Objective 3 Flashcards
expression of values that guide practice
ethics
system of ethics with the central concepts of reason and duty
deontology
used in relation to ethical dilemmas surrounding health care
bioethics
what are the 6 principles of bioethics?
autonomy
nonmaleficence
beneficence
justice
principle of impossibility
fidelity
respecting the rights of others to make their own decisions
autonomy
doing no wrong to a pt
nonmaleficence
the duty to promote good
beneficence
the duty to distribute resources or care equally
justice
that rights or obligations that cannot be met in the circumstances are no longer obligations
principle of impossibility
maintaining loyalty and commitment
fidelity
what are the guidelines for ensuring adherence to standards of care?
Student nurses and practicing nurses have a
legal duty to report risks for harm from
Negligence, irresponsibility, or impairment
Unethical or illegal practices
what are the core responsibilities for Canadian nurses?
providing safe, compassionate, competent and ethical care
promoting health and well-being
promoting and respecting informed decision-making
preserving dignity
maintaining privacy and confidentiality
promoting justice
being accountable
Provides Competent Professional
Care Through the Development of a Therapeutic
Relationship
Standard I
Performs/Refines Client
Assessments Through the Diagnostic and
Monitoring Function.
standard II
Administers and Monitors
Therapeutic Interventions.
standard III
Effectively Manages Rapidly
Changing Situations
standard IV
intervenes Through the Teaching-
Coaching Function
standard V
Monitors and Ensures the Quality
of Health Care Practices
standard VI
Practices Within Organizational
and Work-Role Structure.
standard VII
The domain of international human rights and
declarations and the protection of these covenants
international/national
Provinces & territories each establish mental health
legislation
Distinctions exist with regard to involuntary admission
criteria, the right to refuse treatment, and who has the
authority to authorize treatment
provencial/territorial
what are the pts rights under the law?
Right to treatment/authorization of treatment
Consent
Competency (legal guardian)
Right to refuse treatment
Community treatment orders (CTO’s)
Involuntary admission criteria
Provision of least restrictive type of care
Advance Directive
Guardianship
Confidentiality
Duty to warn
Duty to protect
Reporting of child abuse (Box 7.7)
Confidentiality of communicable diseases
Confidentiality after death
Protection of patients
A record’s usefulness is determined by evaluating—
when the record is read later—how accurately and
completely it portrays the patient’s behavioural status
at the time it was written
Used by the facility for quality improvement
Used as evidence
Electronic documentation
documentation of care
A civil wrong for which money
damages may be collected by the
injured party (plaintiff) from the
responsible party (the defendant)
tort
Willful or
intentional acts that violate another
person’s rights or property
intentional tort
what are the types of intentional torts
assault
battery
false imprisonment
invasion of privacy
defamation of character
Unintended acts
against another that produce injury
or harm
unintentional tort
what are the types of unintentional torts?
negligence
malpractice
refers to the process
(section 241.1 of the Criminal Code) where an eligible
healthcare provider:
Prescribes and administers a medication to a client, at
their request, that causes their death; or
Prescribes or provides a medication to a client, at their
request, so that they may self-administer the substance
and in doing so cause their own death
MAID
who is permitted to determine who is eligible for MAID?
LPNs are NOT permitted to determine who is eligible
for MAiD, this is the responsibility of the Physician
what is the criteria for MAID?
is eligible for health services in Canada
is 18 years of age and capable of making decisions
with respect to their health
has a grievous and irremediable medical condition
makes a voluntary request for MAiD that was not
made as a result of external pressure
gives informed consent to receive MAiD
If you have a physical disability and wish to seek medical
assistance in dying, you may be eligible
Eligibility is assessed on an individual basis
If a mental illness is the only medical condition leading you to
consider MAID, you are not eligible to seek MAID at this time.
Under the new changes made to the law, the exclusion will
remain in effect until March 17, 2023
what is the role of LPNS in MAID?
To have the knowledge, skill, ability and judgement to
provide care
To provide safe, competent, compassionate, and
ethical care
Work within LPN Standards, Regulations, and Employer
policies
what are the guidelines provided by CLPNNL for LPNs and MAID?
- LPNs can aid in MAiD under the direction of a medical
practitioner or nurse practitioner - If requested, LPNs may support access to accurate and
objective information about MAiD to clients so that they may
make informed decisions about their care - LPNs must not initiate a discussion on MAiD with clients
- LPNs must have the knowledge, skill, ability and judgement
to provide safe, competent, ethical and compassionate end
of life care - If the LPN has reason to believe that the client does not
meet the eligibility criteria, or all mandatory safeguards are
not in place, the LPN must immediately discuss this with the
client’s health care team. - LPNs can insert an intravenous line that will be used for
the administration of the medication that will cause death - LPNs are NOT authorized under any circumstances to
administer the substance that causes the death - LPNs can be present to provide end of life nursing care
during the administration of the medication that will
cause death - LPNs must document their involvement in MAiD in
accordance with the standards of practice and
employer policy
what is the CMHA position on MAID?
CMHA does not believe that mental illnesses are
irremediable, though they may be grievous or
unbearable
CMHA recognize that people with Mental Illnesses can
experience unbearable psychological suffering as a
result of their illness, but there is always the hope of
recovery
CMHA’s position on MAiD is that people with a mental
health problem or illness should be assisted to live an
thrive
Ability of nurses to apply knowledge and skill
appropriately in cross - cultural situations
cultural competence
what are the 5 constructs of cultural competence?
- Cultural awareness
- Cultural knowledge
- Cultural encounters
- Cultural skill
- Cultural desire
colonization
ethnocentrism
cultural safety
immigration policy
refugees in Canada
multicultural contexts
what are mental health concerns of refugees?
Post-traumatic stress
Adjustment disorders
Depression
Suspiciousness and distrust of authorities
Needs for culturally relevant and appropriate services
(including for those without dominant language skills, or
for English or French as an additional language)
what are the barriers to quality mental health services?
Communication barriers
Stigma of mental illness
Misdiagnosis
Culture-bound syndromes
Genetic variations in pharmacodynamics
Populations at Risk of Mental Illness and Inadequate Care
* Immigrants
* Refugees
* Cultural “minorities”
Identity found in individuality
* Values Autonomy, Independence & Self-reliance
* Mind and body separate entities
* Disease has a cause, treatment is aimed at cause
* Time is linear
* Success is obtained in preparing for the future
western tradition
Family basis for identity
* Body–mind–spirit one entity
* Time is circular and recurring
* Born into a fate; duty to comply
* Disease caused by fluctuations in opposing forces
eastern tradition
The Indigenous world view of mental
health acknowledges the connection
between an individual and the
collective. It is reflective of the
balance that is achieved between
physical, emotional, cognitive, and
spiritual dimensions.
indigenous population
an ancient
symbol that can be interpreted in
many ways: the four directions, the
four grandfathers, the four
components of human nature
(physical, mental, spiritual, and
emotional).
medicine wheel
Places significance on place of humans in natural
world
* Basis of identity is the tribe
* Person is an entity only in relation to others
indigenous culture
lack of harmony between individual and env
disease
what are mental health concerns of indigenous peoples?
intergenerational trauma
hopelessness and suicide
family violence, family separation, and community violence
substance use
needs for culturally relevant and appropriate services
