The social context of nursing practice

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This assignment will reflect on a scenario concentrating on ageism and will focus on valuing diversity and anti-discriminative practice. It will discuss how they are important to the delivery of care. I shall also discuss how I have developed and improved my interpersonal skills with both patients and colleagues and overcome barriers created through prejudice and labelling. Also considered is how the Johari window (Luft & Ingham 1955) allows understanding of the self and how that has an important effect on practice.

Using reflective practice I have gained insight into my strengths and weaknesses. Reflection is being able to link theory to practice effectively (Jarmen 1993). I have used my reflective diary to support this assignment.

Diversity is the quality of being different or varied (Smart 2000). Therefore each patient's needs differ and care must be delivered accordingly to suit the individual's needs. Diversity is an important part of daily life and is an issue in every workplace and I recognise that it is particularly relevant to the health care profession. Practitioners have a duty to provide appropriate care irrespective of gender, age, race, disability, sexuality, culture or religious beliefs (NMC 2002)

Discrimination is as unfair treatment of a person, racial group, minority based on a prejudice (Smart 2000). It occurs when an individual receives less favourable treatment than others in a similar environment or circumstances on the grounds of disability, gender, class, age, ethnicity, religion, race, soci-economic status or sexual orientation. (JMU equal opportunity policy 2003.) For example someone may think all elderly people are infirm and senile and so when they actually encounter an elderly person they are patronising or rude.

Stereotyping is a standardized image of a type of person (Smart 2000) Everyone stereotypes to a certain extent, we make judgements in our mind which effects interactions. When assumptions are made ie "All old people lose their memory" it is a major part of discrimination as it is based on prejudice. Prejudice is an opinion formed beforehand, the act or condition of holding such opinions, intolerance or dislike for people of a specific race, religion or group (Smart 2000.) These are similar and involve labelling individuals or groups, something which can be destructive to providing individualised care. Labelling is the ascribing of a negative label to an action that is then taken as a means of defining a person (Birchenhall 2000).

At the core of every patient nurse relationship is the ability to communicate effectively (Faulkner 1998). There are two main types of communication; intrapersonal and interpersonal (Northouse 1998.) Intrapersonal communication is communicating with ourselves for example keeping a diary. Interpersonal communication is communicating with the outside world ie a nursing assessment. This is an interaction between either two or more people Balzer-Riley (2000). It is an integral component of any relationship. Communication involves how we perceive others, allows us to form stereotypes, impressions, judgements and opinions. So when you discriminate the individual may feel undervalued and have little confidence (Burnard 1997).

Self awareness is a good way to improve our communication skills and our relationships with others. Therefore this is a major part of how others react to you and can say a great deal about you, so if people constantly convey to you that you are stupid, it is hard not to believe them. This belief happens when a person starts to perceive a negative self image. Self-image is defined as 'our own assessment of our social worth.' (Price 1990)

A concept I feel is relevant is known as a self fulfilling phophecy. A self-fulfilling prophecy is a false definition of the situation evoking a new behaviour which makes the originally false conception come true (Merton 2004). It relates to self-image and self-esteem to the extent that our...
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