Ethical and legal issues applied in the interventions

Introduction:

            The chosen SIM character to analyse the pathophysiological condition is suffering from diabetes type 2 named Inez. The medical report will be including a detailed perspective of the pathophysiological symptoms and signs. Different evidence based practices are also analysed as per the condition of the patient. Despite this, different nursing interventions will be discussed as per the administration and support of the patients. The interventions associates with the administration of Inez will be having different approaches such as medication and diet. Each nursing intervention will be according to the condition of the patient, along with its importance and rationale. This will be providing a detailed overview of the condition and different interventions provided to the patient. Keeping in mind the code of ethics of NMC different legal and ethical practices will be a part of the report. This section will be including three sub sections that are legal, professional, and ethical. Professional issues and the importance of the factors will also be discussed.

Pathophysiology:

            Diabetes is defined as a condition which causes an individual’s sugar level to reach from low to very high. Diabetes has two types of prevalence one is type 1 diabetes, and the other one is type 2 diabetes. Most commonly occurring diabetes is type 2 diabetes, which is defined as the condition in which an individual’s internal system is not able to produce enough insulin, and other than this body’s cell does not show any reaction towards insulin. In type 2 diabetes, the symptoms which are most likely to occur include excessive thirst, peeing a lot, obesity (caused due to physical inactivity), and problems with eyes, heart and nerves. Insulin resistance is associated with type 2 diabetes, and this is defined as the condition in which the body’s cells are not capable of responding to the hormone insulin. The risk factors which are associated with type 2 diabetes are obesity, and it can lead to the occurrence of type 2 diabetes, gestational diabetes, as well as prediabetes. Leading cause of insulin resistance is the physical inactivity in one’s life or intake of a diet higher in carbohydrates. Insulin controls the blood sugar level, and when the body cells become insulin resistant, there are changes to the prevalence of type 2 diabetes. (Donath & Shelson, 2011). Symptoms of insulin resistance include lethargy, hunger, high blood pressure, and high cholesterol level. In case of insulin resistance, the body cells show an impairment in the glucose cells. In insulin resistance body cells produce more insulin rather than the average concentration, and it disturbs the blood glucose level.(Haffner, 2010). The pathophysiology of type 2 diabetes is that the abnormal functioning of pancreas has characterised it. Pancreas is a gland inside the human body which performs its functions in the production to enough insulin required by the body. But in type 2 diabetes, it cannot function properly, causing an increase in the blood glucose level. This condition can also occur due to the impaired regulation of hepatic glucose, and other than this, it also declines the beta cell function of pancreas. All this impairment leads to cause toβ cell failure, and the resulting condition is known as type 2 diabetes. After looking upon the pathophysiology and the condition of Inez, it is clear that she has had type II diabetes. The signs and symptoms predict that she type II diabetes, and she does no find medications as proper treatment. Also, the patient lacks physical activity which also recommends that Inez’s condition could have worsened. Along with the issue of diabetes, Inez is also suffering from hypertension that can impact her health as well. Here age and physical activity are the risk factors to the condition of Inez.

Interventions:

            Nursing interventions are highly required for providing any patient with primary health care services. In the case of Inez, there is also a need to provide her with the appropriate interventions. These interventions are for improving quality of life. Her age and her activity routine is analysed to provide her with the specified interventions. Firstly, the intervention that is suitable for Inez is the addition of daily physical activities in her life. Inez has zero physical activity. So, this intervention will help her to put her diabetes into place. These type of physical activities include aerobic exercise, walking, or getting raining from the exercise training programs. This intervention will help her in diabetes management. Secondly, the next intervention, which is suitable for her, is providing her with the education on medication. This includes any information about how the nursing interventions will help her to make improvements in her current condition. She must also know how these nursing interventions will help her to get what she needs.

Furthermore, this intervention will enhance her knowledge about medication that will help her in diabetes management. As according to her, Inez is no less than that of a slow poison. So, if we get the sound knowledge about the treatments and interventions, then it will encourage her to benefit herself with these interventions. This intervention will help in the personal development of Inez and will develop her self management skills. This intervention also relates to the regular check up of glucose. According to NICE and NHS guideline recommendation, this intervention is highly helpful in self management and can help in improving the conditions like diabetes. The third intervention, which will be beneficial here is the maintenance of the nurse patient relationship. This relationship build up is highly beneficial for Inez as well as for the nurse in a way that the relationship becomes more respectful and it will be easy for the nurse to provide her with primary care and with support.

Moreover, as per the standards of NMC, this relationship has a direct influence on the health and well being of the patient. It also promotes the application of the leadership skills and the improvement in the future services. (NMC, 2019). As Inez is suffering from memory loss, a suitable intervention would be giving her physical support as well in going to see her and building that relationship. Also, being open and honest to patient help build a relationship with the patient and family. Lastly, the development of this relationship is beneficial at both ends and promotes evidence based practice. The next to be considered is here is to monitor if Inez is treated correctly in regards to diabetes.

            CASP tool 2018 can also be considered here for the critical appraisal of the interventions being provided to Inez. This tool will examine the implications of the interventions required to apply on Inez. The health professionals and practitioners use CASP for maintaining the quality standards and for streamlining specific interventions. As one of the checklists of critical appraisal tool also contains clinical prediction rule. So, here in this case of Inez critical appraisal tool will be used for supporting the chosen interventions.

            A specific nursing process is about to be followed here to make Inez understand about the interventions and the importance of these interventions to treat diabetes. First of all, there must be proper nurse management which will help in getting the detailed history of the patient. It will ease in implementation of these interventions. Despite this, a proper nutritional and daily physical activity plan will be managed to make Inez’s diabetic condition come to normal. Other than this, all those factors will also be addressed that can disturb the blood glucose level. Another domain of the nursing process is also that when there was a relationship developed between Inez and the nurse, then the nurse can encourage Inez to read the labels of food. It will help her in diet management. (The Royal College of Nursing, 2020).

Along with the application of nursing interventions, diagnosis, and the evaluation of Inez’s condition will go side by side. This will help in drawing an analysis about how the interventions are impacting on Inez. This analysis includes regular glucose check up before and after meals. It also includes the measurement of the level of cognition which predicts that if the memory of Inez is properly working or not. Diabetes also impacted on the memory of Inez, but the application of these interventions will help her get out of the problems. All the chosen interventions reflects the application of primary health care to Inez, and these interventions can be made clear to Inez after making a sustainable and friendly relationship with her. This relationship will maintain the trust level in both the nurse and the patient. Also, the education on medication will help Inez to get a thorough knowledge about her issues and the factors that can help her in getting out the diabetes. The interventions are chosen to review the detailed history of Inez. Implementation of these will help her recover fast.

Ethical and legal issues applied in the interventions

            Learning code of conduct is highly essential to fulfil the professional responsibilities, and this conduct can be highly essential in making effective decisions as well as in learning and development. NMC code of conduct assists in promoting professionalism and to enhance the effectiveness of safety and trust in between patients and nurses. Every nurse has a duty care of NMC, which is related to the legal standards, and this duty of care means that one’s actions might harm another individual. So, NMC also introduces duty of care for legal practices. Mental capacity act is also applied in the case of Inez to meet the legal values of nursing as well. (Mental Capacity Act, 2005). This act goes in support of the patients by which they can make their own decisions, and they have the right to choose an option in the care and treatment. So, in this case, mental capacity act will be considered to let Inez choose whatever she prefers or find appropriate. Also there must be No making assumptions used on her age as that’s discrimination and it’s illegal so find references on this as well. We have to treat her as anyone else. This also leads to an indication of the application of equality act; this will help Inez in the prevention from any discrimination or unfair treatment by the nurses. Human right Act 1998 is another legal action that must be considered as well to overlook Inen’z welfare as well as the autonomy. Respect to Inez is highly essential no matter from what disease she is suffering. (Nursing Midwifery Council, 2018).

            Respecting her autonomy is also highly essential as she has the right to choose whatever sounds appropriate to her. So, she must be set free to choose any intervention she finds suitable for her. Every patient is supposed to have control of whatever is going to implemented on her body. Same is the case with Inez; her autonomy will be maintained no matter what the situation is. Other ethical principles which will also be considered include beneficence, non maleficence and justice. (Beauchamp and Childress, 2013). If Inez refuses, medication then considering the legal act and ethical principles, she will not be forced. But as a nurse, there must be risk assessment present to deal with the critical issues. Also, her family must be consulted in this case, for it can harm her health. (Beyden & Storey, 2011). Here Inez must also be given with person centred care for treating her appropriately. The only condition in which a nurse can make decisions for Inez is that if she lacks capacity. Lastly, the legal consideration to be considered here is the Data Protection Act, for safeguarding the personal information of Inez. According to this act, Inez’s information must be safeguarded and protected, and a proper written consent form must be presented to maintain the confidentiality. In professional means, the duty of candour as a nurse is also the requirement as it demands to stay open and honest to the patient. Also, it will help Inez to know about her conditions. (Gaylor and Grace, 1995).

Conclusion:

            The above discussion revolves around a case study and different evidence based practices required for providing Inez with treatment. Different approaches and two nursing interventions, along with the rationale, provides a straightway path to treat the patient effectively. Analysis of the patient shows different key points that help out in the implementation of primary health approach and nursing interventions.

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