Implementing and Evaluating Ethical Frameworks in UK Nursing: A Report

This report delves into the ethical and legal landscape of nursing in the UK, focusing on the National Health Service (NHS) and the role of the Nursing and Midwifery Council (NMC). It examines the NMC Code of Conduct, emphasizing its importance in guiding nurses' professional behavior, patient care, and ethical decision-making. The report outlines key legal and ethical frameworks, including the Mental Capacity Act 2005, and discusses the practical application of these frameworks in addressing ethical dilemmas. It highlights the four core themes of the NMC code: prioritizing people, practicing effectively, preserving safety, and promoting professionalism and trust. The report also explores the four domains of professional nursing practice, including professional values, communication skills, nursing practice, and leadership. Furthermore, the report covers the legal frameworks, including case and statute laws, and the importance of safeguarding patient interests. The report concludes by emphasizing the significance of continuous improvement and the evolving role of nurses in modern healthcare, underscoring the need for nurses to understand their professional implications and adhere to ethical standards. This report provides valuable insights into the ethical and legal aspects of nursing, providing a comprehensive overview of the NMC Code of Conduct and its implications for nurses' practice within the NHS.

Nowadays, nurses are responsible to provide high-quality of services to their clients or
patients. They are certainly confronted with some ethical challenges in their specialised
practices. The nurses are familiar with ethical code of conduct which are formed by higher
authorities and these are also essential in making ethical decision making. The ethical code of
conduct has been adopted many professionals in order to serve legal services to patients (Aylott,
2011). Professional nursing is defined as “the promotion, protection and optimisation of health
and abilities, which also prevent illness and injury of human begins”. Present report is focus on
National Health Services which is a public health services in England. The annual budget of this
organisation is approximately £136 billion in order to provide high-quality of services. In this
report, code of conduct of NMC (Nurses and Midwifery Council) has been explained. Along
with this, key legal, ethical and evidence framework which are used in nursing in UK is
discussed. Further, role of nurse in UK while implementing and evaluation of ethical frame work
is discussed.
Nurses and midwifes are facing more ethical dilemmas during their work places,
especially when they are taking care of patients at the end of their life stages. The present case
study demonstrates how nurses are performing their jobs in hospital. When I did my placement
in hospital as a nurse, I met with a patient who was intravenous drug user and was mentally
disturbed. The patient was rude with other nurses and he did not do his medications on regular
basis. The other departments of nurses also were very rude with patient and they shouted on
patient. But I understood that patient is having mentally challenging behaviour and we are not
supposed to shout at the patient. I did a care plan on his condition and the nurses started to follow
that. The patient also was very happy with my service and told me that from tomorrow you need
to give me medication including Tinzaparin (Antithrombotic) injection. Since that day if I was
on duty I gave injection to him because I am a nurse and I have to work in my limits and
boundaries. So, it is essential for organisation to apply all NMC code of conduct, which specifies
about roles and responsibilities of nurses, about how to behave and talk with similar kind of
patients. With the help of ethical code of conduct, nurses will treat their patients properly and
maintain all records which are required by them on regular basis. While doing this, it is essential
for nurses and midwifes to understand their patients’ problems and take further appropriate
actions for giving them treatment (Groves, 2014). For this, there are many ethical frameworks

which are used by NHS in order to serve quality of services to customers. Moreover, role of
nurse is also essential in while making any such plan.
Ethical code of conduct contains professional standards for registered nurses and
midwives. The nurse and midwives of UK are doing work in this line with ethical code of
conduct, whether they are providing individual services or in groups and communities. They are
also increasing their knowledge to practice other roles such as leadership, research and many
more. While interpreting with core values and principles, local authorities, government, they
have set out code in different practice settings which are not negotiable or discretionary (The
NMC Code Professional staff, quality services, 2015). With the help of ethical code of conduct,
it brings commitment to nurses and midwives’ professional standards to do their work in
appropriate manner. NHS are taking action when, these nurses fail to uphold with their code. In
such case, organisation can also take serious actions to suspend them from job. Nursing and
Midwifery Council (NMC) regulates approximately 6,70,000 nurses and midwives and these are
registered in UK. They are updating code of practices and behaviours which govern professional
standards on regular basis.
The codes which has been made should be useful for everyone who cares as good nursing
and midwifery. In NHS nurse and midwives are using code so that they can promote safe and
effective practices at their workplace. In organisation, it is responsibility of employer to help
their staff in upholding their standards and provide quality and safety services as per regulatory
(Brooker and Waugh, 2013). Ethical code contains series of statement which are taken together
and signifies the importance of nurses. It helps to patients and service user to put their interest so
that they can promote trust through professionalism.
The code became effective from 31st March, 2015. As this code reflects the world, in
which human beings live and works. It also reflects changing roles and expectations of nurses
and midwifes towards their professionalism. These codes are structured in four themes –
promote professionalism and trust, preserve safety, to prioritise people and to practice
effectively. In prioritise people; care taker (nurse) has to treat with individual as dignity that they
preserved, and respect them accordingly. In practise effectively, nurses have to clearly
communicate with their patients and work cooperatively with others. Moreover, they have to
share their knowledge and experience for the advantage of people. It is also their responsibility to
maintain proper records without falsification, if any such kind of activity are found then they

have to take a serious immediately. Further in preserved safety, they have help patients in
emergency and take reasonable steps so that they can protect people from risk or neglect also. In
last, promote professionalism and trust, nurse have to uphold their reputation all times. Along
with this they have to cooperate with all audits and investigations which are carried out by higher
authority (Budden, Hayes and Buettner, 2014). The organisation is developing collaboration with
many who are respecting nursing and midwifery, these codes are used by them to reinforcing
their professionalism.
The ethical code of conduct which has to be applied by NHS should be in appropriate
manner which help nurses to work properly. Nurses have to give prioritise people so that they
can easily came to know about patient problems which are facing by them. Along with this they
can also provide effective services to them. It is their responsibility to safeguard themselves from
any dangerous activity which are performed by patients. Nurse have to perform their roles and
responsibilities according to ethical code of conduct which are demonstrated by NMC. While
applying these ethical code of conduct, it empowers the core value of nurse in organisation. It
will aid them, to provide quality of services to patients.
Role of newly qualified nurses are also working in preceptor ship and supernumerary
which are addressing accountability issues. This allows them to have confidence regarding their
competencies and take responsibility to provide better services to customers. Through this nurses
will be aware about their responsibilities in order to prevent foreseeable harm to customers.
Nurses are typically encountering ethical issues in three realm of biomedical ethics which
includes health related problems, overarching and these are impacting societies as whole. If
patients are unhappy with their services, then they can easily tell to them. It’s always best for
patients to take services from those people who really take care them. The codes which have
been issued by NMC, are periodically updated and ensure that they are relevant for nurses and
midwifery practices who are currently working in NHS. The revision of these set of procedures
will reflect change in contemporary. There focus is on to drive continuous improvements so that
nurses and midwifes will provide quality and safety of care services to patients (Casey and
Wallis, 2011).
In modern era, health care practices and knowledge are constantly changes and
developing a new research on treatments. Along with this they are also changing procedure of
providing better treatments to patients. In current scenario, there is a requirement of nurses and

midwives and for this, they have to understand their professional implication. The fundamental
concepts of ethical, legal and professional regarding will help them to understand these
requirements (Elisabeth, Ewa and Christine, 2011). The standards for competency has applied to
all fields of nursing and set out four main areas regarding professional nursing practices. These
are;
Domain 1: Professional Values – In this, all nurses have to safeguard interest of people.
Their practices must be autonomously and they are also responsible for compassionate, safe,
evidence-based. Nurse have to respect and maintains dignity among clients and their human
rights. They have to show their professionalism and integrity towards their work so that patients
can believes on them. Apart from this, if they are working in partnerships, then decisions which
are taken by them, it should be shared among them also.
Domain 2: Communication and interpersonal skills – All care taker must use excellent
interpersonal and communication skills at work place. Their communication must be effective,
respectful towards patients. As there are many disable people in hospitals, so nurse have to work
with them in reasonable and obtain information from supervisors so that reasonable adjustment
can be made. Through this they will promote the optimisation of health in organisation.
Domain 3: Nursing practice and decision-making – The practices of nurse must be
autonomously. They have to maintain their dignity and promote well-being of patients (Groves,
2014). They should assess all range of essential needs of all age of people who are coming into
their care of services. The practices which has been done by nurses should be comply with all
regulations which are framed by governments. Along with this, decision-making process must be
shared with all service-users and with their families also. Moreover, behaviour and culture and
factors of patients should be properly understood by nurse. Through this they will find out health
and issues which are facing by them and deliver services accordingly.
Domain 4: Leadership, management and team working – In NHS, all must be
professionally accountable towards their work. The nurses must be professional accountable and
use all clinical governance process so that they can improve and maintain healthcare standards.
They have to grab opportunities in order to improve their quality of services (Heng and et. al.,
2011).
The current legal framework of nurses in UK includes case and statute laws. Their
legislation has set out the primary responsibility for protecting life of public (Ion and et. al.,

2015). The orders which has been passed out by department of health, professional standard
authority are binding with their principles. Along with, legal framework which has been framed
by them are legal binding on nurse to follow them properly. Legal consideration includes Mental
Capacity ACT 2005, in this, it sets out legal position in determination of capacity to treat with
adults in appropriate manner. This act is applicable to those people who are aged 16 years and
older. There is also a related act (Adults with Incapacity Act 2000). In this there is no statutory
legislation that governing the children who are below the age of 16 years.
Legal framework regarding adult nursing to safeguarding interest from their issues.
Safeguarding is complex area while incorporating the assessment need of individuals. Nurses
have to understand their legal obligations to meet the requirements of Human Rights Act 1998,
Equality Act 2010. As per given scenario, Mental capacity act 2005, have set out legal
framework to protect individual rights who do not have capacity to make decision. The patients
who are having capacity then, then they have to take into account their wishes which involve to
protect their decisions.
Those regulatory frameworks which has been issued by different departments of health
and social care should be regular monitor (Legal and Ethics Guidance, 2012). The above
mentioned frameworks are used by each and every health and care organisation who are
registered under UK. Professional values, communication and interpersonal skills, management
& leadership and nursing practices and decision-making these are applied according to needs of
organisation. It is mandatory for all hospitals to work in regulatory frameworks. Through this,
they will get many advantages and retain in competitive market for a long period of time.
There are number of care practices which are available for asthma, diabetes and heart
failure and mental problems. These practices are not constantly executed in providing care
delivery. Nurse plays an important role at Health and social care because they deal on regular
basis with patients (Jenkins, 2012).
The role of nursing is required at each process which includes planning, implementation
and evaluation. This also provides methodical approach to examine that which problems are
facing by patients and how they are resolving their issues. The nursing process is applied at work
place through which patients needs can be analyse in appropriate manner. As these process
consists four stage and they are in cyclical nature.

Assessment is first step in nursing process. In this, it enables to nurse to undertake a
holistic assessment. They have to consider all individual needs so that they can identify their
problems regarding their health (Kako and et. al., 2014). As, it is essential for finding all these
problems, because without this nurse cannot treat with them in proper manner. As per given case
scenario, nurse have to take care of patient who is suffering from mental problem,
Planning is second process. Nurse have to identify the problem which is facing by mental
person. If problem is identified properly, then they have to do plan accordingly. Plan should be
made with the help of expertise in order to provide proper treatment to patient.
Implementation is third stage, where it clearly set out the direction about what is to be
done, when it is to be done and by whom it is to be done. Through this, patient will get a clear
picture of their care and motivated those to take actively part (Levati, 2014). While, it will give
benefit to nurses in order to understand their problems and accordingly they can also provide
best services to them.
Evaluation is final stage and it is considered as most important process in all steps which
informs about that whether better services are provided to patient or not. In this stage, if patients
are facing by same problems, then they have to again start cyle with assessment. Evaluation of
plans and goals should be achieved with in time period. If not, then they waste the time of nurse
in delivering proper services to patients.
The practices should be supported by evidence based written which informed the tailored
needs of patients (Salanova and et. al., 2011). Treatments and care which are provides by care
taker should be according to culture which does not harm their religion also. The plan of nurse
should be taken into account to diagnose the presence of patients. In NHS, nurse need to adopt
various skills such as communication, learning for giving best quality of services to users.
Interviewing skills is fundamental factor which empathise to user in listing and exchanging
information from others (Sellman 2011).
Effective professional teamwork of professional is central provision of NHS. The skills
and knowledge which are associated with multi professional disciplines are essential to gain
optimal patient care. Nurses are working with them so that they can achieve their common goals.
They have to build their high-professional team in order to provide better treatment to patients.
In this they can also make strong communication with professional team and make good plan
which are suitable for patients. Each professional involved in a patient care contribution which

specifies skills, knowledge and services. So all of them are depended upon each other to perform
certain aspects of patient care. Further, care planning regarding patient should be done with the
help of expertise so that proper treatment can be provided to them. In given case scenario, nurse
have to assess care for mental person time to time which will help them to protect them from
other people in NHS.
Overall, the nurse has to work as professional anywhere. They are abiding with all those
policies and rules which are set out by NMC code of conduct and governments. Along with this,
it is essential for NHS to record all information which will decrease the consequences of
individual’s standards (Sessanna and et. al., 2011). If there is an inaccurate, inappropriate or
incomplete data or information then it may impact to overall treatment which are provided to
nurse and many also include wrong diagnosis.
After summing up report it is concluded that role of nurse is important in those life who
are in habit of taking regular services from them. The code of conduct of NMC is important for
every organisation and nurses who are providing clinical treatment to service users. Further,
framework which are implemented by different health departments are necessary for nurse to
apply because through this they clearly came to know about their roles and responsibilities which
are set in these standards. In last, the process of nurse should be monitored on regular basis so
that they can set their aims accordingly to attain target in time period.

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The NMC Code Professional staff, quality services. 2015. [PDF]. Available through:
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employers.pdf>. [Accessed on 5th July 2017].
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