The role of nurses
The role of nurses in health counseling nursing has been mentioned in the topic of health counseling nursing. And in this section, the role of nurses in caring for obstetric service recipients will be discussed. The author emphasizes nursing in providing obstetric consultation regarding mothers and children, which is based on ethical principles. Obstetric service recipients, especially pregnant women, are considered vulnerable groups. Therefore, there are many ethical issues in providing advice using the role of nurses. Because providing care, counseling, and advice is the direct responsibility of nurses according to the nurses' rights to care for pregnant women and their spouses in screening for Down syndrome in cases where the doctor has informed the results of the screening if there is a risk of Down syndrome. This is a duty to provide advice and guidance from the doctor who has informed the couple of the results of the examination. The ethics that nurses give advice must take into account the following issues:
1. Respect for patient autonomy: Nurses must respect the patient's decision to accept or reject what the nurse has advised on both screening and prenatal diagnosis. After the pregnant woman has received complete information, the nurse will advise on the value, benefits, risks that the pregnant woman will receive and the risks of having a baby with Down syndrome.
2. Benefits that pregnant women will receive (Beneficence) Nurses must explain, advise, and recommend the benefits, advantages, and disadvantages that will be received from prenatal screening and diagnosis. This is based on screening guidelines and reliable medical evidence. The service recipient is aware of the risks to the fetus, whether it is possible for the fetus to have Down syndrome or not. The above will be useful and provide options for pregnant women to decide whether to undergo prenatal diagnostics in the next step or not. Where pregnant women can compare the risks of screening results with the risks of miscarriage or other harm from prenatal diagnosis. When the screening results are known and it is found that there is a risk, when a pregnant woman chooses to undergo prenatal diagnosis, it is a choice whether to terminate the pregnancy or not. In cases where the diagnosis of a baby with Down syndrome is made, the doctor will be responsible for reporting the results. Nurses are responsible for providing advice, counseling, behavior, encouragement, and answering questions that pregnant women have, with the primary consideration being the benefits of pregnant women, not making decisions on behalf of pregnant women.
3. It does not cause any adverse effects or harm to pregnant women (Non-maleficence) in providing any information on prenatal screening and diagnosis to pregnant women and their families. Pregnant women and their families need to receive information from experts who have good communication skills because if pregnant women receive incorrect information, mistakes can occur. For the above reasons, screening and diagnosis are invasive procedures that involve the pregnant woman's body directly. Therefore, receiving information from someone who is not skilled and lacks good communication skills can do more harm than good.
4. Ethics of justice: The Down syndrome screening program implemented by the Ministry of Public Health must provide opportunities for all pregnant women to access this service. Including explanation of various costs, which is a direct responsibility that nurses must know and be able to explain to service recipients.
5. Confidentiality: Any test results of a pregnant woman are considered confidential and can only be disclosed to the pregnant woman. Disclosure of information to other persons must always be obtained with the consent of the pregnant woman, except for minors under the age of 18, whose guardians have the right to be informed of the results and make decisions on her behalf.
6. Truth telling and breaking bad news.
In addition, The Michigan Nurses Association in the United States has stated the rights of nurses as nurses and as human beings like any other person as follows:
1. Each nurse has a responsibility to provide the institution or agency in which he or she works with details of his or her past, current, and future educational qualifications, experience, clinical competence, and moral beliefs affecting his or her practice.
2. Each nurse has a responsibility to change, adapt, or withdraw from situations or events that create feelings of conflict with their knowledge, abilities, and beliefs.
3. The institution or agency where the nurse works must allocate materials and equipment to provide adequate health services to service recipients.
4. Nurses have the right and responsibility to collaborate with the institutions or agencies in which they work to improve the environment for providing better health services.
5. The organization or institution in which the nurse works must respect and trust the knowledge, abilities, values and personal characteristics of each nurse in performing their duties.
In Fagin and Paulen (cited in Siwalee Sirilai, 2013), they mentioned four rights of nurses as follows:
1. Nurses have the rights to create a relationship model with patients by planning nursing care and performing nursing operations as deemed appropriate and suitable for each patient according to professional principles. At the same time, they have the right to receive the recognition, trust, respect and rewards that they deserve.
2. Nurses have the rights to understand and accept their own feelings, the feelings of each individual, which are internal matters of the individual's mind regarding emotions and feelings. Not understanding one's feelings can lead to self-denial and coldness. If each nurse is aware and understands their feelings, they can control their feelings.
3.Nurses have the rights to maintain their dignity and self-expression, which means having the right to listen, question, doubt, make mistakes, or not answer when ethical decisions need to be made. Nurses have the rights to receive advice, assistance and cooperation from others. They have the rights to have others help them to understand and dispel their own fears and grievances just like others.
4. Nurses have the rights to be released from working conditions that undermine their own health, as ordinary people, just like everyone else. Nurses have both strengths and weaknesses. In the case of working conditions that cause stress, anxiety or frustration, some moral issues cannot be resolved. Nurses have the rights to withdraw or withdraw from the situation because providing quality nursing services depends on the well-being of the individual nurse. A nurse whose physical and mental health are not perfect cannot provide quality services to other people.
In view of the rights mentioned above, it is highly appropriate for nurses to protect their rights by studying to understand their roles and responsibilities and to be able to correctly demonstrate their rights. In summary, the rights of nurses
The rights of nurses as professionals are as follows:
1. The right to maintain one's dignity, to demonstrate one's ability to practice a profession based on one's education and to pursue self-learning in order to enhance and promote one's own abilities, one's profession and the institution.
2. The rights to be respected for work under appropriate circumstances and environment.
3. The rights to work in a good environment that is safe for both physical and mental health.
4. The rights to control nursing practice by individuals in their own profession.
5. The rights to determine the standards and quality of professional practice.
6. The rights to participate in determining national nursing-related policies.
7. The rights to demonstrate social power as a type of health professional.
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