Module 9a Ch6,ch7 Flashcards
Professional Values
Altruism: concern for welfare and well-being of others
Autonomy: right to self-determination
Human dignity: respect for inherent worth and
uniqueness of individuals and populations
Integrity: acting according to code of ethics and
standards of practice
Social justice: upholding moral, legal, and humanistic
rights
Altruism:
concern for welfare and well-being of others
Autonomy:
right to self-determination
Human dignity:
respect for inherent worth and
uniqueness of individuals and populations
Integrity:
acting according to code of ethics and
standards of practice
Social justice:
upholding moral, legal, and humanistic
rights
Types of Ethics
Bioethics
Nursing ethics
Feminist ethics
Bioethics
o Encompasses a number of fields of “life sciences”
Nursing ethics
o Formal study of ethical issues that arise in the
practice of nursing
o Analysis used by nurses to make ethical judgments
Feminist ethics
o Critiques existing patterns of oppression and
domination in society especially affecting women and
the poor
Two Categories of Action-Guiding
Theories
Utilitarian: The rightness or wrongness of an action
depends on the consequences of the action.
Deontologic: An action is right or wrong independent of
its consequences.
Utilitarian:
The rightness or wrongness of an action
depends on the consequences of the action.
Deontologic:
An action is right or wrong independent of
its consequences.
Beauchamp and Childress’s Principle-
Based Approach to Bioethics
Autonomy: Respect rights of patients to make health care
decisions.
Nonmaleficence: Avoid causing harm.
Beneficence: Benefit the patient.
Justice: Give each his or her due and act fairly.
Fidelity: Keep promises.
Veracity, accountability, privacy, confidentiality
Autonomy:
Respect rights of patients to make health care
decisions.
Nonmaleficence:
Avoid causing harm.
Beneficence:
Benefit the patient.
Justice:
Give each his or her due and act fairly.
Fidelity:
Keep promises.
Veracity,
accountability, privacy, confidentiality
Characteristics of the Care-Based
Approach to Bioethics
Centrality of the caring relationship
Promotion of dignity and respect for patients as people
Attention to the particulars of individual patients
Cultivation of responsiveness to others
Redefinition of fundamental moral skills to include virtues
Ethical Conduct
Practice based on professional standards of ethical
conduct as well as professional values
Nurses should:
o Cultivate the virtues of nursing (page 105)
o Understand ethical theories that dictate and justify
professional conduct
o Be familiar with codes of ethics for nurses and
standards for professional nursing conduct
Purposes of the Code of Ethics for Nurses
It is a succinct statement of the ethical obligations and
duties of every nurse.
It is the profession’s nonnegotiable ethical standard.
It is an expression of nursing’s own understanding of its
commitment to society.
7 Basic Tenets of Bill of Rights for RNs #1/Registered Nurses Must Be Able to:
Practice in a manner that fulfills obligations to society and
to those who receive nursing care
Practice in environments that allow them to act in
accordance with professional standards and legally
authorized scopes of practice
Work in an environment that supports and facilitates
ethical practice, in accordance with the Code of Ethics for
Nurses
Freely and openly advocate for themselves and their
patients, without fear of retribution
7 Basic Tenets of Bill of Rights for RNs
2/Registered Nurses Must Be Able to:
Receive fair compensation for their work, consistent with
their knowledge, experience, and professional
responsibilities
Practice in a work environment that is safe for
themselves and their patients
Negotiate the conditions of their employment, either as
individuals or collectively, in all practice settings
Ethical Experience and Decision
Making/Ethical Problems
Ethical dilemma: Two (or more) clear moral principles
apply but support mutually inconsistent courses of action.
Ethical distress: Occurs when the nurse knows the right
thing to do but either personal or institutional factors
make it difficult to follow the correct course of action.
Using the Nursing Process to Make Ethical
Decisions
Assess the situation (gather data). Diagnose (identify) the ethical problem. Plan: o Identify options. o Think ethical problem through. o Make a decision. Implement your decision. Evaluate your decision.
Examples of Ethical Problems #1
Paternalism Deception Privacy Confidentiality Allocation of scarce nursing resources Valid consent or refusal Conflicts concerning new technologies
Examples of Ethical Problems #2
• Unprofessional, incompetent, unethical, or illegal
physician practice
• Unprofessional, incompetent, unethical, or illegal nurse
practice
• Short staffing and whistle-blowing
• Beginning-of-life issues
• End-of-life issues
Advocacy in Nursing Practice
Primary commitment to the patient
Prioritization of good of individual patient rather than
society in general
Evaluation of competing claims of patient’s autonomy and
patient well-being
Areas of Concern for Patient Advocates
Representation of patients
Promoting self-determination
Whistle-blowing
Being politically active
Ch7 sprackle ppt
Chapter 7
Legal Dimensions of Nursing
Practice
Definition of Law
Standard or rule of conduct established and enforced by
government
o Designed to protect the rights of the Public
Law Terminology
Litigation: process of bringing and trying a lawsuit
Plaintiff: person bringing suit
Defendant: person being accused of a crime
o Presumed innocent until proven guilty
Litigation:
process of bringing and trying a lawsuit
Plaintiff:
person bringing suit
Defendant:
person being accused of a crime
o Presumed innocent until proven guilty
Types of Laws
Public law—government is directly involved
o Regulates relationships between individuals and
government
Private law—civil law
o Regulates relationships among people
Criminal law—concerns state and federal criminal statutes
o Defines criminal actions (e.g., murder, theft)
Four Sources of Law
Constitutions: serve as guides to legislative bodies
Statutory law: enacted by a legislative body
Administrative law: empowered by executive officers
Common law: judiciary system reconciles controversies,
creates body of common law
Professional and Legal Regulation of Nursing practice
Nurse practice acts Standards Credentialing o Accreditation Licensure o Certification
Reasons for Suspending or Revoking a
License
Drug or alcohol abuse Fraud Deceptive practice Criminal acts Previous disciplinary actions Gross or ordinary negligence Physical or mental impairments, including age
Due Cause for Revoking a License
Notice of investigation
Fair and impartial hearing
Proper decision based on substantial evidence
Nurse’s Best Defense of License
Investigation
Early legal counseling
Character and expert witnesses
Thorough preparation for all proceedings
Criminal Law (Crimes & Torts)
Crime: wrong against a person or the person’s property
as well as the public
o Misdemeanor: punishable by fines or less than 1 year
imprisonment
o Felony: punishable by imprisonment for more than 1
year
Tort: a wrong committed by a person against another
person or that person’s property; tried in civil court
o Intentional
o Unintentional
Categories of malpractice P
Intentional and Unintentional Torts
Intentional o Assault and battery o Defamation of character o Invasion of privacy o False imprisonment o Fraud
Unintentional
o Negligence
o Malpractice
HIPAA-Ensured Patient Rights
To see and copy their health record
To update their health record
To request correction of any mistakes
To get a list of the disclosures a health care institution
has made independent of disclosures made for the
purposes of treatment, payment, and health care
operations
To request a restriction on certain uses or disclosures
To choose how to receive health information
Categories of Malpractice Claims
Failure to follow standards of care Failure to use equipment in responsible manner Failure to assess and monitor Failure to communicate Failure to document Failure to act as a patient advocate
Four Elements of Liability
Duty
Breach of duty
Causation
Damages
Three Outcomes of Malpractice Litigation
All parties work toward fair settlement.
Case is presented to malpractice arbitration panel.
Case is brought to trial court.
Roles of Nurses in Legal Proceedings
Nurse as defendant
Nurse as fact witness
Nurse as expert witness
Recommendations for Nurse Defendant
Do not discuss the case with those involved in it. Do not alter patient records. Cooperate fully with your attorney. Be courteous on witness stand. Do not volunteer any information.
Legal Safeguards for Nurses #1
Competent practice Issues that affect competent practice Informed consent or refusal Contracts Collective bargaining Patient education Executing physician orders Delegating nursing care Documentation Appropriate use of social media
Legal Safeguards for Nurses #2
Adequate staffing Whistle-blowing Professional liability insurance Risk management programs Just culture Incident, variance, or occurrence reports; sentinel events and Never events Patients’ rights Good Samaritan Laws Student liability
Elements of Informed Consent
Disclosure
Comprehension
Competence
Voluntariness
Safeguards to Competent Practice
Developing interpersonal communication skills
Respecting legal boundaries of practice
Following institutional procedures and policies
Owning personal strengths and weaknesses
Evaluating proposed assignments
Keeping current in nursing knowledge and skills
Respecting patient rights and developing rapport with
patients
Keeping careful documentation
Working within agency for management policies
Types of Risk Management Programs
Safety program
Products safety program
Quality assurance programs
Information Contained in Incident Reports
Complete name of person and names of witnesses
Factual account of incident
Date, time, and place of incident
Pertinent characteristics of person involved
Any equipment or resources being used
Any other important variables
Documentation by physician of medical examination of
person involved
OSHA Legal Regulations
Use of electrical equipment
Use of isolation techniques
Use of radiation
Use of chemicals
Laws Affecting Nursing Practice
Occupational Safety and Health National Practitioner Data Bank Reporting obligations Controlled substances Discrimination and sexual harassment Health Insurance Portability and Accountability Act (HIPAA); Restraints People with disabilities Legal issues related to death and dying (wills, advance directives)
Ch6 and 7 note
Nursing Ethics
• Ethical Nursing- Practicing ethically means not only knowing the
right thing to do, but also being prepared to put this into action.
• Ethical guidelines- help nurses work through difficult situations and
provide them with a moral compass to do their jobs fairly.
• Four main principles that are the nursing code of ethics:
Autonomy
Beneficence
Justice
Non-maleficence
Name each professional value?
• Concern for welfare and well-being of others
• Upholding moral, legal, and humanistic rights
• Respect for inherent worth and uniqueness of individuals and
populations
• Right to self-determination
• Acting according to code of ethics and standards of practice
Name these principal based
approaches to bioethics?
- Benefits the patient
- Keep promises
- Avoid causing harm
- Give each his or her due and act fairly
Two types of Ethical problems faced
by nurses:
• Ethical dilemma- a situation where a nurse must decide between
competing values and know that no matter what choice they make,
there are consequences
The books definition- a situation that arises when attempted adherence
to basic ethical principles results in two conflicting courses of action.
• Moral distress occurs when you know the right thing to do but either
personal or institutional factors make it difficult to follow the correct
course of action
What is Advocacy in Nursing?
Skills of an Advocate:
Advocacy is:
• Supporting
• Protecting/defending
• Speaking out
Skills of an Advocate: • Problem solving • Communication • Influence • Collaboration • Patience
Areas of Concern for Patient
Advocates
- Representation of patients
- Promoting self-determination
- Whistle-blowing
- Being politically active
Law Terminology/Name the term
- Process of bringing and trying a lawsuit
- Person bringing suit
- Person being accused of a crime
Name the Type of Law
- Regulates relationships between individuals and government
- Regulates relationships among people
- Defines criminal actions (e.g., murder, theft)
Reasons for Suspending or Revoking
a License
- Drug or alcohol abuse
- Fraud
- Deceptive practice
- Criminal acts
- Previous disciplinary actions
- Gross or ordinary negligence
- Physical or mental impairments, including age
Why are Legal Safeguards
Necessary and what are they:
- Competent practice
- Issues that affect competent practice
- Informed consent or refusal
- Contracts
- Collective bargaining
- Patient education
- Executing physician orders
- Delegating nursing care
- Documentation
- Appropriate use of social media
Why are Legal Safeguards
Necessary and what are they cont.:
- Adequate staffing
- Whistle-blowing
- Professional liability insurance
- Risk management programs
- Just culture
- Incident, variance, or occurrence reports; sentinel events and Never events
- Patients’ rights
- Good Samaritan Laws
- Student liability
what factors may influence a
patients acceptance or refusal of
medical treatment?
- Culture
- Age
- Gender
- Sexual Orientation
- General Health
- Social Support System
