Human rights encompass the concept that everybody should be treated equally, with dignity and respect, no matter what their circumstances, gender, race, age or culture are (Social Care Institute for Excellence; SCIE, 2011). This implies that nobody should be tortured or treated in an inhuman or degrading way (Equality Act, 2010). Everyone strives to be respected and valued throughout their life (National Health Service; NHS, 2018). Dignity and respect in care centers around the importance and value of every person as an individual (National Institute for Health and Care Excellence; NICE, 2012). It is about respecting an individual's views, choices and decisions and not making assumptions on how people should be treated (NICE, 2012). Ensuring respect and dignity is vital to achieve a high quality, person-centered care and support to the patient (Ross et al, 2014). Therefore, within this essay I will be discussing how I demonstrated dignity and respect for a patient, in regards to communication, consent and privacy whilst giving the patient a bed bath.
Respect is defined as "due regard for the feelings, wishes or rights of others." (Oxford, 2018). However, according to Gallagher (2007), he states that "respect is considered with value: where ethical value or worth is present, respect is indicated." Respect must be taken into consideration by listening to the patient's feelings and wishes. For example, a study by Joffe et al., (2003) suggests that, patients who are treated respectfully will experience improved clinical outcomes and a better fulfilment with their care. Nurses and Midwives both have an obligation to respect the patient as an individual (Nursing and Midwifery Council; NMC, 2015). Dignity is another vital concept, important in health care practices. Dignity is fundamental to the well-being of every individual. It is a basic human right for all and health care organisations should pay attention (NMC, 2015). Therefore, it is necessary to explore how the concepts of dignity and respect can be applied in nursing practice.
A fundamental part of the NMC (2015) code is to respect individual's right to privacy and confidentiality. As outlined in the synopsis, Mrs. Wills (pseudonym) is a 75-year-old lady who underwent a total right knee replacement surgery and stayed in the ward for her recovery. She needs assisting with personal hygiene due to her occurring pain. This piece of work will be focused on the understanding the concept of respect and dignity whilst supporting Mrs. Wills with personal care during a 12-week placement as a student nurse along with literature support. During the interaction, different approaches were taken into Mrs. Wills bed bath which ensured respect and dignity. It is required that staff must ensure that the policies and procedure for bed bathing are correct and in line with standards and guidelines to promote respect and dignity for the patients (Department of Health, 2003). This guidance also states that, personal hygiene is a physical act of cleaning the body by ensuring that hair, skin and nails are maintained in the best condition (Department of Health, 2003).
During the communication to Mrs. Wills, it was ensured that consent was attained before proceeding to the task, by speaking to Mrs. Wills and asking for her permission. Consent is described as a “permission for something to happen or agreement to do something” (Oxford, 2018). However according to the RCN (2017) it states that consent is a method in which a health care staff discloses to a competent patient the appropriate information in order for them to make a choice to refuse or to accept the treatment. This is a sign of carrying the patient with dignity and respect (RCN, 2017). According to Matiti and Trorey (2008) they stated that patients felt more dignified if the staff asked for permission, before carrying out on their task (Matiti and Trorey, 2008). Consent is an important principle in which reflects the right of the patient to choose on what they prefer to do with their own bodies (RCN, 2017). Staff have the obligation to seek for the patient’s consent. Consent is only valid if the information has been communicated in a respectful clear manner in regards to the benefit and the risk of treatment or care in a way a patient can understand, ensures respect and dignity (Nursing and Midwifery Board of Ireland; NMBI, 2017). A valid consent was therefore achieved before any physical care happened as a show of respect to Mrs. Wills and to show that we value her opinion. To summarise, as stated in synopsis, we asked for Mrs. Wills’ permission, in order to gain a consent. This ensured respect and dignity because it allowed Mrs. Wills to make her own choice for her treatment of care (RCN, 2017).
To ensure dignity and respect, the method of verbal communication was used to interact with Mrs. Wills. This enabled the staff to seek for her consent by asking if she permitted assistance with her personal care. As stated in synopsis, both staff communicated with a respectful manner, by talking politely using a gentled lowered tone voice and listened to her on what she has to say. According to Laplante (2003) she states that, vocal pitch has been found to vary with intent to convey politeness. Billings et al. (2009) also states that the use of soft tone voice conveys empathy. Both of these points ensured an individual’s respect and dignity as it creates the reassurance from the staff by allowing the patient to feel valued and it provides comfort in vulnerable situations (Bramhall, 2014). It is known that communication is a process in where information is shared through the exchange of verbal and non-verbal (Brookes and Heath, 1985, cited in Bramhall, 2014) and where it creates a good relationship between the individuals by interacting with each other (Groogan, 1999, cited in Bramhall, 2014). Communication is vital, especially when seeking for permission from an individual. This ensures respect and dignity, as it makes the patient feel valued and listened to (Royal College of Nursing; RCN, 2016). During the interaction with Mrs. Wills, it was ensured that she understood and applied the message of allowing us to assist her. Therefore, she replied with a "Yes that would be great and helpful". Staff should show concern for patients by giving the patient a listening ear and showing courtesy to them, ensuring respect and dignity (Murphy, 2010). Verbal communication is an important factor to maintain control respect and dignity by being able to discuss the patient's needs. Webster and Bryan (2009) states that people feel respected and valued by being included in discussions and decisions about their care. Research produced by Webster and Bryan (2009) have shown that the use of verbal communication has been an effective way to ensure an individual’s respect and dignity. Webster and Bryan (2009) also states that communication with individuals, who were welcoming, friendly and listened to their needs, made patients feel valued and cared for. The use of an approachable verbal communication has ensured the patient’s respect and dignity (Webster and Bryan, 2009). To summarise, the use of verbal communication was achieved to speak to Mrs. Wills, by asking for her consent and she replied with a positive response. The use of a soft toned voice showed empathy, which ensured respect and dignity (Billings et al., 2009). This use of method also made the patient feel valued by being part of the conversation (Webster and Bryan, 2009) and to listen to the patient’s needs (RCN, 2016), which ensured respect and dignity.
Another method used to ensure the patient’s respect and dignity is the use of non-verbal communication. A requirement for an effective communication is dependent on the nurses' ability to utilize non-verbal communication skills (Kacperk, 2014). Non-verbal communication indicates facial expression, gestures and posture (Evans, 2003). As stated in synopsis, a smile and an open posture was presented whilst seeking for Mrs. Wills consent. A smile was indicated to show the patient that it would be an honour to assist her. Open posture was also indicated to show positivity towards Mrs. Wills and to show the willingness to assist her. Promoting dignity is about using a respectful language and gesture towards the individual (Social Care Institute for Excellence; SCIE, 2014). Despite having a busy environment, willingness and support were presented to support her personal needs by using a method of non-verbal communication skill. The use of a smile and an open posture allowed the patient to make themselves feel comfortable around the staff (Foley and Gentile, 2010). The use of smiling and an open posture implied compassion, which illustrated a positive verbal communication and ensured respect and dignity for the patient (Manookian et al., 2014). A study conducted by Matiti and Trorey (2008) indicates that patients feel comfortable in the way nursing staff who use good eye contact, open body language and use an approachable manner, helping to ensure respect and dignity. Both methods of communication are important between two interactions because it is central to upholding the respect and dignity of the individuals and by keeping a positive relationship to enable patient-centred care (Skills for Care, 2018). In this interaction, the use of non-verbal communication was used by showing gentle gestures, open posture and a smile that indicated a positive relationship to the patient (Manookian et al., 2014). This was achieved via the use of good body language and this made the patient feel comfortable (Matiti and Trorey, 2008), which ensured respect and dignity.
An additional method used to ensure respect and dignity was to deliver privacy to the patient. The idea of privacy is used to recognise as one of the important concepts in nursing. Privacy is the involvement of protecting the patient’s integrity. Patients are allowed to limit what they prefer to disclose (Agris, 2014). Before proceeding to bed bath Mrs. Wills, bed side curtains were closed to ensure privacy, respect and dignity (RCN, 2008). Closing curtains were made to prevent other people from seeing Mrs. Wills undressed and to prevent people from entering during bed bathing. Privacy was also achieved by exposing the minimum amount of skin to be washed whilst other body parts were covered by a towel. According to Care for Health Services Studies (2009), it states that privacy is maintained by using curtains, screens, walls, rooms, blankets and appropriate clothing and appropriate positioning of the patient. Privacy was maintained during the interaction and it is classed as one of the factors to ensure respect and dignity. By only showing a minimum amount of skin to be exposed during bed bath, it shows how Mrs. Wills felt valued with dignity and respect. According to Care Quality Commission; CQC (2017) guidance it was stated that privacy must be maintained throughout the care. However, it is difficult to maintain privacy in hospitals. In previous research, Baillie (2009) states that threats were present to respect and dignity because a lack of privacy occurred in hospital settings. However, patients felt valued by the staff and provided privacy well by closing curtains and covering up the patient’s bodies. This method of privacy ensured respect and dignity for the patients (Baillie, 2009). Webster and Bryan (2009) reported that, a lack of privacy in hospital wards was unavoidable, however, nursing staff still ensured respect and dignity by closing curtains. Due to the behaviour given by the nursing staff, it allowed patients to feel valued and ensured respect and dignity (Webster and Bryan, 2009). In this reflection, privacy was provided to the patient by closing her bedside curtains (RCN, 2008), which ensured respect and dignity. Respect and dignity would have been ensured more effectively, if privacy was maintained better in hospitals (CQC, 2009). However, as stated in synopsis staff still ensured privacy was provided to the patient to the best of their ability, ensured respect and dignity.
Oosterveld-Vlug et al (2013) states that it is important to achieve dignity and respect during service care interaction to heighten how patients feel during service care. Therefore, patients should be respected and be able to complain without fear and be assisted in maintaining their confidence (Keegan & Drick, 2010). Observing Mrs. Wills reaction, she was feeling anxious and worried as the task was continued. Henderson (2006) states that nursing is a perception that understands the fundamental needs of patients so that nurses can help their patients make their lives as normal and productive. Therefore, Mrs. Wills was reassured that there is nothing to worry about and was informed that we would try our best to meet her needs. Another factor I consider ensuring dignity and respect is achieved, is providing essential care of high standards (Nordenfelt, 2009).
It is important to note why dignity and respect during service care interactions should be focused (Pols, 2013). One reason is to build a rapport between the patients (Carpenito-Moyet, 2008). This is achieved through interactions, which will ensure the patient to feel comfortable during their stay. Example of these interactions according to Gallagher (2004, p.105) includes: being sensitive to the patient, create an empathetic atmosphere for the patient and engaging in the patient conversations. Baillie (2011) states that “dignity is how an individual feel, think and treat a person as being worth in a way that is respectful to themselves and others”. During the interaction, the use of verbal and non-verbal communication enabled the patient to be part of the conversation regarding their care and it made the patient feel comfortable, which ensured respect and dignity.
In conclusion, treating each individual with respect and dignity is everybody’s responsibility. During the interaction, different approaches and methods were achieved, such as, seeking for consent, using verbal and non-verbal communication and providing privacy, which ensured respect and dignity for the patient who required assistance. Maintaining dignity and respect shows the importance of a patient as an individual (NICE, 2012; Ross et al, 2014). The use of verbal communication made a great impact because it allowed both individuals to interact well and understand the message. Verbal communication was used to make the patient feel valued and cared for by the staff (RCN, 2017; Matiti and Trorey, 2008). Non-verbal communication was used with good open posture and a smile (Manookian et al., 2014), which maintained a good relationship between the patient and the staff (Skills for Care, 2018). Verbal and Non-verbal communication, allowed the patient to be treated holistically and to be respected by their own values and beliefs, ensuring respect and dignity (Groogan, 1999 cited in Bramhall 2014). Furthermore, part of communication is seeking for a valid consent from the patient. This enabled the staff to give Mrs. Wills a choice either to refuse or accept the care of treatment, ensuring respect and dignity (RCN, 2017). Finally, the bedside curtains were closed to deliver privacy towards the patient (Baillie, 2009; Webster and Bryan, 2009). However, there were a few difficulties to provide privacy to the patients, but staff interacted with the patient to the best of their ability to provide privacy (Webster and Bryan, 2009). To summarise, the use of verbal and non-verbal communication, seeking for consent and providing privacy to the patient ensured respect and dignity, during the interaction.