective communication and being attentive skills as well as the soul of working along for the good thing about reaching common goal. Also, the process gave me the privilege to get in-depth insight how dignity can be marketed in care setting, initiatives to market dignity and the impact of undignified good care on older people and the susceptible people generally. Analysis is the procedure of making sense of the complete experience or situation and placing it in framework (Bulman and Schutz 2008).
ACTION PLAN: when next the chance of group display arise, I'll try to volunteer to be a part of presenting for the group as this will help enhance and build my communication skills and developed self-assurance to handle the audience. Action plan matching to (Ely and Scott 2007) is a way of planning for the near future and organising yourself in the event similar events take place in the future.
Conclusion: This article has provided me with relevance information regarding EBL presentation, the cause and the use of Gibbs reflective pattern 1988.
