The Influence Of Consent In Nursing Practice
The purpose of this assignment is to discuss issues that influence nursing practice. The topic that has been chosen is consent and it will be discussed using both adult and child fields of nursing. The assignment will look into how consent has an impact on factors such as diversity and how they play an important role within both the child and adult nursing practice. It will also compare and contrast between the two fields and review why consent plays such a significant part throughout a nursing career. According to the Nursing and Midwifery Council code of conduct, (NMC, 2013), nurses must presume that patients are competent enough to make their own decisions regarding consent or refusal of treatment, unless they are unable to understand or
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retain information that has been given to them due to various reasons.
A children’s nurse has to maintain family centred care for the patient. Children may communicate in many different ways that a nurse may not understand depending on social and language skills and developmental issues (Chapter 21, N.D). As consent for a patient is something that may have to be given by a family member depending on each situation, so it is important to be able to communicate with the family or carers of the child. Although the law states that a parent or a person with parental responsibility has the responsibility to give consent, the Family Law Reform Act 1969 believes that minors aged 16 and 17 are competent enough to give consent for themselves (Cleaver and Webb, 2007). There are however, several reasons as to why this may not be possible such as a mental illness or a disability that prevents the patient from being able to provide consent for themselves.
Throughout a child nursing career, there will be occasions where time to gain consent will not be possible and if it is a procedure that could potentially save a child’s life then “emergency treatment can be provided without consent to save the life of, or prevent serious deterioration in the health of, a child or young person” (Patient.co.uk, 2011).
Parental rights automatically go to the mother of a child or young person and as from December 2003, if the parents are not married but the father has been named on the birth certificate then he too gets automatic parental responsibility (Gov.uk, 2014). It is important that a children’s nurse consults both parents when discussing a child’s needs as a conflict of interest could arise. Conflicts could appear for serval reasons including religious beliefs and treatment preferences, in which case the nurse would become an advocate and talk to all parties involved and try to come to an agreement regarding the patient, but most importantly not forgetting to include the patients themselves in the decision making (McQuaid, Huband and Parker, 1996).
To gain consent for any procedure that will be carried out on a child or young person, is a fundamental part of being a children’s nurse.
By communicating effectively with both the patient and their family, a trusting relationship will be built up and this will play a huge factor in gaining consent for future requirements. It is vital that a children’s nurse listens to not only the patient’s family but the patient themselves as they could prove to be Gillick competent. Gillick competency applies when a child or young person under the age of 16 are able to show a mature understanding of advice they are given by a professional and show to have capability to make decisions for themselves whilst understanding the possible consequences (nspcc, N.D). Child nurses have to be able to show an understanding of when they feel a younger patient is able to provide consent for themselves and be confident enough to put this decision forward to parents and other …show more content…
professionals.
Adult nurses have a slightly different role to that of a children’s nurse as they are to presume that the patients they are treating are capable of making decisions for themselves, including the consent and refusal of treatment. Adult nurses also have to understand that even though a patient may look old enough to be able to offer consent, various factors may arise which in fact show a lack of understanding from the patient. According to legislation.gov (N.D), The Mental Capacity Act 2005 states that until all steps have been covered to presume a decision can be made by the patient without effect, only then can they be deemed unable to make a decision and offer consent for themselves. This particular act gives adult nurses the chance to offer the patient different ways in which they can give consent before the decision is taken away from them.
Gaining consent as an adult nurse may seem straight forward as they are only dealing with one patient and one voice, however they still have to take into account a variety of diverse factors that could easily influence a patient’s choice. These factors could include religious beliefs of a patient that a nurse may not personally agree with or treatment being refused because of personal issues. Effective communication skills are a vital part of being an adult nurse as they may help a nurse understand a patient’s decision.
Every nurse has to undertake a minimum number of hours of work to be able to retain their nursing registration code. In order for his to be completed, guidelines and laws are in place for nurses to follow, such as gaining consent and maintaining confidentiality consistently throughout practice. If there is persistent failure to work within these guidelines, nurses should be able to justify particular actions they have carried out in order to protect their registration (GMC, 2015).
If an elderly patient tells a nurse that they no longer want to receive a particular treatment, it is within the nurse’s duty to be able to decide whether that patient is capable to make that decision. As adults are presumed to be competent enough, the nurse has to decide if they are mentally strong enough to make a choice like this and offer alternative treatments if possible. Throughout this process the nurse also has to remember to gain the advice of other professionals if they can but try not to influence the patient’s decision in any way. The nurse must also remember that they may have to explain how they reached such decisions of a patient being capable or not to agree or refuse consent.
There are many similarities between the two fields of adult and children’s nursing when it comes to gaining consent.
Both adult and child nurses have to gain consent prior to starting any treatment with a patient, however an obvious difference is where this consent comes from. Although it is acceptable to assume a patient over the age of 18 is able to make their own decision, nurses from both fields still have to be competent within their role to notice when a patient does not show a full understanding of what is being said to them. As a children’s nurse, gaining consent from a very young baby or child would have to be accepted from a parent or carer due to their obvious decisional incapacity (Glasper and Richardson, 2006). This plays a similar role to that of an adult nurse with an elderly patient. Just because they are over the age of 18 and have automatic rights to consent for themselves, this does not necessarily mean they are able to do so. They may have a disability or illness that makes them incapable of making such decisions and therefore require a family member or other professional to make that decision for them, as they would with a baby or young
child.
Another similarity comes from the nurse having to be an advocate to ensure the patient’s gets the correct treatment for them when consent can be conflicted between parents and family members. As a child’s nurse two parents may conflict and want different choices to be made for the child and an adult nurse may experience the same when a patient refuses a treatment but a family member thinks they should have it.
A final similarity is acts. Many acts can be used for both fields of nursing when it comes to professional values such as the mental capacity act and the human rights act. There are acts however, such as the children’s act which are specified for the child branch of nursing.
Consent as a whole plays a very important part in a nursing role regardless of whether they treat children or adults. Gaining consent in context is easy, however the nurse has a role to make sure that each patient and their family understands what the consent is for and has a duty to explain and answer questions should they arise. Many factors can influence the practice of a nurse, however consent is one that could potentially cause conflict between family members and possibly put a patient’s life in danger. It is therefore important that a nurse keeps their knowledge updated regarding current guidelines to help protect themselves and patients in the future.
retain information that has been given to them due to various reasons.
A children’s nurse has to maintain family centred care for the patient. Children may communicate in many different ways that a nurse may not understand depending on social and language skills and developmental issues (Chapter 21, N.D). As consent for a patient is something that may have to be given by a family member depending on each situation, so it is important to be able to communicate with the family or carers of the child. Although the law states that a parent or a person with parental responsibility has the responsibility to give consent, the Family Law Reform Act 1969 believes that minors aged 16 and 17 are competent enough to give consent for themselves (Cleaver and Webb, 2007). There are however, several reasons as to why this may not be possible such as a mental illness or a disability that prevents the patient from being able to provide consent for themselves.
Throughout a child nursing career, there will be occasions where time to gain consent will not be possible and if it is a procedure that could potentially save a child’s life then “emergency treatment can be provided without consent to save the life of, or prevent serious deterioration in the health of, a child or young person” (Patient.co.uk, 2011).
Parental rights automatically go to the mother of a child or young person and as from December 2003, if the parents are not married but the father has been named on the birth certificate then he too gets automatic parental responsibility (Gov.uk, 2014). It is important that a children’s nurse consults both parents when discussing a child’s needs as a conflict of interest could arise. Conflicts could appear for serval reasons including religious beliefs and treatment preferences, in which case the nurse would become an advocate and talk to all parties involved and try to come to an agreement regarding the patient, but most importantly not forgetting to include the patients themselves in the decision making (McQuaid, Huband and Parker, 1996).
To gain consent for any procedure that will be carried out on a child or young person, is a fundamental part of being a children’s nurse.
By communicating effectively with both the patient and their family, a trusting relationship will be built up and this will play a huge factor in gaining consent for future requirements. It is vital that a children’s nurse listens to not only the patient’s family but the patient themselves as they could prove to be Gillick competent. Gillick competency applies when a child or young person under the age of 16 are able to show a mature understanding of advice they are given by a professional and show to have capability to make decisions for themselves whilst understanding the possible consequences (nspcc, N.D). Child nurses have to be able to show an understanding of when they feel a younger patient is able to provide consent for themselves and be confident enough to put this decision forward to parents and other …show more content…
professionals.
Adult nurses have a slightly different role to that of a children’s nurse as they are to presume that the patients they are treating are capable of making decisions for themselves, including the consent and refusal of treatment. Adult nurses also have to understand that even though a patient may look old enough to be able to offer consent, various factors may arise which in fact show a lack of understanding from the patient. According to legislation.gov (N.D), The Mental Capacity Act 2005 states that until all steps have been covered to presume a decision can be made by the patient without effect, only then can they be deemed unable to make a decision and offer consent for themselves. This particular act gives adult nurses the chance to offer the patient different ways in which they can give consent before the decision is taken away from them.
Gaining consent as an adult nurse may seem straight forward as they are only dealing with one patient and one voice, however they still have to take into account a variety of diverse factors that could easily influence a patient’s choice. These factors could include religious beliefs of a patient that a nurse may not personally agree with or treatment being refused because of personal issues. Effective communication skills are a vital part of being an adult nurse as they may help a nurse understand a patient’s decision.
Every nurse has to undertake a minimum number of hours of work to be able to retain their nursing registration code. In order for his to be completed, guidelines and laws are in place for nurses to follow, such as gaining consent and maintaining confidentiality consistently throughout practice. If there is persistent failure to work within these guidelines, nurses should be able to justify particular actions they have carried out in order to protect their registration (GMC, 2015).
If an elderly patient tells a nurse that they no longer want to receive a particular treatment, it is within the nurse’s duty to be able to decide whether that patient is capable to make that decision. As adults are presumed to be competent enough, the nurse has to decide if they are mentally strong enough to make a choice like this and offer alternative treatments if possible. Throughout this process the nurse also has to remember to gain the advice of other professionals if they can but try not to influence the patient’s decision in any way. The nurse must also remember that they may have to explain how they reached such decisions of a patient being capable or not to agree or refuse consent.
There are many similarities between the two fields of adult and children’s nursing when it comes to gaining consent.
Both adult and child nurses have to gain consent prior to starting any treatment with a patient, however an obvious difference is where this consent comes from. Although it is acceptable to assume a patient over the age of 18 is able to make their own decision, nurses from both fields still have to be competent within their role to notice when a patient does not show a full understanding of what is being said to them. As a children’s nurse, gaining consent from a very young baby or child would have to be accepted from a parent or carer due to their obvious decisional incapacity (Glasper and Richardson, 2006). This plays a similar role to that of an adult nurse with an elderly patient. Just because they are over the age of 18 and have automatic rights to consent for themselves, this does not necessarily mean they are able to do so. They may have a disability or illness that makes them incapable of making such decisions and therefore require a family member or other professional to make that decision for them, as they would with a baby or young
child.
Another similarity comes from the nurse having to be an advocate to ensure the patient’s gets the correct treatment for them when consent can be conflicted between parents and family members. As a child’s nurse two parents may conflict and want different choices to be made for the child and an adult nurse may experience the same when a patient refuses a treatment but a family member thinks they should have it.
A final similarity is acts. Many acts can be used for both fields of nursing when it comes to professional values such as the mental capacity act and the human rights act. There are acts however, such as the children’s act which are specified for the child branch of nursing.
Consent as a whole plays a very important part in a nursing role regardless of whether they treat children or adults. Gaining consent in context is easy, however the nurse has a role to make sure that each patient and their family understands what the consent is for and has a duty to explain and answer questions should they arise. Many factors can influence the practice of a nurse, however consent is one that could potentially cause conflict between family members and possibly put a patient’s life in danger. It is therefore important that a nurse keeps their knowledge updated regarding current guidelines to help protect themselves and patients in the future.