Posted at 11.01.2018
Every human person has his own unique beliefs, attitude, prices and preferences. To accomplish patient- centered treatment, a nurse needs to recognize and respect patient's personality, dignity and diversity. The maintenance of patient dignity is an important factor of nursing attention and is highly valued by patient. The International Council of Nurses also shows the importance of patient dignity. According to the ICN Revised Code of Ethics (2012) this can be a nurses' responsibility to respect human rights including the to dignity, alive and also to treat patient with admiration. In addition, the sole goal of a nurse-patient romantic relationship is the betterment of the individual which could be achieved giving dignified care. Quite simply, dignity can be an important factor which a nurse must consider while providing holistic care.
The reason for selecting this matter is that mental health is the most neglected field in Pakistan. In socio ethnical context, it has been seen that psychiatric patients are one of the very most socially excluded communities (Qasim, 2012). In our society, there a wide range of stigmas attached to it. This leaves great effect on patient's mental health, thus interfering in all natural care. Since it is a nurses' professional obligation to promote patients' dignity therefore, it is important to emphasize undignified practice issues and analyze it critically. This paper will discuss importance of dignity in psychiatric ward setting up, related threats and exactly how it could be promoted.
During my scientific rotation at Karwan_e_Hayaat, a 32 yrs. old male patient admitted with the diagnosis of schizophrenia was continually irritating the patients and nursing students present in the hall. After many warnings, staff held the individual forcefully and slapped him before everyone. Upon research of the function, patient verbalized that he sensed very embarrassed. Following day, he was asked to share his concerns with the staff but he refused. Relating to him, staff responded rudely when he shared his concerns with them.
After encountering this circumstance, I couldn't stop great deal of thought. I wondered what sort of staff could behave so about with an individual. Doesn't he consider its effect on the individual? I understood that such humiliating and undignified action towards the individual made him feel ashamed. This not only reduced his self-confidence, but also shattered his trust after the staff.
Dignity is described a special dimensions of value. The word "dignity" comes from the Latin word "dignus" meaning deserving. Relating to Oxford English Dictionary (2002) it is "the state of hawaii or quality of being worthy of honor or value". Patient dignity is the sensation of being respected and comfortable psychologically.
According to the Nordenfelt (2004) there are four types of dignity which includes merit, moral status, personal personality and Menschenwurde. Firstly, merit is a type of dignity which relates to the social status ascribed by the people because of their position in a contemporary society. For example doctor, nurse etc who are recognized by the individuals. Psychiatric patients are mostly excluded off their role in a contemporary society and they may experience lack of dignity. Subsequently, moral status entails person's moral integrity and autonomy. If one is in a position to live matching to his moral worth, the average person will feel a sense of dignity. Finally, personal identity relates to the self-respect and individual's id as a person. That is most relevant in the framework of the elderly. It can be violated by physical interference and mental or mental health insult such as humiliation. Lastly, Menschenwurde is an intrinsic dignity which all human beings have at a same level. It can't be lost as long as real human exist. In medical practice, need for acknowledging worthy of of human no matter human condition is specially related to the concept of Menschenwurde. Morover, dignity of personality helps in providing individualized care (Gallagher et al, 2008).
Dignified good care has significant impact on health and recovery of the individual. Patient feels comfortable when he is happy, calm, and clear of stress and anxiety when he knows that his personal privacy is not invaded without invitation. If an individual feels in control, only then he will be comfortable and able to cope. Lack of dignified care influences negatively on subconscious health of the individual. It can lead to stress, aggression, anxiety, embarrassment and public isolation. This may delay their restoration and could lead to help expand complication. In case scenario additionally it is evident that the patient felt humiliated when he was slapped and forcefully taken up to his room. Corresponding to literature, staff action is one out of three factors which threatens patient dignity (Baille, 2009).
According to the individual Dignity Model (Baillie, 2009) staff behavior, clinic environment and patient factor affect patient's dignity. It portrays that the individual has central place in this model. The hospital environment and personnel action surround patient which can promote or threaten their dignity. This model is divided into top and lower halves. The top one half of the model shows why patient is susceptible to loss of dignity as the lower fifty percent shows how these factors promote patient dignity irrespective of their vulnerability.
There a wide range of factors in medical center which violate patient dignity. Lack of privacy, inadequate physical and human resources and dehumanizing ward culture improves patient vulnerability. Lack of privacy in relation to physical environment, mixed-sex environment and bodily exposure has emerged as a significant factor that brings about lack of dignity. Other factors may include overcrowding of patient in a ward, less staffing or staff workload and unhygienic environment. Furthermore, staff behavior also offers significant impact on patient dignity because they are folks who connect to them mostly. A couple of two ways where staff can threatens dignity: staff communication and breaching personal privacy. Curtness, insufficient kindness and courtesy in relationship business lead to undignified care. Authoritarianism, controlling rather than respecting need in interactions are also threat to dignity. Additionally, Patient's intrinsic factor also impacts dignity. Impaired health insurance and older age are two major factors which will make patient vulnerable to loss of dignity. Impaired health position contributes to dependency in personal care and attention which impacts negatively on patients' psychological health. (Baillie, 2007)
Therefore, modifying medical center environment and enhancing staff patterns can promote dignity. A nurse should play an important role in modifying both factors. A nurse should offer an environment that consists of well-maintained, clean, safe and conducive environment as it makes patient comfortable. Environmental level of privacy should be managed. Social connection with other patient should be prompted as this can help patient to share his sense and understand other patient as well, which impacts favorably on the patient's self-esteem.
Furthermore, staff habit also plays an important role in promoting dignity. They are able to promote dignity by providing privacy and restorative connections. Providing environmental, physical and auditory level of privacy is available helpful to advertise dignity. Auditory privacy identifies confidentiality of patient's diagnosis and treatment. Healing communication makes patients feel safe, in control and valued. Use of reassurance, laughter, friendliness and professionalism and reliability helps patient to feel safe. Professionalism portrays competence and efficiency which makes patient feel contented and safe. Moreover, patients feel in control when they are given with information, justification, independence and alternatives. Interaction which shows consideration, concern, helpfulness, politeness and value as an individual, makes patient feel respected (Baillie & Gallagher, 2011).
In conclusion, a patient is susceptible to loss of dignity. It can be threatened by various factors. Individual staff behavior specifically has strong affect on patients' mental health which is evident in case scenario. Therefore, it is strongly recommended to use special care when it comes to patient's dignity. Essential steps in hospital settings can be taken to promote dignity. This not only enhances nurse-client relationship, but will also promote healing relationship, thus speeding up patients' restoration. Therefore, as a medical student it's important for us to comprehend the importance of dignity as this will help us to provide all natural care.
(Word Matter: 1298)