Community Nursing Placement in Swinburne University Health Croydon

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Table of Contents

Introduction
My Role and how it is Community Nursing
Analysis of Role
Ethical Considerations
Conclusion
References

Introduction

Nurses are some of the key players in health care provision. The impact that they have to the health industry is monumental and the World Health Organization confirms that nurses make a substantial contribution to health-delivery systems all over the world (Lundy & Janes, 2009). One of the areas where nurses make a substantial contribution is in community nursing practice which is characterized by multiple roles. In the recent past, I did my clinical placement as a nurse in Swinburne University Health Croydon (facility). In this paper, I will provide a detailed reflection on my community nursing placement. I shall begin by demonstrating how my role was community nursing and explain the roles of the community nurse that I played during my experience. The paper will conclude by identifying some of the ethical and legal issues that did or may have affected my professional practice.

My Role and how it is Community Nursing

In my clinical placement, I was charged with fulfilling a number of varying roles which ranged from first aid management to consultation services. I also engaged in awareness programs to improve the present status of clients as well as encourage preventative health. Van Loon (2007) reveals that community nurses work in diverse community settings to meet a continuum of health needs. My role also focused primarily on the needs of the clients whose well being I viewed holistically. This is in line with the role of community nurses who promote health and intervention consciously centering on the client who is “viewed holistically; thus, care also considers the social conditions and relationships that affect an individual or a population’s health status” (Van Loon, 2007, p.315).

Analysis of Role

A community nurse should make use of opportunities presented to her to act as an advocate for social justice. Douglas et al. (2009) assert that the community nurse should apply principles of social justice as the guide in all decisions which relates to clients. The principle of social justice is based on the premise that everyone deserves to be treated with dignity no matter their race, economic status or creed. Social justice requires the nurse to act in an impartial manner and be fair and tolerant while at the same time showing respect for self and human dignity (Douglas et al., 2009). In my clinical placement at Swinburne University, I demonstrated impartiality when dealing with my clients who came from varied socio-economic status. Some where students while others were refugees who could not communicate well in English.

Australia is a multicultural country and community nurses need cultural competence because they make clinical decisions based on multiple social factors (van Loon & Carey, 2002). My clinical experience brought me to contact with clients of differing cultural backgrounds. This is because the Swinburne University Croydon Campus has international students who come from various cultures. Professional nurses need to have specific knowledge about culturally diverse individuals. This entails knowing about specific cultural practices, definitions and beliefs about health and illness (Leeder, 2003). In my placement, I took the time to listen to the thoughts of my clients regarding illnesses and other health issues that affected them.

Winsome and Keleher (2006) declare that health equity is central to the social model of health. This principle is grounded in distributive justice where “more access to more care for the same health problem than those with more money, better social support and better opportunities” (Braverman & Gruskin, 2003). By educating people on preventive health care services that are available to them, I was able to promote equity. Equity proposes that every person should have an opportunity to be healthy and it is need rather than privilege that should demand the resources allocated to the individual (Braverman & Tarimo, 2002). In my experience, I took more time with the clients who appeared to be more in need of my nursing services. By doing this, I promoted equity.

Access to health care resources is a major problem especially to people who have low social-economic-status. This group is more likely to elicit for curative health care services instead of preventive services. Building relationships and capacity in the community helps to facilitate access and equity (Diem & Moyer, 2004). My nursing experience involved numerous instances of consultations during which I build relationships with my clients. By demonstrating confidentiality, I was able to be of more use to my patients. Kuhse and Singer (2009) declare that in order for health care practitioners to do a good job for their patients they often require information of a sort that is generally regarded as private. Patients are unlikely to pass on such information without the assurances of confidentiality.

Ethical Considerations

While handling patients, nurses are constantly faced with ethical issues some of which may have some legal implications. One issue that nurses commonly face is with regard to respecting the autonomy of the patient. Kelly (2009) defines autonomy as the freedom by the patient to make decisions on issues concerning their health. This implies that the patient has a right to make choices about their health care. In my experience, I interacted with clients whose health care choices I felt were faulty. I therefore made attempts to influence the patients to make choices which I felt were better suited for them. My actions caused the patients to adopt better health services which were beneficial to them. Johnstone (2008) asserts that professional nursing ethics require nurses to protects and promote the interests and wellbeing of the people in their care.

Another issue that nurses face is maintaining confidentiality of the patient. The obligation of the nurse to maintain client’s confidentiality is one of the fundamental tenets of health care. Confidentiality is especially significant when dealing with youths and at risk groups. A nurse may at times be obliged to disclose information without the consent of the patient is necessary to prevent harm to others. The General Medical Council (2009) advices that personal information may be disclosed if this disclosure will help protect individuals or society from risks such as those posed by communicable diseases. If a patient has an STI and does not want to inform their sexual partner, the nurse is obliged to break confidence. Another instance when confidence can be broken is when the patient confides about violence being perpetrated against them. Even if the patient insists that the information be kept secret, it may be in the patient’s best interest that confidentiality be broken since it may assist in the prevention or prosecution of the individual who perpetrated the serious crime against the patient

Conclusion

In this paper I set out to provide a detailed reflection of my clinical placement experience. In particular, I have reviewed how the roles I played were those of a community nurse. I have also identified relevant ethical issues that may have an impact on nursing practice. Acting in a professional manner can help the nurse to deal with the issues that are encountered in the field.

References

Braverman, P. & Tarimo, E. (2002). “Social inequalities in health within countries: not only an issue for affluent nations”. Soc Sci Med, 54: 1621-1635.

Braverman, P. & Gruskin, S. (2003). “Defining equity and health”. J Epidemiol Community Health, 57: 254-258.

Diem, E. & Moyer, A. (2004). Community health nursing projects: making a difference. NY: Lippincott Williams & Wilkins.

Douglas, M.K. et al. (2009). “Standards of Practice for Culturally Competent Nursing Care: A Request for Comments”. Journal of Transcultural Nursing Volume, 20.

General Medical Council (2009). Confidentiality Guide.Web.

Johnstone, M. (2008). “Questioning Nursing Ethics (Ethics & Legal)”. Australian Nursing Journal, Vol 15. p. 19.

Kelly, P. (2009). Essentials of Nursing Leadership & Management. Michigan: Cengage Learning.

Kuhse, H. & Singer, P. (2009). A Companion to Bioethics. NJ: John Wiley and Sons.

Leeder, S.R. (2003). “Achieving equity in the Australian healthcare system”. MJA, 179 (9): 475-478.

Lundy, K.S. & Janes, S. (2009). Community health nursing: caring for the public’s health. Massachusetts: Jones & Bartlett Learning.

Van Loon, A.M. & Carey, L.B. (2002) Faith community nursing and health care chaplaincy in Australia: a new collaboration, in L.M. Vandecreek and S. Mooney (eds) Parish Nurses, Health Care Chaplains and Community Clergy: Navigating the Maze of Professional Relationships. NY: Haworth Press.

Van Loon, A. (2007). The changing professional role of community nurses. NJ: Blackwell Publishing.

Winsome, J. & Keleher, H. (2006). Community Nursing Practice: Theory, Skills and Issues. Auckland: Allen & Unwin.

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