It is important that you are familiar with the requirements for your profession in the jurisdiction where you will be licensed/registered. If you are interested in knowing more about professional standards please see:
www.nmc.org.uk/standards/standards‐for‐nurses
www.gmc‐uk.org/about/what‐we‐do‐and‐why/setting‐the‐standards‐for‐doctors
https://policybase.cma.ca/en/viewer?file=%2fdocuments%2fPolicypdf%2fPD19‐03.pdf#phrase=false
Maintaining professional standards
The Code of Practice or requirements for good practice for each profession clarify the standards for education and practice that must be consistently met by all members of that profession. Maintaining standards of professional practice is important because they enable the public to have confidence in the healthcare professionals to whom they entrust their care and that of their families. The public can be satisfied that each registered healthcare professional has met the standards for entry to the register and ongoing requirements in order for their registration to remain live.
Activity
You are invited to consider the professional implications of the behaviour demonstrated by the radiography student in this clinical scenario.
Chan has brought Hu, her 2‐year‐old toddler, to the emergency department. Chan suspects that Hu has swallowed a small metal key. The key is clearly visible on an X‐ray image, which has been viewed by several members of the radiology team. A radiography student takes a picture of the X‐ray on his mobile phone and shares it with a friend through social media. The friend posts the photograph to a public social media site and it is viewed by 5000 people.
From your reading of the relevant professional code, what issues does this raise? Do you feel this behaviour is professionally acceptable? Give a rationale for your answer.
Thinking of the Person‐centred Practice Framework, consider which component(s) of the prerequisites domain you can draw upon to explore this scenario.
In your discussion, you may have considered professional issues such as dignity, confidentiality and the challenges of using social media. For example, Chan has not given consent for this image to be shared in this way. This may have breached data protection requirements relating to the sharing of information and its justification. In this scenario, there is no apparent permission or justification for sharing the image and the action therefore compromises the privacy and dignity of Chan and the family, which may have serious consequences for the student and the healthcare provider. You may have also considered the Person‐centred Practice Framework, specifically the prerequisites domain including clarity of professional beliefs and values such as the need to demonstrate respect for personhood and commitment to the job. The student is not role modelling person‐centred behaviour and by sharing this information has breached procedures and shown abuse of his position.
Legal and ethical responsibilities
Our professional codes and standards are underpinned by legal and ethical responsibilities and aligned with values and rights that are fundamental to person‐centred practice. These include considerations such as the primacy of the individual, the individual's right to self‐determination, social justice and equitable access to healthcare (Levinson et al. 2014). Health and social care regulators also have a role in managing risks to the public, to other healthcare professionals and to individual practitioners themselves, so that only those who are fit to practise are permitted to do so. Regulators depend on registrants, employers, the public and law enforcement bodies to report any concerns that may bring into question a registrant's fitness for professional practice. The following activity encourages you to think about issues of risk.
Activity
John is a second‐year student currently undertaking practice learning in a community residential setting for older people. Whilst the registered staff are attending a meeting, Mr Gregor presses the call bell requesting a commode. The safe transfer of Mr Gregor from his bed to commode will require two people to operate the use of a ceiling hoist and there is no‐one else around. John has never used this type of equipment and he's frightened of asking for help. Mr Gregor urgently needs to use the toilet. John manages to apply the sling on his own and hoists Mr Gregor onto the commode. Afterwards John asks one of the registered staff to help him return Mr Gregor to bed and comments that Mr Gregor nearly slipped during the earlier transfer.
What professional issues does this raise? Using the Person‐centred Practice Framework, what components of the practice environment domain are relevant in this episode of care?
In your discussion, you may have considered professional issues such as competency, accountability and preserving safety. In relation to the care environment domain of the Person‐centred Practice Framework, you might have considered appropriate skill mix, shared decision making, power sharing and effective staff relationships. You may have questioned why John did not feel able to ask for help; is this based on his previous experience or current levels of support? Additionally, you may have questioned why John was left alone and why he was prepared to engage in care activities beyond his scope of competency. Consider the potential trauma for Mr Gregor if he had slipped. For John there could also be consequences, both in terms of accountability for his actions and the risk of injury as a result of inappropriate moving and handling. The appropriate professional response would be to prioritise the interests of the client and to seek help. This experience could be used as an opportunity for reflection between John and his practice supervisor, to explore their values and competencies and the culture of the care environment. A possible outcome could be that John attends a moving and handling update, demonstrates safe client transfers and has the confidence to seek help and challenge unsafe practice.
Person‐centredness, professionalism and organisational structures
Key learning from a range of international inquiries into high‐profile failures in health and social care practices has highlighted the importance of organisational structures and cultures in achieving safe and effective, person‐centred practice (Sinclair 2000; Douglas et al. 2001; Francis 2013; Gosport Independent Panel 2018). Recurring issues from such inquiries include failure to raise and challenge concerns, poor performance management, ineffective leadership and inadequate clinical governance systems (Walshe and Shortell 2004). It is therefore essential for healthcare professionals to be vigilant to issues in their own practice, and that of others, which are inconsistent with person‐centred values. These may include issues that are explicitly unacceptable. It may, however, include more subtle instances that nonetheless lead you to feel uncomfortable when you believe personhood and dignity have not been respected. The following vignette offers an example of this.
A clinical manager attends a multidisciplinary bed management meeting in a large NHS teaching hospital. The senior bed manager tells staff that there are 23 patients