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Nurs 200 > Lecture 4 > Flashcards

Lecture 4 Flashcards

1
Q

Values

A

Standards = right and wrong = code of conduct for living

  • dynamic
  • grown
  • determine action

Helps us decide what matters most
(change if we self reflect)

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2
Q

What is ethics

A

Morals, ethics, morality

Linked with values

Involves critical reflection, exploring ones values behaviours, actions, judgements and justifications (IMPORTANT)

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3
Q

Ethical Principles

A

Guide moral conduct

Assists RN to take Position on issues

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4
Q

Autonomy

A
  • Right to choose what happens to your person
  • Respecting PTs right to make choices on care or treatment, even in disagreement
  • Not absolute right –(restrictions to make sure you don’t put people in danger)

(assuming they have the same values as you is wrong)

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5
Q

Beneficence

A

• Promotion of good and wellbeing of client

Prevent harm; remove harm

(pain meds, empathy, respect prayer, die without life support)

Complex balancing treatment against risk and costs

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6
Q

Non- maleficence

A

Don’t hurt people

Balance between this and beneficence

End goal of reducing suffering

Based on experience and values

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7
Q

Veracity

A

Telling the truth
Pt. Education
Intent to be honest (within scope)

Veracity impacts autonomy principle (important)

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8
Q

Fidelity

A

Keeping promises (Five Cs)

Do not promise anything

Inherent respect

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9
Q

Paternalism

A

Domination

Letting one person to decide for another

Help pts making choices beyond their knowledge base

adding genuity turns it into advocacy

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10
Q

Justice

A

Fair and equal treatment

Issue when short supply

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11
Q

Nurses Role - Responsibility

A

Reliability and dependability

Responsible to the patient, family, group, population, communities and to society

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12
Q

Nursing Role - Accountability

A

-Respect for dignity, worth and self determination of patients

Balance between responsibility to the patient and to the employer and organization

-practice with integrity

  • meeting standards
  • competence
  • sharing knowledge
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13
Q

Code of Ethics (5)

A
  1. Foundation for nursing practice
    2. Guidance for ethical relationships, responsibilities, behaviours and decision-making, S
    3. Self-evaluation and self-reflection for ethical nursing practice
    4. Ethical basis from which nurses can advocate for quality work environments that support the delivery of safe, compassionate, competent and ethical care. (IMPORTANT)
    5. Privilege and self-regulation - informs other health-care professionals as well as members of the public about the ethical commitments of nurses and the responsibilities nurses
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14
Q

Context of the Code

A

• Changes as society and generations evolve

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15
Q

Primary Values of the Code7

A

Providing safe, compassionate, competent, and ethical care

Promoting health and well-being

Respecting informed decision-making

Preserving dignity

Maintaining privacy and confidentiality

Promoting justice

Being accountable

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16
Q

Types of Ethical Experiences

A

Awareness = better ability to discuss ways to address it and receive support

Goal = allow positive outcomes

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17
Q

Ethical uncertainty

A

Indecision or lack of clarity

Cant tell what the moral problem is

Feeling of uncomfortableness

(doesn’t love her work anymore)

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18
Q

Ethical Dilemmas

A

Come from a situation where there are equally compelling reasons for and against two or more possible courses of action

One is let go

Infrequent in health care

(Let them walk or fall)

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19
Q

Ethical Distress

A
  • fail their ethical obligations
  • fail to do what they believe to be right
  • error in judgement, insufficient personal resolve or anything beyond their control
  • Feel guilt, concern or distaste
  • Short staffed

most common

20
Q

Ethical Residue

A

Allow themselves to be morally compromised

-self reflection important

21
Q

Ethical Disengagement

A
  • if nurses begin to see the disregard of their ethical commitments as normal
  • non-compassionate or even cruel
22
Q

Ethical Violations

A
  • actions or failures to act that breach fundamental duties to the persons receiving care or to colleagues and other health-care providers
  • lack of informed consent, lack of pt rights, deliberate withdrawal of treatment, failure to question unsafety
23
Q

Ethical Courage

A
  • response to ethical violation
  • professional obligation
  • standing up for what is right
24
Q

Right and Laws

A
  • right = privilege to one is entitled to think, say or act according to their beliefs
  • carries obligation(right to health care and obligation to carry it)

-Laws regulate behaviour of citizens

25
Q

Informed Consent (right)

A

Pt fully informed

Health condition, prognosis, and treatment options, risks

-Lack of information- deprives the client of making a fully informed decision

26
Q

Right to Health Info and Teaching

A
  • Rns smooth transition from hospital to community to home

- Resources

27
Q

Right to Confidentiality

A
  • info confidential
  • health care team can know
  • pull curtains, speak low, separate room
28
Q

Limits to confidentiality

A
  • not absolute
  • autonomy limited if it prevents harm to others
  • communicable diseases
  • Protect public health > privacy
29
Q

Right to Respect

A
  • Pts with respect

- preference by name

30
Q

Advocacy

A
  • Active support of an issue or cause
  • those who cannot speak for themselves
  • legal and ethical
  • equity and better health
  • assist pts
31
Q

Advocacy - Rights Protection Model

A

Autonomy model (best known)

  • advocate for ethical and legal rights
  • what they want rather then what the team want
32
Q

Advocacy - Value based Model

A
  • Therapeutic communication used to understand the patient’s needs and desires.
  • Ultimately helps the patient make choices that are consistent with their beliefs, values
  • sharing info btwn nurse and patient
  • -empowering pts to speak on their own behalf
33
Q

Advocacy - Respect Model

A
  • Inherent human dignity and respect is at the center.
  • Always valuing the person who is involved.
  • Acting to protect rights, dignity and choices
  • if they don’t have autonomy then advocate their best interest
  • promote uniqueness
34
Q

Barriers to resolving ethical issues

A
  • Lack of workplace supports
  • Conflict
  • Limited resources
35
Q

1994 - Pediatric Cardiac Surgery Program

A

Nurses didn’t like doctors doing things

infants were dying

Sinclair report = nurses weren’t treated as equal members

-12 infants died before program ended

36
Q

Strategies for Resolution of issues

A
  • review code
  • familiar with legislation, standards, policies
  • ask for advice and support
  • establish moral community
  • what can u do as a group or u -work culture
  • bring up ethical concerns
  • connect with risk management
37
Q

Ethical Issues in Nursing Practice

A

Care that does not help

Subjective by nature

38
Q

How do we determine futility

A

Not futile: Beneficial to overall well-being

Futile: nonbeneficial to overall well being

Futile from pt perspective: indicated but not valued by pt

Futile from HCP: not medically indicated but valued by pt

39
Q

Ethical decision making process (7) important

A 
Describe the problem
Gather the facts
 Clarify values
 Verbalize the problem
 Consider possible action
 Reflect on the outcome 
 Evaluate the action and outcome
40
Q

The problem and gathering facts

A

Don’t assume without facts - ask lots of questions

expect uncertainty

41
Q

Clarify Values

A

-Clarify values of the patient, yourself, other members of the health care term.

  • No biases
  • form own opinion and differentiate from others
  • find common ground
42
Q

Verbalize the problem

A
  • same page
  • mark way forward
  • consider desired outcome
43
Q

Consider action

A
  • What options are available within the context of situation and patients values?
  • How do the alternatives fit the lifestyle and value of person affected?
44
Q

Reflect on the outcome

A

Most important and delicate step

This can take place informally with patient and family at the bedside, but could need an official setting.

Multi-disciplinary

45
Q

Evaluate the Action and Outcome

A
  • ethical uncertainty been resolved
  • any new problems?
  • need more action (if not positive)
46
Q

Ethics and Nursing student practice

A
  • they know youre a student and can refuse you

- meet level of care for your knowledge

Nurs 200 (6 decks)

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