Introduction
The reflective essay aims to reflect critically on how student nurses can promote professionalism and trust as they provide fundamental nursing care. The essay will pay particular attention to the concept of fundamental nursing care, professionalism, and trust in the context of nursing practice in the United Kingdom. Quality health and care outcomes depend highly on the extent to which nurses observe the concepts cited above. Fundamental nursing care implies engaging in actions that respect and focus on a patient’s critical care needs, such as nutrition, hydration, mobility, elimination and hygiene, to improve their physical, psychological, and social well-being (Richards et al., 2018). Conversely, professionalism is a complex concept to define; it loosely refers to the exhibition of professional behaviour and upholding and applying the values of the nursing profession, including respect, accountability and integrity when attending to patients, even under time constraints and other professional challenges (Hodges et al., 2018; National Health Services (NHS), 2023). Notably, this definition implies that professionalism allows nurses to uphold the values and standards of practice and behaviour outlined in the Code, such as prioritising people, practising effectively, preserving safety, and promoting professionalism and trust (Nursing and Midwifery Council (NMC), 2018). Finally, trust in the nursing practice refers to the attitude of confidently relying on others, mainly characterised by risk and fragility. Therefore, through critical and creative thinking and secondary research, the essay will effectively demonstrate how student nurses can promote professionalism and trust while delivering fundamental nursing care to patients.
Overview of a Specific Element of Fundamental Nursing Care
Fundamental nursing care is critical to ensuring the provision of holistic patient-centred care in different clinical settings. Jackson and Kozlowska (2018) observe that the aspects of patient care considered important in nursing practice include those focusing on upholding human dignity, promoting self-care, ensuring comfort, and improving personal safety. Mudd et al. (2020) argue that fundamental nursing care is founded on supportive care contexts, care integration, and trusting nurse-patient relationships. Notably, this indicates that the delivery of fundamental nursing care largely depends on a trusting nurse-patient relationship. Patient experience is a critical determinant of the quality of care delivered, making fundamental nursing care critical to promoting the patient’s physical and psychosocial well-being. According to Richards et al. (2018), fundamental nursing care involves interventions for people’s nutrition, hydration, mobility, elimination, and hygiene needs. Notably, the two viewpoints indicate that fundamental nursing care largely depends on the nurse-patient relationship.
Fundamental care emphasises the nurse’s ability to sensitively and respectfully engage with different patients. Jackson and Kozlowska (2018) argue that fundamental care reflects nursing values and focuses more on the primacy of being with, supporting, and engaging authentically with patients to promote their physical, psychological and social well-being. Due to the growing popularity of person-centred care, nurses must exercise flexibility to help meet the unique needs of different patients by considering them as equal partners in their care. Moreover, Rasheed et al. (2019) indicate that nurses must possess high levels of self-awareness to develop an effective nurse-patient relationship. Grealish et al. (2019) believe patient-centred care delivery is possible through the nurse’s willingness to respect their patients’ opinions. Person-centred care is a critical dimension of fundamental care in the nursing practice since it encourages working with patients in their care rather than treating them as passive recipients of care. Feo et al. (2017) observe that the delivery of person-centred care highly depends on a trusting relationship between nurses and patients. Notably, a trusting nurse-patient relationship allows them to be comfortable sharing their care needs with nurses promoting care delivery. Feo et al. (2017) further indicate that building trust allows the nurse to communicate effectively with patients and freely share their care preferences with the nurse. Therefore, fundamental nursing care is highly dependent on the quality of the nurse-patient relationship, implying that nurse students must build trust with their patients to help them share their care preferences.
During my practice placement, I cared for a patient’s personal hygiene, which involved emptying the urine catheter and changing the stoma bag. The patient was diagnosed with advanced dementia, which reduced his capacity to engage in daily activities fully. According to Henskens et al. (2018), dementia affects patients’ physical functioning, consequently undermining their ability to engage in daily activities. Notably, this implies that student nurses attending to such patients must apply the concept of fundamental care to promote their physical and psychosocial well-being. The Code requires nurses to preserve the safety and prioritise people achievable through accurate identification and assessment of a patient’s vital signs, getting proper informed consent and documenting it before carrying any action (NMC, 2018). In compliance with these requirements, I introduced myself and gained the patient’s consent before conducting the assigned duty, including changing the patient’s urine catheter and the stoma bag. Notably, an appropriate introduction and gaining a patient’s informed consent are critical aspects of fundamental nursing care.
Breakdown of Nurse’s Role in Promoting Professionalism and Trust
Personal hygiene is a critical element of fundamental care since it promotes the patient’s physical, psychological and social well-being. Patients with different mental health symptoms, such as dementia, experience reduced capacity to take care of personal hygiene, making them highly dependent on nurses (Henskens et al., 2018). Provision of personal hygiene care to the patient tends to be challenging since it requires a high level of trust between the nurse and the patient and requires proper informed consent to ensure compliance with patient confidentiality requirements. According to NMC (2018), the Code requires nurses to respect the rights and confidentiality of their patients. Nurses must seek their patient’s consent before delivering personal hygiene care. Many patients often feel uncomfortable receiving personal hygiene from their nurses, making it critical for nurses to seek their consent before providing this type of care. Fundamental care aims to provide person-centred care, implying that nurses must work closely with patients during their care. However, Feo et al. (2017) observe that the success of person-centred care depends on a trusting nurse-patient relationship which is challenging. An effective nurse-patient relationship promotes patient safety and the quality of provided care (Conroy et al., 2017). In this context, nurses must promote professionalism and trust when delivering care to ensure safe and quality care.
Professionalism remains a challenging concept for medical professionals, including nurses. According to Sullivan and Thiessen (2015), defining, understanding and learning the concept of professionalism remains challenging due to the complex nature of the term in nursing practice. However, NHS (2023) indicates that the concept can be understood from value and behavioural perspectives. Notably, from these two perspectives, professionalism in the context of nursing is defined as the demonstration of professional behaviour and upholding and applying the nursing profession’s values, including integrity, honesty, autonomy, altruism, human dignity and social justice. The Code outlines the critical standards of the nursing practice, including prioritising people and practising effectively. Bifarin et al. (2022) indicate that mental health nursing is a skilled profession, although it is surrounded by various challenges that require nurses to exercise high levels of professionalism to overcome. Moreover, Roberts et al. (2019) argue that professionalism has evolved from being regarded as an individual-level core competency to a collective competency, making it challenging to assess. Notably, the assessment of individual professionalism depends on its conceptualisation. Despite the challenges associated with delivering care to patients with mental health issues, student nurses must uphold professionalism and trust when delivering care to patients to promote the safety and quality of care.
Based on the chosen element of care, student nurses can promote professionalism when providing care to patients experiencing different symptoms of mental issues, such as dementia, in different ways. First, student nurses must seek students’ informed consent before delivering any care. The Code requires nurses to prioritise people, indicating that seeking their consent before delivering any care services, such as personal hygiene, is critical to promoting professionalism. For instance, before providing personal hygiene care to patients, it is critical to ensure that informed consent is properly sought and gained. Second, student nurses must uphold the standards and values of the nursing practice outlined in the Code by being selfless and dedicated towards the patient’s welfare. Personal hygiene is critical to a patient’s physical, psychological and social well-being. Therefore, upholding the standards and values of the Code is critical to promoting professionalism. Third, student nurses should uphold the integrity and act honestly while caring for patients and upholding the freedom of choice. NMC (2018) argues that nurses can ensure professionalism by acting with honesty and integrity while providing care without discrimination, harassment or bullying. Finally, student nurses must keep to the laws of the countries where they practice, including fulfilling the registration requirements. Therefore, student nurses must ensure that they observe the above requirements to help them uphold professionalism when providing care to patients with mental health challenges.
Trust is another critical element of fundamental nursing care that nurses must build with their patients to ensure quality and safe care. Leslie and Lonneman (2016) argue that trust is critical to a successful nurse-patient relationship. Establishing a trusting relationship with patients allow nurses to promote engagement and increase the patient’s probability of actively participating in the care team. Notably, the success of person-centred care largely depends on the nurses’ willingness to respect their patients’ opinions and treat them as equal partners in their care teams (Grealish et al., 2019). Trust promotes patients’ confidence in healthcare, allowing them to share accurate information with nurses, leading to positive care outcomes (Khullar, 2019). The reflection focuses on personal hygiene as an element of fundamental nursing care. Due to the private nature of personal hygiene, student nurses must build trust with their patients to promote the acquisition of informed consent. For this reason, nurses can promote trust while providing personal hygiene care through various approaches, including the following. First, student nurses must always exercise professionalism to establish trust with their patients. According to NMC (2018), nurses can promote trust through professionalism. Professionalism means behaving and upholding the nursing profession’s values while attending to the patients regardless of time constraints. Second, student nurses must communicate effectively with their patients to establish trust with the patients. According to Busari et al. (2017), effective communication refers to the nurse’s capacity to converse with their patients, which is critical to building trust between the nurse and the patient. Admittedly, effective communication enabled me to build trust with patients quickly, promoting the quality of care. Third, student nurses should apply active listening when attending to patients since it promotes the delivery of person-centred care. McKenna et al. (2020) indicate that active listening is critical to developing trust between the nurse and the patient. Vidourek and Burbage (2019) observe that active listening skills promote help-seeking behaviour among patients with various mental health challenges. Therefore, effective active listening skills help nurses to establish trust and commitment with their patients, promoting the quality of care. Delivery of personal hygiene to patients with mental health issues, such as dementia, requires a high level of trust between the nurse and their patients. Finally, student nurses should be models of integrity and leadership at all times to promote the development of trust. NMC (2018) indicates that integrity and leadership lead to patients’ trust and confidence in the profession. Van Dyk et al. (2021) argue that trust and trusting relationships between nurses and their patients promote person-centred care since patients tend to be willing to contribute to their care under such circumstances. However, building trust is significantly challenging with patients with mental health patients since their conditions reduce their ability to engage effectively in verbal communication. Pergolizzi et al. (2019) observe that mental health issues, such as dementia, have a negative effect on the patient’s linguistic skills. Therefore, through professionalism, effective communication, active listening, and being models of integrity and leadership, student nurses can overcome these challenges, leading to the establishment of trust.
Conclusion
The reflection demonstrates that professionalism and trust are critical to delivering fundamental nursing care. The Code provides different standards and values that nurses must uphold while delivering care to patients from different backgrounds. Fundamental nursing care focuses on providing holistic person-centred care to promote a patient’s physical, psychological and social well-being. In this regard, it focuses on attending to a patient’s nutrition, hydration, mobility, elimination, and hygiene needs. Notably, the primary goal of fundamental nursing care is to promote personal safety, human dignity, self-care, and comfort. However, to realise these goals, nurses must promote professionalism and trust while delivering care. Professionalism entails exercising professional behaviour and upholding the values of the nursing profession. On the other hand, trust is critical to the nursing profession since it promotes the development of a positive nurse-patient relationship. Therefore, nursing students can promote professionalism when providing care by seeking informed consent, upholding the standards and values of the nursing practice, upholding integrity and honesty, and keeping to the laws of the countries in which they practice. On the other hand, they can foster trust while delivering care by exercising professionalism at all times, communicating effectively, listening actively, and acting as models of integrity and leadership for others to emulate. Therefore, these actions will help student nurses to promote professionalism and trust when providing care.
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