The purpose of this essay is to look at Rita’s situation, vulnerability and how a multidisciplinary team, focusing on the nurse could help. In normal circumstances consent would need to be gained from the client and false name used to protect the client, however Rita is a fictitious client therefore consent is not required, case scenario in appendix.
The department of health Clinical Governance and Adult safeguarding (DH 2010 Page 14) guidance states “There is no formal definition of vulnerability within health care although some people receiving health care may be at greater risk from harm than others” however this document goes on to quote No secrets (DH 2000 Page 8) which defines a vulnerable adult as someone “who is or may be in need of community care services by reason of mental or other disability, age or illness; and who is or may be unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation”. People are generally more vulnerable when their health or usual function is compromised, vulnerability is increased by a change in surroundings, situations and relationships. Special consideration needs to be taken when working with the physically frail, mentally ill, those with learning disabilities and children to protect these groups from abuse. (NMC 2006 Page 1) The Mental Capacity Act 2005 “applies to England and Wales and provides a statutory framework to empower and protect vulnerable people who are unable to make their own decisions. It applies to those aged 16 and over with potentially 1.2 million people directly affected and will include those with dementia, learning disability, brain injury, mental health problems and autism. Scotland has similar legislation in place with The Adults with Incapacity (Scotland) Act 2000.” (http://www.nmc-uk.org/Nurses-and-midwives/Advice-by-topic/A/Advice/Mental-Capacity-Act-2005/) This is in place to protect the client’s autonomy, but also protect those who are vulnerable from various forms of abuse. The nurse has a responsibility to report any abuse they see, hear or anything they have concerns about so that the appropriate agencies can get involved in resolving any issues, this does not mean that control would be taken away from client. (NMC 2009 Page 15)
Rita would be considered to be vulnerable as her normal function has been compromised by firstly heart failure but also what appears to be a slight cognitive impairment. Rita’s feeling of vulnerability would be added to by being admitted to hospital, taking her away from familiar surroundings and home comforts. As previously mentioned age affects vulnerability as generally later in life the immune system and memory has a tendency to deteriorate. Rita may also be feeling pressure from her daughter to make the decision to go into respite care making Rita feel she has become a burden to her family.
The role of the nurse is a varied one with emphasis on patient centred care. Patient centred care...