Ethics and Legal Flashcards
Psych nurses are held to the same standard of care as MedSurg nurses, T or F?
true, if not, higher standards
The state has the power to protect and care for who?
people with mental illness
police have the responsibility and power to protect who?
the community
crisis intervention protects who?
individuals with mental illness
admission criteria
must be a danger to self & others
preferences sometimes can be met (depending on bed availability and insurance)
financial situations (if none, DPC)
voluntary or involuntary
definition of M.I
disability severe enough to warrant hospitalization with continued treatment and monitoring
DE’s Commitment Process
complaint of actions - arrested/taken into custody - examined and Dr. determines dangerousness - may commit voluntary or be d/c’ed - if committed voluntary: taken to psych facility to be eval’ed for 24 hrs ( 72 = minors) - still able to commit voluntary or be d/c’ed - if certified as mentally ill (hold for 2 days) - Writ of Habeus Corpus w/ due process hearing - if certified mentally ill, court determines involuntary commitment
Involuntary Commitment
unable to care for self or deemed danger to self or others; may be detained & committed to a hospital or outpatient program on compulsory basis — GOVERNED by STATES
Criteria:
danger to self &/or others, inability to attend to basic needs, gravely disabled, refuses hospitalization, incompetent to consent
emergency
risk of harm to self or others (short term stay)
civil/judicial
protects community from a threat (longer term) eval’ed first
Due Process
balance person’s right to freedom with protection of the M.I person who is unable to care for self & the protection of society
Petition
person on voluntary basis can ask to be released (standards must be met)
Duty to Warn - must document what authors you contacted ( DSP, NCCPD)
mental health professional has duty to a specified individual if a threat is said about them and person threatening has current plan, resources and ability to do, hx of violence, impulsivity, extreme emotional changes, depression
Children
parents make decisions for minors - adults who can’t give legal consent may have a legal guardian
NANDA for children
support their best interests, treated fairly, inform and involve in treatment plans
Least restrictive environment
use least restrictive environment
use most clinically appropriate treatment
use most cost-effective interventions
least to most restrictive
one to one interaction (pulling aside from group)
separating the patient from the area/stimulus (taking out of an area)
redirecting the patient (go to room and stay there)
limit setting (one minute to finish convo)
voluntary med admin. (would you like prn meds?)
quiet room/”time out” w/ restraints (4 RNs must decide)
involuntary med admin (we decide to medicate if extremely out of control)
seclusion
locked room with a security window or camera; requires constant 1:1 monitoring, nursing assessment and care ** DOCTORS ORDERS**
order is usually standing
restraints
must have 1:1 for pt safety
nurse can restrain but have dr’s order ASAP and have DR assess pt within 1 hour
order must be renewed q. 4 hr for 18 >, q. 2 hr for 9-17 and q. 1 hr for < 9
legal competency COURT DECISION
all citizens are competent unless declared incompetent in court of law or minor
Guilty but mentally ill
person has intent and means of committing a crime
go to prison and treated for mental illness
court commitment in DE - goes to Mitchell building at DPC
Not guilty by reason of insanity
refers to state of mind at time of offense
usually occur by responding to command auditory hallucinations
unable to form intent due to mental illness
utilitarianism
actions should promote happiness
kantianism
action is based on morals – SENSE OF DUTY
christian ethics
do unto others as you would want done unto you – decisions on wrong and right centered in the love for God
natural law theory
right v wrong is determined by human nature
ethical egoism
what is right and good is what is best for the individual making the decision
ethical principles
justice, veracity, beneficence, nonmaleficence, and autonomy
right to refuse meds
unless 3 criteria are met: behavior dangerous to self/others, meds have a reasonable chance to help client, judged incompetent to evaluate benefits of treatment
right to least restrictive treatment alternative
TALK FIRST
Patient self-determination act
pts must have clear written information about their rights to make healthcare decisions
nurse practice acts
determine what nurses can and can’t do – defined within each state
statutory law
enacted by legislative body
common law
derived from decisions made in previous cases
civil law
protects private and property rights of individuals and businesses
tort: WANT COMPENSATION FOR EMOTIONAL DISTRAUGHT
intentional: touching another person w/o consent – can result in battery
unintentional: malpractice/negligence
contracts: WANT COMPENSATION FOR REMEDY
failing to fulfill an obligation
criminal law
provides protection from conduct deemed injurious to the public welfare
ex: theft by a hospital employee of supplies or drugs
Informed Consent
persons have right to decide whether they want treatment or not unless:
- mentally incompetent
- refusing treatment endangers life or health of another
- during an emergency, and person cannot exercise good judgement
RN may
sign as witness for client’s signature
three major elements of informed consent
knowledge: pt knows enough info to base a decision on
competency: pt is not impaired of cognition
free will: pt gives consent voluntarily
false imprisonment
deliberate and unauthorized confinement of a person with infixed limits by the use of verbal or physical means (secluding or restraining against pt’s wishes – ONLY for voluntary clients)
malpractice action could be taken if:
breach of confidentiality: revealing private info
defamation of character: detrimental to character
libel: info is written
slander: info is verbal
invasion of privacy: client searched w/o probable cause
assault: threat to touch someone w/o consent
battery: actually touching w/o consent
