Chapter 3 Flashcards
Exam 1
What was the Nursing Ethics: For Hospital and Private Use (IH Robb, 1900/1916). highlighted slide
Addressed professional nurse relationships
Physician-centered focused on obedience
ICN Code of Ethics for Nurses (1953)
“Obedient” focus shifts in 1965 to patient needs
What are the three Professional Codes of Ethics made in Nursing?
- Nursing Ethics: For Hospital and Private Use (I.H. Robb,1900/1916)
- ICN Code of Ethics for Nurses
- ANA Code of Ethics for Nurses
What did the ANA Code of Ethics for Nurses outline?
Outlined nine nonnegotiable provisions
What was the ANA Code of Ethics based on?
Based on deontology and normative ethics
What was the ANA Code of Ethics focus on?
Focused on the “patient” (NCLEX uses “client”)
What else did the ANA Code of Ethics for Nurses emphasis?
- Wholeness of character:
Recognition of values within nursing profession - Personal integrity: Nurses’ attention and care to their own needs
What does the ICN Code of Ethics for Nurses relate to?
Relates to four key action-based standards of conduct
Four key action-based standards of conduct the ICN Code of Ethics for Nurses has: highlighted slide
Nurses and people
Nurses and practice
Nurses and the profession
Nurses and global health
What is the ICN Code of Ethics for Nurses based on?
Based on deontological, normative ethics
What do professional boundaries do?
Limit nurse’s power and therefore limit patient’s vulnerabilities
Facilitate safe connections
What are consequences of boundary violations?
Voluntary surrender, suspension, or revocation of license
Prohibition from practice
Legal considerations of Professional boundaries in Nursing
Negligence
Malpractice
Moral integrity is the commitment to what?
Commitment to follow-through
What is the role of the state board of nursing (having to do with the Nurse Practice Act)
- State boards of nursing are responsible for enforcing their Nurse Practice Act to promote safe and competent care
- State Boards of Nursing function to protect the public, not individual nurses or the nursing profession
Moral Integrity is the understanding of what?
Understanding of moral obligations
Moral Integrity is the pursuit of what?
Pursuit of moral purpose
Each state and country has a _________ Nurse Practice Act
Each state and country has a LEGALLY ENFORCEABLE Nurse Practice Act
Moral Distress
Emotional and physical exhaustion and suffering from compromised moral integrity
When one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action
Causes of moral distress:
Multiple or dual expectations
Inability to act according to moral integrity
Pressure to do something that conflicts with their values (Ex. falsify documentation)
Crisis situations where essentials are at risk
Ex. Nurse safety, resources, and relationships during Covid-19 pandemic
What is the most important cause of moral distress?
Crisis situations where essentials are at risk
Ex. Nurse safety, resources, and relationships during Covid-19 pandemic
What does the AACN recommend to mitigate the harmful effects of moral distress?
The AACN strongly recommended strategies for healthcare institutions and for nurses and that every institution must implement readily accessible resources to identify and mitigate the harmful effects of moral distress
Moral courage
Stand up for or act upon moral principles to do what is right
What does moral courage turn into?
Turns into noticeable actions
What can moral courage entail?
Can entail potential threats
How can moral courage be facilitated?
Can be facilitated through self-talk and scenario assessment
Examples of moral courage
Confronting an impaired colleague
Confronting physicians who order questionable treatments not within the reasonable standard of care
Confronting an administrator regarding unsafe practices or staffing
Veracity
Truth or fact’ accuracy
Be honest and tell the truth
Why is veracity important?
Honesty is a prerequisite for trust
Dishonesty is always exposed.
Nurses are expected to be honest.
What does veracity entail?
Commitment to promises to patients
Follow-through with appropriate behaviors
Ongoing self-evaluation
Being genuine in words and deeds
Communicating truthfully “Just a little stick…”
Preserving patient’s respect for autonomy
Not withholding information
Benevolence
Refers to the propensity and desire to act to benefit others, which often prompts beneficent acts (beneficence)
What is noted as a central factor in decision making?
Benevolence
Confucianists place high value on what?
Confucianists place high value on human character or virtuous conduct
Word for practical wisdom
Phronesis (practical wisdom)
Prudence (wisdom)
Intellectual accomplishment and proclivity to seek the right and good
Clinical wisdom
Necessary combination of prudence and practical wisdom
Advocacy
Safeguard patients’ autonomy
Act on patients’ behalf
**Showing/Sharing Concern*
Culturally sensitive care
Adapts care consistent with patient’s culture
Culturally sensitive care requires what?
Requires a basic knowledge of culturally diverse customs
What does culturally sensitive care demonstrate?
Demonstrate constructive attitudes based on that knowledge
Power
Having influence over others
Socialized power
an indication of the principles of beneficence, nonmaleficence, and justice at work
Stein’s (1967) doctor–nurse game focused on what?
Focus on hierarchal relationship
What is Stein’s (1967) doctor–nurse game characterized by?
Characterized by avoidance of conflict and open disagreement
What is the conflict related to the nurse-physician relationship?
Institutional hierarchies
The hierarchical way ethical care decisions are made
Competency and quality-of-care conflicts
Lack of communication
Horizontal violence (workplace bullying):
via interpersonal conflict, harassment, and intimidation
Types of horizontal violence
Tall poppy syndrome
Walking wounded
Wounded healers
Tall poppy syndrome
describes when successful people are criticized by their peers for being too successful or bragging about their achievements.
Benefits of healthier relationships
Improved moral climate for safe care
Increased sense of community
Nurses and Social Media: Moral Spaces and Blurred Lines
Nurses must respect this “moral space”
