It is clear from my observations within adult cardio-surgical patients, that human diversity is a complex issue for the nurse, that has many inter-linking facets providing novel situations, ethical dilemmas, and also a wealth of skills, knowledge and competencies to solving critical health and social care issues. Nursing is a social activity and so the range of patient, co-worker and the general public temperaments that personal will come into contact with is vast. In order for these therapeutic relationships, however brief, to have an impact on the healing process, it is apparent to me that a nurse must develop their communication, caring, justice and fairness skills. This paper will briefly review my personal reflection on the topic of nursing philosophy/human diversity.
Communication, care and justice and fairness within nursing are critical issues as staff must be able to engage with, and develop therapeutic relationships with a diverse range of individuals, cultures, communities and aggregate groups that comprise a community. In order to be sensitive to the human diversity of patients, it is evident to me that a nurse must continually develop skills of sensitivity to other’s ways of expressing their needs, expectations and responses to health care issues. Further, the nurse must cultivate an awareness of the socio-political issues within her community which will impact on decision-making of patient care, such as gender roles, issues of multiculturalism, and social protection of the socially excluded (e.g., the elderly, disabled or the homeless).
It is clear to me, that the issues of fairness and justice are bound up in concepts of power relationships, and that the nurse must be aware that they are perceived as the one’s who have the power (in the form of knowledge) by the patients. In cardiac medical care, a patient may choose a particular treatment option presented to them based on the advice of the nurse. The nurse must remain aware of the influence the power the role of the nurse brings with it, and so not unduly influence a patient deciding on their treatment, as this would infringe on the patient’s right to not be coerced into any particular procedure.
The development of communication involves not only learning and putting into action active listening, empathy, use of silence and reflection. Being able to comprehend and appreciate what another is saying about a situation is important to enable all medical details of the patient to be obtained, and for the patient to develop a rapport and bond of trust with their nurse. Caring is often considered a given requirement of a nurse. It is important that a nurse foster a caring approach to all patients, regardless of their physical, psychological or socio-cultural differences, as the feeling of being cared for can dramatically impact on the progress of treatment and so a patient’s well being.
Especially, with cardiac patients, it is necessary that the nurse be aware that older patients may be famished for caring interactions with others, and that a caring attitude from a nurse can often greatly support their therapeutic experiences. Further, nursing skills requires investment in knowledge of ethical guidelines (such as the Nursing and Midwifery Council [NMC], and the British Medical Association [BMA]), the concept of social justice, social responsibility and clinical governance. These codes of conduct draw on internationally recognized standards of clinical, research, supervision and community practice of accountability, respect and care for the well being of others.
In conclusion, it is my nursing philosophy of human diversity that communication, caring, justice and fairness require constant reflection upon due to the fast-paced nature of the medical arena in the 21st century. Many factors impact on a nurse’s ability to be sensitive to the diversity of human needs that they engage with on a daily basis, as shown in Figure 1. For example, long work hours, insufficient wage, low staff numbers, an aging population with their own specific needs, changing family structures, personal lifestyles, as well as more global economic, socio-political and environmental events, all exist as part of the web of a nurse’s ecological existence. I feel that a code of ethics provides a filter for nurses to guide their administration of communication, caring, fairness and justice practices to a diverse human population.
Figure 1. My personal philosophy of how the degree of a nurse’s sensitivity and problem solving ability is determined by internal and external factors, that are filtered by ethical codes.