Nursing Midwifery Council (NMC) Code: Safeguarding Standards

The UK parliament developed the Nursing Midwifery Council (NMC) code for regulating the nurses as well as midwives in the UK and nursing associates present in England. The NMC Code is important as it protects the health and well-being of the public as well as assist in developing higher standards of education, training, performance and conduct so that the nursing professionals and midwives are able to deliver consistent healthcare through their careers (NMC, 2014). In this essay, while relating with the NMC, the detailed function and purpose of NMC are to be explored and their relationship with the professional role of the nurses are to be discussed. Moreover, the significance and reason to need confidentiality as element of patient care and communication as element of patient safety mentioned in the NMC is to be discussed. Further, the key principles of NMC for demonstrating competency and way of fitness related with practising professionalism is to be discussed.

The function and purpose of the NMC Code is important to be discussed to understand the way they are guiding and relating with the role of the professional nurses in healthcare. According to Dean (2017), the NMC Code developed has the key purpose of providing guidance to the nurses and midwives regarding the care principles to be followed to deliver quality care. Harrison (2018) argues that the purpose of NMC Code relates with improving professionalism and quality of care delivery by the nurses or nursing associates. This is because the Code educates nurses about the way they are to follow professional courtesy, ethical consideration, patient communication and other to effectively perform their responsibility of providing quality care to the patient under any considerations which ensure patient’s well-being. Thus, in this condition, accessing guidance through the NMC Code helps the nurses in understanding the way they can effectively achieve their responsibility to ensure enhanced well-being of the patient. One of the functions of the NMC Code (2018) suggested by Pearson and Wallymahmed (2020) is to inform the nurses regarding the way to prioritise the care of the patients so that all their needs and demands of care are effectively fulfilled. In this relation, Bradford (2021) suggest that it relates with the role of the nursing professionals or associates because they are responsible to deliver care in the best interest of the patient and are professionally obliged to meet the social, psychological and physical needs and demands of care of the patients.

The other function of the NMC Code (2018) is to inform the nurses regarding the way they are to assess needs and provide treatment to the patient to the best of their ability to support enhancement of their health (NMC, 2018). In this relation, it is suggested by Bucher Della Torre et al. (2018) that it relates with the role of the nurses because they have the role to rightfully make needs assessment of the patient and accordingly delivery pharmacological treatment or arrange any additional non-pharmacological treatment to enhance the health of the patients. Thus, the NMC Code helps the nurses in fulfilling their professional responsibility in an appropriate way. For example, the study by Budiningsari et al. (2018) mentioned that the nurses have the responsibility in making need assessment regarding food intake among the patients so that they can be provided required amount of nutrient and energy through required as per their health condition.

The study by Bennett (2019) suggests that NMC Code also have the function to inform the nursing professionals or associates regarding the way safety of the patients are to be preserved. It is also related with the role of the nursing professional as they have the role to avoid any form of harm or abuse towards the patients and avoid any risk towards the patient’s health under their care for well-being of the patient (Jang and Lee, 2017). Murray et al. (2018) argues that failure to provide safe care without avoiding risk for the patient would lead the nurses to be face legal actions for their negligence in care. This is evident from the instance of MidStaffordshire Hospital where due to lack of enhanced patient safety management, led the nurses as well as the hospital face legal charges for their failure (NHS, 2014).

The study by Leigh and Roberts (2018) mentions that NMC Code has the function to inform the nurses regarding the way they are to act professionally and uphold their reputation (NMC, 2018). This relates with the role of the nurses as they are responsible in acting professionally by maintaining all standards of care delivery, in turn, helping the nurses to meet their professional role (DeNisco, 2019). For instance, the study by Lee and Kim (2019) mentioned that professionalism in nursing helps to create better care efficiency of the patient as well as ensure quality nursing care to be delivered.

Confidentiality means protecting the personal details of the patient and it is important because it ensures avoidance of disclosure of personal identified medication information of the patient by keeping it private (McGrath et al., 2019). The NMC Code features confidentiality as an important care element because if confidentiality of the patient is not protected then it leads to create trust issues in the nurse-patient relationship. This lack of trust leads the patients to avoid disclosing vital information regarding their health that could be used by the nurses to frame better care support for the patients to ensure their higher well-being (Campos-Castillo and Anthony, 2019). It is further suggested by Campos-Castillo and Anthony (2019) that the lack of trust between the patient and nurse created by lack of confidentiality also leads the patients to avoid accessing care from such nursing professionals out of fear of being exposed of their private medical details in the public. Thus, NMC Code also features confidentiality to be an important element of care to enhance the willingness of the patient in seeking care. However, to maintain trust in breach of confidentiality, the nurses are to mention the patients how it has happened and way the breach is managed. Moreover, the patients are to be assured through effective evidence and care support no such breach are to occur in future. This would make the patient trust nurses as they feel no facts in care are hidden from them to misguide them and effective action for the error been done by the nurses to avoid such condition which shows the nurse value the patients while delivering care (Karasneh et al., 2021).

The study by Noroozi et al. (2018) argued that inability to maintain confidentiality of patients by the nurses makes them to lead the patient vulnerable to abuse in the public. This is because exposure of the personal health details of the patients makes the public know regarding the weakness, violation of any custom and social norms been done by the patients and they develop rage on the individual to harm them by understating the individual is unprotected. As criticised by Beltran-Aroca et al. (2016), confidentiality breach in nursing also negatively affect the reputation of the nurse or clinical professional. This is because they are considered to be incompetent in following simple care rules and assure enhanced patient care with safety. One of the legislations that support patient confidentiality is Human Rights Act 1998 mentions that patient’s data are not to be disclosed without their consent and it is to be held confidentially and securely. This is because failure to ensure such action would create breach of right of private life mentioned in the constitution (legislation.gov.uk, 1998). The Data Protection Act 1998 mentions that confidence of confidentiality of the patient data is to be provided to the patients and they are to be ensured that their personal data is never to be misused (legislation.gov.uk, 1998). The confidentiality breach by nurses in case of patients leads them to violate these legislations which makes them face lawsuit which hindered their reputation and can make them lose their registration as mentioned in the NMC Code (NMC, 2017). In the medical field, de Vries et al. (2020) mentions that it is seen that few of the health issues related to sexual, reproductive, mental heath and other aspects are strongly stigmatised by public without medical knolwdege which also leads them at times to cause harm to the patient out of stigmatisation. For instance, patients identified to be HIV positive are often stigmatised in the society because uneducated people thought they may be transferred through touch. In this condition, the revelation of the personal detail of the patient who is affected by HIV makes them face abuse in the society for being carrier of the disease and experience isolation as other fear to interact with them. This creates hindered mental condition of the patient as they are unable to interact with others, ub turn, negatively affecting their health (Khac Hai et al., 2017). In some cultural communities, dementia or any other mental illness is considered as shame for the family and revelation of such information regarding the patient living in family makes community individuals out of stigmatisation abuse and isolate such people to live alone. The breach of confidentiality regarding such disease worsen the condition of the patient and family as mentioned as therefore effective confidentiality of patient is to be ensured (Thomas and Milligan, 2018). In general, the personal details of the patients are never disclosed by the nurses. However, during exceptional condition such as educating people regarding any health issue with proved evidence or arranging specialised care for the patients in multi-disciplinary care, the patient data are shared but with due permission and consent of the patient (Price, 2015). The patient confidentiality usually does not occur due to nurses but may occur due to system issues. This is because currently patient data are stored in computer and an attempted hacking by external authorities may led to cause the patient data and other confidential data to be revealed with no intention of the nurses (Price, 2015).

The NMC Code (2018) highlights effective communication as important part of patient safety because it helps in creating an excellent culture that allows delivering valued care to the patients and their family members (NMC, 2018). The value is important because it improves safety outcomes and care efficiency to promote safety of the patients (Bekelman et al., 2017). As mentioned by Nusa et al. (2017), effective communication with the patients leads the nursing professionals to develop trust from the patient, which in turn, makes them disclose sensitive details about the aspects they consider to be risky for them and compromises their safety. This is because the trust developed through effective communication makes the patient feel the nurses would be attentive and take actions in avoiding the risks without delay (Ward, 2018). Thus, the NMC Code highlights effective communication to ensure patient safety as it helps the nurses identify the extra risk from the patient perspective that are to be minimised to provide them holistic safe care. The communication required to be transparent, show consistency, positive body language by nurses and clarification is been maintained to gather trust of the patient through it (Liu and Jiang, 2021). According to Kennedy (2017), NMC Code also focuses on effective communication to ensure patient safety because it promote teamwork that is the key to ensure safety of the patient. This is evident as Sibiya (2018) suggested enhanced and effective communication helps the nurses as well as other professionals and agencies responsible to support and ensure patient safety to be well-informed of their actions to be executed that improve security of the patient from any harm or abuse or risk of any nature.

The study by Expósito et al. (2018) mentions that in the NMC Code (2018), one of the key principles is demonstrating and maintaining competency in care by the nurses. This is because competency ensures right and equipped professionals to be present in the clinical environment who has the ability to make effective use of potential resources to achieve optimal care outcome for the patient. However, Poorchangizi et al. (2019) argues that failure to maintain competency leads the untrained and unskilled care professionals to be included in care deliver who creates error in care and leads the patient to suffer negative health consequences. Thus, evaluation of NMC Code to promote competency in nursing professionals is important so that qualified professionals are able to be allocated to the care of the patients that bring in their well-being and enhanced health outcome.

The NMC Code mentions that nurses to act according to their competence so that satisfactory and quality care is received by the patient (NMC, 2018). This is because competent nurses are able to identify the key need and demands of the patient and arrange care or treatment accordingly of any nature to be delivered to the patient to offer them quality and satisfactory care (Hovland et al., 2018). However, El-Sayed et al. (2019) argued that incompetent nurses are unable to develop effective communication with the patients to understand their need and deliver complex care in accordance with the need. The NMC Code (2018) also ensure nurses demonstrate competency as it helps in promoting professionalism by the nurses and enhance clinical support (NMC, 2018). This is because nurses working within competency avoid delivery of care beyond their skills and access support from experienced professionals or refer the patients to competent professionals for their care (NMC, 2018). It leads the nurses to express their professionalism of acting in best interest of the patient by avoiding causing any risk toward their health.

All the nurses and nursing associates must ensure that public and patient safety will not be affected by any of their actions. All of them will be required to practice by implementing their knowledge and skills and ask the seniors if they have any difficulty. They are required to raise the concerns immediately if they found themselves in a new situation in which they are confused about their decisions or have any sort of doubt. All of the nursing associates are required to resolve the issues as soon as possible by using their appropriate knowledge and can even discuss with each other if the situation is unmanageable for one person (Rafferty, 2018).

NMC code works on the principles of fitness and aims to deliver effective practice and make decisions about nurses and midwives to make them fit and safe. According to

(Griffith, 2015), the majority of the principles for fitness to practice involves the approach that shows a link with regulatory concerns necessary for the nurses and midwives. To ensure the protection and support for the patients and other members, the management practices to reduce the risk for nurse poses an important place. It has been evident that the NMC code shows alignment to secure the patients and helps the people affected by unsafe care; this requires the involvement of nurses that ultimately demand their fitness to be considered in the first place. Fitness to practices is all about risk management by involving the nurse or midwives and highlight the skills, knowledge, and character to ensure the safe or effective job role.

With the help of fitness to practice, there is an opportunity for nurses to ensure transparency and help them to protect the patients and members of the public to have safe treatment. This is because being fit in practise leads the nurses to have positive physical and mental state to be make critical care decision through enhanced thinking in fresh mind and take required complex physical action to deliver care to the individual without safety issue (Moseley, 2018). The study of (Orr, McGrouther and McCaig, 2014) shared that fitness to practice defined by the NMC code relate with the professionalism of nurse by enhancing their knowledge, skills, good character, good health by which an effective performance can be attained. With the help of the NMC code, secure standards are set for the nurses, increasing the chance to upgrade the qualities, capabilities, and relevancy of the nursing practices. An association between fitness to practices by NMC code and nursing has been explained by the study of (The Nursing and Midwifery Council, 2021)

in which the core principles of the NMC code prefer to prioritise the people, practice the care effectively, preserve the patients’ health as well as promote professionalism. Thus, in this manner, the NMC code and necessary measures of fitness can relate to the nursing associates. Another viewpoint shared by (The Nursing and Midwifery Council, 2021) directs that aims and principles for fitness to practice designed by NMC code emphasised the development of professional culture by prioritising the learning needs of patients. This also promotes to reflect professional and safe nursing practice and maintain professional standards.

Conclusion

On evaluating the gathered information, it has resulted that the NMC code helps to protect the patients and members of the public by involving the fitness to practice to ensure healthy practices. It has been obtained that there is the importance of confidentiality and effective communication to ensure the patients’ safety; meanwhile, the fitness to practice associated with the NMC code is having an effective link with nursing.

References

Bekelman, D.B., Johnson-Koenke, R., Ahluwalia, S.C., Walling, A.M., Peterson, J. and Sudore, R.L., 2017. Development and feasibility of a structured goals of care communication guide. Journal of palliative medicine, 20(9), pp.1004-1012.

Beltran-Aroca, C.M., Girela-Lopez, E., Collazo-Chao, E., Montero-Pérez-Barquero, M. and Muñoz-Villanueva, M.C., 2016. Confidentiality breaches in clinical practice: what happens in hospitals?. BMC medical ethics, 17(1), pp.1-12.

Bennett, S., 2019. Respecting duty of care and patient safety when training and prescribing. Journal of Aesthetic Nursing, 8(9), pp.444-445.

Bradford, H., 2021. The Essential Role of Nurse Practitioners and Midwives on Maternal Mortality Review Committees. Nursing for Women's Health.pp.34-78.

Bucher Della Torre, S., Courvoisier, D.S., Saldarriaga, A., Martin, X.E. and Farpour‐Lambert, N.J., 2018. Knowledge, attitudes, representations and declared practices of nurses and physicians about obesity in a university hospital: training is essential. Clinical obesity, 8(2), pp.122-130.

Budiningsari, D., Shahar, S., Abdul Manaf, Z. and Susetyowati, S., 2018. Needs assessment for patients food intake monitoring among Indonesian healthcare professionals. International nursing review, 65(3), pp.317-326.

Campos-Castillo, C. and Anthony, D., 2019. Situated trust in a physician: patient health characteristics and trust in physician confidentiality. The Sociological Quarterly, 60(4), pp.559-582.

de Vries, J., Landouré, G. and Wonkam, A., 2020. Stigma in African genomics research: Gendered blame, polygamy, ancestry and disease causal beliefs impact on the risk of harm. Social Science & Medicine, 258, p.113091.

Dean, E., 2017. Unlocking the NMC code of conduct. Emergency Nurse (2014+), 25(2), p.13.

DeNisco, S.M., 2019. Advanced Practice Nursing: Essential Knowledge for the Profession: Essential Knowledge for the Profession. Jones & Bartlett Learning.

El-Sayed, A.E.G., EL-Guindi, F.K. and Omar, H.A., 2019. Nursing Core Competencies of Staff Nurses Providing Care for Burned Patients. Master Degree in nursing science, Faculty of Nursing, Ain Shams university, pp.113-116.

Expósito, J.S., Costa, C.L., Agea, J.L.D., Izquierdo, M.D.C. and Rodríguez, D.J., 2018. Ensuring relational competency in critical care: Importance of nursing students’ communication skills. Intensive and Critical Care Nursing, 44, pp.85-91.

Griffith, R., 2015. Understanding the Code: acting in a patient's best interests. British Journal of Community Nursing, 20(9), pp.458-461. Nursing & Midwifery Council, N., 2021. Aims And Principles For Fitness To Practise. [online] Nmc.org.uk. Available at: [Accessed 12 January 2021].

Griffith, R., 2019. Electronic records, confidentiality and data security: the nurse's responsibility. British Journal of Nursing,28(5), pp.313-314.

Harrison, P., 2018. NMC Code updated to cover delegation and associates. Gastrointestinal Nursing, 16(9), pp.50-50.

Hovland, G., Kyrkjebø, D., Andersen, J.R. and Råholm, M.B., 2018. Self-assessed competence among nurses working in municipal health-care services in Norway. British journal of community nursing, 23(4), pp.162-169.

Jang, H. and Lee, N.J., 2017. Patient safety competency and educational needs of nursing educators in South Korea. PloS one, 12(9), p.e0183536.

Kennedy, C.J., 2017. What is person-centred care and can it be achieved in emergency departments?. Emergency Nurse, 25(2).pp.78-90.

Kurth, A.E., 2017. Planetary health and the role of nursing: A call to action. Journal of Nursing Scholarship, 49(6), pp.598-605.

Lee, K. and Kim, S.H., 2019. Professionalism of the Nurse: A Concept Analysis. Journal of Convergence for Information Technology, 9(9), pp.94-107.

legislation.gov.uk 1998, Human Rights Act 1998, Available at: https://www.legislation.gov.uk/ukpga/1998/42/contents [Accessed on: 6 March 2021]

Leigh, J. and Roberts, D., 2018. Critical exploration of the new NMC standards of proficiency for registered nurses. British Journal of Nursing, 27(18), pp.1068-1072.

McGrath, L., Swift, A., Clark, M. and Bradbury-Jones, C., 2019. Understanding the benefits and risks of nursing students engaging with online social media. Nurs Stand, 34(10), pp.45-49.

Murray, M., Sundin, D. and Cope, V., 2018. The nexus of nursing leadership and a culture of safer patient care. Journal of clinical nursing, 27(5-6), pp.1287-1293.

Nisa, S.N.U., Hussain, M., Afzal, M. and Gilani, S.A., 2017. Quality of nurse patient therapeutic communication and overall patient satisfaction during their hospitalization stay.pp.45-78.

NMC 2014, NMC Code, Available at: https://www.nmc.org.uk/news/press-releases/2014/nmc-code-set-to-highlight-importance-of-delivering-fundamental-care-to-both-living-and-dying/ [Accessed on: 6 March 2021]

NMC 2018, The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates, Available at: https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf [Accessed on: 6 March 2021]

Orr, J., McGrouther, S. and McCaig, M., 2014. Physical fitness in pre-registration nursing students. Nurse Education in Practice, [online] 14(2), pp.99-101.

Pearson, S. and Wallymahmed, M., 2020. The new NMC standards: Changes to student supervision and assessment. Journal of Diabetes Nursing, 24(3), p.136.

Poorchangizi, B., Borhani, F., Abbaszadeh, A., Mirzaee, M. and Farokhzadian, J., 2019. The importance of professional values from nursing students’ perspective. BMC nursing, 18(1), pp.1-7.

Sibiya, M.N., 2018. Effective communication in nursing. Nursing, 119, pp.19-36.

Stonehouse, D., 2020. Reflection and you. British Journal of Healthcare Assistants, 14(11), pp.572-574.

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