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Patients Bill of Rights: A welcome development By Dr. Grace Ogiehor-Enoma, RN
Date Posted: 24/Jan/2019
As a Registered Nurse practising in the United States for almost 28 years, I know from firsthand experience the dynamic and crucial impact of patient rights in healthcare. Patient rights are an integral part of healthcare today. The efforts of the Federal Government to ensure good health services that are effective, safe and of good quality by launching Nigeria’s first Patients’ Bill of Rights on July 31, 2018 is commendable. During the launch, Vice President Yemi Osinbajo said, “The goal of health services is to provide all patients with high quality health care in a manner that clearly recognises individual needs and rights.” This is a welcome development for a healthcare system in need of transformation.
 
The rights of patients drive the provision of safe and effective health care and form the framework for ethical decision-making. Nurses, as advocates for the patients, have a responsibility to deliver safe care to their patients and when successfully done, promote the healing process. However, in the absence of adequate resources, the strain could result in poor patient outcomes. The government must partner nurses and ensure that they have the tools and resources needed to provide high-quality, exceptionally patient-centred and compassionate care to every patient who walks through their doors. The government is to ensure that nurses use the latest technology and innovative solutions to enhance workflow and improve the way patients receive care. Nurses at every level should be empowered to use their voice to influence patient care.
 
Patients’ bill of right empowers the patients to feel more confident in the healthcare system and nurses are committed to respond to that empowerment by providing care that puts people first. Nurses advocate accessible, high-quality healthcare, delivered with compassion, integrity and kindness. Nurses are on the frontline of patient interaction. From the earliest days of nursing, nurses have been entrusted with the care and safeguarding of the patient. This includes not only the physical being of the patient, but also the mental and social as well. Nurses bear great responsibility because they spend a long time with patients. Patients and the public benefit from improved healthcare quality that results from nurses’ involvement in health policy. Nigeria has the opportunity to transform its healthcare system, and nurses can and should play a fundamental role in the transformation
 
Patients’ bill of rights is closely parallel to the Code for Nurses and Midwives which presents the professional standards that nurses and midwives must uphold in order to be registered to practise. The Code of Professional Conduct empowers the Professional Nurse Practitioner to provide effective care to individuals, families and communities. The Nursing and Midwifery Council of Nigeria subscribes to the fact that “Nursing is an inalienable right of citizens and as such, the professional nurse has the responsibilities of assisting them to attain the optimal level of health.” The nurse must provide care in such a manner as to enhance the integrity of the profession, safeguard the health of the individual client/patient and protect the interest of the society (NMCN).
 
The International Council of Nurses first adopted an international code of ethics for nurses in 1953. Inherent in nursing is a respect for human rights, including cultural rights, the right to life and choice, dignity and to be treated with respect. According to the ICN, nurses have four fundamental responsibilities, namely, promote and restore health; prevent illness; and protect the people entrusted to their care. The Code is a guide for action based on social values and needs. The nurse’s primary professional responsibility is to people requiring nursing care. In providing care, the nurse promotes an environment in which the human rights, values, customs and spiritual beliefs of the individual, family and community are respected.
 
Nurses work to alleviate the suffering experienced by individuals, families, groups and communities. In so doing, nurses provide services that maintain respect for human dignity and embrace the uniqueness of each patient and the nature of his or her health problems. From that early and direct, “Do no harm” caveat from Florence Nightingale, professional nursing has been built on a strong base of moral principles, behavioural standards and dictates of conscience.
 
The code of ethics for nurses is also consistent with the UN’s Universal Declaration of Human Rights. Formalised in 1948, the Universal Declaration of Human Rights recognises “the inherent dignity” and the “equal and unalienable rights of all members of the human family.” It is on the basis of this concept of the person, and the fundamental dignity and equality of all human beings, that the notion of patient rights was developed. In other words, what is owed to the patient as a human being, by practitioners and by the state, took shape in large part thanks to this understanding of the basic rights of the person (WHO).
 
Some of the key areas of the current Patients’ Bill of Rights are in line with the code for nurses and midwives. Others require collaborative approach.
 
Bill of Right: Right to relevant information:
Code for nurses and midwives: (the nurse must)
 
Know that all clients/patients have a right to receive information about their condition
 
Provide information that is accurate, truthful and presented in such a way as to make it easily understood.
 
Nurses are in the position to inform patients of their rights. Through teaching and education, nurses adequately inform patients about their care by answering questions that the patient may have and refer them to the appropriate authority if they have questions that are beyond the realm of the nurse to answer.
 
Bill of Right: Right to privacy,
Code for nurses and midwives: (the nurse must)
 
Keep information and records of the client confidential except in consultation with other members of the health team to come up with suitable intervention strategies or in compliance with a court ruling or for protecting the consumer and the public from danger.
 
Bill of Right: Right to be treated with respect,
Code for nurses and midwives: (the nurse must)
 
Demonstrate professional values such as respectfulness, responsiveness, compassion, trustworthiness and integrity.
 
 Relate with a consumer in a professional manner only.
 
 Be courteous, honest and resourceful.
 
Bill of Right: Right to receive urgent care:
Code for nurses and midwives: (the nurse must)
 
Provide care in emergencies where treatment is necessary to preserve life without clients/patients consent, if they are unable to give it, provided that the nurse can demonstrate that you are acting in their best interests.
 
Bill of Right: Right to decline care:
Code for nurses and midwives: (the nurse must)
 
Respect clients and patients’ autonomy, their right to decide whether or not to undergo any health care intervention even where a refusal may result in harm or death to themselves or a fetus, unless a court of law orders to the contrary.
 
Bill of Right: Right to decline or accept to participate in medical research:
Code for nurses and midwives: (the nurse must)
 
Respect clients and patients’ autonomy, their right to decide whether or not to undergo any health care intervention even where a refusal may result in harm or death to themselves or a fetus, unless a court of law orders to the contrary.
 
Bill of Right: Right to quality care,
Code for nurses and midwives: (the nurse must)
 
Provide care, using current evidence based principles and practice and the Nursing Process.
 
Access the adequacy of resources and make known to appropriate persons and authorities, any circumstances which could place clients/patients in jeopardy or which militate against safe standards of practice.
 
Protect the public against danger or harmful agents.
 
It is also important to note that patients’ right is about partnership. The federal, state, local governments, hospitals, employers, healthcare practitioners, and patients must join to form partnership for quality care. In a health care system that protects patients’ rights, patients are expected to take on some responsibilities as well. These responsibilities include, treating health care workers and other patients with respect, following treatment plan of care, paying the bills for care and becoming an active, involved and informed member of the healthcare team. Having patients involve in their care increases the chance of the best possible outcomes and helps support a high quality, cost-conscious health care system.
 
About The Author
Dr Ogiehor-Enoma, an Adjunct Associate Professor at Hunter-Bellevue School of Nursing, New York, is the Executive Director and founding member of the National Association of Nigerian Nurses in North America. [email protected]

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