Confidentiality In Care

Mr. J is a 65 years old Caucasian male. A pretentious name is used in this study in compliance with (NMC) Code of Practice (2015) and competency 8, domain 2 of the NMC standard (2010). The Code of Practice was specific about the legal and professional responsibility of nurses in regards to maintaining patients’ privacy and their confidentiality. The NMC competency states that nurses must respect patients’ right to confidentiality regardless of race or creed. The issue of privacy and confidentiality is also enshrined in the legislation by the Parliament with two laws called the Data Protection Act (1998) and the Human Right Act (1998).
Mr. J was handed over as an acutely ill patient with morbidly obese occasioned by type 2 diabetes Morbid
obesity is a medical term describing people who have a BMI of 40, or of 35 to 40, with significant medical complications caused by or made worse by their weight (Public Health England Obesity, 2014) . BMI of 40 amounts to approximately 100 pounds above ideal weight. He also suffers from hypothyroidism and refractive error in both eyes, caused by myopia. He had undergone bariatric surgery before this admission to the Community Urgent and Intermediate Care Unit. Bariatric surgery is a weight loss surgical procedure offered for patients with type 2 diabetes (National Institute for Health and Care Excellence, NICE, 2015). Due to all of the above co-morbidity, it was agreed with Mr. J’s consent to move him home where he will receive the same level and quality of care in the community as he would in the hospital. Moreover, he has the opportunity to use the Community Urgent and Intermediate Care Unit whenever.
Mr. J was a manager of a food processing plant before he became too ill. He subsequently took early retirement. His wife is a nursery school assistant and both have 2 children between them. Mr. J had recently become a grandfather. His prognosis dated back to 13 years. His lifestyle was not helping either. He was heavily dependent on alcohol and became non-compliant with treatment.
Living with diabetes had left its mark on him. He is also severely depressed. Depression is considered to be one of the most common psychological conditions in the normal course of life which leads to enormous losses and disappointments (Dhara & Jogsan, 2013). It varies from simple mood swings to severe affective disorder (Dhara & Jogsan, 2013). People who are diagnosed with a chronic physical health problem such as diabetes are 3 times more likely to be diagnosed with depression than people without it (NICE, 2009). And it has been considered as the most common psychiatric disorder witnessed among diabetes sufferers (McManus et al, 2009; Eva O Melin et al, 2014; Lesley Lowe et al, 2014). Due to his mental state, Mr. J was neglect if his personal care, always giving excuses of feeling unwell.

ESSENCE OF GOOD COMMUNICATION AND INTERPERSONAL RELATIONSHIP IN CARING FOR ACUTELY ILL PATIENT
The NHS Trust Protocol on acutely ill patients is very specifics in what are expected of the care team.
NICE (2007) guideline on acutely ill patient states among others that patient’s physiological observations should be recorded at the time of their admission or initial assessment. A clear written monitoring plan that specifies which physiological observations should be recorded and how often it is recorded should be outlined in a care plan. Before any of such intervention is carried out, Mr. J’s consent has to be sorted (NMC, 2015). Together with the Mental Capacity Act (2005) and Human Tissue Act (2004), it is a legal and professional requirement of any healthcare practitioner to seek consent of patient. On the contrary, where and when the patient lack the capacity to consent, health practitioners are to act in the best interest of the patient (Department Of Health,
2009).
Having been assigned to care for Mr. J, he was approached and introduces self as a student nurse (NMC, 2010) Professional Guidance for Student Nurses. He was asked how he wanted to be addressed, this in line with competency 1, domain 2 of NMC (2010) which addresses the issue of individuality of care. The name he gave was exactly as written in all of his medical notes. Addressing patients by their preferred name is an important aspect of care (NICE, 2012) and this was the beginning of the partnerships and therapeutic relationships through communication (Peplau, 1997), as outlined in domain 2, competency 1of the NMC Standard (2010). Been a peculiar patient, Mr. J was adequately engaged in conversation in a friendly and appropriate manner. Active listening skills were employed in dealing with Mr. J as outlined in the NMC competency. Considering his failing sight, his capability to read is diminished. A care plan with Mr. J’s consent was developed to get him to start a course on the use of the braille in concordance with competency 1 of domain 2 of NMC (2010) which stipulates that care must be individualised, and competency 8 of same domain which stipulates patients right to confidentiality. Mr. J was glad when this was suggested. The course is run by The Speech and Language Therapist and The Royal National Institute of Blind People (RNIB).

Effective Communication in Nursing.

The positive results of effective communication in adult nursing as stipulated by domain 1, competency 2 of NMC (2010) are well documented and are essential in achieving, amongst others, increased recovery rates, a sense of safety and protection, improved levels of patient satisfaction and greater adherence to treatment options (Leonard, et al., .
Aside from these, successful communication through a patient-centred approach also serves to reassure relatives that their loved ones are receiving the necessary treatment. Within the nursing field, good communication and interpersonal relationship are considered indicative of best practice (McCabe and Timmins,
2006).