The principal problem of the definitions of dignity as stated above is that they are too broad; they are not specific enough for patient dignity. Other scholars have talked about dignity in a casual manner. For example, Barnett (2000) has sought to restore dignity in individuals with dementia, while Yeats (1990), trying to discuss the importance of restoring dignity in clients, does not actually define the concept. It is patent, therefore, that a clarification of the concept of patient dignity be sought.
Besides the concept of dignity itself, which forms the basis of understanding the concept, patient dignity has numerous problems and needs clarifying.
This research is concerned with patient dignity in nursing. It proposes the introduction of the concept of Perceptual Adjustment Level (PAL) in order to resolve the problem of the definition of patient dignity and its maintenance within nursing care. The aims of the study are to identify how patients and nurses perceive patient dignity, to investigate the extent to which patient dignity is maintained and to identify nursing care activities in maintaining patient dignity. The implications of the findings of this study for nursing education and the development of policy on clinical practice are also examined.
Case Example
Mrs Smith is an 82 year old lady, who was cared for in an acute medical setting. To facilitate client confidentiality (NMC, 2009) her name has been changed.
Helping meet the client's hygiene needs is a fundamental aspect of the nurses role. A comprehensive assessment of their needs is necessary. This assessment is undertaken with the patient to ensure they maintain some control of their care needs (DH 2008). For example: the patient may be able to identify what their needs are and make decisions such as to the use of soap or lotions.
The registered nurse is accountable for the care she gives (NMC 2008) as the student's mentor she is also accountable for care devolved to the student. The student has a responsibility to acknowledge her own limitations and ask for advice when unsure of a procedure (NMC 2009).
While undertaking Mrs Smith's hygiene needs she requested that her legs were not washed, as her skin was dry and itchy. Heckenberg (2008) found soap acted as an irritant to skin and dried the skin further; suggesting scented soaps should be avoided. This is further supported by Jaysekera (2009) who found that the use of non-rinse skin care cleaners were effective in preventing skin dryness compared to use of traditional soap and water. The use of moisturising lotions were also found to dryness of skin when used immediately after washing (Heckenberg 2008).
Mrs Smith thought this was a good idea so the registered nurse asked to doctor to prescribe aqueous cream for washing. This demonstrates good practice and professionalism as practice was based on contemporary evidence. Decisions were made with the approval of the patient.
Ethical Issues
Aristotle's doctrine of the mean claimed that in relation to moral virtues, we can go wrong in either ways: too much ...