NMC Code of Conduct: Reflection on Ethical Challenges in Nursing

This essay provides a reflective account of a nursing student's experience navigating an ethical dilemma during a clinical placement, focusing on the application of the Nursing and Midwifery Council (NMC) Code of Conduct. The situation involved a patient diagnosed with breast cancer whose family chose not to disclose the diagnosis, requesting the student nurse to withhold information about the planned mastectomy. The essay details the student's internal conflict, guided by the NMC codes, leading to the decision to inform the patient, thereby upholding her autonomy and right to informed consent. The reflection analyzes the ethical principles at stake, such as respecting patient dignity and ensuring informed consent, and concludes with an action plan for future professional development, emphasizing the importance of continuous learning and adherence to ethical guidelines in nursing practice. Desklib provides students with access to similar solved assignments and resources for their studies.

Running head: REFLECTION
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Name of the student:
Name of the university:
Author note:

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Code of professional conduct may be explained as the necessary component to any of the
professional that is extremely important for maintaining the standards for the individuals within
that domain of the profession. This mainly helps in bringing about the accountability of the
persons in their professions and ensures that they are maintaining their responsibility and trust to
the individuals whom such professionals serve in their domain (Fisher, 2017). Professional
conduct mainly involves the professionals to involve different aspects of the profession like that
of the ethics, behaviors, standards as well as morals. The purpose of the professional codes of
conduct developed for the nurses by the NMC mainly helps in guiding the nurses as well as the
midwives in the day to day practices. This help the nurses to understand their professional’s
responsibilities in providing care for the patients not only in a safe way but also in the ethical as
well as the effective way (Jenkins et al., 2015). This assignment will show how the NMC codes
of conduct had helped me to overcome an ethical situation that once developed during my
clinical placements and the ways by which I have handled it.
Description:
Once a patient named Mitchell Brown of 46 years of age was admitted to the ward after
her immense pain in the breast region that continued for several months. A number of lumps
were also found in her chest region when diagnosis was made. She was seen to be quite cheerful
and was communicating in a descent manner with the nursing professionals. However, after
initiating a discussion with her husband and her son of 26 years old, it was known that she was
diagnosed with breast cancer but the family members had not disclosed to her all these thinking
that it would break her heart and she would not be able to tolerate the shock. They stated that it
the expert oncologist had advised them to conduct a mastectomy on the patient so that she can be
freed from the chances of further progression of her breast cancer. However, it was not revealed

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to the patient and they had admitted the patient stating to her that only a small surgery would be
conducted on her that would help her to remove the limps. They stated that removal of her
breasts would affect her mentally as well as physically and this might make her suffer from
depression as she had been very conscious about her appearance and fitness from very young
age. They stated that if such situation of mastectomy is revealed to her, she would never get
ready for undertaking the surgery and this will affect her life. Hence, they requested me not to
reveal her but continue preparations of the surgery so that she could be saved. They also stated
that they would handle the situation successfully after the operations are over.
Feeling:
I was completely shocked after hearing the explanation and was clueless at that very
moment. Such an action taken by the family members shocked me and I became nervous about
what steps I needed to take at that situation. I came to the patient and tried to communicate with
her. I tried to ask her “Do you know what has happened to you?” To this the patient answered
“Yes, I very well know.. I only have a number of lumps in my breast region and the doctor will
operate them. I believe I would not require much time and pain”. To my surprise, I understood
that indeed the patient was very unaware of the fact about the reason of her admit and I became
more nervous seeing that she had no clue about her disorder. At that very moment, I decided that
I could not behave in any unprofessional ways that the NMC professional code of conduct does
not allow to perform.

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Evaluation:
The patient was not at all aware of her real health issue of breast cancer and that her
breasts need to be removed. However, at that time I was forced by her family members to make
her not know about it and conduct surgery. This would make me breach the codes like
maintaining autonomy and dignity of patient and breaching the taking of informed constant of
the patient. This made me nervousness and I felt stressed at the situation. However, the good part
was that this stress and nervousness did not prevent me from providing safe and ethical care to
the patient. I was able to follow the NMC guidelines and revealed the information to the patient
as I felt she had the right to know. She stated “I am glad that you said it to me… it is my body…I
have the right to know about every part of my health… however, I cannot accept that i could be
affected by cancer”..
Analysis:
The first breach of the codes that would have resulted is the breaching in the principle of
treating patients as individuals and respecting them with dignity. It is extremely important for
every human being to be given the choice about their own lives and the decisions that they want
to take about their own treatment options and other important aspects of healthcare (Shepherd,
2017). It is important for every healthcare professional to respect the choices of the patients and
thereby take interventions that will align with their choices and help to act according to their
will. Researchers are of the opinion that when the nursing professionals do not maintain this code
of conduct and ethics, it may upset the patients making them depressed and anxious where they
may feel that they are not given independence and freedom to experience their own thoughts
over their lives (Papadopoulos and ali, 2016). This may in turn lead to legal and ethical

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obligations. Therefore, in such situation I took the resort to NMC codes of professional conduct
as the guidelines and decided that I need to maintain the dignity of the patient. The patient has
the right to know about her disorders and illness (NMC, 2015). Therefore, I discussed the matter
with my member and revealed to her the different diagnosis that had been made about her
present condition. The patient broke down miserably but my seniors could rightly counsel her
and the situation was brought under control. The mentor also supported me and appreciated my
decision stating that I had rightly followed the codes.
Another code of professional conduct that also needed to be followed is the ensuring of
the informed consent. It is extremely important for the professionals to understand the
importance of informed consent. It is extremely important for the patients to understand their
present conditions and then learn about the treatments that need to be conducted over them.
Every patients should know about the treatment would be conducted over them, the advantages
and disadvantages with the professionals and help in educating the different types of important
knowledge and health literacy for the patient. Moreover it was important that the patient should
know about what exactly she requires at that moment and what experiences she might have
during and after the surgery (Kangasniemi et al., 2015). Therefore, this code of conduct taught
me that I should first provide importance to taking the consent from the patient that she is now
ready with the interventions and that she is allowing the professionals to carry on with the
interventions proposed to her (Royal College Of Nursing, 2015). After informing her about all
the mentioned aspects, I asked her consent about conducting the mastectomy surgery to which
she stated that she needed time for taking decisions. Such approach made the seniors happy and I
was appreciated for my decisions.
Conclusion:

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I understood that in many a times, there might be situations where I may face ethical dilemmas
and need to critically think about the different approaches that I need to pick up for caring of the
patients. NMC codes of professional conduct are extremely helpful in maintaining ethical and
professional care in ways that not only maintains laws but also ensure patient satisfaction and
maintain the principles of healthcare services. I had been able to handle the situation successfully
by following each of the guidelines that our mentor had mentioned in the theoretical classes.
Initially, I was distressed but I did not let my nervousness affect my work and make me
unprofessional. When such situations would occur again in the future, I should immediately take
the resort of the NMC guidelines of the codes of professional conduct. I should try to gain more
experiences so that such codes and ethics get imprinted on my practice and skills so that I never
get confused and nervous and always provide the best care.
Action plan:
To develop myself and to become more efficient, I believe that I have to handle more of
such cases individually so that I get the scope to develop knowledge about how to be
professional in my approach and follow codes effectively. Moreover, I also need to attend to
workshop classes where I would be able to develop self-regulation skills and handle my stress
and nervousness effectively. I would also discuss cases with my mentor where they can provide
me many narratives and how he had effectively handled cases to maintain the NMC codes of
conduct. I would gain huge knowledge and would be able to use them successfully.

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References:
Fisher, M. (2017). Professional standards for nursing practice: How do they shape contemporary
rehabilitation nursing practice?. Journal of the Australasian Rehabilitation Nurses
Association, 20(1), 4.
Jenkins, R. (2015). Unlike ours, most professional codes have an ethical dimension. Nursing
Standard (2014+), 29(37), 32.
Kangasniemi, M., Pakkanen, P., and Korhonen, A. (2015). Professional ethics in nursing: an
integrative review. Journal of advanced nursing, 71(8), 1744-1757.
Nursing and Midwifery Council (2015) Becoming a nurse or midwife. Available at:
https://www.nmc.org.uk/education/becoming-a-nurse-or-midwife/
Papadopoulos, I., and Ali, S. (2016). Measuring compassion in nurses and other healthcare
professionals: An integrative review. Nurse education in practice, 16(1), 133-139.
Royal College of Nursing (2015) Revalidation- 6cs-nursinG. Available at:
https://rcni.com/revalidation/6cs-nursing-32156
Shepherd, J. (2017). Midwifery basics: becoming a midwife 4. Promoting professional behavior
in practice. The Practising Midwife, 20(2), 13-15.