Professional Boundaries in Nursing

Professional Boundaries in Nursing The scope of work of Assistant Medical Officer is very clearly governed by the Board of Medical Assistants which was comes under the preview formed under Malaysian Medical Assistant Act (Act 180), AMO takes the oath of Medical Assistant Code of conduct which serves as an ethical guide map to morally binds steer AMO to its rules and responsibilities. It is therefore the responsibility and morale duty of every Assistant Medical Officer to uphold the medical ethics with professionalism and honor. At no other circumstances AMO are allowed to carry out other work outside the specified prescribed boundaries. However in reality AMO in my clinical set up does lots of duties actually falls under the scope of other professional such as doctor, psychology counselor and dietitian. While it feels good that as an AMO, we can perform many works normally done by other professions however it is not without possible legal implications. Boundaries are an imaginary line that separates the duties of a pa rticular professional from the others. Boundary is the ability to know where one ends and where another person begins. Professional boundaries are important because they define the limits and responsibilities of the professional with whom we interact in the workplace. When workplace boundaries are clearly defined, the organization can function more efficiently because redundant work assignments are eliminated.improve this rational it is because health professional have specilised skills and high quality pt care is a collaboration of skills the optimum benefit of the pt outcome. When everyone in an organization is made aware who is responsible for what, healthier workplace environments are created. Crossing borders No professionalism by AMO No collective power Criss crossing of professional boundaries is the norms of today s chores especially working in Haemodialysis Centre .AMO in Haemodialysis Centre especially in my state is working under a great stress. duress and precarious role. Currently, AMo provide care for 000 dialysis care pt over 19 centre through the state requiring close mentoring and care. In Haemodialysis lots of duties specify critical procedures e.g performed by AMO are not legally sanctioned covered under MA act. These porecedures are carried out on the instructions of Renal specialist who by hirechrichal position of power who acts like Kings control the strings where AMO forced to puppet without questions. Being in this precarious position, AMO professional are extremely vulnerable, as if everything goes well, we will get just get condescending a pat at the back, but when something goes wrong support strings are quickly cut and one get ostracized for breach of professional boundaries. Officers nowadays in Haemodilysis centres are not only to ensure that patients comes for three times dialysis treatment, patients gets adequate dialysis treatment but also to carry out mentorship, the staff as a mentor and the patients as the mentee. Through this the Renal doctors expects nurses and AMO to functions as mini-doctors, i.e the mentor are to know the day to day medical conditions, nutritional conditions, medications and blood parameters of their patients. They are expected to know how to make adjustment to tritrate patients medications and dialysis treatment and also to make referral to renal specialist when necessary as there is no. The ironiny is there is no Renal specialist /doctors through the 18 other rural regionla dialysis centres but a total 12 specilaist conviently stationed in urban hospital in the state`s city. Failure of the mentor to make proper mentorship and care of their patients, the mentor will be scolded admonlished by the doctors and if the mentor dis agree question their role with this ruling, they will be asked to leave of the Haemodialysis Centre. Thus a profession dictated by others without voice of empowerment over a long term cannot mature professionally (RRRRR) and it is for this reason that I have chosen this topic to explore and expose the various flaw, the impact and the possible remedy to our health care system. Lain lain u buat sendirilah Nowadays the public or consumers are more knowledgeable, educated and know their rights, medical knowledge can now be easily accessed right at the comforts of their home via internet and as a results any wrong practices will be subject the AMO and nurses to litigations. It is therefore no surprising that patients are more knowledgeable, than the nurses. As a result they have a higher expectation to receive a good quality of health care and thus push the AMO and Nurses to a stressful situation. Although the AMO and Nurses are capable performing the job but with thoughts of professionalism hanging on their heads they feel that patients are not getting the best professional treatment. Though AMO tried everything possible in order to meet the demand of the patient, but sometime patient are not satisfied as they prefer doctors to AMO/Nurses in terms of prescribing medications and blood test and hence AMO and nurses continue to be yelled. (Vondras et al, 2004).These things make the AMO fee l uneasy as at one point they want to be obedient subordinates but at the same time feel that unprofessionalism is practice. And so the AMO/Nurses works about like headless chicken doing their work without much thinking. I feel that Innocent Nurses and AMO are the most vulnerable groups in the medical professions as they can be force by their superior to carry out jobs which is not in their list of jobs descriptions .However in the last line of the list of jobs descriptions, it states that, to carry out orders or instructions as ordered by a higher authority from time to time . I personally feel that this statement has been long abused by higher authorities such as doctors as this controversial statement is deemed to be a license for doctors and higher authorities to compel the nurses and Assistant Medical Officer to carry out clinical or non clinical activities. Somehow the order of carrying out a mini-doctors job which is a vertical substitution with controversial permissions, are reluctantly carried out by the Nurses and AMO because of the unavailability of Renal specialized doctors and moreover if they dont do the job then the patient will suffer and may even cost the patient life. The mentors wh ich is working under stressed however carry out their jobs minus their heart and with frustrations and they may eventually burnt out, Curci, Linda. (2004) Therefore the Associations of Dialysis for Medical Assistant and Nurses (ADMAN) must stand up and issue a strong collective voice to protects the AMO/Nurses from this continuous exploitations. .However the more important questions is, are the nurses or AMO adequately protected from the law when carrying out certain task which may be a risky procedure and may have a medico-legal implications? The Medical Assistant Board has underline codes of Ethics and professional conduct of AMO which must be observed by all Assistant Medical Officer As not all AMO task are specified, I wonder if the ministry of health will go all the way to protect her staff in the case of law suits. The experience faced by AMO and Nurses is therefore akin to force labor. This abuse is therefore professionally wrong as it lays the major platform of destroying the medical support industry. As a protective strategy in the medical profession, doctors have given the nurses low regard therefore making them to have low self esteem towards their profession and assume subordinate perspectives (Fritz, 2008, p. 82) However jobs which are not listed in the main AMO jobs descriptions are Credentialed and privileged. It is therefore important that all terms and conditions of the process of credentialing and privileging must be observed and documented in order to comply the requirement of credentialing and privileging. How To Document on Credentialing and Privileging Applications. Available at : http://www.ashp.org/s_ashp/docs/files/SCSS_HowtoCredPrivdoc.pdf accessed 30 September 2010 . While credentialing is the process of obtaining, verifying and assessing the qualifications of a healthcare practitioner and to provide patient care services privileging is the process used to identify, document, and approve the specific procedures and treatments that may be performed in a specific setting. Privileges are granted based on the findings of the credentialing function and should only be granted for services that are currently offered by the hospital. Available at : http://knol.google.com/k/kathy-matzka/credentialing-and-privileging/3ep8m4hgro5l7/1# accessed 30 September 2010. The noble mission of ministry of health Malaysia is to lead and inspire through excellence in medical device regulatory system., to influence change and forge partnership that ensure public health and safety, to ensure that only high quality, effective and safe medical devices are available in Malaysia, to encourage and support the innovation and development of technology in medical device industry.( Medical Device Bureau Ministry of Health, Malaysia ). And in Nursing, professional boundaries simply means to establish the immediate legislations and requirements that differentiate the nurses and doctors scope of works (Ruth Constance ,2008, p. 39). Nursing profession is born out of ethics and desire to ensure that high levels of purity and integrity of life is observed (Barbara Lynn, 2008, p. 109). When there is lack of clear definition of specific boundaries in terms of specialization, the doctors are considered to have more impact in treatment of the patients than the nurses (Anne, 2008, p. 277). Nurses are not allowed to challenge any of the surgeons decisions but just to follow instructions as the surgeons finish the patients operations within short periods and then leave the nurses to carry out nursing care of the patient (Fritz, 2008, p. 82). Besides being a clear generalization, assumption, deliberate or unintentional underrating of the nurses profession, it is a clear indicator of torn delineations that lacks clear outlining for harmonious operations (Bessie Huston, 2008, pp. 752-753).Nurses are therefore required to assume their major activities when they are away irrespective of the main reason (Ruth Constance, 2008, p. 40). With lack of proper institution for defining the boundaries, the nurses are consumed in their calm built nature of service towards humanity (Colyer, 2004, pp. 408-104) .Using strong legislative framework and policy guidelines, nursing should be guarded like other professions and define the required relationship with the doctors in their areas of work (Bridgit, 2008, p. 569). When there is a criss crossings violations by doctor intrusions they allow do but wont empower you. Surface icing doctors may need AMO/Nurses helps but in reality they dont allow the AMO/Nurses to practice outside making the AMO/Nurses only the tool of convenience .However If everybody wants their own border of practice, everything have to wait for the doctors thereby causing a mark increase of public complaints. Therefore care should now be multi-taskings and coordinating care . Why I do cross boundaries, I do for the following reasons :- Because I am facing the patients If I dont do the public will complaints Critical to do patient will do Sometimes expatriate doctor with questionable qualifications patients may die but if my mother or relatives I want them to do it correctly. What happen if I do then Patient recovered really well I will save reputations of the my hospital Pat on the back from the doctor however it not done openly However patient will not be happy . But what happen if there is a complications when I do it then I will be Trying to be smart Trying to be a doctor Model for crossings borders Counsellings deepressed patients suicidal Anne, M. (2008) Advanced Practice Nursing: Essential Knowledge for the Profession. New Jersey: Jones Bartlett Publishers Barbara, M. Lynn, K. (2008) Holistic Nursing: A Handbook for Practice. New Jersey: Jones Bartlett Publishers. Credentialing and Privileging? Available at : http://www.ashp.org/s_ashp/docs/files/SCSS_HowtoCredPrivdoc.pdf accessed 30 September 2010 Colyer, H. M .(2004) The Construction and Development of Health Professionals: where will it end?, Journal of Advanced Nursing, 48 (4), pp. 406-412. Fritz, A. (2008) Physicians at War: The Dual-Loyalties Challenge. Miami: Springer Publishing Press. How To Document on Credentialing and Privileging Applications. Available at : http://www.ashp.org/s_ashp/docs/files/SCSS_HowtoCredPrivdoc.pdf accessed 30 September 2010 Medical Device Bureau Ministry of Health, Malaysia http://www.mdb.gov.my/mdb/index.php?option=com_contenttask=viewid=62Itemid=113 Ruth, F. Constance, J. (2008) Fundamentals of Nursing: Human Health and Function. San Francisco: Lippincott Williams Wilkins. Curci, Linda. (2004). Burnout. http://www.counseling.caltech.edu/articles/burnout.html. Life Positive. 2000. Stress at workplace. http://www.lifepositive.com/Mind/psychology/stress/stress-at- work.asp#causesofworkplacestress

Up The Coulee :: essays research papers fc

Reconciliation   Ã‚  Ã‚  Ã‚  Ã‚  In â€Å"Up the Coulee,† Hamlin Garland depicts what occurs when Howard McLane is away for an extended period of time and begins to neglect his family. Howard’s family members are offended by the negligence. Although his neglect causes his brother, Grant McLane, to resent him, Garland shows that part of having a family is being able to put aside negative feelings in order to resolve problems with relatives. Garland demonstrates how years apart can affect family relationships, causing neglect, resentment, and eventually, reconciliation.   Ã‚  Ã‚  Ã‚  Ã‚  After a decade of not seeing his mother and brother, Howard returns to his hometown in Mississippi. It is evident how thrilled he is. As the train approaches town, he begins â€Å"to feel curious little movements of the heart, like a lover as he nears his sweetheart† (par. 3). He expects this visit to be a marvelous and welcoming homecoming. His career and travel have kept his schedule extremely full, causing him to previously postpone this trip to visit his family. Although he does not immediately recognize his behavior in the past ten years as neglectful, there are many factors that make him aware of it. For instance, Mrs. McLane, Howard’s mother, has aged tremendously since he last saw her. She has â€Å"grown unable to write† (par. 72). Her declining health condition is an indicator of Howard’s inattentiveness to his family; he has not been present to see her become ill. His neglect strikes him harder when he sees â€Å"a gray â₠¬â€œhaired woman† that showed â€Å"sorrow, resignation, and a sort of dumb despair in her attitude† (par. 91). Clearly, she is growing old, and Howard feels guilty for not attending her needs for such a long time period: â€Å"his throat [aches] with remorse and pity† (par. 439). He has been too occupied with his â€Å"excited and pleasurable life† that he has â€Å"neglected her† (par. 92). Another indication of Howard’s neglect is the fact that his family no longer owns the farm and house where he grew up. They now reside in a poorly conditioned home: It was humble enough--a small white house, story-and-a-half structure, with a wing, set in the midst of a few locust trees; a small drab-colored barn, with a sagging ridge pole; a barnyard full of mud, in which a few cows were standing, fighting the flies and waiting to be milked. (par. 74) Grant explains to Howard, who has obviously forgotten, that the mortgage on the old farm was too expensive for them to afford.

Prescriptive Grammar Essay

This lesson highlights the important fact that linguists describe the grammatical system of a language on the basis of what people actually say, not what they should say. To a linguist, grammar consists of those constructions judged acceptable by a native speaker’s intuitions. This is what it means to say that linguistics is descriptive and not prescriptive. Linguistics is descriptive, not prescriptive. Many people associate knowing a language with speaking and writing it according to the grammatical rules established for that language in grammar books and dictionaries. The study of linguistic competence does not include the study of prescriptive standards that claim that one sentence rather than another is correct. Instead, linguists are interested in what speakers of a language actually say and what they accept as possible in the language, regardless of whether the construction matches the grammar rules posited by the grammar â€Å"police.† This approach to grammar is descriptive rather than prescriptive. Descriptive grammar is what speakers say, and when, why and how they say it (and not whether they should or shouldn’t say it.) Linguists concern themselves with discovering what speakers know about a language and describing that knowledge objectively. They devise rules of descriptive grammar. For instance, a linguist describing English might formulate rules such as these: 1.Some English speakers end a sentence with a preposition (Who do you want to speak to?) 2.Some English speakers use double negatives for negation (I don’t have nothing.) 3.Adjectives precede the nouns they modify (red book, nice guy) 4.To form the plural of a noun, add -s (1 room, 2 rooms; 1 book, 2 books) 5.The vowel sound in the word suit is produced with rounded lips. Linguists don’t make judgment calls as to whether the speakers should or shouldn’t speak a certain way. Descriptive grammar, then, is created by linguists as a model of speakers’ linguistic competence. Prescriptive grammar is what speakers should or shouldn’t say. When most people think of â€Å"grammatical rules,† they think of what linguists call rules of prescriptive grammar. Prescriptive rules tell you how to speak or write, according to someone’s idea of what is â€Å"good† or â€Å"bad.† Of course, there is nothing inherently good or bad about any use of language; prescriptive rules serve only to mold your spoken and written language t o some norm. Here are a few examples of prescriptive rules; you  can probably think of others. 1.The subject of a sentence must agree with the verb (The instructions are clear NOT The instructions is clear.) 2.Use much for count nouns. Use many for non-count nouns (We don’t have much coffee AND We don’t have many cups of coffee.) 3.Capitalize the first letter of a sentence (The television is broken. It needs to be fixed.) 4.Use subject pronouns after the verb be (It was I who called you NOT It was me who called you.) 5.Use the definite article the before names of rivers and geographical areas but not before the names of lakes or continents (the Nile, the Middle East AND Lake Tahoe, Asia) Notice that the prescriptive rules make a value judgment about the correctness of an utterance. Descriptive rules, on the other hand, accept the patterns a speaker actually uses and try to account for them. Descriptive rules allow for different varieties of a language; they don’t ignore a construction simply because some prescriptive grammarian doesn’t like it. If linguistics is descriptive and not prescriptive, then why do we have prescriptive rules anyway? So, if prescriptive rules are not based on actual use, how did they arise? Many of these rules were actually invented by someone. During the 17th and 18th centuries, scholars became preoccupied with the art, ideas, and language of ancient Greece and Rome. The classical period was regarded as a golden age and Latin as the perfect language. The notion that Latin was somehow better or purer than contemporary languages was strengthened by the fact that Latin was by then strictly a written language and had long ceased to undergo the changes natural to spoken language. For many writers of the 17th and 18th centuries, the rules of Latin became, whenever remotely feasible, the rules of English. It is somewhat surprising that rules that do not reflect actual language use should survive. There are several reasons, however, for the continued existence of prescriptive rules. 1.Rules provide a standard form of a language that is accepted by most speakers of that language. Adherence to prescriptive rules allows a speaker to be understood by the greatest possible number of individuals. This is especially important for a language such as German, which has dialects so different from one another that their speakers cannot always understand each other. 2.A set of standard rules is necessary for students learning English (or any other language) as a second language. Imagine the chaos if there were no guidelines for learning English  (or Spanish, or Japanese, or Arabic, etc.) Thus, rules serve a very useful purpose for language teachers and learners as well. 3.Most importantly, there are social reasons for prescriptive rules. Nonstandard dialects are still frowned upon by many groups and can inhibit one’s progress in society. The existence of prescriptive rules allows a speaker of a nonstandard dialect to learn the rules of the standard dialect and employ them in appropriate social circumstances. Therefore, prescriptive rules are used as an aid in social mobility. This does not mean, however, that these judgments about dialects are linguistically valid. The idea that one dialect of a language is intrinsically better than another is simply false. From a strictly linguistic point of view all dialects are equally good and equally valid. To look down on nonstandard dialects is to exercise a form of social and linguistic prejudice. We’ll learn more about language and identity in our next module. According to the Merriam-Webster Online Dictionary, the term dates from 1706 and is defined as â€Å"a person who adheres strictly and often excessively to a tradition†, especially â€Å"one preoccupied with the purity of a language and its protection from the use of foreign or altered forms.† A purist is one who desires that an item remain true to its essence and free from adulterating or diluting influences.

How Does Divorce Create Long Term Negative Effects For...

Divorce is one of many controversial subjects in family and human development research. What inspired me to critically analyze the article â€Å"Does Divorce Create Long-Term Negative Effects for Children?† is the challenge it would be for me to put my bias aside considering I am from a divorced home. After reading the article and analyzing it over and over, I can’t help but think that the writer answering â€Å"YES† to this controversial question overlooked many variables and over generalized his findings and research. With Zinsmeister overgeneralizing his research, not considering enough alternate explanations for long-term negative effects divorce, and his lack of relevant information needed to assess reliability and validity are why I find this article to be insightful but not accurate and hope to show why. In the introduction to the article, the authors David Gately and Andrew Schwebel best wrote â€Å"Karl Zinsmeister uses studies of children and divorce to argue against the contention made by many parents that it is better to divorce than to rear children in a marriage with conflict. He maintains that children’s sense of stability and family structure supersedes parental needs.† Throughout the article Zinsmeister uses the headings â€Å"Fear and Loathing of Divorce Among the Young†, â€Å"Short and Long-Term effects of Divorce on Children†, and â€Å"A Catalogue of Behavioral Changes† as a platform to prove/explain his opinions and back them by research. Essentially Zinsmeister wrote one: thatShow MoreRelatedDivorce Negative Effects1285 Words   |  6 Pages2017 A Positive Outlook on a Divorce Divorce is always a dreadful experience in a persons life, especially a childs’. When parents divorce, children are left hopeless and confused. 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