student nurses/registered nurses, can you help me please?????

[tiredemma]

doing my 1500 wrd assignment on codes of conduct, am going to give specific examples of various clauses within the code, but as I have not had much ( only 3 weeks) worth of placement so far, im struggling to come up with some s%$t hot examples on

breach of confidentiality.

consent

i have done examples for accountability and duty of care, but am just struggling ( through lack of any real clinical practice) to find good examples of the above.

Do any of you have any real life scenarios that I could use? if you are unsure about putting a scenario on here, im quite willing to give my email addy.
I have been sat here for about an hour racking my brains.

please help a useless 1st yr.

please?

Well its several years since I was on a ward, but had 10 years of nursing experience so will think.
Breach of confidentiality, several spring to mind...

• giving info out over the phone re patient's condition
• leaving patient notes, your notebook, list of to-do items on ward, that type of thing on full view, like on the reception desk where anyone can see them.

Consent I'm not so sure about. In my day (!) doctors had to get all written consents, not sure if that is still the case.
I guess its consenting to things like catheterisation, injections, blood transfusions (though they have to be prescribed.)

Sorry am a bit rusty. Is this the type of thing you're after? If so and you need more details, let me know and will give it some more thought.

tired emma - am a second year. If you want, I can email you my outcomes that I did for my first year which dealt with consent and things? I dunno if it'll help, but its something at least. I never had to do an essay like your, so i can't be of anymore help

my email is nutterly_uts at hotmail dot com

With regards to consent you could look at the various types of consent used. Implyed consent ie;someone giving you their arm to take BP or give injection, verbal consent: Mrs Smith we need to catheterise you as you've gone into retention and she responds positively and written consent, forms for operations, forms for vaccinations to be given to children etc. You could also look at who can legally consent for who, age limits, even Fraser/Gillick competence with regard to under 16's and sex.
Don't know if thats much help.

oh thank you so much, it would help if i wasnt trying to do this with a raging hangover. I worry that im off the mark with all of this sometimes and that im getting it all wrong.

thnaks for your help.
Nutterlyuts, I am just about to email you. many thanks

I think it would be a good idea to discuss about how consent is becoming more and more of an issue in what is becoming an improving client led service. Issues around consent are the times when it is not possible to obtain - as already said, when unconcious in emergency etc. Should family be asked or is that then a breach of confidentiality?

Issues around confidentiality - a good one recently, a relative of a patient living far away abroad ringing to find out about their NOK - asking detailed info I was not happy to give out over the phone. Should info be given out in these circs where the relative can not otherwise make a decision to visit etc? Answer here was I rang him back to ascertain he was who he said he was, and went into slightly more detail - but I wouldn't use this as an example as you would be on dodgy ground. Some solutions would be to refer them to the team of doctors (then it becomes their issue of confidentiality and not ours - we can't be held responsible!) and also to set up a password for the relative to use when they phone. If you include these do stress that this would not be ideal or common use, but as in this case, an elderly, isololated patient's relative who had no other way of finding out how their parent was doing.

Hope that might help the brain going!

How about for consent, written, verbal & as Sallystrawberry says, implied. also for consent not only consent to treatment or a procedure but consent to have a student observe a procedure.
Breach of confidentiality refer to Caldicott principle. Also not discussing patients with colleagues in public areas where you can be overheard.

I have an essay on consent (that I passed!!) do you want to read it for some info tiredemma?

I talked about how consent relates to the NMC guidelines about treating the patient as an individual and talked about the nurse as an advocate. The NMC website has some handy a-z guides for bits from the guidelines.

would you mind? can you email it to- ELW662 at BHAM dot AC dot UK

thnaks so much, ive nearly cracked it now!

Sent - its from a hull.ac.uk address!

how you getting on today?

Also think about "Informed Consent" and how this implies full understanding of the procedure the patient is consenting to.
What about language difficulties if, for example you have to use an interpreter?
What procedures does your Trust have in place by way of leaflets in different languages etc.
How much time is the person given to consider the information you have discussed with them, before giving consent?
You might want to look at the COREC Website re: clinical trials - there are lots of issues around informed consent and research.
I can't do links, but Google should work.
Who takes consent? Is it always a consultant? Can it be delegated and in what circumstances, and to whom?

I will try to think of some scenarios, but confidentiality makes it difficult.

You might want to look up the issue of consent and sectioning under the mental health legislation there are bound to be some case reports on the MIND website.
HTH

Actually - I might write this up myself - lots of good ideas on here. (I have to choose my own subjects and write up 4 or 5 major areas). Thanks everybody!! And good luck with your assignment tiredemma.

There was a well publicised case a few years ago when a nurse in a psychiatric unit put a patient's medication in his tea. the patient was so disturbed/demented that he could not be persuaded to take it voluntarily. I think the case came to a disciplinary hearing and the conclusion was that the nurse's actions were unacceptable - I can't remember much else about it, but it was an interesting and challenging dilemma.

3lfrogs - if thats the case, then there are many many many nurses out there in the wrong. 3/4 of the wards I worked on did this - all elderly care.

Exactly - hence the analogy of coalfaces and ivory towers!

And very clearly documented in the medical records. Unfortunately it is often unclear documentation of agreements and decisions that can cause problems. It is so important in this increasingly litigeous society that everything is written down.

thanks everyone for giving me some fantastic info. My assgnmt is all done and ready to hand in.

I have learnt some really interesting, valauable things here.

thanks again
xxx