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Safe practice: Professional, Legal and Ethical issues

The nursing vocation is underpinned by many professional, legal and honest conditions that are essential for safe practice and ensure the best interest of patients are being satisfied. The three main key points this essay will discuss are accountability, enlightened consent and dignity. Nurses are governed by legal and professional requirements that protect the basic safety and wellbeing of patients but also have ethical factors that arise when delivering nursing treatment.


The Nursing and Midwifery Council (2008) status as a nurse you are individually accountable for actions or omissions and must have the ability to justify behaviour. In the event the NMC find behaviour undesirable, they have the power to remove enrollment from nurses. Nurses are independently accountable, lawfully and professionally for his or her own specifications of care and should only practice within their opportunity of competence and ability, knowing their restrictions.

The NMC requires nurses to keep their knowledge and skills current guaranteeing they use data established practice (NMC 2008). This means that nurses can effectively make decisions about the delivery of attention in difficult circumstances using sensible professional medical knowledge and skill enabling nurses to account for decisions they make.

Patients trust that nurses will do them no damage. Which means that nurses have a moral and professional obligation to act correctly such as cleansing hands and wearing gloves, increasing consent and keeping dignity, learning anatomy and using current research based practice. Savage & Moore (2004) highlight four regions of accountability; accountability to the general public, accountability to the occupation, accountability to the individual and accountability to employers. Nurses are governed by professional, legal and moral frameworks such as NMC requirements and rules of professional do, moving and controlling suggestions and local procedures. These frameworks are placed in place to protect patients and assist nurses in delivering safe and effective care.

Informed Consent

Patients have a legal right to refuse examinations, methods and treatment. Nurses should always respect patient's hopes even if they're declining something that is beneficial to there health. Consent provides nurses with justification for treatment and if a nurse handled a patient or carried out an operation without valid consent then they can be sued for power supply (UK Clinical Ethics Network 20101).

Expressed consent can be either written or verbal. Implied consent can be presumed by a patient's actions or used in an emergency situation (Pozgar 2005). Consent should be given voluntary rather than be forced upon. Patients likewise have the right to withdraw consent at any time making it illegitimate to continue.

Consent must be "knowledgeable consent", this requires information to get to the individual about the treatment and really should include factual details, benefits or hazards, potential problems and alternatives available (Aiken 2004). Nurses attaining consent on someone's behalf should only do it if they are certified to provide sufficient information and answer any questions regarding the procedure. Nurses can be performed negligent if key information is not given when obtaining consent.

Nurses must ensure consent has been created by a person who is experienced and has the legal capacity to provide consent. The (Adults with Incapacity (Scotland) Take action 2000) defines incapacity as not capable of decision making, communicating decisions, understanding decisions and retaining storage of decisions. If someone is unable to give consent then it should be gained by somebody who authorisation, maybe a guardian or proxy directive. Cognitive capabilities can be damaged by factors such as learning problems, dementia and neurological conditions. Regulations allows decisions to be made on behalf of a person, if they are incapable of making decisions as long as it is in the needs of the individual.


Dignity The RCN (2008) defines dignity as "how people feel, think and act with regards to worthy of of themselves and more". Nurses can promote dignity by firmly taking time to understand people and discover why is them feel valued. Dignified care means relating individuals in their attention, giving them self-assurance to assume control and make decisions about their attention.

Gallagher, Li, Wainwright et al (2008) carried out intensive research into dignity and have analysed the conclusions and discovered four key dignity promoting factors: environmental attention, staff behaviour and behavior, culture of attention and specific treatment activities. Environmental good care is an enormous obstacle when attempting to keep up patient's dignity as wards can be of merged making love and can be overcrowded. They could also have poor facilities such as unwell fitting curtains. Personnel behaviour and behaviours can promote dignity by dealing with individuals with respect and factor, not dealing with people as though they are things and by having sympathy and compassion. Culture of attention is important in delivering dignified care, individual beliefs and cultures should be well known. Specific activities of treatment such as personal hygiene and toileting should be carried out with personal privacy and respect and modesty should be secured.

Nurses need to build up an understanding of dignity in health care and develop the required skills to make people feel comfortable and dignified in the health care they obtain. If dignity in treatment is absent it can result in patients sense distressed or embarrassed and causes unnecessary suffering. Dignity is a basic human right and should be a main priority when undertaking all nursing activities.


Nurses are in a privileged position because they are trusted with the health of others. This comes with great responsibility and nurse need to ensure that they are competent to cope with the professional, honest and legal issues that occur in medical. Nurses are accountable for their own practice and should make the interest of the patients their first matter. If nurses do not act in a specialist manner and do what's ethically there can be serious repercussions to both the nurse and people in their treatment. Professional, honest and legal guidelines are not straight forward and continual learning and representation is necessary to progress and improve as a nurse.

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