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CNA802 Advanced Professional Nursing Practice

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CNA802 Advanced Professional Nursing Practice Question: Discuss about the Ethical Issues in Mental Health of the Nurses.   Answer: Introduction: Occupational stress is slowly becoming the biggest risk factors in any workplace environment as it comes with a wide range of harmful health issues. Many nurses in Australia are showing signs of severe depression and anxiety as they suffer from dreadful occupational stress while withstanding tremendous physical exhaustion (Rickard et al., 2012). The report deals with a case study of an Australian nurse who is suffering from tremendous depression and gives an idea to the coworkers that how to deal with the situation. This report gives an insight relating this grave issue with the relevant sections of Australian Registered Nurse Standard for Practice. The purpose of this report is to discuss the proximity of the rules of Australian Registered Nurse Standard for Practice with respect to the ethical issues like occupational stress.   Discussion: A study published in the Medical journal of Australia revealed that the rate of depression and suicide in higher in the medical professionals compared to the people with other professions (Milner, Spittal & Bismark, 2017). The study revealed that the occupational gender norms are causing the male nurses to dive deep to depression and attempt suicide as the gender norm makes the practitioners reinforce some traditional feminine behaviors. The stigma around the profession creates anxiety amongst the male nurses, which sometimes drive the male nurses to attempt suicide. On the other hand, the female practitioners suffer from severe anxiety and depression over family-work conflict, their inability to give their family the required time, late working hours, and job demands. They always feel anxiety over their performance at their workplace (Orly, Rivka, Rivka, & Dorit, 2012).  Moreover, the nurses need to provide the patients a caring environment. Sometimes, they grow to be emotionally attached to some dying patients, whose death leads them to be traumatized for sometimes. This also leads them to have depression (Khamisa, Peltzer, & Oldenburg, 2013). According to a study (2015) conducted by the Australian Institute of Health and Welfare, almost 89% of the nurses are female. The same data reveals that their average age is 44.4 years (, 2017). At this age, every nurse becomes quite experienced and suffers from depression due to age, physical stress, mental stress, work overload, time pressure, and excess responsibility.  The Australian nurse from the above-mentioned case study is suffering from severe depression and she even mentioned that she is having suicidal thoughts. Albeit, the Australian health care system enables the medical practitioners to have a ‘Mental Sickness Day’, the nurses are suffering from depression due to stress (Lemont, 2016). The medical practitioners like the doctors, nurses, and midwives are considered to be in a crucial and vital position as they provide care for the patients. However, they are also human beings who need to care for themselves. The unsettling workplace demands and constant stress leads them to develop both physical and mental illnesses. These issues can harm their ability to practice professionally. A study shows that almost 65% of Australian nurses and midwives have more or less one chronic disease, such as asthma, higher blood pressure rate and depression (Perry et al., 2016). The same study suggests that the nurses and the midwives have a larger exposure to high physical and emotional demands. If a nurse is suffering from a mental health issue, there is a bigger risk that that particular nurse in not compatible to give the patient the proper care. Their mental health compromises with their ability, and productivity.   A nurse only can become an asset to the hospital when she (or he) is at the peak of her (or his) physical and mental ability. Only a healthy person can cope with the seemingly normal anxieties, which comes with this noble job. Having an illness has nothing to do with being at the peak; it means that the particular nurse is doing a good job in managing her (or his) job and caring for her own mental or physical health issues. A 2013 study by the National Mental Health Commission reported that more or less half of the Australian citizen aged 18-65 suffers from mental illnesses. If left untreated, the nurse with a diagnosed mental illness would have a disrupted ability to perform the ultimate crucial task that is, providing care for the needful patients (, 2017).  Immediate action: If a nurse has a severe mental illness like depression and anxiety disorder or is suicidal, the colleagues should help her battling the illness by taking care of the individual. The care should include taking the individual to a psychiatrist, helping the person to ease the workload. Many of the nurses can suffer from severe depression and PTSD (Post Traumatic Stress Disorder) because of the severe stress and events they undergo. The co-workers have to understand that reacting to particular trauma with anger, fear or emotional outburst is normal. Nevertheless, everyone has to be alert about one particular fact that, if the emotional reactions sustain for more than four weeks, the nurse may have to undergo treatment. If a colleague of the nurse spots the signs and symptoms of any mental illness like depression, anxiety or PTSD, he or she should express concern over the condition. Doing this would provide the person a warm and supporting work environment. Having a friendly work environment would somehow ease up that person (Opie, 2013). What do you must do following this?: The colleagues of the mentioned nurse must take her (or him) to attain all the counseling session of the psychiatrist. The colleagues also should follow up about many small facts like, if their coworker has taken the prescribed medicines or not and if she (or he) has followed all the remedies prescribed by the therapist. The colleagues may suggest the person undergo the process of self-helping. This includes the practice of managing the thought-process, overall behavior and feelings. The self-help strategies include getting enough sleep, having a diet full of necessary nutrients, having a productive physical activity, keeping the stress level at bay and practicing mindfulness. As the nurses get minor time to relax, she (or he) can practice some relaxing techniques while having a bath. Many groups provide support to the nurses and midwives having any mental illness. The co-workers can help the particular nurse by taking her (or him) to any of the group (Quenot et al., 2012). The co-workers should understand one important fact, which is, the person with mental illness needs concern. Not being judgmental to the person would help her (or him) to recover even faster.  The beautiful country of Australia features a diverse community with many populations with different heritages. The registered nurses of Australia follow the general rule of Registered Nurse Standard for Practice, which respects the culture of every people along with the general culture of health and prosperity. The noble profession of nursing goes beyond the general rule of clinical practice as the nurses can provide service to any ailing person being paid or unpaid.    Which sections of the Australian Registered Nurse Standards for Practice apply here and why?: The registered nursing (RN) standard 2 and 3 can be applied here in this above-mentioned case. The standard two deals with the professional and therapeutic relationship between the nurses and the patient. In the above-mentioned case, the nurse mentioned here is now a mental patient and co-workers would have to play the role of her (or his) caregiver. To give care to that person, every other co-worker nurses would have to communicate with her (or him) effectively (section 2.2). The colleagues have to support and direct the patient towards the proper direction (section 2.4). According to section 2.5, the colleagues of that nurse have to use delegation, consultation, coordination, supervision, and referral to get the nurse with depression under proper care. In this case, the co-worker nurses have to be compassionate towards their colleague (, 2017). The RN standard 3 deals with the maintenance of the capability of practice. The nurse who is dealing with depression should be aware of this nursing standard. The RN standard 3 states that the nurses have to be responsible to maintain their own physical and mental health. They have to be sure about if they are capable of treating the patient or if their physical and mental state is safe for the patients. The registered nurses have to ensure if they are contributing to uplift their own professional development as well as helping their colleagues to be more professionally developed (, 2017). The colleagues of the mentioned nurse have to remind the nurse about taking care of her (or his) own health (section 3.1). This way both the professional relationship and the work environment would be healthier as everyone in the clinic would be capable of giving their best. The colleagues of the nurse would have to provide their troubled coworker with the needed education and information to help her (or him) to take control of her (or his) own health (section 3.2). The cordial relationship between the co-workers should be productive, as they need to learn from each other in order to develop and update their knowledge and skills along with the time (section 3.3). The troubled nurse has to be ready to take review and feedback from the colleagues in order to do better work. This way the depression and suicidal thoughts would not cause any problem in the way to do better work (section 3.5). The person has to know and identifies the role the profession plays in influencing the desirable health outcome for the common people (section 3.7) with the help of the colleagues. Doing this would be helpful for building a strong bond between the coworkers that would further promote the person to recover from the mental illness faster and better (, 2017). What are the possible legal/ethical implications?: The statement one from the code of ethics for nurses says that the nurses have to provide the quality nursing for everyone. To provide quality nursing, they have to be careful about themselves regarding the fact that, they are responsible for somebody’s well-being. The nurse who is battling depression should get help from the psychiatrist as she (or he) has to be more open minded accepting the moral and legal responsibilities of the patient to provide more competent and accurate care (Baldwin, & Barker, 2013; Hegney 2014). The colleagues of the mentioned nurse would also have to be more alert to see if the nurse is being able to provide care for the patient. However, the code 1 states the colleague to report any incompatibility, unsafe or unethical practice to report directly to the authority, the nurse with depression might not be able to differentiate between good practice or bad practice. The colleagues have to show more humanity in this matter and help the depressed colleague to recognize the problem. The harmony in workplace is much needed, where everyone is helping each other (Winland-Brown, Lachman, & Swanson, 2015; Quenot et al. 2012)   The value statement 2 says that the nurses always give value to self and the others. Having self-respect is necessary for everyone as well as respecting the others. The colleagues would respect the knowledge and competency the nurse suffering depression has (Lamont, 2016). All of the coworkers should show care and kindness towards each other and should help each other. If needed, the coworkers have to provide support to each other by collaborating. All the colleagues have to respect their mutual goal of providing proper care to the ailing (, 2017). Conclusion: The Health Workforce Australia published a report in 2012, which states that, by the year 2025, there will be a huge shortage of nurses. The Australian government is making an effort to increase recruitment in the nursing sector and retaining the experienced nurses. The current shortage of nurses in Australia is causing the nurses to face a huge workforce. The work ethics of nurses makes them be compassionate to the patients, but this may be the cause of the growing cases of compassion fatigue amongst the nurses. The compassion fatigue is common amongst the nurses who remain exposed to physical and emotional suffering for a long time. Long exposure to the compassion fatigue along with the occupational stress causes depression amongst the nurses. The severity of this problem is extreme, as some of the nurses even become suicidal. The co-workers would have to be more helpful, compassionate and kind towards them to help them battle the depression. The nurses would also have to take professional help to fight it and make a way for a better and healthy life.   References: Baldwin, S., & Barker, P. J. (2013). Ethical issues in mental health. Springer. Hegney, D. G., Craigie, M., Hemsworth, D., Osseiran?Moisson, R., Aoun, S., Francis, K., & Drury, V. (2014). Compassion satisfaction, compassion fatigue, anxiety, depression and stress in registered nurses in Australia: study 1 results. Journal of Nursing Management, 22(4), 506-518. Khamisa, N., Peltzer, K., & Oldenburg, B. (2013). Burnout in relation to specific contributing factors and health outcomes among nurses: a systematic review. International journal of environmental research and public health, 10(6), 2214-2240. Lamont, S. (2016). ‘Mental health day’ sickness absence amongst nurses and midwives: workplace, workforce, psychosocial and health characteristics. Retrieved from (2017). Our National Report Cards | National Mental Health Commission. Retrieved 30 August 2017, from Milner, A., Spittal, M., & Bismark, M. (2017). Suicide by health professionals: a retrospective mortality study in Australia, 2001-2012. The Medical Journal Of Australia, 206(11), 506. (2017). Nursing and Midwifery Board of Australia – Registered nurse standards for practice. Retrieved 30 August 2017, from Opie, T. (2013). Nursing in the bush: occupational stress in very remote Australia. Orly, S., Rivka, B., Rivka, E., & Dorit, S. E. (2012). Are cognitive–behavioral interventions effective in reducing occupational stress among nurses?. Applied Nursing Research, 25(3), 152-157. Perry, L., Gallagher, R., Duffield, C., Sibbritt, D., Bichel-Findlay, J., & Nicholls, R. (2016). Does nurses’ health affect their intention to remain in their current position? Journal of Nursing Management, 24(8), 1088-1097. doi: 10.1111/jonm.12412 Quenot, J. P., Rigaud, J. P., Prin, S., Barbar, S., Pavon, A., Hamet, M., … & Moutel, G. (2012). Suffering among carers working in critical care can be reduced by an intensive communication strategy on end-of-life practices. Intensive care medicine, 38(1), 55-61. Rickard, G., Lenthall, S., Dollard, M., Opie, T., Knight, S., Dunn, S., … & Brewster-Webb, D. (2012). Organisational intervention to reduce occupational stress and turnover in hospital nurses in the Northern Territory, Australia. Collegian, 19(4), 211-221. (2017). Retrieved 31 August 2017, from (2017). Code of Ethics for Nurses in Australia. Nursing and Midwifery Board of Australia. Retrieved from Who are nurses and midwives? (AIHW). (2017). Retrieved 29 August 2017, from Winland-Brown, J., Lachman, V. D., & Swanson, E. O. C. (2015). The new code of ethics for nurses with interpretive statements. 2015: Practical clinical application, Part I. Medsurg Nursing, 24(4), 268-71.

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