The nursing profession works on a set of ethical guidelines to maintain a standard of holistic care for patients. Similarly, in psychiatric settings, sometimes patients cannot fully express their rights and decisions. It is the integral responsibility of a nurse to help them gain the trust of the patient to get an accurate history. Therefore, the psychiatric nurse should have a complete understanding of the code of ethics. The nursing code of ethics includes various principles such as beneficence, non-malfeasance, justice, and confidentiality. The most basic principle of this profession is to maintain their dignity and respect the patient. It is so because if a nurse is not respecting her client, her behavior will portray the same and she will not be able to develop trust with the client. This would eventually hinder every aspect of care towards the client.
During my clinical rotation of mental health course, I encountered a 36-year-old male patient suffering from Mania. He used to talk a lot, laugh a lot, mimic different voices, and sing songs. As this was my first experience with a psychiatric patient, I found it a bit atypical and funny. My colleagues and I had similar feelings.
We all used to tag him as the funniest and most talkative person. Moreover, we used to joke and laugh at him in our clinical group meetings. Later, when I reflected on this scenario, I realized that as a nurse it is my ethical responsibility to respect the patient. Regrettably, in this case, I was unable to fulfill my ethical obligation towards the patient. This incident persuaded me to explore more and refine my knowledge about respect as a nurse’s ethical duty towards the patient.
This concept of respect in psychiatric care is not new. The founding mother of psychiatric nursing, ‘Peplau’ also regarded respect as a part of a psychiatric nurse’s role. While considering the concept of respect in mental health care one cannot separate the work of Carl Rogers. His theory describes four core aspects of the necessity of respect in mental health care. He first highlights that every individual can live a meaningful life.
The treatment includes interpersonal assets of respect, and then this will lead to the personal development, growth, and wellness of the client. He emphasizes using the term “client” instead of “patient”. According to Rogers, implementing this in healthcare would enhance the capacity of a healthcare professional to see the humanness of the client. Rogers regards congruency, empathy, and respectfulness are the three most important qualities of mental health professionals. He stresses that when a client encounters a respectful, congruent, and empathetic health professional then this supportive atmosphere guides the person towards becoming a fully functioning individual and also improves their mental health by seeing themselves as an important part of society by being respected as a healthcare professional.
If I relate these aspects to my scenario, firstly I should understand that my client possesses the right to live a meaningful life without being judged for his atypical behavior which is a symptom of the disease process and not a thoughtful act. Thus, it is our ethical responsibility as a nurse to respect our client, even when we are not with him because as a human being it’s his basic right to receive respect. Therefore, it is important to understand the patient under care is not inferior to me nor am I superior to him so empathy instead of sympathy should direct my care.
If I demonstrate respect towards my client through my care and behavior this would strengthen the relationship with the client. This consolidation of therapeutic relationships would eventually guide me toward delivering better care.
Understanding the importance of respect is inevitable, many organizations have developed policies for the provision of respect in mental health care. The American Nurses Association has regarded respect as the first provision of its Code of Ethics for Nurses. Similarly, the College of Registered Psychiatric Nurses of Alberta also considers respect as an integral part of a nurse’s duty.
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In conclusion, as nurses, it is our ethical responsibility to respect our clients to avoid violations of such ethical principles. It is very necessary to develop guidelines at the national and organizational levels. Furthermore, it is very important to ensure its implementation as well. The most important requirement is the development of self-awareness and modifying our perspective at the individual level.
Mrs. Shabana Rajkamal
Vice Principal
M. Sc. Nursing (Mental Health Nursing)
SAGE College of Nursing
SAGE University Bhopal
