Nursing and Consent free essay sample

There are a number of legal and ethical duties expected of nurses. Most of these involve care for patient’s autonomy and confidentiality despite the medical care. Failure to act regarding these can give rise to liability. One aspect of Patient’s autonomy involves giving or withholding his consent about treatment. This paper takes into account ‘consent’ as the aspect of law regarding nursing. Consent is defined by NHS Choices (2010) as: the principle that a person must give their permission before they receive any type of medical treatment. †1 Under the Nursing and Midwifery Council (hereafter NMC) code of conduct (enforced in May, 2008) the patient can either extend or withdraw his consent regarding treatment after which he should be or cannot be treated as per his wishes respectively. Cowan (2009) observed that the idea underlying this is to empower patient to acknowledge the treatment options available to them and choose whether or not they want to have it. We will write a custom essay sample on Nursing and Consent or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Therefore, a nurse cannot administer the treatment to a patient if he withholds his consent about the treatment. As per NMC, there are three â€Å"over-riding professional responsibilities† to obtain a valid consent. These are quoted as below: â€Å"To make the care of people their first concern and ensure they gain consent before they begin any treatment or care. †2 â€Å"Ensure that the process of establishing consent is rigorous, transparent and demonstrates a clear level of professional accountability. †3 â€Å"Accurately record all discussions and decisions relating to obtaining consent. †4 The NMC Code (2008) also states that, â€Å"make the care of people your first concern, treating them as individuals and respecting their dignity. † Scott (et al. 2003) observed that being respected implies that not to treat patients against their will. Tomkin Hanafin (1995) observed that respecting the patient’s autonomy means respecting his ‘consent’. Mason Laurie (2010) observed that just because the healthcare professional believed that the treatment was appropriate doesn’t mean that the patient must undergo it, consent must be obtained. Failure to do so amounts to the crime of battery in English law. Booth (2002) observed that patients should not be subjected to treatment by any health professional unless their consent is at hand. He further observed that pre-requisites of obtaining valid consent include informing patient regarding disease, diagnosis, options regarding types of treatment, consequences that might or might not take place as a result of treatment to the patient. Thus, if a nurse treats the patient without his consent it would amount to treating him against his will which would constitute a crime of battery on nurse’s part. It is therefore imperative that before administering the treatment, nurse obtains consent of patient. However, consent alone is not sufficient; it must be valid as well. Therefore, the NMC code also requires from nurses that in order to obtain a valid consent it must be obtained from a competent individual i. e. one who possesses the capacity to consent. Furthermore, if a person is giving consent on behalf of another, he must be lawfully appointed. No one can give consent for someone who possesses the mental capacity to give consent. (Mental Capacity Act 2005) Consent is considered to enhance partnership between practitioner (e. g. nurse) and patient. Providing information alone is not sufficient, communication is the key to obtain valid consent. There exists difference between merely giving information and communicating effectively with patient about the information. Bristol Inquiry Recommendations are helpful in understanding the difference regarding this. These are quoted below: â€Å"The process of informing the patient, and obtaining consent on a course of a treatment, should be regarded as a process and not a one-off event consisting of obtaining a patients signature on a form. The process of consent should apply not only to surgical procedures but all clinical procedures and examinations which involve any form of touching. This must not mean more forms: it means more communication. As part of the process of obtaining consent, except when they have indicated otherwise, patients should be given sufficient information about what is to take place, the risks, uncertainties, and possible negative consequences of the proposed treatment, about any alternatives and about the likely outcome, to enable them to make a choice about how to proceed. †5 Besides, if a person lacks mental capacity to give valid consent, nurses caring for such a person should be involved in assessing the treatment to be administered. However, they must be â€Å"aware of the legislation regarding mental capacity, ensuring that people who lack capacity remain at the centre of decision making and are fully safeguarded. †6 The Mental Capacity Act (2005) offers assistance regarding ‘capacity’. The Act applies to all aged 16 and above and to those with learning disability, dementia, brain injury, autism and mental health issues. The Act presumes ‘capacity’ in relation to adults unless situation exists otherwise. It requires extending all sorts of help to the person in question before drawing conclusion that they cannot consent. Even an apparently unwise decision if is extended by a person of full mind must be respected and adhered to. Doing something for those who lack the capacity to consent must be done in the best of their interests and it should be least restrictive of their independence and rights. However, exceptions to this include: emergency situations and mentally incapacitated people. Emergency situation might involve someone who has temporarily become unable to consent e. g. due to in unconscious state of mind. In such instance he may be given necessary treatment to save life. The law in such instance allows medical practitioners such as nurses and doctors to administer treatment without the consent of person in so far it is in his best interest. There are some situations where courts must be referred to for lawfulness of administration of treatment for a person unable to consent. These include: withdrawing the patient from persistent vegetative state, sterilization for the purpose of contraception, obtaining tissue for bone marrow, where the doubt exists regarding the capacity of the person. 7 In Sidaway v Bethlem Royal Hospital Governors (1985), Lord Diplock said that the information to be disclosed to patient for obtaining consent should be done by following the Bolam standard (named after the case it was enunciated in: Bolam v Friern Hospital Management Committee, 1957) It was held in this case that if the medical practitioner acted in accordance with the practice which is accepted responsible by a respectable body of medical opinion he is not held in breach of law. Therefore, if a nurse is administering treatment in emergency situation (usually under the supervision of doctor) to a patient who is unable to consent and that is accepted reasonable by a respectable body of medical opinion e. g. by medical board then she may not be held in breach of law regarding consent.

Free Essays on On His Blindness

Unlike Shakespeare's poem, but still refusing to acknowledge the sonnet's traditional form, the story of Milton's "On His Blindness" is autobiographical and describes a man who has suffered enormously through the loss of his sight and his talents. These are equal to the author and he refers to them as punishments. The whole of the poem consists of questions ("Doth God exact day labour light-denied?") revealing Milton's pain and although humility is sensed, there still remains the inevitable and haunting "Why me?". However, he is answered by Patience that it is not the one who has talents who earns God's love but the one who is able to "bear his mild yoke". The idea by itself resembles the theme of stoical endurance. The main message of Milton's sonnet is emphasised by the use of symbolism. The imagery consists of references to time, light/darkness, which resemble life and talents and the loss of them, time and God, all aiming at clarifying the picture of the author's suffering. First, there is "half my days", then come the "light", spent in this "dark world and wide". The uneasy and agoraphobic atmosphere is hastened by the appearing of God's figure: "He", "my Maker" and the pain sharpened by the mentioning of "gifts" once more. The sonnet, however, finishes with Patience - a symbol of faith, strength and maturity - pleading for the hero's stoical endurance. There is a similar development of attitude in "On His Blindness". The extreme resignation from the beginning of Milton's sonnet are eventually replaced by a more objective, less personal and wiser viewpoint. The statement "His state/ is kingly" proves the hero's obedience and the fact he has accepted to "bear his mild yoke", be patient and wait for God's sign. The English poet John Milton pondered these two distinct meanings of â€Å"talent† when, in 1651, he composed the well-known sonnet on his blindness, which begins, â€Å"When I consider how my light is spent [i.e., has fa... Free Essays on On His Blindness Free Essays on On His Blindness Unlike Shakespeare's poem, but still refusing to acknowledge the sonnet's traditional form, the story of Milton's "On His Blindness" is autobiographical and describes a man who has suffered enormously through the loss of his sight and his talents. These are equal to the author and he refers to them as punishments. The whole of the poem consists of questions ("Doth God exact day labour light-denied?") revealing Milton's pain and although humility is sensed, there still remains the inevitable and haunting "Why me?". However, he is answered by Patience that it is not the one who has talents who earns God's love but the one who is able to "bear his mild yoke". The idea by itself resembles the theme of stoical endurance. The main message of Milton's sonnet is emphasised by the use of symbolism. The imagery consists of references to time, light/darkness, which resemble life and talents and the loss of them, time and God, all aiming at clarifying the picture of the author's suffering. First, there is "half my days", then come the "light", spent in this "dark world and wide". The uneasy and agoraphobic atmosphere is hastened by the appearing of God's figure: "He", "my Maker" and the pain sharpened by the mentioning of "gifts" once more. The sonnet, however, finishes with Patience - a symbol of faith, strength and maturity - pleading for the hero's stoical endurance. There is a similar development of attitude in "On His Blindness". The extreme resignation from the beginning of Milton's sonnet are eventually replaced by a more objective, less personal and wiser viewpoint. The statement "His state/ is kingly" proves the hero's obedience and the fact he has accepted to "bear his mild yoke", be patient and wait for God's sign. The English poet John Milton pondered these two distinct meanings of â€Å"talent† when, in 1651, he composed the well-known sonnet on his blindness, which begins, â€Å"When I consider how my light is spent [i.e., has fa...

Stock Price and Trading Volume Essay Example | Topics and Well Written Essays - 1000 words

Stock Price and Trading Volume - Essay Example Wood, McInish, and Ord (71), had found contradicting evidence, in the price-volume relationship. For they established the ratio between the price change and trading volume to be greater for the share prices downticks. Smirlock and Starks (64) had found that the relationship could only be supported during the time intervals when they could distinguish when the new information ex ante had reached the financial market. Due to the lack of the delivery of information to the financial market and the upbeat transaction costs, small amounts of evidence found that the relation had been lower for the up-ticks in the price than for the downticks. Data collected over an hourly basis from an extensive market index by Jain and Joh (38), had discovered the trading volume relates positively to the enormity of the price change. Findings have shown though, that the volume is more sensitive towards the positive price changes in contrast to the negative price changes. Epps, Hanna, Jain, Joh and parts of Smirlock and Starke's findings shown an implication of a positive correlation between the price change and trading volume per se. Ying's items (1) and (2) and a numerous number of researchers had found a similar positive correlation as found above. Rogalski (60) had... tedly found a positive correlation as well as Richardson, Sefcik, Thompson (58), Comiskey, Walkling and Weeks (12) all had found through tests on annual volumes of turnover and the price change to have positive traverse correlations. No such correlation had been found however by James and Edmister (39). So by looking at the empirical evidence summarized in Table 2, the two features discussed are, all the findings are from data collected from stock and bond markets, unlike previously mentioned empirical correlations between the price change and trading volume, and the data collected has not been collected from any futures markets. The statistical results found are weak, certain correlations found by Rogalski were found to be low for example and there were a couple findings that were inconsistent with a positive relationship to be found. Theoretical explanations by several authors of their findings, say the association of volume with the methodical risk through to stock returns, suggested by Morgan (51). A positive correlation between the price change and trading volume had been implied by the 'mixture of distributions hypothesis', only if the conditional indication of the stock price procession is in proportion to the quantity of new information into the market. There is however an unclear sense as to how the above could actually work. For the MDH with indicating minority is inconsistent with the markets equal balance, since it implies that the price change expected is from the arrival of new positive information into the market. Epps (20) found that a positive price change is cause for a larger volume on share transactions than for the negative price changes. His assumption that the 'bull' investors are optimists about their asset value at the close of the

Main differences in the approach to urban policy between Scotland and Essay

Main differences in the approach to urban policy between Scotland and England in the period 1979-1987 - Essay Example It is a common belief of most of the people that all the factors are collaborated and need to be addressed simultaneously (McCarthy 67). The nucleus of Scottish urban regeneration policy consists of several particular government programmes. Moreover, other policies have greater impact on the Scottish communities. It is true that, people of Scotland, especially the urban people were suffering from inadequate environmental and social situations. This nucleus of urban regeneration policy historically had two broad threads in Scotland. Urban Programme is considered as one of those broad threads. This Urban programme was fundamentally a funding administration that helped to stimulate a vast range of several relevant activities (Blackman 91). The considerable changes in the Scottish urban regeneration policy tried to bring election of the labour government approaches together. The Scottish Urban programme had several significance source of funding. Key indicators that are characterized as disadvantaged included short-term and long-term employment, uptake of education support, low household income, low educational attainment level and increasing crime rate. After Second World War, the economic and social condition of Scotland violated drastically. The country was suffering from several racial conflicts, colour and gender discrimination in workplace, high unemployment rate and low disposable income of citizens and communal or social conflicts. The government of Scotland tried to develop several policies in order to lift the standard of living of the Scottish people. Moreover, majority of a population group started to migrate in several countries to achieve social and economical advantages. These migrations and environmental conflicts hampered the social and economical balance of Scotland. Therefore, the government of Scotland started to develop urban regeneration policy to bring stability in the society and economy. The Priority Partnership area scheme emphasized the communities’ designation for realistic support for particular projects within the regeneration strategy. This idiosyncratic combination of all the policy elements reflected the chronological development of urban growth and regeneration policy in Scotland. This Priority Partnership area concept initiated to increase of Scottish corporatist tradition. This Priority Partnership Area brings both the local and central government. The significant nature of several Scottish urban regeneration policies have arisen from the municipal intervention legacy. The Scottish urban renewal unit was established in 1975. Scottish Urban regeneration forum is an important independent regeneration network for Scotland. It helps to improve the regeneration policy and practices. This forum works closely with several policy makers in the Scottish agencies and governments. Scottish Urban regeneration has evolved into a distinguishing approach. Since 1969, the Scottish urban regeneration programme has been considered as the key source of funding for the economic, environmental and social improvement of urban areas suffering from social disadvantages and deprival problems. In Practice, the eligible areas for urban programme funding had been constantly interpreted by the office of Scotland. Through this funding, the Scottish Urban

The life AND death of Tiberius Gracchus Essay Example | Topics and Well Written Essays - 3000 words

The life AND death of Tiberius Gracchus - Essay Example Tiberius began his military carrier during the Third Punic war when he was appointed in a military tribune attached to Scipio Aemilianus (his brother in law) staff. The period he served under Aemilianus as a military tribune built his status making him popular, thanks to his bravery and discipline. He is remembered as the first of his kind to scale the enemy walls. His outstanding performance earned him another significant appointment in 137 BC as the questor to consul Gaius Hostilius Mancinus. This position saw him serve in Numantia , a region found in the Hispania province. Here, he was among the army that took part in the botched Numantine that saw mancinus army suffer major defeats. During this war Mancinus made an unwise decision of withdrawing his army at night causing not only the defeat but also loss of their possession as their camp was looted. Seeing the danger that lingered, particularly on the army, Tiberius took advantage of his position as quaestor to sign a peace treat y with the Numantines against the general requirement that required a legate to complete the signing. During the negotiation, Tiberius revisited the adventures of Tiberiu Elder (the father), who equally fought in Spain but negotiated a peace accord with (Numantines, 24). This move caused him be regarded highly by the Numantines so much that when they discovered their army had taken his ledger in the process of despoiling the Roman camp, they made arrangement to have him get it back. Such is the case that they invited him in person, throwing a banquet in his honor and allowed him not only to recover his ledger but also take any other thing he wished to have from the spoils. Tiberius integrity could not permit him to do as they asked but instead he took back his ledger and only accepted some incense used for sacrificial rituals. There was so much frenzy in Rome on account of this

Recognizing Abuse and Self Harm in Service Users

Recognizing Abuse and Self Harm in Service Users Abuse is a violation of an individuals human and civil rights by any other person or persons, consisting in single or repeated acts, may occur in any relationship and any context, some instances of abuse will constitute a criminal offence. A definition of abuse in vulnerable adults was given in 1997 Consultation Paper â€Å"Who Decide† by the Lord Chancellors Department, who said that any person who is or may by in need of community care service by reason of mental or other disability, age or illness, who is or may be unable to take care or protect of him/herself against significant harm or exploitation. Types of abuse include: physical or sexual; emotional/psychological, including that related to age, race, gender, sexuality, culture or religion; financial; institutional; self neglect; neglect by others. The vulnerable adults could be abused by a wide range of people, including multidisciplinary team in health care setting, family, friends, strangers, one in four vulnerable elders are at risk of abuse and only a small proportion of this is currently detected. The NHS and Community Care Act 1990, have eligibile criteria for those who suffer or cause harm or exploitation. The role and responsibility of every member from multidisciplinary team is to collaborate effective in identifying, investigating and responding to allegation of abuse. This must start from staff as a operational level, line manager, corporate authority, chief executives and to the local authority members. In the case of Stafford Hospital scandal, were found many forms of abuse against people. There was a complete failure of management what led to a totally unacceptable failure to treat emergency patients safely and with dignity. The low staffing levels, inadequate nursing, lack of equipment, lack of leadership, poor training and ineffective systems for identifying when things went wrong. Some other problems was that the patients arriving at AE department were checked by unqualified receptionist, nurses have no trained to use vital equipment in emergency assessment unit, not enough staff to provide health assistance, not supervision for quality of care, unacceptable waiting time in AE without assistance and no experienced surgeon for the night shift, patients left crying for help, not food and drinks being left out of reach. Cite by BBC it said that â€Å"there were between 400 and 1,200 more deaths than would have been expected between 2005 and 2008, although it is impossible to say all of these patients would have survived if they had received better treatment†. A case of people who wanting answers include a 79 years old person whom wife 73 years old, died five weeks after she were admitted at Stafford hospital in February 2009. She was suffering from dementia and was taken ill with dehydration and an infection and had to be taken to the hospitals AE department. At first checking the medical staff didnt find anything wrong with her and sent her home, but she came back few days later. The husband complaint was because during her five weeks in hospital the only treatment received was a disgrace, she was left wet, not washed, ignored by the staff members and he decided, unfortunately too late, to move her in to the care home setting. A similarity of abusing vulnerable adults is the case of Whipps Cross University Hospital in east London hospital, where three healthcare assistants who abused elderly patients have been sentenced. Whipps Cross Univeristy Hospital provides a full range of general inpatient, outpatient and day case services, elderly patients suffering from dementia and recovering from operations, strokes and falls, as well as maternity services and a 24-hour Emergency Department and Urgent Care Centre. The hospital has a strong reputation as a centre of excellence for various specialist services, including urology, ENT, audiology, cardiology, colorectal surgery, cancer care and acute stroke care.The abuse happened in spring of last year on the Beech Ward at Whipps Cross Hospital in east London,and came out when one of student nurse LB, blew the whistle after completing a placement on the hospital’s Beech Ward. At NHS control were uncovered a large range of failings at a London hospital includin g dirty equipment, poor hygiene standards, staff not assisting patients with eating or drinking, not feeding tube were done, not given medication at request and a high mortality rate. Some of the wards had to share equipment which come in conflict with infection control, and this led to sores pressures developed in five patients after admission. The three healthcare assistants worked on Beech Ward at Whipps Cross employed to carry out basic feeding and washing duties, have been suspended by the hospital and barred from working anywhere in the NHS while an urgent investigation is conducted by police and hospital bosses. They had physically and verbally abuse patients, telling them to shut up, handling them in a non professional manner, grabbing sore or painful areas of patients, pushing them and forcing to sit in chairs, make the patients believed that it was due to their conditions. The care professionals damaged patient trust and not followed the quality of care for the elderly and vulnerable at Whipps Cross. Outline the vulnerability of these patients, follow the codes of practice, the duty of every member of staff to report such behavior, whistle blowing policy is made clear to all staff on day one of their employment with the Trust, with ongoing statutory and mandatory training to those that providing care professionally. In order to protect our clients of harm and abuse we had to review the risks factors by monitoring and evaluating how policies, procedures and practices are working in the workshop and receiving feedback. Work with person- centred care value, promoting empowerment, prevention and managing risk but keep a balance between managing risk and enabling independence, choice and control. Recognize and explain the new signs of abuse or potential abuse in vulnerable adults must be the basis of developing outcome measures which can be used by service users and service providers in monitor and evaluate service provision regarding safety and protection generally speaking. References C. Cooper, A. Selwwod G. Livingson, Oxford Journal, Age Ageing, (2008), The prevalence of elder abuse and neglect: a systematic review, Vol.37, Issue 2, Pp.151-160 E. Salend, R.A. Kane, M. Satz J. Pynoos, Oxford Journal, The Gerontologist, Elder Abuse Reporting: Limitations of Statutes1, Vol24, Issue 1, Pp61-69 Links: http://news.bbc.co.uk/1/hi/programmes/politics_show/8022608.stm, checked 09.03.2014 http://news.bbc.co.uk/1/hi/health/8531441.stm, checked 09.03.2014 http://www.bbc.co.uk/news/health-11696735, checked 09.03.2014 http://www.bartshealth.nhs.uk/our-hospitals/whipps-cross-university-hospital/, checked 08.03.2014 http://www.guardian series.co.uk/news/10461128.Whipps_Cross_nurse_left_dementia_patients__screaming_in_pain_/ ,checked 08.03.2014 http://www.bbc.co.uk/news/uk-england-23808971, checked 08.03.2014 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/194272/No_secrets__guidance_on_developing_and_implementing_multi-agency_policies_and_procedures_to_protect_vulnerable_adults_from_abuse.pdf ,checked 08.09.2014

kids in the butt :: essays research papers

Substance Use and Abuse Among Children and Teenagers During the past several years, there has been a renewed national concern about drug abuse, culminating in the current "war on drugs." In this review, we emphasize that even though child or teenage drug use is an individual behavior, it is embedded in a sociocultural context that strongly determines its character and manifestations. Our focus is on psychoactive substances both licit (cigarettes and alcohol) and illicit (e.g., cannabis and cocaine). We feel that it is critical to draw a distinction between use and abuse of drugs and to do so from a multidimensional perspective that includes aspects of the stimulus (drug), organism (individual), response, and consequences. Our selective review of substance use and abuse among children and adolescents covers epidemiology (patterns and extent of drug use), etiology (what generates substance use), prevention (how to limit drug use), treatment (interventions with drug users), and consequences (effects and outcomes of youthful drug use). In this abbreviated review, we selectively examine the recent literature and current status of substance use and abuse among children and adolescents. Our focus is on psychoactive substances both licit and illicit, including cigarettes, alcohol, cannabis, cocaine, and other drugs. We examine the use and abuse of substances by children and teenagers from five perspectives: epidemiology, etiology, prevention, treatment, and consequences (see Rogers, 1987 , for additional overviews and references). The United States is a drug culture. Drugs are used commonly and acceptably to wake up in the morning (coffee or tea), get through the stresses of the day (cigarettes), and relax in the evening (alcohol). The Marlboro Man and the Virginia Slims woman are widely seen models, and licit drugs are pushed to remedy all of the ills one may face–stress, headaches, depression, physical illness, and so on. Children face a monumental task of sorting out the many images and messages regarding both licit and illicit drugs. Adolescents are quite adept at spotting hypocrisy and may have difficulty understanding a policy of "saying no to drugs" when suggested by a society that clearly says "yes" to the smorgasbord of drugs that are legal as well as the range of illicit drugs that are widely available and used. A few words are in order on the distinction between use and abuse of drugs. This differentiation is critical to such diverse topics as societal justification for limiting access to drugs (whether By legal or other means) or for considering psychological intervention.