Ethical Considerations

Question 1

Borders

Answer 1

Hx, roles, standard, health equity, race & culture, evidence informed practice, community assessment & development

Question 2

Middle

Answer 2

epidemiology, CD, environmental health, family nursing, structurally vulnerable populations, health policy, disaster nursing

Question 3

Parish/Faith Community Nursing

Answer 3

Reaching out for more whole person ways of ministering to people who are hurting

Question 4

Nursing Ethics: Morals

Answer 4

Shared and generational societal norms about what constitutes right or wrong conduct

Question 5

Nursing Ethics: Values

Answer 5

Beliefs about the shared worth or importance of what is desired or esteemed within a society

Question 6

Population Health Definition

Answer 6

To improve the health of groups of people while reducing health inequalities and their underlying determinants
Requires coherent multi-level policies in health and other sectors
Uses a social equity lens

Question 7

Community Health: Three Common Dimensions

Answer 7

Status
Structure
Process

Question 8

Community Health: Status

Answer 8

Physical - measured by morbidity & mortality rates, life expectancy and risk factors
Emotional - measured by satisfaction & mental health
Social components - reflected in crime rates; indiv and family functional levels

Question 9

Community Health: Structure

Answer 9

community services/resources and structure (social indicators of health)

Question 10

Community Health: Process

Answer 10

effective functioning/problem solving

Question 11

Characteristics of Healthy Community

Answer 11

clean, safe physical environment
peace, equity & social justice
access to food, clean water, shelter, income, safety, work & recreation
Participation in decision making
Strong cultural and spiritual heritage
Diverse and robust economy
Opportunities for learning and skill development
Access to health services, including public health and preventive programs

Question 12

Socio-Structural Determinants

Answer 12

• Authentic engagement of the community in planning, monitoring, and evaluating programs is essential in addressing SDOH
• Determinants do not reside in isolation from each other; they are nested/inter-related; and as one determinant changes, another may also shift
• The DOH approach recognizes the need to implement population health intervention at multiple levels of the system
• Research to uncover the social determinants include etiological and laboratory studies, integrative reviews, qualitative and quantitative

Question 13

Intersectionality: Advanced critical community nursing work

Answer 13

A “lens” for understanding: How multiple social identities such as race, gender, sexual orientation, socioeconomic status and disability intersect at the micro level of individual experience to reflect interlocking systems of privilege and oppression
How to Avoid a cookie cutter approach: use an intersectional Approach.

Question 14

Social Equity Lens

Answer 14

• Health care planning and policy development: crucial to ensure the health and social needs of population groups are met
• Negative stereotypes permeate across all levels of society. Present in media - serving to discriminate against individuals based on their age
• Note: there is considerable variability in health & functioning in population groups (homeless, older adults, LGBTQ2S)
• Viewing pop. Groups as a homogenous group does not acknowledge the diversity

Question 15

Roles and Functions of CHNs

Answer 15

Public Health Nurse
Forensic Nursing
Home Health Nurse
Primary Care Nurse
Parish/Faith community nurse
Telehealth Nurse
Outreach/Street Nursing
Military Nursing
Rural Nursing
Occupational Health Nurse

Question 16

Ethics and Community Health Nursing

Answer 16

CHNs are required to uphold the values identified in the CNA code of ethics for registered nurses and follow the Canadian community health nursing stardards of practice in ethical, legal, and professional nursing practice situations/

Question 17

Two important ethical obligations CHNs face

Answer 17

Confidentiality
Accountability

Question 18

CNA Nursing Values and Ethical Responsibilities

Answer 18

a) provide safe, compassionate, competent and ethical care
b) promote health and well-being
c) promote and respect informed decision making
d) honour dignity (worth of each person)
e) maintain privacy and confidentiality
f) promote justice
g) being accountable

Question 19

Ethical principles for effective advocacy

Answer 19

• Act in the client (group/community) best interest
• act in accordance with the client’s wishes and instructions
• Keep the client properly informed (communication)
• Carry out instructions with diligence and competence
• Act impartially and offer frank, independent advice
• Maintain client confidentiality

Question 20

Advocacy: a nursing responsibility

Answer 20

CNA Code of Ethics & CHNC Standards of Practice: advocacy as an important nursing responsibility
- reduce the occurrence or severity of public health problems
- For Community health nursing: Apply information and resources to effect systemic change that shape the way people in a community live
- For public health nursing: Advocacy is intended to benefit aggregates

Question 21

Harm Principle

Answer 21

justification to take action to restrict the liberty of an individual or a group in order to prevent harm to others

Question 22

Principle of Least Restrictive

Answer 22

achieve public health needs, but the full authority and power should be used for exceptional circumstances
Education, facilitation, and discussion should precede any restriction or coercive measures

Question 23

Reciprocity Principle

Answer 23

Society must be prepared to facilitate individual and community efforts to discharge their duties

Question 24

Transparency Principle

Answer 24

Manner and context in which decisions are made

Question 25

Approaches to Diversity in Community Health Practice: CNA position statement

Answer 25

nurses require “knowledge, skill, attitudes, and personal attributes to maximize respectful relationships with diverse populations”

Question 26

ASKED: mnemonic represents key questions to encourage reflexive practice

Answer 26

Awareness
Skills
Knowledge
Encounters
Desire

Question 27

Approaching clients equitably =

Answer 27

practising nursing with awareness and an underlying respect for diversity

Question 28

Key Health Inequities in Canada Report

Answer 28

• Adopt a human rights approach to action on the SDOH and health equity
• Intervene across the life course with evidence-informed policies and culturally safe health and social services
• Intervene on both proximal (downstream) and distal (upstream) DOH and health equity
• “public health actions that focus on individual-level behavioural determinants may inadvertently increase health inequalities in the absence of accompanying efforts that target “upstream” socioeconomic, political, cultural and environmental factors”

Question 29

Targeting the spheres: Inequities

Answer 29

Critical equity-focused multi-level interventions are necessary:
individual, organizational, community and systemic problems
- community health programs must identify root causes of inequities
- engage diverse leadership and stakeholders
- develop collaborative partnerships
- build capacity at various levels

Question 30

Planning - Implementation - Evaluation Cycle

Answer 30

Identify problem -> consider possible alternatives -> select best alternative -> design program -> implement program -> evaluate program -> analyze findings -> utilize results -> analyze situation -> back to start