Professional Values in Nursing Practice: Upholding Confidentiality and Effective Communication

This text discusses the importance of confidentiality and effective communication in nursing practice, with a focus on the legal, ethical, and professional codes and standards that regulate nursing practice. It also explores the ethical dilemmas that nurses may face when trying to uphold these values. The subject is nursing practice, and the course code and college/university are not mentioned.

Professional values 1
Professional values
Name
Institutional affiliation

Professional values 2
Introduction.
The nursing practice is broad; from patient care to research and education. The various
aspects of nursing practice are regulated by various legal, ethical and professional codes and
standards. All nurses are included in the register when they commit to abide by the requirements
of the profession which are stipulated in the codes and standards. Adherence and compliance to
these regulations are enforced by a professional regulatory body. The nursing and midwifery
council is mandated with this task in the UK (Osborne, 2015). Their legal standards are those
which are those whose adherence is required by a law to be undertaken. A failure to comply
attracts a punitive action following a criminal proceeding.
Professional codes are not necessarily a requirement of the law. They are stipulated by
the professional body for its members. A deviation from the expectations subjects an individual
to disciplinary measures through a professional tribunal that analyses their conduct. According to
Feo, Rasmussen, Wiechula, Conroy, and Kitson (2017), this is done by considering their
professional expectations with reference to their skills and qualification. Ethical requirement
derives the expectations of the values and virtues gained in practice. It also has demanded some
level of professional judgement. Ethical requirements may be a legal requirement or just an
expectation of the professional body. Personal values in practice are the main consideration.
In the case scenario, professional values of confidentiality and communication are the
main concern. These are important aspects of a nurse-patient interaction. They are the basis of
building a rapport and trust upon which nursing practice happens. These values cut across the
legal, ethical and professional requirements in practice. These two basic components of nursing
practice are comprehensively discussed below.

Professional values 3
Confidentiality
According to the nursing and midwifery council (2015), the nurse owes the duty of
confidentiality to all those receiving their care. Patients have a right to privacy and
confidentiality (Moss, 2017). When a nurse takes up the responsibility of care, they are obliged
to treat the patients with utmost level confidentiality. They enter into an agreement of non-
disclosure which must be respected. A breach of this agreement is punishable by law and the
regulatory body. Confidentiality is argued to be the most important value for any health
professional. Care can only be provided when the patient discloses all the necessary information
to the care provider during history taking (Griffith, 2015). The course of interventions is based
on the acquired information. If the patients withhold some information, a care plan that is
formulated may miss some very vital details which may have some far-reaching consequences to
the patient. This may range from the prescription of the wrong drugs or prescription of drugs in
lower quantities than the required doses. Some studies have shown that healthcare providers have
spent so much time and resources treating the symptoms rather than the root cause of a problem.
The root problem could have otherwise been detected in the process of history taking.
Taking a good history is influenced by the level of trust a healthcare provider inspires
from their interaction with the patient. Patient integrity is a major concern to them that does not
influence their health-seeking behaviour but also their adherence to the treatment regimen. The
success of nurse-patient interaction is pegged on the level of confidence (Gilbert, Rickert &
Aalsma, 2014). It is one aspect that cannot be substituted. The issue of confidentiality has some
legal and ethical requirements surrounding it. In law, the aspect of confidentiality is a key factor
in patient care. There is no single law that has been formulated to address the issue of

Professional values 4
confidentiality (Ferguson, 2016). The sources of these laws have been judicial precedents
following cases that touched on the matter. For instance, in the case of Hunter v Mann (Carr,
2015), the court ascertained that a doctor is bound by duty not to voluntarily disclose,
information, which they have gained in their professional capacity from the patient, without their
consent. This law addresses the nurses and all other healthcare providers involved in care
provision.
The law protects the dignity and autonomy of individuals (Monrouxe, Rees, Dennis &
Wells, 2015). Confidentiality is necessary to uphold this human right (Michalowski, 2017).
Medical information is recognized as private and the law requires its protection. Handling of
patient data is done to in confidence and by only those authorized. Consent is sort in case the
information is to be shared. In the case scenario, being a nurse, the duty of responsibility has to
be upheld at all times. Patient information, concerning their course of treatment and prognosis
can be disclosed to other people only when consent has been sought from them. Without a
consent, it is prohibited to do so. The information that is being sorted in the case scenario is
identifiable to the patient; thus should be held handled with strict confidentiality.
Sharing information with friends and relatives is also guided by the principle of
confidentiality. The patient should consent to disclosure of information to them (Dheensa,
Fenwick & Lucassen, 2016). The law has a provision where a patient can give the power of
attorney to a family member or attorney to make decisions concerning their care if they are
incapacitated. Such an individual will be granted the right to access their information in order to
make an informed decision. By signing the legal documents granting such powers, the patient
will have consented to disclosure as per the terms and conditions governing the relationship. In

Professional values 5
the case scenario, it would only be possible to provide the information with the friend required if
they had such powers of attorney or if the mother consented to such an action.
The law also provides some statutory provisions where confidentiality can be breached
(Ley & Hayes, 2018). In the case of the notification of an infectious disease, a health practitioner
is required to inform the necessary authorities for action without necessarily having to ask for
consent. The circumstance is viewed as the best move for the public interest. To protect other
people from infection, the authorities should be notified. A court may be issued requiring
disclosure of such information (Gerrard, 2018). If the court finds it necessary to retrieve such
information, a nurse may be subpoenaed to testify and shed light on a matter in a particular case.
The case scenario above does not fit the above requirements and thus disclosure confidentiality
cannot be breached.
The scenario poses an ethical dilemma while trying to uphold the principle of
confidentiality. Respect of autonomy of the patient is mandatory even if the patient will not
know it even if it was breached. It is possible that the friend's mother will not know that the
information was not breached. Legally, the issue would be punishable if the issue is brought
before a court or medical tribunal. Ethics focus on the actions of the healthcare provider. What is
considered professionally correct even if it may not be a requirement of law.
In confidentiality, a nurse will be required to view the consequentialism of their actions
(Lunt, 2016). Their clinical judgement should guide their decision. The disclosure may break the
trust that the patient has in the healthcare provider. This may result in the withholding of vital
information that may be essential for the further provision of care. Inpatient care, the relatives
and friends are equally affected if a friend or relative is suffering. It is understandable when there
is a conflict of interest when a family member or friend expresses their needs and one feels that

Professional values 6
they can meet them. However, the principal duty of a healthcare provider is to the patient
(Hébert, 2015). Once they agree to take care of them, they assume the duty of care to that patient.
Any action that may undermine the autonomy of the patient is avoided at all costs. The ethical
decision, in this case, is to seek the patient's consent on disclosure of information.
Communication
Communication is a deliberate sending and receiving of information. All the patient-
nurse interactions are founded on the ability to pass and receive information (Rowe, 2017). The
patient can give an account of their health when consulted while healthcare providers can explain
the treatment plans and options available. Communication is important in creating a rapport
between the patient and the care provider. Essentially the relationship is completely based on
communication. Thus there has been a lot of emphasis on communication as a very essential
interpersonal skill among healthcare providers (Fitzpatrick, 2018). A nurse is expected to have
good communication skills for effective interaction with both the colleagues and the patients.
Some of the good communication skills include being a good listener. The simple rules of turn-
taking enable the nurse to allow the patient to express themselves without interruption. The use
of open-ended questions is a way of encouraging the patients to communicate and making them
make a decision free from bias. Compassion and empathy are expressed by the use of use of kind
words. Trust can be built and maintained through communication and giving assurance to the
patients (Brashers, Phillips, Malpass & Owen, 2015). In a healthcare team, effective
communication is necessary for interaction between the different professionals in the team.
Communication has been a matter of great emphasis in both training and practice. Patient
education is the hallmark of preventive medicine (Alligood, 2017). The nursing and midwifery
council has set out the important considerations for an effective patient education program. The

Professional values 7
information should be clear, intelligible and accurate.it should be in a way that the patient can
easily synthesize and understand. It is the duty of the nurse to explain to the patients about their
condition in a way that they can easily understand. The nurse is expected to customize the
education to suit the suit the needs of the patient keeping in mind their level of understanding
and level of education. In establishing a patient-centred care plan, patient education is important
in order to encourage their participation
Current trends in healthcare are being directed towards a patient-centred approach in
care. The patient is made aware of all the treatment options they have, the expected outcome and
the complications associated therewith. Communication enables the health provider to explain
the contents of an informed consent (Kurtz, Draper & Silverman, 2016). It may enable them to
make decisions in anticipation of the expected outcome. For instance, in the case scenario,
during her patient education, the mother should have been informed of the expected outcome and
those that should be contacted to provide support. they could also decide who to make decisions
in case they are unable to do so. Passing such information to the patient will empower them and
make them feel in control. They can make arrangements and make decisions about their care and
the people that should be involved.
However, the nurse also has a responsibility of care. They should be cautious of the
mental health of an individual and the overall impact of the information on the patient recovery
(Fitzpatrick, 2018) Balancing the duty of care and the right to information poses a challenge to a
nurse. In such a situation, the nurse will have to critically judge the situation and arrive at a
decision. They should be aware of how and when to break down some critical information to the
patient. A support structure which may involve the relatives and friends may be important.

Professional values 8
In the case scenario, the concerned nurse should take up the responsibility of the
explaining to the patient about consenting to family members accessing the health information.
The process will include explaining to her the right to autonomy and confidentiality (DoH, 2015)
and how her consent will be necessary for the family members to gain information on her
progress. However, they should inform them that their decision would be without coercion. In
any case, her decision will be honoured. Proper communication of the issue at hand will enable
her to gain all the necessary facts for her to make the decision (Herring, 2015). The issue of
consent has both legal and ethical connotations. Legally a consent will give permission for the
healthcare provider to share information with those close to the patient. The friend's mother
should be consulted on the information to be shared so that they can consent. Ethically, it is
prudent to recognize that those individuals close to the patient play a very significant role in their
recovery. Some information is very sensitive to the patient and they should agree if it is to be
shared and specify to whom it should be shared. Communication is what will enable a healthcare
provider to identify the wishes of the patient and consequently honour them.
Sometimes, in viewing the patient’s condition, the nurse may feel that the course of the
recovery may be influenced by those around them. In cases of terminal illnesses, it is usually
advisable to improve the quality of life of the patients by allowing them to spend some time with
their loved ones. However, this may not be the wish of the patient as some of them would not
want their loved ones to see them in such a condition. In the case scenario, the condition of the
patient or their wishes has not been expressed. The situation described above poses as a conflict
of interest in the discharge of duty.
The healthcare provider has a duty to listen to the concerns of the relatives and family
members (Al-Jawad, Winter & Jones, 2017). They should weigh the impact of the information

Professional values 9
and the therapeutic benefits that would be drawn from giving the information to them. They have
a duty to tell the patient what the close relatives and friends would wish to know regarding the
condition. However, they should honour the wishes of the patient at whatever cost. Sometimes
the patient may have particular directives to the healthcare provider not to disclose information
to some individuals. If those individuals they had been requested not to disclose that information
ask, they should listen to them. However, they should judge whether the patient will consider it
as a breach of professional confidentiality (Sokol, 2015). In the case scenario, it is the duty of the
nurse to explain to the friend's mother that the friend wanted to have to get some information
about their health. They should then explain to them the essence of providing such information to
her, then let them make their own decision regarding the issue.
As a Pre-registered nurse, complying with the codes of professional and ethical conducts
is the only way to acquire a practising license. Communication and confidentiality are critical in
nursing care. In the case scenario, it's a matter of professional and ethical standards in patient
care. Practising to abide by them is the only way to ensure professionalism and promotion of
patient rights and dignity. Consulting with superiors on such conflicting issues will be a way of
seeking assistance on issues they may need support.
Conclusion.
The conduct of nurses is tightly regulated by professional and ethical codes. By the virtue
of being a nurse, one is expected to abide by the regulation to ensure safe practice. The code
prioritizes on the interest of the people. It considers needs and the safety of the people
paramount. They ensure an effective practice and promote professionalism and trust. These are
key concepts in the provision of care and building a fruitful professional relationship. Punitive
actions accompany individuals who violate the regulations. Criminal proceedings may be

Professional values 10
initiated if the act committed is prohibited in the law. Professional violation, in most cases, if not
criminal, is dealt with by the regulatory professional body. The principle of confidentiality cuts
across both law and professional codes. A punitive action following the breaking of
confidentiality may be handled both in the court of before a professional body tribunal
formulated to analyse the conduct of a professional. In the case scenario, the disclosure of
patient’s private information without prior consent would be punishable. Confidentiality is an
ethical principle that defines the nurse-patient interaction (Laurie & Porter, 2016).
Communication is also a major component of a therapeutic relationship. Good
communication skills have a bearing on the success of the interaction (Hargie, 2016). Barriers to
communication, such as poor listening skills, have been implicated with the majority of the
medical errors. Patient education falls in this category. It has been championed as one of the
most effective ways of developing a patient-centered approach in care. consultations with the
patient can be made and decisions discussed and arrived at with the health care provider. in the
case scenario, communication was important in expressing the wishes of the friend to the mother
and receiving a feedback for the same.

Professional values 11
References.
Al-Jawad, M., Winter, R., & Jones, E. (2017). Communicating with relatives. Bmj, 359, j4527.
https://www.bmj.com/content/359/bmj.j4527
Alligood, M. R. (2017). Nursing Theorists and Their Work-E-Book. Elsevier Health Sciences.
Brashers, V., Phillips, E., Malpass, J., & Owen, J. (2015). Measuring the impact of
interprofessional education (IPE) on collaborative practice and patient
outcomes. Measuring the impact of interprofessional education on collaborative practice
and patient outcomes, 67-133.
Carr, C. (2015). Beginning medical law. Routledge.
Department of Health UK. (2015) “CINAHL Database.” EBSCO Health Medical Databases and
EBooks, www.rcn.org.uk/professional-development/principles-of-nursing-practice.
Dheensa, S., Fenwick, A., & Lucassen, A. (2016). ‘Is this knowledge mine and nobody else's? I
don't feel that.’Patient views about consent, confidentiality and information-sharing in
genetic medicine. Journal of medical ethics, 42(3), 174-179.
Feo, R., Rasmussen, P., Wiechula, R., Conroy, T., & Kitson, A. (2017). Developing effective
and caring nurse-patient relationships. Nursing Standard (2014+), 31(28), 54.
Ferguson, A. H. (2016). Should A Doctor Tell? The Evolution of Medical Confidentiality in
Britain. Routledge.
Fitzpatrick, L. (2018). The importance of communication and professional values relating to
nursing practice. Links to Health and Social Care, 3(1), 26-40.

Professional values 12
Fitzpatrick, L.(2018) The importance of communication and professional values relating to nursing
practice. Links to Health and Social Care Vol 3 (1), pp.
Gerrard, J. W. (2018). Threats to doctor-patient confidentiality. bmj, 363, k4948.
Gilbert, A. L., Rickert, V. I., & Aalsma, M. C. (2014). Clinical conversations about health: the
impact of confidentiality in preventive adolescent care. Journal of Adolescent
Health, 55(5), 672-677.
Griffith, R. (2015). Understanding the Code: scope of the duty of confidentiality. British journal
of community nursing, 20(6), 304-306.
Hargie, O. (2016). Skilled interpersonal communication: Research, theory and practice.
Routledge.
Hébert, P. (2015). Ethical Issues in Medical Confidentiality and Privacy. In Ethical and Legal
Issues in Modern Surgery (pp. 47-74).
Herring, J. (2015). Q&A Medical Law. Routledge.
Kurtz, S., Draper, J., & Silverman, J. (2016). Skills for communicating with patients. CRC Press.
Laurie, G. T., & Porter, G. (2016). Mason and McCall Smith's law and medical ethics. Oxford
University Press.
Ley, R., & Hayes, N. (2018). Confidentiality and Release of Medical Information. A Medic's
Guide to Essential Legal Matters, 25.
Lunt, C. (2016). Breaching confidentiality and ‘empowerment’?. Ethics and Social
Welfare, 10(1), 75-81.

Professional values 13
Michalowski, S. (2017). Medical confidentiality and crime. Routledge.
Monrouxe, L. V., Rees, C. E., Dennis, I., & Wells, S. E. (2015). Professionalism dilemmas,
moral distress and the healthcare student: insights from two online UK-wide
questionnaire studies. BMJ open, 5(5), e007518.
Moss, L. S. (2017). Collaboration, confidentiality, and care. Psychological services, 14(4), 443.
Nursing & Midwifery Council. (2015). The code: Professional standards of practice and
behaviour for nurses and midwives. London: NMC.
Osborne, K. (2015). Duty to provide fundamentals of care spelled out in new NMC code.
Rowe, G. (2017). VALUES AND ETHICAL FRAMEWORKS IN HEALTH AND SOCIAL
CARE. The Handbook for Nurse Associates and Assistant Practitioners, 20.
Sokol, D. K. (2015). Update on the UK law on consent. BMJ: British Medical Journal
(Online), 350.