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Biomedical Model: The Nurses and Midwives Council Code

Introduction

Several models have been derived to look at health-related theories but biomedical model brings out an interesting coverage of the topic. Biomedical model looks at health from an individual point of view. In this case, the body is a machine with constituent parts that could be repaired or manipulated (Birn, Pillay & Holtz 2009). Biomedical model helps people to understand the functions of the body, both normal and abnormal. These functions range from genes to phenotype. This model also seeks to provide preventive solutions or therapeutic practices to human ailment (National Research Council Staff 1998). Biomedical model notes that age, genes, and behaviour can lead to diseases.

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Biomedical model focuses on the organic symptoms that the disease shows. In some cases, the medical practitioner tries to match the symptoms with medicines. The biomedical model also focuses on the perception that proper treatment can be offered only in medical centres. This perception at times proves challenging to patients.

The Nurses and Midwives Council Code came into effect in May 2008. This code replaced the UK Central Council for Nurses, Midwives and Health Visiting Code of Conduct. The NMC covers Nurses, Midwives, Community medical practitioners as well as independent prescribers.

NMC code of conduct focuses on fostering accountability, confidentiality and consent among medical practitioners. It also seeks to create an environment of care, alternative and complementary medicines and homeopathy among medical practitioners (Franklin and Beckwith 2011). According to this code, only nurses, midwives and practitioners who have legal backing can prescribe to a patient or community.

In NMC, Practitioners can offer patient-specified directions in patient’s notes (primary care) and drug chart (secondary care). Most importantly, this code states that medical practitioners should listen and respond to patients’ needs. They should support the patients as they seek to improve and maintain their health. The practitioners should also share the information they have with patients in a language they can understand so that they can know more about their health (Franklin and Beckwith 2011).

Some practitioners have, however, gone against this code by keeping to themselves, vital information involving their patients. In some cases, the practitioners do not taken responsibility for wrong medical prescriptions and decisions that lead to patients’ deaths. Medical specialists render diagnosis depending on what a person experiences and not the person himself. In this case, the sick person plays a passive role in the consultations.

Criticism of the biomedical model

The biomedical model is more suited for cases of physical disability, for instance, cognitive, emotional or intellectual disability (Riggar & Maki 2004). The biomedical model has created prejudice. In this model, experts treat patients without giving them enough information and choice about the treatment. This model puts all the belief on the medical practitioners who rely on the professional training they have. The patient does not actively participate in the decision-making process as the practitioners take action without her consent. There is, therefore, need for patients to be involved in medical decisions. Since the patients are the ones who withstand the pain involved in a medical procedure, it is vital that practitioners involve them in every step they take (Pozgar 2011).

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Biomedical model describes a world without disability or illness. In many cases, therefore, patients with cancer and other illness face discrimination. Whenever people display physical, psychological or social symptoms, they are ill. Some of the physical symptoms are headache or back pains. Psychological symptoms include anxiety and depression whereas social symptoms are social discrimination or isolation. Some of these symptoms are regular. It is, however, crucial for people to seek medical attention. Since some diseases, for instance cancer, do not have any symptoms before diagnosis, patients should undergo regular medical check-ups to be sure of their health.

Certain illness behaviour makes a patient seek medical attention. This behaviour is known as a symptom. Mishler (1981, p. 8) states a symptom is an “unorganized phase of a disease or illness.” It is during this time that a doctor and a patient hold discussions to discuss what the patient feels and the practitioners’ decision about the condition. The discussion between the patient and the doctor at this point aims at negotiating a certain illness. This is what should be done instead of the medical practitioners making decisions on their own. Diagnosis involves trying to match the symptoms that the patient exhibits with various existing diseases to find the appropriate treatment.

Various people believe in carrying out self-diagnosis when they experience certain symptoms. It is a common behaviour for people to buy medicines from chemists in order to cure the ailments they have. For instance, when people have headaches, they resort to buying painkillers to end the headaches instead of going to the hospital to get proper check-up. Often, people end up taking the wrong prescription. Any medical attention sought by the patient after this action will lead to diagnosis based on the symptoms that result from the medication (Lupton 1998).

The purpose of illness narrative is to transform illness events and create a world where illness in not viewed with a negative perception. It helps individuals to reconstruct their life history in case they are chronically ill. This narrative also tries to help an individual understand an illness. There is an increase in the need to carry out patient narratives (Bury 2001). The changes in disease patterns and medicines are the cause of the creation of these narratives. Increased illness has led to the increased demand for chronic illness narratives.

In line with the NMG code or professional conduct which champions for confidentiality, the patient’s identity in this narrative is withheld. This is meant to safeguard her privacy. The name used herein, is not the real name of the cancer patient. This story results from a direct narration of events by the patient to the writer.

The lump that Mrs. Summer realised in her breast triggered in her a desire to go for a medical check-up. She did not seek self-prescription like some patients do when they realise they have certain symptoms. Her cognitive recognition of the symptoms as signs of breast cancer made her go for the check-up. In her mind and from what she had heard and read, she developed fears that the lump in her breast could be a sign of breast cancer. She had concerns for her family and the emotional implications that the cancer will cause. She, however, realised that going for the tests was the best decision.

The first testing did not go well because of miscommunication between the different medical practitioners at the health centre. During the time of diagnosis, there was a communication breakdown between pharmacists and the patient service coordinators. Relevant information about the symptoms that Mrs. Summer was experiencing was not clearly shared between the two specialists. This action led to an improper medical prescription to Mrs. Summer. The assumption was that the lump was nothing serious.

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According to Strom, Buzdar and Hunt (2008, p. 2), the “services involved in breast cancer care require the patient to visit several centres.” The discomfort that the lump created in Mrs. Summer, clouded with psychological unrest, caused her to seek an alternative medical check-up in a different health care.

Naturally, according to Kaelin and Coltrera (2005, p. 4) the breast symbolizes “beauty and admiration.” The breast is also a source of milk for babies. However, when affected with cancer, the breast becomes a risk to other parts of the body and the only way to prevent the cancer from spreading is by elimination. According to Kaelin and Coltera (2005.p 1), women who have been diagnosed with breast cancer find the news “shocking and dreadful.” This was not different with Mrs. Summer who had gone to get the results with her long time family friend Naomi Thompson. Mammogram tests were carried out. The mammogram exposes various interior tissues of the breast. Features that are similar to cancer were present in her breast. The doctor told Mrs. Summer that she had breast cancer. Further tests had to be done to confirm this result.

Mrs. Summer could not believe what she heard; she, therefore, went for an ultrasound. An ultrasound is a test for breast cancer. It is carried out when a person suspects the results found from a mammogram (Kelman and Coltrera 2005). It visualizes small areas of the breast accurately. Mrs. Summer’s breast had cysts which appeared as black holes.

The third test involved carrying out a biopsy to verify the presence of this disease. According to Kelman and Coltrera (2005, p. 15.) a biopsy involves “removing a tissue sample for further testing using a microscope.” The tests carried out confirmed that Mrs. Summer had breast cancer. The worst was yet to come. The cancer type was Invasive Ductal Carcinoma (ID). According to Kelman and Coltrera (2005 p. 10), this cancer “breaks the duct walls and invades surrounding tissues of the breast.” This cancer spreads through the blood vessels. These vessels facilitate blood flow to and from the breasts. The cancer had widely spread in her breast.

The diagnosis made the narrative take a turn; the disease could not be cured. Management was, therefore, the appropriate move making it long term condition. Primary care was, therefore, the vital step to take in this case as the disease could not be treated (Bury 2001). The only solution was to cut off the breast to stop it from spreading. This solution is an outcome of a meeting between the medical practitioners without the inclusion of Mrs. Summer. Other than Invasive Ductal Carcinoma (ID), Kaelin and Coltrera (2005 p.11) highlight “Ductal Carcinoma in situ (DCIS) and Invasive Lobular Carcinoma (IL) as other common forms of breast cancer. Medullary Carcinoma, Tubular Carcinoma Papillary Carcinoma, Paget’s disease of the Breast and inflammatory Breast Cancer (IBC) are the uncommon forms.”

Bury (2001, p. 267) states that a doctor should be the first person to console and comfort a patient because he or she “understands what the patients feels.” This move, however, did not work with Mrs. Summer, who remained fixed on the spot for more than five minutes without moving an inch. In her time of shock, Mrs. Summer had a quick reflection on her life from childhood to present. Mrs. Summer was born of a wealthy family.

Her father had a well-known law firm while her mother was the owner of a million-dollar company. Health inequality was present in the case of Mrs. Summer (Smith 2003). These differences come due to the financial and social capital. Life course approach looks at events before and after diagnosis. It focuses on early life experiences since previous researches have focused on patients’ adulthood (Smith 2003). Mrs. Summer had a perfect childhood. She ate healthy food and exercised a lot like many rich children. However, the absence of diseases could also lead to adulthood illness (Smith 2003). The cause of cancer is probably due to the long term patterns of stability, and the transitions that Mrs. Summer faced.

Socioeconomic issues have for long been related to various causes of poor health. Psychological stress, poor diet, and genetic differences are the significant socioeconomic factors that cause diseases. The environment that one lives in and his childhood lifestyle could also lead to a person being sick in his adulthood (Bury 2001). Issues of poverty, poor relationship and poor achievements were unheard of in Mrs. Summer’s life since she had a perfect childhood. Age was also a factor since there is a difference between biological and historical age. Breast cancer often occurs in mid-aged women compared to the young ones.

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Mrs. Summer’s life had taken a turn, and she had to adapt to it. She silently went through the causes of breast cancer as highlighted by Christopher Li. These causes, according to Li (2010, p. 111), include “Hormonal Contraceptives.” Ovarian hormones and estrogen also cause breast cancer (Li 2010). Family history analysis is also one way of predicting breast cancer occurrences among women. Peshkin (2007, p. 69) says that it is necessary for people to undergo genetic counseling to help them “understand and adapt to the condition they are in.” In this situation, an analysis revealed that Mrs. Summers inherited the breast cancer. This is because, by reviewing the family history, it was discovered that Mrs. Summer’s grandmother died of breast cancer. The grandmother’s cause, however, was negligence since the discovery was late. These findings led to the testing of Mrs. Summer’s daughter in order to prepare early treatment or prevention of breast cancer. Luckily, she was negative.

There are cases where diseases do not differentiate between the rich and the poor. In Britain, for instance, research shows that, both the wealthy and the less wealthy experienced the same life expectancy and infant mortality. This argument is meant to foster the idea that financial status does not affect a person’s health status in her adulthood (Smith 2003). Smith, however, states that the lifestyle linked with the wealthy people, for instance, a lot of travelling, and interaction with different people would lead to health infections. Despite great food that they have access to, the aristocrats are still vulnerable to fall sick. The wealthy, however, have access to resources that could help them solve health issues compare to the poor. This was the case with Mrs. Summer.

Her husband had died on a plane crash a few years ago and, therefore, her parents took the responsibility of treating her. She was given professional support group where she met highly professional personnel to help her adapt to changes in her life. She was given western-oriented biomedicine, which involved acupuncture and chiropractic. This system professionalizes the indigenous healing tradition.

Mrs. Summer did not experience much discrimination and stigma due to her wealth. Most of her friends stood up for her and supported her both psychologically and emotionally. Mrs. Summer joined a professional group to help her deal with mental stress.

The mental stress could be caused by medical diagnosis (Collier and Kalathil 2011).Mrs. Summer did not have any difficulty in seeking medication because she was financially stable.

According to Erickson at al. (2009, p. 112), there was a switch from “using the word compliance to adherence.” This is because compliance shows that the patient is passively taking prescription given. In this case, the patient takes the medicine as per the doctor’s directives. This comes into play mostly when the patient is incorporative. Adherence stands for a situation in which a patient takes a medical prescription as advised by the doctor (Eriksson 2009). Adherence requires the patient to cooperate with the doctor and take the prescription given. In concordance, there is a clinical encounter involving the patient and the doctor. In this case, the patient’s view is considered, and a consultation is made to satisfy the patient’s needs.

The doctors did not involve Mrs. Summer in the decision making as is advised in the NMC Code of Professional Conduct. An adherence method was used as she was just briefed of the treatment she will need. When the medical practitioners told Mrs. Summer that her breast should be chopped off, they did not consider how that will affect her. The purpose of the decision was to stop the disease from spreading.

Mrs. Summer was given a couple of Complimentary and Alternative Medicines (CAM). Her friend in Africa brought her herbs that could cure breast cancer. She was to use these herbs for two weeks. This, however, could not cure her. Religious leaders from her church also visited her in the hospital to pray for her. This form of CAM was allowed by the doctors as stipulated in the NMC Code. This action aimed at giving her courage and strength to withstand the hard times ahead.

In her narration, Mrs. Summer believes that everyone should take the matter of health seriously. She says that we cannot say we are healthy just because we are not ill. She agrees that health is “a complete, physical, mental and social well-being” (Mishler et al. 1981, p. 3). Romano reiterates this by defining health as the “ability of an organism to maintain a life balance that is free from pain” (Mishler et al. 1981, p. 3).

Mrs. Summer also advices every person to carry out regular medical examinations to make sure all is well. Concerning the biomedical model, she insists that there should be dialogue and negotiation between medical practitioners and patients. This action will make everyone in agreement with the medical decisions taken. The biomedical decision should also focus on alternative treatments to fight a disease instead of relying on one resort. Mrs. Summer says that she was not given the chance to choose her medication. As days pass by, Mrs. Summer’s strength seems to leave her. The skin of Mrs. Summer is pale while her eyes are dull. Evidently, Mrs. Summer’s breath is leaving her slowly as she clearly states, “my money cannot save me anymore, am living by faith and hope for tomorrow.”

Reference List

Beckwith, S & Franklin P 2011. Oxford Handbook of Prescribing for Nurses and Allied Health Professionals. Oxford University Press Inc. New York. USA.

Birn, A, Pillay, Y, A & Holtz, T 2009.Textbook of International Health: Global Health in Dynamic World, 3rd. Oxford University Press, Inc. New York, USA.

Bury, M 2001. Illness narratives: fact or fiction? Sociology of Health & Illness. Vol 23. Blackwell publishers Ltd. Oxford, UK.

Collier, B & Kalathil, J 2011. Recovery & Resilience: African, African-Caribbean and South Asian Women’s narratives on recovering from mental distress; Mental Health Foundation & Survivor Research. Recovery & Resilience: lessons in healing from black women’s stories. Mental Health Foundation. UK.

Eriksson et al. 2009. Drug Related Problems in the Elderly. Springer + Business LLC. New York, USA.

Hunt et al. 2008. Breast Cancer. (2nd ed). Multidisciplinary care of breast cancer patients: Overview and implementation. Strom, E., Buzdar A., Hunt, K. Springer Science.

Jasper, M 2007. Professional development, reflection and decision-making. John Wiley & Sons. USA.

Kaelin, C & Coltrera, F 2005. Living Through Breast Cancer: What a Harvard Doctor and Survivor want you to Know about Getting the Best Care while Preserving your Self-Image. The McGraw Hill Companies.USA.

Li, C 2010. Breast Cancer Epidemiology. Springer Science+ Business Media. Netherlands.

Lupton D (1994) Medicine as Culture. Sage. London.

Mishler et al. 1981. Social Contexts of Health, Illness, and Patient Care. Press Syndicate of the University of Cambridge, New York, USA.

National Research Council Staff 1998. Biomedical Models and Resources: Current Needs and Future Opportunities. National Academy Press. USA.

Peshkin, B 2007. Genetic Counseling in Breast Cancer. Beth Peshkin. IOS Press. Amsterdam, Netherlands.

Pozgar, G 2011. Legal Aspect of Health Care Administration. Jones & Bartlett Publisher. USA.

Riggar, T.F. & Maki, D 2004. Handbook of Rehabilitation Counseling Springer Publishing Company,Inc. New York. USA.

Smith, G 2003. Health Inequalities: Lifecourse Approach. The Policy Press. UK.

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