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The event occurred in the fourth week of my practice. I was tasked with the duty of checking patients’ vitals and providing basic care. I witnessed a situation whereby a buddy nurse refused to give a patient the level of comfort she deserved because the nurse thought that the patient’s request was not a priority. As a result, the patient’s care was compromised because I did not defend her right to comfort by granting her a request to use the toilet. The issue was about the patient’s right to quality care and how a nurse (in this case me) can advocate for that patient if his/her rights have been ignored or violated by a fellow practitioner.
In my opinion, the nurse’s refusal to help the patient simply because her request was not a priority was not justified. I believe that as a nurse, it is my duty to help all my patients get quality care and the level of comfort that they require. The nurse’s behavior was unethical and I wanted to make sure that she understood that. This was important to me because I do not believe in double standards. One cannot provide service to one patient and ignore another. I believe in being fair regardless of my patient’s prevailing status, and I would like my fellow nurses to showcase the same level of professionalism in all their endeavors.
It was on a Wednesday during the fourth week of my clinical practice. An occupational therapist came in to dress the patient and assist her to do some motion exercises in bed as part of her daily exercise routine. Afterward, we transferred her to a wheelchair. Later on, the patient asked me to assist her to get to the toilet. I had to go and ask the buddy nurse to come and assist because the patient needed two people to help her get to the toilet. The nurse responded by saying that she was busy dealing with other patients and that my patient had to wait.
I went back to the room and relayed the message to the patient. Twenty minutes later, the nurse came into the room and started working with other patients. My patient was really pressed and I was getting overly concerned about her. I asked the nurse for her assistance and she told me to wait. I felt powerless and useless. I wanted to help my patient but I could not do it alone. I tried thinking of ways I could help her alleviate her discomfort. I knew and understood her need to go to the toilet. This was an uncontrollable action and if not addressed it would be messy and embarrassing for the patient.
What pained me was the fact that her request was simple and logical. It would not take much time. I could not understand why the nurse allowed this to happen well knowing how delicate the situation was. In school, we were taught how to defend patients and advocate for their rights. I wondered whether the nurse attended those classes. A nurse should be caring not dehumanizing. I looked at my patient and saw sadness in her face. I placed my hand on her shoulder and told her to hold on for a few minutes as I try to find other alternatives.
The key issue in this event was that I failed to advocate for my patient’s right to comfort. According to Morse (1996, p. 6), providing comfort is a process that “includes discrete, transitory actions such as touching, or broad, longer-lasting interventions, such as listening (as cited in Kozier et al, 2010, P. 385). I failed to provide comfort because the patient eventually soiled herself. If I had listened to her and taken action immediately, this humiliating situation could have been averted.
Similarly, Heijkenskjol, Ekstedt and Lindwall (2010) assert that patients may participate in the delivery of their own care. This means that they can advice or recommend a course of action that benefits them and helps in the healing process. I did not do this because I failed to listen to my patient, which led to her embarrassing herself. My failure to advocate for my patient led to a situation whereby her care was compromised.
Looking back at the event, I believe that I was wrong and that I could have done more to help my patient. I comforted the patient by holding her shoulder and reassuring her that it was alright. However, I compromised her care by not listening to her, and taking swift action in response to her request. I will work hard towards developing positive therapeutic relationships with my patients. This means listening to them, taking actions swiftly and providing viable alternatives in cases where procedures are not working efficiently. For example, in this situation, I would have called in another nurse to help me when I realized that my buddy nurse was too busy. Alternatively, I would have provided the patient with a bedpan if no one was available to help me take the patient to the toilet. These alternatives would have helped the patient get the comfort she deserved and assist me in fulfilling my duty as a patient’s advocate.
It is my duty as a nurse to provide patients with the level of care they deserve despite the prevailing conditions. Patients have rights and as nurses, we are obligated to protect and avail these rights to patients without compromise. I believe that I can become better at my job if I learn to evaluate situations and come up with viable solutions to these situations. In some cases, the help that we are expected to get may not arrive on time. As such, we must be proactive in order to ensure that our patients get the best care under all circumstances.
Heijkenskjol, K., Ekstedt, M., & Lindwall, L. (2010). The Patient’s Dignity from the Nurse’s Perspective. Nursing Ethics, 17(3): 313-24.
Kozier, B., et al. (2010). Fundamentals of Canadian Nursing: Concepts, Process and Practice (2nd Canadian ed.). Toronto: Pearson Education Canada.