Legal and ethical aspects of psych nursing

Question 1

what is the purpose of legislation

Answer 1

determine what is “right” or “good” within a society

Question 2

malpractice

Answer 2

a tort action that a consumer plaintiff brings against a professional defendant when the plaintiff believes the professional injured him or her within the consumer-professional relationship

Question 3

common liability issues

Answer 3

protection of clients
defamation of character
supervisory liability
short-staffing issues

Question 4

examples of defamation of character

Answer 4

libel

slander

Question 5

guidelines to avoiding liability (5)

Answer 5

1. always put the client’s rights and welfare first
2. comply with the rules and regulations in the hospital’s or agency’s policy manual
3. practice within the scope of the state’s nurse practice act
4. maintain current understanding and knowledge of established practice standards
5. keep accurate concise and timely nursing records

Question 6

basic rights of psych clients (7)

Answer 6

• appropriate treatment
• individualized care
• ongoing participation in treatment
• right to refuse treatment, except in emergency situation
• decision making around experimental treatment
• freedom from restraint or seclusion except during emergency situation with written provider order
• humane treatment environment

Question 7

basic rights of psych clients (8)

Answer 7

• confidentiality of records
• right to access records
• access to visitors, telephonic and mail communications
• access to these rights
• right to assert grievance if rights are infringed upon
• right to access protection, service, and a qualified advocate in order to understand one’s rights
• right to assert these rights without reprisal
• right to referral to other providers upon discharge

Question 8

informed consent

Answer 8

• consent that patient gives to the provider after receiving suficient information allowing patient to understand a procedure

Question 9

types of sufficient information (in regards to informed consent)

Answer 9

• benefits/costs
• ways procedure will be administered
• prognosis
• side effects/risks
• possible consequences of refusing treatment
• other alternatives

Question 10

psychiatric special considerations

Answer 10

• many psych clients can’t give informed consent due to their symptoms

Question 11

what consent is given when informed consent is not possible

Answer 11

substituted consent

- is obtained in instances where competency is in question

Question 12

examples of substituted consent

Answer 12

• health care proxy
• guardian
• next of kin

Question 13

why is confidentiality very important with mental illness

Answer 13

• stigma
• HIPAA
• responsible record keeping
  client’s employer

Question 14

when would we not preserve confidentiality?

Answer 14

• we have a duty to warn and protect third parties

- child and elder abuse reporting statues

Question 15

legal rights

Answer 15

• right to treatment
• right to treatment in the least restrictive environment
• right to refuse treatment
  right to aftercare

Question 16

parts of psych hospital admission

Answer 16

• voluntary admission ** just because they signed themselves in, does not mean they can sign themselves out, need evaluation **
• paperwork signed by patient
• involuntary admission (commitment)
• nature and purpose of involuntary admission

Question 17

types of involuntary admission

Answer 17

judicial
administrative
agency

Question 18

nature and purpose of involuntary admission

Answer 18

• emergency (NYS - 9.39)
• observational or temporary
• long-term or formal
• outpatient

Question 19

Ethics

Answer 19

the study of philosophical beliefs about what is considered right or wrong within a society

Question 20

ethical dilemma

Answer 20

a situation that requires a choice between morally conflicting alternatives

Question 21

bioethics

Answer 21

used in relation to ethical dilemmas surrounding client care

Question 22

five principles of bioethics

Answer 22

beneficence
autonomy
justice
fidelity
veracity

Question 23

beneficence

Answer 23

duty to promote good

Question 24

autonomy

Answer 24

the right to make one’s own decision and respect for the rights of others to make their own decisions

Question 25

justice

Answer 25

treating others fairly and equally

Question 26

fidelity (nonmaleficence)

Answer 26

maintaining loyalty to a commitment; doing no wrong to a client

Question 27

veracity

Answer 27

one’s duty to always tell the truth (exception: when the truth would be knowingly harmful to a client)

Question 28

different resources for guidelines in ethical dilemmas

Answer 28

• Nurse practice acts
• Hospital and organizational polices
• Patient bill of rights
• Code of Ethics for Nurses with Interpretive Statements of the American Nurses Association
• Standards of Care from the Scope and Standards of Psychiatric-Mental Heath Nursing Practice

Question 29

violence

Answer 29

• nurses must protect themselves
• employers not held responsible for employee injuries caused by violent client behavior
• nurses knew they could be in danger by agreeing to care for unpredictable clients
• GOOD JUDGMENT MEANS NOT PLACING ONESELF IN A POTENTIALLY VIOLENT SITUATION
• KNOW YOUR ENVIRONMENT!

Question 30

Libel

Answer 30

published false statements

Question 31

slander

Answer 31

spoken false statements

Question 32

example of emergency (NYS 9.39)

Answer 32

• individual is a danger to themselves
• individual is a danger to others
• individuals are unable to care for themselves