peer 1 The American Nurses Association creates guidelines to foster a safe atmosphere for patients and medical personnel (ANA Principles, 2017). The ANA has established a list of principles, their definitions and guidelines on how to properly execute the principal. Following these principles, should yield your career to becoming a competent and compliant nurse who delivers excellent, moral care to each and every patient you encounter.
The principle of nursing documentation is a crucial component of the care we provide. “Clear, accurate, and accessible documentation is an essential element of safe, quality, evidence-based nursing practice” (ANA Principles, 2017). This principle is applied across all specialties and areas of nursing. Documentation holds each nurse responsible for their actions. We have all heard the expression “if you didn’t chart it, then it didn’t happen.” There are six essential principles further outlined to ensure proper nursing documentation that is to ANA standards.
Nursing documentation is used as a communication method between the health care team and other professionals. The six principles of nursing documentation are documentation characteristics, education and training, policies and procedures, protection systems, documentation entries, and standardized terminologies. These recommendations for nursing documentation apply to practicing registered nurses, employers and health care agencies, patients and consumers, health care systems, nursing education, and nursing research.
Nursing documentation should be accessible, accurate, consistent, concise, readable, timely, and reflective. Nurses should take into account education and training when forming documentation for patients. They must also remain competent to use the equipment provided for such documentation. A nurse must be familiar with organizational and state policies and procedures. Nurses must be aware of and utilize systems in place to protect patient information, maintain confidentiality and secure data. Documentation must be complete, accurate, authenticated, dated, and time stamped. All terminologies used must be standard and known across the nursing field.
I remember hearing about the miscarriage of justice that took place against Nurse Wubbels in real time. An officer was requesting a blood sample from Nurse Wubbels from a patient who had been in an accident. The hospital had a policy that had been agreed upon with the police precinct that the only three ways to allow a blood draw was with a warrant, patient consent, or intent to arrest, which in this case none of these were present. Nurse Wubbel had documentation in her hand that backed up the information she was the responding detective. As troubling as the situation was, i is more troubling that none of the other officers intervened.
Nurse Wubbel was doing her job. As a nurse, our job is to respect the autonomy, justice and beneficence for our patients. It is very easy to look at a situation and make judgements about who is in the wrong. However, in our field, that is not our job or our place. Nurse Wubbel was just trying to protect the integrity of the care that she was providing for her patient. That meant protecting him and his bodily fluids.
The position statement I have chosen is delegation. Delegation is a decision to assign a task to another person in the health care setting. This delegation is determined by the registered nurse and needs to be in the competence of the person assigned to this task. According to the American Nurses Association delegation is an essential nursing skill (Joint Statement, 2018). The American Nurses Association lists out guidelines for the delegation that must be followed for the task to be delegated. It is important for the registered nurse to take these criteria into consideration when delegating a task.
Based on the American Nurses Associations position statement the delegation process is multifaceted (Joint Statement, 2018). When choosing to delegate a task the registered nurse must take into consideration if the delegate is allowed to perform the skill, if additional training has been met, and if they are competent to carry out the task. There are five rights of delegations, The right task, the right circumstance, the right person, the right direction and communication, and the right supervision and evaluation (Joint Statement, 2005). These five rights must be met to determine if a task can be delegated. The nurse is still responsible for the outcome of the task but if these criteria are met then the task may be delegated if appropriate.
I believe that the delegation of tasks is an important aspect of nursing. Nurses are busy doing their jobs and others such as phlebotomy, housekeeping, dietary, and radiology just to name a few. Delegation allows nurses the flexibility of being able to assign tasks to nursing assistants. This has been helpful in my own practice when I have needed a blood sugar or set of vitals taken but I am busy dealing with an emergent situation. I do think that some nurses take advantage of the delegation system and will often delegate too much to nursing aids. In general, being able to delegate certain tasks has helped to improve nursing care and ease some of the workload nurses have.
While obeying the guidelines set by the American Nurses Association delegating tasks can help lessen the workload on the nurse. It is the responsibility of the nurse to do follow-ups to make sure tasks are done correctly and safely. Following the five rights of delegation can help ensure this. Providing feedback after the delegated task is completed can foster a positive work environment and allow for improvement if needed. Delegation can allow better patient outcomes and satisfaction when implemented correctly.
Ethical standards were violated in the above video. The nurse in question was doing her due diligence to her patient when apprehended by the police officer. Some of the ethical standards demonstrated in the video include autonomy, beneficence, justice, and nonmaleficence (Why Ethics, 2023). It is unethical to breach these principles when there are concerns, even if ordered by a public official.
Autonomy is an ethical principle that means the right to self-determination (Why Ethics, 2023). When a patient has autonomy, they are given adequate information from nurses to make informed decisions. It is as simple as a nurse administering medications, it is imperative to inform the patient of what medication is being administered and the side effects the medication may cause (Why Ethics, 2023). This is given the patient autonomy to choose if they want the medication. In this video, the patient’s autonomy was considered by the nurse. She was not able to draw the patient’s blood without the patient’s consent since he was unconscious.
Beneficence is the promotion of good (Why Ethics, 2023). Nurses can promote good by considering and putting the patient’s best interest at the forefront of treatment. A nurses own personal opinion does not weigh into the decisions being made but the focus is on solely the patient (Why Ethics, 2023). Beneficence can be seen in this video when the nurse was putting the patient’s own interest before the interest of the police officer. The police officer did not have a warrant or a doctor’s order for the patient’s blood to be drawn; he just wanted it to be taken. The nurse kept the interest of the patient first by refusing to draw the blood when a warrant was not in place.
Nonmaleficence is the minimization or avoidance of harm and ties into veracity (Why Ethics, 2023). Veracity is the nurse’s obligation to tell the truth. Veracity is in the American Nurses Associations’ code of ethics provision 4.2 (Werezak, 2022). In the video, the nurse displayed nonmaleficence by providing safe and effective care to the patient. This is because she deemed it unsafe and a breach of ethical principles to draw blood from the patient without consent. The nurse also demonstrated veracity by being truthful and following her hospital’s policy which clearly stated it was unethical to draw the patient’s blood without a court order.
Even though the nurse faced consequences for refusing the officer’s orders she followed ethical principles when caring for her patient. The nurse stood her ground and advocated for her patient even when faced with threats from the officer. Following the four ethical principles listed on the American Nurses Association website can help to ensure quality care is given to all patients. Nursing ethical principles serve as a moral compass for nurses. As this nurse displayed, she was firm in her stance to ethically protect her patient and to uphold him as an individual.