NURSES PRACTICING WHAT THEY PREACH

Nurses practicing what they preach



Nurses practicing what they preach

Introduction

Nurses have always been heroes. In wartime, they stayed with their patients when bombs were dropping and when the enemy was fast advancing.1 In peacetime, they have worked double shifts, risked job security, and taken the moral high ground—all in the interest of their patients.

Recently, registered nurses—more than 230 000 of them—have contributed significantly to the health of the nation. In 1976, 121 700 female nurses who were between the ages of 30 and 55 years old completed a mailed questionnaire on their medical history and lifestyle for the Nurses' Health Study from Harvard University, School of Public Health. A second group of 117 000 female nurses between 25 and 42 years old were enrolled in 1989 to create a new and younger cohort. The aim of the Nurses' Health Study is to identify the effects of diet, lifestyle risk factors, and use of oral contraceptives on health. To enter the study, the nurses could not have been diagnosed with cardiovascular disease, diabetes, or cancer.

The expert has practiced for 6 or more years in the same or similar setting and does not rely on maxims, rules, or analytic frameworks. In this conceptualization, it would be very difficult for nurses concurrently to gain experience and knowledge, and develop skills, in the education and clinical settings to achieve dual expertise. The characteristics of the competent practitioner described by Benner (1984) i.e., years of experience and modes of planning care, seem more in line with the qualifications of sessional clinical instructors than classroom faculty. We propose, therefore, that the term competence is more accurate and achievable than expert when describing the clinical practice requirements for a full-time faculty member.

Discussion

Legal Implication

The Blue Book sets out the rules on patient confidentiality and it stipulates that Patients have a right to expect that information about them will be held in confidence by their doctors. Confidentiality is central to trust between doctors and patients. Without assurances about confidentiality, patients may be reluctant to give doctors the information they need in order to provide good care (GMC:1993)

In common with other professional men. the doctor is under a duty not to disclose [voluntarily] without the consent of his patient information, which he, the doctor, has obtained in his professional capacity, save in very exceptional circumstances.

The only circumstance in which a clinician may breach this is where there is competing public interests:

Rarely, cases may arise in which disclosure in the public interest may be justified, for example, a situation in which the failure to disclose appropriate information would expose the patient, or someone else, to a risk of death or serious harm.

In the case of x v Y one or more of the employees of the claimant health authority supplied information to a report (defendant 1) of a national newspaper (defendant 2) identifying two doctors who had AIDS, yet were still practicing medicine. This information was obtained from confidential medical records held by the ...