Ethics And Communication Flashcards
Up to 80% of medical errors is due to what?
Poor communication about
• documentation
• consult with other doctors, nurses, patients
• shift changes and hand overs
Name the 5 principles of dealing with the difficult or upset patient according to the universal upset patient protocol in healthcare communications
• Listen to the grievance
• show respect and understanding to the problem - put yourself in their position
. Don’t be confrontational or defensive
• offer a solution to the problem - negotiate within the limits of ethics and the law
• get the patient or relative to agree
Define empathy
The capacity to understand or feel what another person is experiencing from within that person’s frame of reference. The capacity to place yourself in another’s position.
Name the 6 steps of the universal upset patient protocol in healthcare communications
- you look really upset
- Tell me about it
- I’m sorry this is happening
- What would you like me to do
- This is what I propose
- Thanks for sharing
Name the 6 steps of breaking bad news according to Robert Buckman’s six step protocol for breaking bad news
- Getting started: private setting, comfortably seated, asks who else they want present. “How are you feeling”
- Find out how much patient knows: about what has been told, technical sophistication, emotional state
- Find out how much patient wants to know
- Share the info: decide on agenda before consult, diagnosis, treatment, prognosis, support, coping. Small chunks, stopping often to make sure they understand. Simple language
- Respond to patients feelings
- Planning and follow through: management plan, next consultation , appropriate referral, contact number
Define ethics
The correct thing to do, what the majority will do, what most people will do
Name the 5 principles of ethical practice
- Beneficence
- non-maleficence
- patient autonomy
- justice
- (honesty)
Define beneficence
Do good to benefit patients, well-being, cure, improvement.
Define non-malifence
First do no harm - end goal for all medical decisions! Even if beneficence, non- malifecence trumps
Define autonomy
Patient has final decision regarding their health or otherwise
Non-paternalism
Name the surrogate decision makers in order (5)
• Spouse • life partner • parent • adult child . Brother or sister
Define justice
Access to health care
Financial aspects
All treated equal
Name the 8 elements of informed consent according to the HPCSA booklet 9
- Voluntary and without constraint
- HIV test preferably written consent but can be implied
- consent must not conflict with good morals or constitution
- patient must be capable of consenting
- pt must give consent personally unless proxy applicable
- pt should know why doctor needs results
- sufficient info about diagnosis, proposed treatment,expected benefits, risks, alt treatment, probable results etc
- patient must actually understand May need interpreter.
Name the 5 general ethical guidelines of informed consent for HCP according to hpcsa booklet 9
• Give pts info they ask for or need about condition, treatment and prognosis
• give info in way they can understand by language, literacy, understanding, values, beliefs
• refrain from withholding any info, investigation, treatment that would be in patient’s best interest.
• on going process
. Allow access to medical records
Define child according to children’s act
Under 18 years
Name 7 procedures that require informed consent
• Surgical investigations • anaesthesia, including local • blood transfusions • chemo and radiotherapy • some advanced medical tests eg biopsy • vaccinations • some sensitive blood tests eg HIV Document all these!
Define Trauma (5)
A person’s emotional response to a distressing experience . unlike ordinary hardships, traumatic events tend to be sudden and unpredictable, involve serious threat to life- like bodily injury or death- and feel beyond person’s control. Most important, events are traumatic to the degree that they undermine a person’s sense of safety in world
Define secondary trauma
Trauma develop from exposure to Trauma of another
Define vicarious trauma
The transformation that occurs within counsellor/professional as result of empathetic engagement with clients’ trauma material
Define compassion fatigue
Fatigue/exhaustion of compassion - natural consequence of working with secondary trauma
What are the ABCDs of end of life care
Ask what they want, advanced directive
Better (feel better)
Communicate and identify caregivers
Decisions
Name 5 consequences of untreated occupation stress according to NIOSH
- Medical errors and more near misses
- somatic complaints eg changes in eating habits, git distress, headache, fatigue, sleep disorders
- change in work habits eg tardiness, absenteeism
- mental and emotional difficulties eg memory disturb, anger, self doubt, isolation,impaired judgement
- accidents
Define primary traumatic stress
Direct physical and psychological injury that occurs as result of traumatic event
Define burnout
Gradual emotional exhaustion, depersonalization, reduced sense of personal accomplishment that occurs when work-life domains are unbalanced between organization and worker
Name 3 risk factors for medical caregiver secondary traumatic stress
• Severity of exposure
. Duration
• individual vulnerability
Define countertransference
Distortion by therapist resulting from therapist’s life experiences and associated with their unoncious, neurotic reaction to client’s transference
Define repression
Consciously or unconsciously holding back or fighting, thoughts, feelings, behaviours. Type of self regulation
Name 3 components of self regulation
• self monitoring
- self evaluation
•Self-reinforcement
