PROFESSIONALISM IN GENERAL OBJECTIVE •On completion of the unit the learner will demonstrate ethical and professional competence, responsibility , creativity, and accountability when responding to the needs of individuals, families and communities

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Specific objectives; By the end of the unit the learner will be able to; . Define terminologies in nursing. Discuss trends in nursing education and practice .Demonstrate knowledge and understanding of the nursing code of ethics. .Outline the professional code of ethics governing nursing education and practice

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) .Outline the roles and functions of; .International, regional and national professional nursing organizations

. Definitions; .Health; Health is a state of complete physical, mental social and spiritual wellbeing and not merely the absence of disease and infirmity. (WHO)

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) .Profession; It is a calling or a vocation requiring specialised knowledge, methods and skills as well as preparation in an institution of higher learning in the scholarly, scientific and historical principles underlying such methods and skills

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) .Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness and the care of the ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Management, and education are also key nursing roles Ethics are morals and philosophical principles that define actions as being either right or wrong. Always remember to respect the beliefs, values and customs of the patient/client.

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Professional nurse is an individual who has successfully undergone a prescribed nursing training program, has passed a licensing examination and is registered by the national nursing regulatory body, in our context ,the Nursing Council Of Kenya.

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Characteristics of a professional Nurse. A professional nurse : •Displays high standards of performance and integrity in nursing practice •Seeks constantly her/his technical and interpersonal skills through continuing education and research •Uses sound judgement and discretion in dealing with patient, clients and their relatives

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •Provides holistic care to patients, family and community •Deals competently with crisis situations •Puts what is good for professional services to patients ahead of herself •Coordinates and evaluates nursing services in cooperation with members of other health services

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •Is not overly concerned with materialistic aspects of nursing •Expects to find satisfaction and spiritual values in her work •Feels responsible for the status of nursing and tries to advance and never to retard it •Has inner resources to which he/she can turn to, for renewal of faith and courage when weary and discouraged

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Personal grooming is important, every patient has a mental picture of how his nurse should be. The nurses appearance provides security and hope to a patient

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •Is proud of his/her profession and considers it to be at par with other professions like medicine or law or any other vocation practiced for compensation, which at the same time contributes in its own unique way to the welfare of humanity

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •Personal attributes that make a nurse display professionalism: • Good personal appearance with a quiet voice that does not scare patients •A ready smile gentle hand, orderly in the thought and action •Emotionally mature, compassionate, dignified, tolerant, friendly sympathetic and friendly to other people

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •His/her personal attributes are conducive to the creation of a friendly and conducive environment to the patient recovery •You must at all times have serenity of mind and self control to be able to handle a variety of situations and patients •A professional nurse at all times displays integrity, commitment and ethical behavior.She/he displays intelligence and handles emergency well.

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) PROFESSIONAL CODE OF NURSING ETHICS- Ethics are defined as morals and philosophical principles that define actions as being either right or wrong The ethical concepts touch on your practice as you interact with other people, the society, co-workers and the profession. The patient is at the centre of your practice with a right to his care.

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) As you provide care always remember to respect the beliefs, values and customs of the patients/clients The following is the code of ethics: •You should always hold personal information in confidence and use your discretion in sharing this information •You should always remember it is your responsibility to keep abreast with current trends in the nursing profession

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) So as to maintain competence in nursing practice through continuing education •Always maintain the highest standards of nursing care possible within the given reality of a specific situation •When accepting any responsibilities delegated to you, ensure that you are competent to carry out the assignment •Maintain professional standards of personal conduct that reflect credit upon

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) The profession at all times •Share with other citizens the responsibility for initiating and supporting action to meet the health and social needs of the public during your practice •Sustain a co-operating relationship with the co-workers in nursing and other professions •Take appropriate action to safeguard the individual when a co-worker or any other

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Person endangers his/her care You have a major role in determining and implementing desirable standards of nursing practice and nursing education •Be active in developing a core of professional knowledge •Acting through a professional organisation, you are to participate in establishing and maintaining equitable social and economical working conditions in nursing. Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) This therefore means, that you are to be a member of your professional association. ICN Code of Ethics: •It states that the fundamental responsibility of the nurse is to promote health, prevent illness restore health and alleviate suffering. •Inherent in nursing is respect for life dignity and the rights of man.

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •Nurses are to provide care to individuals regardless of their nationality, race, creed, colour,age,sex, politics or social status. •As a nurse you will be providing to individuals , family and community •You will be operating in teams such as a nursing team which is within a health team.

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) The professional nurse has to be knowledgeable of what he is practising at the health facility and should acquire the technical skills that will assist in and improve the work performance. The code of ethics embodies the standards by which each forms a conscience, a capacity for moral reasoning and governs the practice of reasoning.

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Professional organisations •Nurses in Kenya are members of professional organisations at national regional and international levels •In Kenya the professional nursing organisation that has both regional and international recognition is the National Nurses Association of Kenya(NNAK) •NNAK is registered by the registrar of societies as a welfare association

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Membership: •It is open to all nurses, has branches in all provinces •Members in each province elect their own chairman secretary and treasurer organising secretary and their respective deputies •Various nursing disciplines are represented as Chapters

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) The Chapters of NNAK include: •Midwives •Education Theatre Nurses Mental Health and Psychiatric Nurses •General Nurses •Private Nurse practitioners •Paediatric Nurses •NNAK is a member of a regional body known as the East Central Southern Africa College of Nursing(ECSACON)whose offices are situated in Arusha Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •It is also a member of the Association of Professional Societies of East Africa (APSEA) and International Council of Nurses( ICN) situated in Geneva •NNAK collaborates with other professional bodies e.g. The Royal College of Nurses, The Canadian Nurses Association, Kenya Medical Association, and Association of Kenya Obstetricians/Gynaecologists

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Major functions of NNAK •Promoting nursing and maintaining the honour, interests and practice of all aspects of the profession as whole •Promoting and maintaining high standards of nursing education •Stimulating and encouraging •Promoting cooperation between this body and other national and international professional bodies Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •Promoting good understanding good understanding between the association, central and local governments and all communities •Acting as a local representative body of the nursing profession •Supporting a high standard of nursing ethics, conduct and practice which is organised and functions unrestricted by consideration of nationality, race creed politics sex or social status

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •Assisting whenever possible members who by reason of adversity or ill health are in need of help. •Arranging and holding periodic meetings of the association for professional educational and social purposes •Circulating such information as may be thought necessary by means of a journal, a bulletin or any other method

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Maintaining an update list of all members according to its constitution

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Benefits of NNAK: •Updates in knowledge, attitude and skills in nursing and midwifery practice to improve your performance for quality care to patients •Interactions and the opportunity to share experiences with the other nurses •The formation of links with other organisations

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •Advocacy on welfare issues such as better remuneration and improved conditions of service

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) ECSACON: •It is a professional agency of the Commonwealth Regional Health Community(CRHC) •Its objective is to promote and reinforce professional excellence through the development of programs •To strengthen nursing and midwifery practice, education, research leadership and management to improve service delivery Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Its membership states are: •Botswana •Lesotho •Kenya •Malawi •Mauritius •Mozambique •Namibia •Seychelles, South Africa, Tanzania, Uganda •Zambia Zimbabwe

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Benefits of membership: •Sharing of knowledge through research findings •Interacting wit nurses from other regions and sharing experiences

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) International Council of Nurses(ICN) • It is a federation of Nurses Associations in 122 countries • It was founded in 1899 as the first health professional organisation , it remains the largest among international organizations related to the provision of health care • It is headed by a president.

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Goals of ICN: •Influence health and Nursing globally •Strengthen Nurses associations Values: •Encourage visionary leadership inclusiveness, flexibility and partnership among all member states and the achievement of excellence in nursing

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Vision: •To unit all nurses within the ICN to speak with one voice as advocates of all that ICN serves •To acknowledge that a human being has the right to preventive and curative care •To spearhead the health care progress and shape health policy around the world through enhancing nursing expertise strength, their numbers, alignment of their efforts and collaboration with the public Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) And other health professionals Philosophy: •Commitment to caring, advocating on behalf of patients and helping people help themselves •It ensures that the nursing profession is highly valued, appropriately utilised, recognised, rewarded and represented throughout the health care system

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Nursing Council Of Kenya: The Nursing Council Of Kenya was established by the Nurses Act, Chapter 257 of the Laws of Kenya. •The council is a corporate body having perpetual succession and a common seal with the power to sue and to be sued and to purchase, hold manage and dispose of land and other property and to enter into such contracts as it may consider necessary

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) The Nurses Act Chapter 24 of the Laws Of Kenya was enacted as an Act of Parliament to make provision for the training, registration, enrolment and licensing of nurses, to regulate their conduct and to ensure their maximum participation in their health care of the community and for connected purposes(Nurses Act 1985)

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) The membership of the Council comprises:

Two ex-officials who are ; •The Director of medical services •The Chief Nursing officer •One person responsible for higher education •Two persons representing religious organisations providing Health services in Kenya

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •Two persons representing nursing associations •Four persons nominated by the outgoing council to represent: •General Nursing •Midwifery •Community health Nursing •Mental Health and Psychiatric Nursing •Eleven elected members who may be involved in clinical practice,

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •Nursing administration and education. They must be registered nurses as follows: Three registered nurses three midwives three community health nurses

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Functions of the Nursing Council: •Establishing and improving all branches of the nursing profession in all their aspects and in safeguarding the interests of all nurses •Establishing and improving the standards of professional nurses and health care of the community •Prescribing and regulating syllabuses of instruction and courses of training for

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •Persons seeking registration or enrolment under the Act. Prescribing and conducting examinations for persons seeking registration or enrolment under the Act. •Prescribing badges, insignia or uniforms to be worn by persons registered, licensed or enrolled under the Act

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •Regarding the contact of persons registered, licensed or enrolled under the Act, and to take such disciplinary measures as may be necessary to maintain a proper standard of conduct among such people •Regarding the standards for nursing care qualified staff facilities and environment of health institutions •Directing supervising the compilation and maintenance of registers, rolls and records

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Required to be kept under sections 12, 14, 16. •Advising the minister on all matters concerning nursing

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •The functions of the Nursing Council are executed through committees which comprise the full Council and the standing committees: •Education Standing Committee •Registration Standing Committee •Investigations Standing Committee •Finance Standing Committee •Disciplinary Committee

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Nursing council secretariat: •The Nursing Council Secretariat conducts the day to day activities of the Council •It is composed of officers and the Council staff. The council officers are: 1. The registrar 2. Education officers 3. Examination officers 4. Registration officers 5. Standards and Ethics officers

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •They are all employees of the Ministry of Health •The Council staff also comprises of the accountant, accounts assistant,secretaries,and other support staff

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Legal aspects of Nursing in Kenya •As a nurse you are liable to the national laws as well as professional ethics related to your practice •Examples of offences: •Misconduct: •Includes stealing drugs or hospital property ,forgery or fraud, coming on duty drunk fighting on duty using abusive language on duty

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Negligence: Failure to give appropriate care to clients Malpractice: Performing procedures which are out of scope of your practice Impropriety: Fighting in a bar or anywhere else, if you conduct yourself unprofessionally you will have discredited or shamed the nursing profession, you will be liable to be charged

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Other laws related to nursing practice •The Public Health Act: Cap 242 It describes the health delivery services in the country •Pharmacy and poisons Act: Cap 244 It deals with laws of prescription and administration •Medical Practitioners and dentist Act Cap253 ,regulates the private practice of the nurse

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •Narcotic Drugs and Psychotropic Substances control, related to the dangerous drugs, Act 1994 •Medical Laboratory Technicians and Technologists Act 1999, regulates laboratory procedures •Clinical medicine Act , regulates diagnosing and treating of minor ailments •Food ,Drugs and chemicals Act Regulates the food handlers in the community

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Children and Young Persons Act: Children have rights which must be recognised •As a nurse you are expected to : •Provide necessary support for the child and for those who care for the child •Identify children suffering from abuse and torture •Report and refer for investigations, treatment and follow up of cases of child abuse and neglect

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Workman compensation Act: •It outlines what you should do in cases of accidents during practice. •It guides you on how to apply for compensations of the damages caused as a result of the accident

•Law of succession Act: •It relates when clients are faced with ma rital problems

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) The Bill of Rights:

This applies in the provision of health care for the patient and the nurse

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) The patients Bill of Rights •Health care is a right to every individual in this country. He /she has a right to: 1. Considerate and respective care. 2. Obtain complete information concerning his/her treatment progress and prognosis of the disease. In certain situations the patient may not be in a reasonable condition to understand

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) An appropriate person should be given the information on his behalf 3.Know by name the person caring for him 4.Receive information necessary for him to give consent prior to the commencement of any procedure or treatment except for emergencies .The information given should include specific procedures and treatments, the medical risks involved, probable

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Duration of incapacitation, where alternative medical care or treatment exists or when he requests information concerning medical alternatives, he has the right to such information 4. Refuse treatment to the extent permitted by the law but must be informed of the medical consequences of his action

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Privacy concerning his care. Those persons not directly involved in his care must get permission for the patient in order to be present 5. Confidentiality with regard to all communication and records pertaining to his care 6. Obtain information as to any relationship of his hospital or other health care facilities and education institution

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) In so far as his care is concerned 7 Obtain information regarding the existence of any professional relationship among individuals who are treating him. 8. Be advised if the hospital proposes to engage in or perform human experimentation affecting his care or treatment . The patient has a right to refuse to participate in such research

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) 11. Know what hospital rules and regulations apply to his conduct as a patient 12. Expect that a hospital within its capacity can make reasonable response to the patients request for service .the hospital must provide evaluation service or referral as determine d by the urgency of the condition, he medically permissible the patient may be transferred to another

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Health facility only after he has received adequate information and explanation concerning the need for alternatives to such at transfer.

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) TRENDS IN NURSING Nursing is as old as man. The family is the oldest and most used health care delivery in the world. •Florence Nightingale is the founder of professional nursing •She initiated formal nursing training and made the first curriculum

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Task allocation/job assignment •The patient was fragmented into a series of jobs assigned to different nurses of different grades. •This fragmentation of care resulted into continuity of care ,with patients subordinated to the system rather than being central to it. •In the 1950s, nurse leaders in North America began to recognize that the

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •Development of nursing knowledge and practice must run simultaneously with research. •Between1960 and 1980s many developments and changes took place stemming from professional desire for innovation and change in practice •The nurse leaders felt that the patient was alienated from his own care and there was a need to improve the nursing care. Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) In 1966 Virginia Henderson stated the unique function of the nurse as : ``To assist the individual sick or well in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will and knowledge, and to do this in such a way as to help him gain independence as rapidly as possible.``

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) In the search of a unique body of knowledge the nurse theorists were using scientific methods to describe explain and predict nursing practice and its outcomes. •After attaining independence in 1963 Kanu manifesto declared its intention to fight poverty, illiteracy and disease. In this context health care had to be made available to the community.

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •This led to the introduction of community health nursing training in 1966 in Kisumu MTC •Midwifery training had been started in 1950 at enrolled level. •The registered level started in 1965. At this time expatriate nurses were leaving the country and the gaps had to be filled. •Diploma in Advanced Nursing was started in 1968 at the University of Nairobi

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) •To prepare Nurse Educators and Administrators •Nurse leaders worldwide became dissatisfied with the task allocation method of organising patient care, they needed accountability of the care needed •In 1980 nurses started moving away from the task to individualised care This paved way for the introduction of the , a systematic method of

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Individualised nursing care. The progression of nursing care organisation started with the patient allocation, team nursing and primary nursing Team nursing: Nursing teams in the ward are divided into teams. Each team headed by the team leader takes care of a group of patients

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) Patient Allocation Each nurse is allocated a small number of patients to look after during the shift

Primary nursing •This is the patient centred nursing system •One nurse(the primary nurse) assumes individual responsibility for a particular patient for the entire period the patient stays in the ward. The nurse can delegate

Create PDF files without this message by purchasing novaPDF printer (http://www.novapdf.com) To other nurses(associate nurses) during period of absence from the ward.

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