M4 Ethical & Legal Flashcards
Advocacy goal
Helping others to grow and self actualize
In nursing, managers advocate for
Self
Patient
Subordinates
Workplace
Advocacy in action
Inform others of their rights
Be sure they have adequate info to make decision
Whistleblowing
Act of drawing attention to a wrongdoing
Internal whistleblowing
within an organization, reporting up the chain of command
External whistleblowing
reporting to media or elected officials
When to whistleblow
aka violations of
Patient rights
Working conditions
Nursing practice
Management conduct
Specific behavior (assault, abuse, etc.)
Whistleblowing can be averted by organizations sponsoring a culture of
Accountability
Transparency
Integrity
Bad organizational practices that could lead to whistleblowing
Poor top down structure
Poor bureaucracy
Defensiveness
Maintaining status quo
Emergency cover ups
Secrecy
Silence
Blame
Fear
As a manager you must _ for the whistleblower
Advocate
Whistleblowing guidelines
Make sure there is a problem
Seek validation from colleagues
Follow chain of command
Have evidence
Know your rights by state
Do TJC of National committee of quality assurance offer protection
NO
Only the State and National regulations do
Key to whistleblowing
Documentation
Safe harbor is a
Nurse peer review process
Who may invoke safe harbor
PN
RN
APRN
any nurse
When to call safe harbor
When asked to do something that would violate the NPA or their duty to a patient
Safe harbor good faith
protects employee from employer and BON retaliation
Safe harbor must be invoked…
or
PRIOR to engaging in the assignment
at any time when INITIAL assignment changes
During safe harbor litigation do we engage in requested conduct
Yes, care for your pts
Can you be reported to the BON while pending peer review
NO
Can you disciplined by the BON while pending peer review
NO
Does the ability to invoke safe harbor change depending on whether you refuse or accept the assignment
NO
When must safe harbor be invoked
PRIOR to accepting assignment
Nurse may not engage in care even after safe harbor if the request is
Criminal
Unprofessional
Nurse lacks knowledge
Do safe harbor protections have expirations
NO
Safe harbor is protected against what retaliation actions
Demotion
Forced shift change
Pay cut
All really
What does safe harbor protect
A nurses ability to retain a license
2 types of nursing peer review
Safe harbor
Incident based
What do peer reviews check
Nursing services
Qualification of nurse
Quality of care
Merit of complaint
What do incident based peer reviews determin
If nurse can be remediated with training or is not at fault due to extenuating circumstances
or
If nurse will be reported to BON
Who is on the committee for peer review
3/4 nurses (RN LVN APRN)
At least 2/3 are RNs and only they may vote
At least 1 RN with working familiarity to the same area as being reviewed
Incident peer review boards and administrative authority
May NOT participate in peer review, unless called on as a witness
Safe harbor review boards and CNOs Nurse Managers and individuals with authority
May ONLY appear before committee as witnesses
ANA provision 2
Nurses primary commitment is to the patient
ANA provision 5
Nurse owes same responsibility to self as to others including
Integrity
Competence
Personal/professional growth
How many nurses are impaired or in recovery
1 in 10
Factors that increase substance abuse risks
Staffing shortages
Unprofessional administrators/Drs
Rotating shifts
Long hours
Bullying
Disorders that co-occur with substance abuse
Depression
PTSD
Genetics
Fatigue
Stress
Drugs abused by nurses
Alcohol - most common
opioids, stimulants, CNS depressants
If you or a nurse you know needs help it is your / duty to report
ethical/LEGAL
Students should report to
Practicing nurses should report to
Faculty
Managment
Going through a SUD rehabilitation program can
Save your nursing license
Barriers to reporting substance abuse
Self-denial
Culture or norms
Feeling of betrayal
Fear of retaliation, ostracization, loss of license, litigation
Are you legally required to report suspicion of substance abuse
YES
Who will take action against you for not reporting
TXBON
If you, in good faith, report a suspicion of substance abuse you reserve
immunity from civil or criminal liability
immunity from retaliation
TPAPN
Texas Peer Assistance Program
Help nurses with SUD, anxiety, depression, bipolar disorder, and schizophrenia
TPAPN helps both
Nurses and Patients
Marginal Employee
Employee with poor performance who also is not benefited from teaching reinforcement or discipline
