Understanding Equality Diversity and Inclusion in Healthcare and Workplace Settings

1.1 Legal context of equality, diversity, and inclusion in adult care nursing

Equality means providing everyone in a care setting with equal opportunities, regardless of their abilities and lifestyles. Diversity is denied as the differences among people in terms of their lifestyle, cultural values, and beliefs. Inclusion is identified as an individual's experience within the workplace or healthcare settings.

According to Tayler, and Price (2016), nurses have duties that promote values of equality and diversity while they are interacting with patients. It is also applicable in case of conversation with families, careers, and peers. The legal context is associated with the Equality act 2010 and the Human rights act 1998. This helps in promoting people from various types of discrimination. The nurse's responsibility of promoting equality in adult health care is outlined in such acts (Stonehouse, 2021). It is identified as an offense for carers to discriminate between the patients. Equality should be established irrespective of gender, race, and age. The nurse needs to treat all colleagues and patients with respect and dignity. As a head nurse, I find that nurses are supposed to be recognizing discrimination wherever it is noticed and delivering high quality of care to the patients. Adult care nursing is accountable for the inclusion of all gender, races types of patient care. The care act 2014, mental capacity act 2015 is also concern with the management of dignity and care for vulnerable adults. Some other legislation is found out to be:

Sex discrimination act 1975 (healthknowledge.org.uk, 2021

NHS and community care act 1990

GSCC code of practice for social care workers

Care Standard act 2000

Equality and diversity are frequently used terms in nursing and healthcare. Nurses' professional standards, practices, and behaviors are associated with equality and diversity. According to the Equality Act, nurses are required to treat people as individuals. They should be deprived of making assumptions about a patient or colleague. Upholding the dignity of human rights is essential in nursing practices, which is a crucial consideration in education dissertation help related to healthcare. According to Gostin, and Wiley (2016), inequalities and discrimination suffered by staff members cause a lack of nursing to the patients. No equal distribution of pay and work duties are seen to be degrading the organizational culture of care. Enhancing the practices of organizational development is associated with the promotion of equality and diversion. Adults face severe health care issues due to age and they need to be ensured of proper care. An illness or stress should not occur to the patient due to discrimination. The adult care nurses are expected to uphold their responsibilities against any social and regional inadequacy. The care should be appropriate with vulnerable adults and nurses should not harm the patients in sexual, physical, or mental ways.

1.2 Models of practices associated with equality, diversity, and inclusion

Evolution has occurred over some time in the nursing profession. As explained by Willis et al. (2017), high levels of commitment to adult care and anti-social working hours are making the lives hard for carers. However, any social and occupational pressure should not harm the quality of care for patients. For equality, diversity, and inclusion to become part of healthcare each member needs to understand the worth of it. Being a head nurse, I have identified that inequalities in the workplace can be of direct and indirect types that occur within nursing professionals. In the healthcare sector, giving favorable choices to a particular group of patients and staff is not valued. Some models that are associated with adult care nursing in this domain are the Equal opportunity model and the difference & diversity model (Cloyes, 2016). According to the equal opportunities model, every person associated with adult care nursing requires to be treated with equal support and care. As a head nurse, any irrelevant criteria like eye color, sexism, and ethnicity should not become a barrier to quality promotion. According to this model, any such practices should be identified and it should be removed for promoting positive intervention.

Patients’ and fellow staff's disability and religious beliefs should not impact the process of care for nurses and it should not affect the health quality as well. There is a lack of research seen in older adult health. Sometimes nurses are mentally distressed and release their resentment against the older people they are caring for by tormenting them mentally and physically. This action is strictly prohibited in-laws and requires to be highlighted. The difference and diversity model states that each person is unique in his or her way (Walker, and Valentine, 1984). They should be valued for being empowered on their own. People with diverse cultural experiences and perspectives add value to the healthcare domain. In adult nursing, mentally vulnerable patients should be taken care of without any discrimination. Giving responses against any kind of prejudices are important. People that are bullied at work or become prey to negativity suffer mental illness and low self-esteem issues, which are covered by these models.

1.3 Potential effects of barriers to equality and inclusion in nursing

Barriers to promote equality and inclusion in nursing are as follows:

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Personal: The barrier is related to having different personalities among individuals. Lack of self-esteem and poor communication skills are becoming a barrier in the inclusion of nursing equality and diversity. Depending on the way staff treat each other the discrimination can be discussed.

Lack of flexible work practice: Lack of flexibility in working hours is creating a differentiation between adult carers (Salvucci, and Lawless, 2016). Lack of fair pay structure creates a mental dilemma for all the people working inside the organization.

Lack of leaders and culture: Staff members are not given enough training on inclusion criteria in adult care. Lack of inclusion from higher authority and community of care staff is becoming a barrier to inclusion and diversity. Staff from different cultural backgrounds is not welcomed with a warm heart in healthcare and I have come across such incidents while performing the duty of nurse.

The societal expectation of gender roles: The gender roles are changing and women are not just managing the household work and childcare. They are focused on nursing work irrespective of anti-social working hours and critical work conditions. There are threats of being affected with deadly viruses as well. Hence, the lack of women leaders in adult care nursing promotes gender bias. Sexism and gender stereotypes are leaving a negative impact on people (Yanicki, Kushner, and Reutter, 2015).

Lack of investment in healthcare equality: Promoting healthcare is largely associated with investments. There are lesser campaigns and efforts are seen from the NHS that promotes healthcare equality, diversity, and inclusion. Merely producing some laws is not enough yet as considering them for action is required.

Communication: Accent biases among the people of healthcare are becoming a threat to the patients. "A barrier to Black African‐born nurses seeking managerial and faculty positions in the United States" has been spotted many times (Iheduru‐Anderson, 2020). This is causing many talents to remain undiscovered and many patients from getting their desired help. This barrier of language also incorporates racism in adult healthcare. "Many staff feels that they do not have adequate time to perform the tasks detailed in the individual's care plan" and they may have to rush some activities due to further commitments.

1.4 Ethical dilemmas on balancing individual rights and duty of care

From a health and safety perspective, individuals need to balance their rights and duty of care. For example, stopping a caring staff from treating a wound of a patient can be considered. Different people follow different rules of dressing. Now, asking a person to perform in someone's way is not accepted. As a head nurse, I think speaking to individuals within a healthcare domain in the calmest state is identified as one of the best ways to manage conflicts and dilemmas. A dilemma arises when a person's choice of action prevents the selection of others. Best interest decisions are made based upon overpowering a caring staff that cannot make its own decision. For a balanced relationship, it is important to construct healthy relationships with fellow staff. Effective risk management and promoting person-centered care safety has become essential to process duty of care (Rainer, Schneider, and Lorenz, 2018). For example, if a patient refuses to take medications on time then it becomes the duty of the nurse to make the patient understand the importance of taking medication. As an individual, it is right for the patient to refuse any food or medication. However, understanding the consequences and not allowing such requests become a duty of care in adult healthcare.

A service user has definite rights of smoking and they might ask for one. However, as a professional nurse in adult care, it becomes important that the person understands the duty of care and does not allow the person to smoke. Analyzing the consequences which might occur to the service user should be analyzed by the care staff at first. An area can be settled up for the service used for smoking, after analyzing the risk factors (Ganz, Wagner, and Toren, 2015). Now, as the conflicts are clear, it is important to understand how complaints can be responded to. Getting angry or making an excuse is never the solution and it only ends up generating concern for the staff member. Reassuring the person that is willing to do some work effortlessly, becomes important in professional development. Environments should be created that safeguards the adults with a high risk of vulnerability. Confidentiality and disclosure are important as a head nurse, I have to abide by the data protection act. I must be responsible for any person under me for breaching this act.

1.5 Principle of informed choice

Definition of informed choice is identified concerning the decision maker's values that are behaviorally implemented. In healthcare, informed decisions are taken to manage the individual beliefs and a patient is given full information on inclusions of treatment. Any reasonable alternative along with benefits and risks are to be highlighted. Following information needs to be followed for screening of patient such as:

Purpose of screening

Likelihood of positive and negative findings and the possibility of results

Significant medical, social and financial screening of a condition

Following plans and support services

Uncertainties or identified risks attached to the process

The problem in informed choice is that participating in screening programs is not being done effortlessly. It claims to help in the effective reduction of mortality rates. Any potential harms are prevented from generation along with analysis of follow-up tests. Population-level benefits and cost-effectiveness are maximizing participation (McCaffery et al. 2016). Hence, the solution is to engage in consultation with the informed public in the health care domain. Informed consent helps in the essential alignment of services and reduces any inefficiencies of work. Balanced information manages the perception of harms and benefits. Changing public information might increase participation in more affluent groups (healthknowledge.org.uk, 2021). "Existing information about most screening programs may overemphasize the benefits and the impact on informed choices”. Furthermore, it can be explained that informed choices are identified as a dimension of screening program evaluation. Increases in informed choices are expected to lead towards a better "benefit: harm ratio". However, there is a lack of everyday advocates for inclusive care. Existing literature and surveys are not focused on statistics and the provision of long-term services for older adults (Grady, 2015). Lesbians, bisexual adults need care with equal respect and dignity. Similarly, the care staff irrespective of their gender choices should get respect from patients. The equation should be positively drawn by both parties and informed choices should be made.

mpact of legislation and policy initiatives on the promotion of equality and diversity inclusion

As a head nurse, I am responsible for my development and providing adequate training to other fellow nurses. In addition to meeting the higher authority regarding promotions of quality, it becomes my responsibility to provide the staff with information on issues. Some policies and procedures can be explained as:

Health and social care act 2008: This establishment of the act provides the people the right to quality healthcare. The protection and promotion of social services by staff members are explained (Lymbery, and Postle, 2015).

Codes of practice: General Social Care Council (GSCC) is identified to hold the responsibility of managing the care services. Standards are ensured for protecting and promoting care services among adults.

Equality Act 2010: It asks all nursing staff not to judge people on protected characteristics like age, sexual orientation, race, gender reassignment, and disability.

Promotion of equality, diversity, and inclusion as a head nurse, can be done in the following ways:

Dignity and respect: There should be respect promoted on the development of individual privacy and dignity as a nurse. Service users are supposed to be handled with a non-judgmental attitude.

Embracing difference: Improvement of patient care methods and retaining staff has been essential in the promotion of healthcare equality, diversity, and inclusion.

Valuing the contribution:

Individual contributions made towards the creation of a sustainable and a diverse environment for service users is important. It can be promoted at the individual level by offering online classes and training sessions on workplace equality in adult healthcare (Simonsen et al. 2017).

Information and communication: Breaking the stereotypes in gender-specific roles can be done with adequate communication and information sharing between the nurses.

Some challenges faced while implementing equality in adult healthcare are as follows:

Equipping each individual with training, standards for recognizing healthcare particulars

Creation of culture for promoting inclusion

Service users and families are engaged in shaping the future support

Impact on inclusion helps in feeling accepted inside the healthcare profession. Moreover, diversity helps to create a team of nurses that have strong opinions to treat patients in critical conditions.

Issues of individual capacity affecting informed choices

Individual consent is considered to be valid only if it is voluntary and informed. Moreover, the concerned person has to be in a mental state of making decisions. The Mental capacity act of 2005 can be primarily focused to provide a legal framework, which allows making decisions on behalf of adults that are unable to do so. Informed choices are two other types like voluntary and informed. The consent of voluntary treatment is made alone without any support from medical staff and family (Greenhalgh et al. 2015). On the other hand, the person is given full information on what the treatment is. Now, the act codifies decision-making processes "regarding the management of those who" because of a lack of capacity" are unable to make decisions for themselves". An incompetent person can take a wrong treatment decision and hence questions the capacity of informed choices. A person is identified to be taking an adequate decision until they can perform the actions:

A person, unless certified to be incompetent should have the rights to tackle decisions

A decision can be taken on behalf of a person with disabilities based on the best choices of decision-maker

A person should be treated effectively even if there is the identification of a lack of decision-making criteria

Analysis of systems and process promoting equality and inclusion

Systems and processes that promote equality and inclusion have to be in a documented format. As a nurse, it becomes a main area of responsibility to look for the policies that promote a code of practices. Reinforcement of legislative practices for managing discrimination requires to be dealt with correct way. Code of practices and statutory framework is applicable for the treatment of quality and inclusion issues. According to Mor Barak et al. (2016), discrimination for a certain group of workers required to be strictly prohibited. Some policies lead to discrimination unwillingly to a set of people. Conducting surveys on whether the service users are gaining an equal advantage or not can be helpful. Taking interviews of healthcare staff in adult health care settings might eliminate institutional discrimination. Systematic update taking from staff on equal rights and opportunities is important for effective management of this process. The creation of an action plan for promoting communication of staff has become easier. Identification of departments from where the maximum discrimination complaints are coming from is required. Key management of the approach on the participation of equal rights programs for all can be taken. Current practices are associated with a staff's self-esteem and it is important to promote inclusion as per the human rights law. In the current setting, as a head nurse, I must ensure that all staff is participating in the self-evaluation process.

Effectiveness of policies and practices for promoting equality and diversity

The effectiveness of policies and practices for promoting equality and diversity can be evaluated in terms of how well the practices are considered in action by leaders. A person with a protected characteristic has to be evaluated in terms of getting equal rights. The effectiveness of policies underlies the promotion of cross-cultural communication skills in a diverse workplace. Having clear and concise communication with coworkers and managers creates equal opportunities in the workplace (equalityhumanrights.com, 2021). Some of the certain occurrences of events are evaluated that helps in reinforcing equality such as:

Identification and prevention of conscious bias: Some organizations conduct an Implicit Association Test, which helps to pay attention to protected characteristics such as age, race, and gender.

Equality policies in action: Work-related decisions like nursing training, allocation of work, recruitment, payment, and promotion embrace people's differences.

Selective use of language: Checking out that all communications are “free of discriminatory and sexist practices” can promote equality. Any stereotyping comments should be mitigated and checked.

Looking for indirect discrimination:

It is important to ensure that “company policies do not inadvertently put working groups to disadvantage”. Favoring a particular religion or group needs to be stopped.

While the code of the practices is applied, individuals inside the organization feel safe and they feel protected (Stonehouse, 2021). Gender, religion, and sexual orientation left an impact on the adult healthcare staff morale. It also affects the service provided to service users directly and hence, it becomes a matter of concern to follow equality legislations.

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References

Books

Gostin, L.O. and Wiley, L.F., 2016. Public health law: power, duty, restraint. Univ of California Press.

Lymbery, M. and Postle, K., 2015. Social Work and the Transformation of Adult Social Care: Perpetuating a Distorted Vision?. Policy Press.

Tayler, K. and Price, D., 2016. Gender diversity and inclusion in early years education. Routledge.

Journals

Cloyes, K.G., 2016. The silence of our science: Nursing research on LGBT older adult health. Research in Gerontological Nursing, 9(2), pp.92-104.

Ganz, F.D., Wagner, N. and Toren, O., 2015. Nurse middle manager ethical dilemmas and moral distress. Nursing Ethics, 22(1), pp.43-51.

Grady, C., 2015. Enduring and emerging challenges of informed consent. New England Journal of Medicine, 372(9), pp.855-862.

Greenhalgh, T., Snow, R., Ryan, S., Rees, S. and Salisbury, H., 2015. Six ‘biases’ against patients and carers in evidence-based medicine. BMC medicine, 13(1), pp.1-11.

Iheduru‐Anderson, K., 2020. Accent bias: A barrier to Black African‐born nurses seeking managerial and faculty positions in the United States. Nursing Inquiry, 27(4), p.e12355.

McCaffery, K.J., Jansen, J., Scherer, L.D., Thornton, H., Hersch, J., Carter, S.M., Barratt, A., Sheridan, S., Moynihan, R., Waller, J. and Brodersen, J., 2016. Walking the tightrope: communicating overdiagnosis in modern healthcare. Bmj, 352.

Mor Barak, M.E., Lizano, E.L., Kim, A., Duan, L., Rhee, M.K., Hsiao, H.Y. and Brimhall, K.C., 2016. The promise of diversity management for climate of inclusion: A state-of-the-art review and meta-analysis. Human Service Organizations: Management, Leadership & Governance, 40(4), pp.305-333.

Rainer, J., Schneider, J.K. and Lorenz, R.A., 2018. Ethical dilemmas in nursing: An integrative review. Journal of clinical nursing, 27(19-20), pp.3446-3461.

Salvucci, C. and Lawless, C.A., 2016. NURSING FACULTY DIVERSITY: BARRIERS AND PERCEPTIONS ON RECRUITMENT, HIRING AND RETENTION. Journal of Cultural Diversity, 23(2).

Simonsen, S.E., Ralls, B., Guymon, A., Garrett, T., Eisenman, P., Villalta, J., Tavake-Pasi, O.F., Mukundente, V., Davis, F.A., Digre, K. and Hayes, S., 2017. Addressing health disparities from within the community: community-based participatory research and community health worker policy initiatives using a gender-based approach. Women's Health Issues, 27, pp.S46-S53.

Stonehouse, D.P., 2021. Understanding nurses' responsibilities in promoting equality and diversity. Nursing Standard (Royal College of Nursing (Great Britain): 1987).

Walker, T.D. and Valentine, J.W., 1984. Equilibrium models of evolutionary species diversity and the number of empty niches. The American Naturalist, 124(6), pp.887-899.

Willis, P., Raithby, M., Maegusuku-Hewett, T. and Miles, P., 2017. ‘Everyday advocates’ for inclusive care? perspectives on enhancing the provision of long-term care services for older lesbian, gay and bisexual adults in wales. The British Journal of Social Work, 47(2), pp.409-426.

Yanicki, S.M., Kushner, K.E. and Reutter, L., 2015. Social inclusion/exclusion as matters of social (in) justice: a call for nursing action. Nursing Inquiry, 22(2), pp.121-133.

Website

equalityhumanrights.com, 2021. Available at: [Accessed on 12/06/2021]

healthknowledge.org.uk, 2021. Available at: [Accessed on 12/06/2021]