NMC Code and Compassionate Nursing

Introduction

The nurses have the key duty of assessing and planning care for the service users to ensure their effective health and well-being. They also have the role to manage records, monitor patient’s health, administer medication, supervise care and others. The NMC Code of Conduct is developed to mention series of statement and guidance to be followed by the nurses while offering care to the service users so that professionalism and safety are maintained along with high-quality care can be provided. In this assignment, a brief explanation of NMC Code of Conduct is to be mentioned and one aspect of the code that is "Preserve Safety" is to be explained in detail to assist the nurses to understand the guidance to be followed to ensure the safety of the patients during care. The Egan Soler’s Model of Communication is to be discussed with focus on one of the aspects of the model to inform the way it can be used to build proper communication with the service users. The value-based approach in nursing is also to be discussed and the way compassionate care is to be provided to the patients is to be explained. Moreover, the reason behind care to be compassionate is to be mentioned along with its importance for service users.

Explaining the NMC Code

The NMC Code of Conduct informs the professional standards which are to be followed by the midwives, nurses and nursing associates to remain registered to practice within the UK. The code is structured around four themes which are prioritise people, practice effectively, preserve the safety and promote professionalism and trust. The code is developed through collaboration with various professionals and is ensured to be followed by the nurses so that professionalism is maintained. In case the code is violated, the nurses, nursing associates and midwives are to experience questions regarding their actions (NMC, 2018). The first theme of the code is "Prioritise people" which informs that nurses are required to consider the interest of the service users at first while planning their care. It also informs that the nurses are to make sure that the patient's care and safety are one of their main concern as well as dignity and needs of the patients are assessed, recognised and responded in an effective manner. The nurses according to "Prioritise people" are to behave a non-discriminated manner while offering care to people who are challenged (NMC, 2018).

The second theme of NMC Code is “Practise effectively” in which the nurses are to assess needs as well as demands of the services or provide them advice regarding their treatment or offer them assistance without delay to the best of their ability to ensure their well-being. The nurses are to communicate in an effective manner by keeping accurate records of the patients and need to have appropriate knowledge in delivering proper care (NMC, 2018). The third theme is “Preserve safety” which informs that nurses are to make sure the safety of the patient and public are not negatively affected in any condition. The nurses are to make sure they have proper information about the limits to be maintained and disciplinary steps to be taken to protect the safety of the service users (NMC, 2018). The fourth theme is “Promote professionalism and trust” informs that nurses are to show personal commitment to follow standards and behaviour of practice mentioned in the code. This is because it would lead the patients to develop trust and confidence in the nurses while receiving care from them (NMC, 2018).

Explanation of one aspect of NMC Code

The word preserve means to maintain something in proper state and the word “safety” means protection from any form of risk, danger or injury. The “Preserve safety” theme is to be followed so that the nurses are able to take appropriate and necessary actions in protecting the service users from any nature of harm or abuse. In order to “Preserve safety”, the nurses along with nursing associates and midwives are to identify and work in their limit of competence, provide timely referral and accomplish proper training to execute a specific role (NMC, 2018). As mentioned by de Holanda et al. (2015), the nurses require to work within the limit of their competence so that proper care is provided to the patients that respect diverse beliefs, values and behaviour of the patients. This is because competence indicates the core abilities of the nurses which they have to fulfil their duties. As argued by Fida et al. (2016), nurses who work beyond their competence and do not take training to improve their competence regarding special role often develop errors in care which negatively affects the service user's health. This is because they do have proper expertise and added abilities to provide the care they are intended to deliver in turn providing wrong services.

The "Preserve safety" informs the nurse that they are to develop open and candid communication with all service users regarding all aspects of care as well as treatment and take prompt actions to resolve any mistake or harm that has occurred (NMC, 2018). As mentioned by Garrett Jr (2016), development of effective and candid communication with the services users leads the nurses to get easily informed about the risk or harm feared to be faced by the patients. This is because effective interaction in a candid way makes the service users develop ease to inform their fear and needs, in turn, helping the nurses take effective actions against the mentioned harm that could take place to ensure safety of the patients. The “Preserve safety” informs that nurses are to take immediate action within their competence and knowledge in case of emergency and take personal account of own safety along with others (NMC, 2018). As argued by Knutsson et al. (2017), inability to take proper emergency actions in case of harm towards the patients makes the service users unable to be protected from negative consequences and harm towards their health. This is because the factor or aspects which are intended to cause harm cannot be avoided. Therefore, necessary prompt actions within competency of the nurses ensure safety of the patients as proper authorities and services are able to be engaged in reducing or avoiding the harmful factor or aspects that are posing risk of safety for the patient.

The "Preserve safety" theme of the NMC Code mentions that nurses are to raise concerns if they think that any patient is vulnerable or is intended to be harmful and require additional protection and support. In order to execute this role, nurses are required to take reasonable steps and share information regarding the vulnerable patient with proper authorities. It is to be executed by following the relevant laws and policies (NMC, 2018). As commented by dos Santos et al. (2016), use of proper policies and laws are to be made in protection of vulnerable patients so that they remain legally protected and individuals who are causing them harm can be punished by the law. This informs that safety of patients is able to be ensured by following the laws. For example, nurses working in the mental health ward required to have proper information regarding the Health and Safety Act 2008, Mental Health Act 2017, Safeguarding Adults Act 2006 and others to be able to take proper legal action in protecting the safety of the mentally-ill patients. In addition, the nurses are required knowing the way police and social care workers along with other authorities to be involved when a mentally-ill patient reports they are experiencing harm or abuse from others.

The "Preserve safety" also informs that medication and treatment are to be provided by nurses within their competence and limits of training as well as considering the guidance mentioned in the laws (NMC, 2018). This is because hindered way of delivering medication and treatment by nurses due to lack of knowledge creates risk for the patient's health which in turn disrupts their safety. The "Preserve safety" mentions that the nurses are to be aware and reduce the probability of any possible harm towards the patients in practice by ensuring them they have proper knowledge regarding developments in nursing (NMC, 2018). This is because improved knowledge would lead the nurses to lower their mistakes in care delivery, in turn, ensuring better care and safe healthcare services to the patients.

Egan’s Soler Model of Communication

The Egan SOLER Model is a nature non-verbal communication model in which different skills are mentioned that are to be followed to become a good listener to effectively communicate with individuals. As asserted by Kay (2018), SOLER model is used for clinical counselling and in nursing practices to develop proper baseline for effective listening. This is because the model mentions the key body language to be maintained so that the individuals with whom the communication is being established feel dignified and cared. The key aspects of the Egan SOLER Model of Communication are face squarely (S), maintaining open body posture (O), leaning forward (L), maintaining eye contact (E) and relaxing (R).

The sit squarely informs that the person listening is to sit in a way so that they face the individual who is interacting. This is because it helps the individual interact directly sees the face of the person as well as let the person listening to ensure that they are paying attention to the details (Moorley et al. 2019). The open posture during communication indicates that the person involved in listening during the interaction is face forward to the individual communicating with hands present apart on the arm of the chair. This posture is essential in non-verbal communication as it indicates readiness and interest of a person to listen to the individual trying to communicate (Kay, 2018). The leaning forward informs that the person listening is to be lean towards the face of the individual interacting to indicate their strong sign of interest (Kay, 2018).

The direct eye contact during communication indicates that the person is listening with focus and attention. Thus, maintaining direct eye contact is regarded to have great social influence on the individual interacting to inform detailed information as they feel valued (Kay, 2018). The relaxing posture indicates that the person listening required remaining calm to understand the details mentioned by the other individual communicating. This is because showing fidget indicates that the person is not focussed on listening (Tevendale, 2015). One of the limitations to be faced while using this model is that in few cultures maintaining direct eye contact with adult individuals while interacting is regarded as rude (Le, 2017). Thus, in this condition following the communication model may lead nurses and midwives to face issues with developing proper interaction.

Explaining impact of one aspect of Egan SOLER Model

One of the key aspects to be followed in making effective non-verbal communication according to Egan SOLER Model is maintaining direct eye contact. As mentioned by Ivey and Daniels (2016), direct look during conversation into the eye of the individual interacting makes them feel they have a proper audience who care about the feelings and thoughts being expressed by them. This mentions that maintaining direct eye contact with patients in the nursing field would lead the nurses to inform the patients that they are acting as a proper audience to capture and listen to whatever information is being shared by them. As argued by Lukmanulhakim and Anna (2016), lack of feeling of the person interacting that the audience is not properly listening to them makes them feel demotivated to reveal further details and continue the interaction. This is because they feel lack of value as no one is paying attention to their details. Therefore, direct eye contact as mentioned in SOLER model is essential to be followed by the nurses to make them show that they are interested in listening to details of the service users. Moreover, this creates an effective bond between the speaker that is the service users and the listener that is the nurses leading to help the professionals face less hindrance in providing services.

The direct eye contact in communication is significant because it informs that the listener is showing concentration on the message being mentioned by the speaker (Thodberg et al. 2016). The nurses when becomes the speaker require to ensure they maintain direct eye contact with the patient who acting as the listener to understand whether or not they are paying concentration to their information. This is because if the patients are not paying concentration to the information mentioned by the nurses then they would show slump behaviour and avoid making eye contact with them (Abraham et al. 2016). In this condition, the nurses would be able to aware what changes in communication are to be made so that the concentration of the service users can be achieved and they maintain direct eye contact with them. As commented by Kee et al. (2018), lack of eye contact during communication leads the speaker unable to understand what the listener already knew and may lead the speaker to undermine what they are expressing. This informs that when direct eye contact is not made during communication between nurses and patients, the nurses are unable to understand what is already known by the patients making them at times undermine the saying of the patients.

The nurses while communicating with the patients requires ensuring they do not stare at the patients but maintaining good eye contact with proper facial expression (Elliott et al. 2016). This is because staring at the service users may make them feel insecure and uncomfortable out of fear that the person they are interacting with is rude and anxious. As mentioned by Henderson et al. (2016), maintaining good eye contact in a polite manner leads the service users reveal their intricate details. This is because they feel ease in interacting with the nurses. The good eye contact is required to be maintained by the nurses with the patients so that through effective interaction they are able to make the patients comply with the treatment and avoid showing fewer tantrums in accepting care (Krupic et al. 2016). As argued by Isobel and Delgado (2018), in Asian culture nurses maintaining direct eye contact with the patients who are older indicates being rude. This is because it indicates that the nurses are showing authority over the patients and they are not respecting the people according to their age. However, in Western culture, direct eye contact by the nurses is regarded as showing concentration towards the information mentioned by the speaker. This informs that the nurses require ensuring which patient belongs from which culture before maintaining direct eye contact with them during interaction so that alternative actions can be taken to ensure attention towards the speaker who is the patients is provided.

Discussion of the value-based approach in nursing

In nursing, the value-based approach includes taking into account the evidence base in delivering treatment and considering value of the service users during decision-making in providing care. It indicates that value-based approach acts as a theory which helps the nurses to make proper decision regarding care by offering them skill as well as tools for evoking individual values and to negotiate with the values of the service users with the best evidence available. This nature of approach is effective in mental healthcare as it helps the nurses develop proper interpersonal relationships between them and the patients (Traynor et al. 2017). The central idea of the value-based approach is that any decisions are made by the use of both values as well as facts. However, in case sets of values are being shared, their presence is unnoticed and in case they are regarded as constant parameters in process of the care decision-making them the lack of their recognition in care is going to impact on the outcome (Nilsson et al. 2017).

The value-based approach in nursing offers skill-based approach to help the nurses link scientific knowledge from evidence gathered to the needs, wishes and expectations that are the values of individual patients faced in providing clinical care (Ghadirian et al. 2018). The principle of the value-based approach is developing shared care decision by involving the patients, their family members and the healthcare practitioners (Moss et al. 2016). This indicates that in this approach priority in making care decision are provided to the health professionals and patients as both of the individuals values are considered in planning care. In this approach, the values of the patients can be identified by developing proper analysis and paying attention to the information shared and language used by the patients (Ghadirian et al. 2018). This is because while interacting and sharing information the patients mention the needs, demands and expectations they are wished to have while availing care. The conflict which arises in value-based care in nursing is resolved through mutual interaction where balance between perspectives and thoughts shared by patients and professionals are reached (Salmond and Echevarria, 2017).

Discussion of the importance of compassionate care in nursing

The compassionate care is referred to the care which is provided to the patients by considering their emotions and clinical condition to show commitment to improving the health of the patients (Blomberg et al. 2016). The compassionate care is to be provided to the patients by practising good manners, expressing personal interest, taking time to consider the feelings of the service users, acknowledging the thoughts of the service users and availing time to care for the emotional needs of the patients (Henderson and Jones, 2017). For instance, a patient was found to be suffering from stage II lung cancer. The patient often expressed pain and suffering from the terminally-ill condition and expressed lack of zeal to live out of the extreme pain felt during chemotherapy provide to the individual to treat for cancer. The patient often behaved in an improper way with the nurses and expressed unnecessary anger at the nurses as well as showed tantrums to accept care.

The nurses to provide care to this patient suffering from stage II ling cancer they tried at first to always maintain good manner irrespective of the behaviour expressed by the individual. As mentioned by Hercbergs et al. (2015), maintaining good manners while providing care makes the nurses show respect and uphold the dignity of the service users. This leads the nurses to offer compassionate care as compassion means showing concern and nurses do express their concern of maintaining good manner towards the patients irrespective of their behaviour that may have been negatively influenced by their diseased state. Thus, nurses irrespective of the rude and angry behaviour of the patients always showed good manner as they know the patient is disturbed by their health condition in turn showing compassionate care. As argued by Henderson and Jones (2017), showing personal interest indicates compassionate care as it leads the nurses to show that they are not only professionally but also as a person concerned towards the well-being of the patient. This is seen to be followed in caring for the stage II lung cancer patient where the nurses in charge were seen to visit the patient even after their duty hours to check if the person has properly taken meals and medication has been offered in time to ensure good health.

The care provided by the nurses where they plan the care services for the patients by considering the perspectives and emotions of the service users is regarded as compassionate care (Schellekens et al. 2017). In the case of patient suffering from stage II lung cancer, it was seen that the nurses always tried to understand the pain and feelings of the patient and accordingly provide individual care. This is evident as after chemotherapy when the patient would show tantrums from pain the nurses would never act in a rude way and instead they would try to calm the patient down in accepting their care by gently massaging the person’s forehead and body. Therefore, it was ensured that the nurses while caring for the mentioned patients did showed compassionate care.

The importance of compassionate care is that it helps nurses to resolve communication gap and effectively understand the needs of the service users as well as make them the patient accept care without much hindrance (Schellekens et al. 2017). This is evident as nurses by offering compassionate care was able to understand that feeling of pain is making the patient with stage II lung cancer after chemotherapy reacts inappropriately with them and the nurses require to make the person relaxed to comply with them. The nurses execute the care in the mentioned way where they at first soothed the patient’s pain by giving the individual gentle massage and then offering proper care so that the patients accept the services properly. As asserted by Frenkel et al. (2016), the significance of compassionate care is that it helps the nurses develop sympathetic as well as trustful relationship with the patient. This is because when the patient understands that the individual’s pain and perceptions are understood by the nurses and without showing any hindrances they instead offered concerned care it makes the patient gradually develop trust out of value. In the mentioned case, it was seen that the patient immediately after first chemotherapy though expressed avoidance to accept care but in later phases, the person never avoided care and instead reported that the nurses properly treated the individual even after the person expressed tantrums.

Conclusion

The NMC Code of practice discussed above mentions that there are four key themes which are "Prioritise People", "Practice Effectively", “Preserve Safety" and "Promote Professionalism and Trust". The “Preserve Safety" is focussed from which it is informed that nurses are to act within their competence to provide care to the service users so that patient's health is protected and remain safe. In addition, the nurses are required to take immediate steps when they identify any patient is vulnerable to be abused or harmed. The nurses are required to have proper knowledge of laws and policies to ensure proper actions are taken by them to legally protect the service users from any abuse or harm. In case of emergency, the nurses require to take prompt actions by alerting concerned authorities to ensure the safety of the patients.

The Egan SOLER Model of communication mentioned that nurses are to sit squarely, maintain open body posture, lean forward, maintain direct eye contact and relax in showing proper concentration and listening to the detailed information shared by the clients. The direct eye contact is to be maintained so that the nurses are able to show they are attentively listening to the service users when the service users are speakers. When the nurses are the speakers, they are to maintain direct eye contact with the patients to understand whether or not the patients able to understand the information provided by them. The value-based care approach in nursing informs that care is to be provided to the service users by including the patients, their families and health professionals in planning the care. The compassionate care in nursing is essential so that values of service users are respected and effective quality care that satisfies the patients is delivered.