Professional boundaries and ethical issues

Question 1

Mandatory ethics?

Answer 1

Ethical functioning at minimum level of professional practice

Question 2

Aspirational ethics?

Answer 2

Doing what’s in the best interests of the client

Question 3

Positive ethics?

Answer 3

When healthcare professionals seek to incorporate aspirational ethics (do what’s in best interests of client) rather than just mandatory ethics.

Question 4

Fear based ethics?

Answer 4

Acting in a way to avoid punishment

Question 5

Concern based ethics?

Answer 5

Asking yourself how can I be the best nurse possible

Question 6

What is the CNA Code of Ethics?

Answer 6

Statement of ethical values of RNs that demonstrate nurses commitment to people with healthcare needs. It’s aspirational (informs everyone about ethical values/responsibilities) and regulatory (nursing is a self regulating profession so they are bound to code of ethics as part of a regulatory process).

Question 7

True or false: we need to put the client’s need before our own?

Answer 7

True

Question 8

Steps in ethical decision making?

Answer 8

1. Identify problem
2. Identify personal issues
3. Consult code of ethics
4. Consider laws/regulations
5. Seek support/guidance
6. Brainstorm possible solutions
7. Consider consequences of decisions
8. Choose best course of action

Question 9

True or false: no code of ethics can solve every ethically challenging situation you encounter

Answer 9

True- must be balance between following code but not being wrapped up in worry about legalities

Question 10

What to do when having to make ethical decisions?

Answer 10

Discuss challenging situations/ethical dilemmas with colleagues, be informed about policies/laws/regulations, and reflect (self examine and self awareness).

Question 11

What is informed consent?

Answer 11

Ethical/legal requirement that involves right of clients to autonomy/decision making. Includes educating, empowering, and build trust with clients.

Question 12

Confidentiality?

Answer 12

Keep conversation private and it’s an ethical concept. It’s central to developed trust in relationship. Important to disclose degree of confidentiality promised

Question 13

Why are boundaries important in nursing?

Answer 13

Inspires confidence/trust in our patients. Demonstrates respect and reflective of ethical obligations.

Question 14

Professional boundaries definition?

Answer 14

Spaces between nurses power and patients vulnerability. RN will establish professional boundaries that are client centered.

Question 15

Boundary crossings?

Answer 15

Brief excursions across professional lines of behaviour that can be thoughtless or purposeful, while attempting to meet a special therapeutic need of patient. Can be done ethically to enhance therapeutic relationship.

Question 16

Boundary violation meaning?

Answer 16

Serious breach that can cause harm/is unethical. Can result when there’s confusion between needs of nurse and those of patient. This moves relationship from professional to personal which cause jepordization/client stress.

Question 17

Continuum of professional behaviour?

Answer 17

Therapeutic relationship is at middle and is the optimal selection. Protects pt dignity/autonomy/privacy. Under involvement represents disinterest, neglect, abandonment, and distancing. Over involvement represents confusion between needs of nurse vs needs of patient. (favouritism, social contact, boundary violations)

Question 18

Over involvement warning signs?

Answer 18

Excessive self disclosure, favouritism/special treatment, flirting, overprotective/secretive behaviour, and believing you are only one who understands client.

Question 19

How to prevent boundary violations?

Answer 19

Be aware, be observant of behaviour of other professionals, act in best interest of pt, evaluate your interactions/relationships, and be aware of feelings/behaviour.

Question 20

Decision making framework for appropriate professional behaviour?

Answer 20

Framework that helps nurses decide to proceed with behaviour when they interact with the client.

Question 21

What is the nightingale effect?

Answer 21

When nurses continue working despite being physically or psychologically compromised.

Question 22

Nursing education climate?

Answer 22

Nursing students report experiencing verbal abuse, academic abuse, and high stress levels. Nursing faculty are faces with more work to meet education requirements and they are at higher risk of psychological illness.

Question 23

What should faculty and students do?

Answer 23

Work together to promote wellness through collaboration. Create a partnership that emphasizes caring/listening/acceptance/relationship building.

Question 24

What are some activities that may violate boundaries?

Answer 24

Accepting gifts from clients, self disclosure, commencing a social relationship with a former client, and entering a therapeutic relationship with family/friends

Question 25

5 components of of therapeutic relationship according to college of nurses ontario?

Answer 25

1. Trust- nurses doesn’t exploit clients trust
2. Respect- nurses respects different ways of knowing
3. Empathy- validate client’s experiences while maintains emotional distance from client to be professional
4. Professional intimacy- nurse maintains therapeutic boundaries
5. Power- nurses know about power imbalances/doesn’t misuse this power