Law & Comm & Education Flashcards
3 Client Rights
- Right to execute written healthcare directives in advance.
- Right to refuse medical treatment.
- Right to appoint an agent on their behalf if they’re incapacitated.
2 types of advanced directives
Living wills: instructions or guidance on the kinds of healthcare that are allowed/forgone in specific situations (typically end-of-life).
Durable power of attorney: agent if incapacitated.
Nurses role in advanced directives/POLST
Ask if they have one & document response
Place copy in EHR
Review it and state laws
Clients can always change code status between admissions.
Provider prescriptions for LST
Full Code vs DNR
DNI (intubate)
AND (allow natural death)
Full Code
Every attempt must be made to resuscitate if breath/heart stops.
Obligated standard unless there’s a DNR or AND.
POLST & dif from advanced directives
For people without long to live.
Remain with patient everywhere.
Some states allow POLSTs for those living at home so EMS can respect wishes.
Doctors instructions to carry out what is written in the living will. Only for limited populations & medical decisions (IN A CRISIS). Complements AD as a translational tool & continuity of care assurance. Not a substitute.
Assertive communication: when to use and how to respond
Use when: hostile sarcasm, threatening, yelling, sexual comments.
“I”. Directly address issue/action (focus on that, not on the person).
Seek guidance and support.
Use chain of command.
Aggressive behavior characteristics
Asserts their rights in a way that violates other’s rights.
Verbal or physical.
Angry tone, condescending, threatening.
Focus is on “winning at all costs”
Assertive communication characteristics
I statements
Open body and confidence.
Ability to work to capacity w/ or w/out supervision.
Remaining calm under supervision.
Asking for help when necessary.
Giving & accepting compliments.
Admitting and taking responsibility for mistakes.
When should therapeutic communication be used?
Depressed or anxious client.
Sensitive issues.
Grief/loss.
When client says they need to verbalize concerns.
To build rapport.
Therapeutic vs non-therapeutic characteristics
T: silence, touch, humor, validating/clarifying, knowledgeable about topic, avoid words with dif interpretations. Includes Active Listening.
Non-T: cliches, closed Qs, giving advice, judgment comments, changing the subject, false reassurances.
What age can you make advanced directives?
Any age! Earliest is best
Follow living will or durable power of attorney?
Living will 1st.
DPOA is used when decisions aren’t included in the living will & makes sure the living will is followed.
What is 1st step of teaching?
Evaluate teaching needs
Goal-oriented & specific
What 3 things do RNs teach?
Prevention
Recovery
Coping skills
