TERM 3- MY NOTES MENTAL HEALTH NURSING CARE CH.2 "ETHICAL AND LEGAL ISSUES" Flashcards
ETHICS IN NuRSING
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Ethics is the science relating to moral principles or standards that govern conduct. It is the body of knowledge that answers the question: “All things considered, what is the right thing to do in a given situation?” Nurses work with ethical issues every day.
A)true
B)false
A
All things considered, what is the right thing to do in a given situation is called
A)ethics
B)values
A
Personal Values
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Nurses muse understand their own values before they make decisions related to professional ethics.
A)true
B)false
A
Values are personal beliefs abom the worrh of an idea, object, or behavior.
A)true
B)false
A
Values are an individual’s decisions about what is right, what is wrong, and what is most important.
A)true
B)false
A
People are often passionate on the subject of values.
A)true
B)false
A
It is values (such as patriotism, freedom, justice, equality, religion) that make people go To war, or march against it. People are often willing to fight or even die for their values.
A)true
B)false
A
Personal values can affect a nurse’s behavior at work.
A)true
B)false
A
A nurse who values self-sufficiency very highly may prioritize the care of an independent client over that of a client who has quadriplegia.
A nurse who puts a high value on physical appearance may answer the call lights of attractive clients first.
These nurses may not know why they behave this way unless they clarify their values for themselves.
A)true
B)false
A
Values clarification is a process of self-discovery in which people identify their own values and prioritize them. When nurses clearly understand their own attitudes about right and wrong, it is easier for them to decide on ethical professional behavior.
A)true
B)false
A
The process of values clarification has three steps:
l. Choosing from alternatives which values to hold
2. Prizing the chosen values, which means making a public commitment to the values (such as with bumper stickers, symbolic jewelry, tattoos, telling people, etc.)
3. Acting on the chosen values
True
Integrity means acting on one’s values. If a person values honesty and acts consistently in an honest way, this person is said to have integrity.
If this person says he values honesty, but acts in a consistently dishonest way, he is acting with hypocrisy (behavior contrary to seated values).
A)true
B)false
A
Some personal values (such as racism) are not acceptable anywhere in rhe practice of nursing.
A)true
B)false
A
In the nursing profession, the rights of all clients to nursing care are more important than an individual nurse’s right to act according to her own values. This nurse will either need to work in a different area of the hospital or reexamine her decision to exclude certain clients from her care.
A)true
B)false
A
A person who has personal values that require excluding groups of people from nursing care should consider other career options.
A)true
B)false
A
Nurses do not need to agree wirh the behavior or values of their clients. In fact, they often disagree. However, nurses must provide care to people with respect for their human dignity and regardless of their personal attributes
A)true
B)false
A
Codes of Ethics for Nurses
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The American Nurses Association (2001) has established an ethical guide for the entire nursing profession, the Code of Ethics for Nurses. Notice that the code provides principles and guidelines, but no specific directions for nursing interventions.
A)true
B)false
A
Professional ethical codes must be general in order to cover the variety of situations in which they will be used.
A)true
B)false
A
The ethics of the profession evolve over time as societal attitudes and sociological circumstances change.
A)true
B)false
A
The Code was first written in 1950
A)true
B)false
A
The National Federation of Licensed Practical Nurses (NFLPN) ;
The organization has standards for education, legal/ethical status, practice, continuing education, and specialized nursing practice for Licensed Pracrical/Vocarional Nurses
True
American Nurses Association Code of Ethics for Nurses
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- The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.
- The nurse’s primary commitment is to the patient, whether an individual, family, group, or community.
- The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.
- The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligation to provide optimum patient care.
- The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth.
- The nurse participates in establishing, maintaining, and improving health care environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action.
- The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development.
- The nurse collaborates with all other health professionals and the public in promoting community, national, and international efforts to meet health needs.
- The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy.
True
Legal/Ethical Standards for the Licensed Practical/Vocational Nurse
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The Licensed Practical/Vocational Nurse:
- Shall hold a current license to practice nursing as an LP/VN in accordance with the law of the state wherein employed.
- Shall know the scope of nursing practice authorized by the Nursing Practice Act in the state wherein employed.
- Shall have a personal commitment to fulfill the legal responsibilities inherent in good nursing practice.
- Shall take responsible actions in situations wherein there is unprofessional conduct by a peer or other health care provider.
- Shall recognize and have a commitment to meet the ethical and moral obligations of the practice of nursing.
- Shall not accept or perform professional responsibilities which the individual knows (s)he is not competent to perform.
True
Standards of Care
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Standards of nursing care are the ethical and legal expectations for practice; they are the level of work quality considered adequate by the profession.
A)true
B)false
A
Society expects that nurses will use at least ordinary and reasonable care to see that no unnecessary harm comes to the client. When there is a question about a nurse’s care, the nurse’s actions can be compared with professional standards.
A)true
B)false
A
These internal standards often consist of written policies and procedures for doing nursing tasks. Nurses are held responsible for knowing and following the policies and procedures of their employer.
A)true
B)false
A
There are also external standards, which are set by state and national organizations. State boards of nursing, professional nursing organizations such as the ANA and the NFLPN, and the federal government all provide external standards. Nurses are expected to know about and adhere ro these standards.
A)true
B)false
A
Ethical Principles
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Ethical principles provide a basis for discussion and ethical decision making. These principles may be used alone, but are usually used in combination wirh each other
A)true
B)false
A
The seven ethical principles most pertinent to nursing are:
- Justice. Justice means that people have the right to be treated equally and fairly. All resources available for health care should be distributed equally to people.
- Beneficence. Beneficence means to do good for others. This is the foundation for most nursing actions: doing good.
- Nonmaleficence. Nonmaleficence means doing no harm. Health care providers should not harm their clients either intentionally or unintentionally
- Autonomy: Autonomy involves personal freedom and self-determination. It is the right to choose what will happen to oneself.
- Paternalism: Paternalism allows someone to act “in the best interest” of other people, making decisions for others when they lack the full information or ability on which to base decisions
- Veracity: Veracity means truth telling. This principle says that the whole truth should always be told.
- Fidelity. Fidelity means keeping promises. When you are loyal you keep your promises.
True
Beneficence is the foundation for most nursing actions: doing good.
A)true
B)false
A
ETHICAL DILEMMAS
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An ethical dilemma exists when there are conflicting moral alternatives to consider for action. In an ethical dilemma, some evidence exists that a particular course of action may be right, and some evidence exists that it may be wrong.
A)true
B)false
A
ETHICAL DECISION MAKING
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In the healthcare culture in the United States, the client’s autonomy is highly valued. If a client is old enough to make legal decisions (the age varies by scare), has not been declared legally incompetent by a court of law, or has not had a legal guardian appointed, the client is considered the decision maker in medical treatment situations
A)true
B)false
A
beneficence (doing good)
A)true
B)false
A
paternalism (knowing better for clients than they know for themselves)
A)true
B)false
A
So, what good are nurses if we can’t make clients do anything, you might ask. Clients don’t need nurses to force them to act in a healthy way. Nurses create a relationship with their clients. In the nurse-client relationship we foster trust and we reach clients what they need to know so they can make informed decisions for themselves.
A)true
B)false
A
We care for clients, reach them, and advocate for them. We do not have to approve of their behavior or ideas, we just care, reach, and advocate. The only behavior we can control is our own.
A)true
B)false
A
LEGAL AsPECTS OF MENTAL HEALTH NuRSING
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Although the ethical principles of nursing care protect the rights of clients, the law protects the needs of society. The legal context of care concerns the rights of clients and the quality of care they receive.
A)true
B)false
A
Types of Law
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Two types of law apply most directly to nurses. They are sracutory law, which is law that is passed by a legislative body, and common law, which is derived from previous court decisions.
A)true
B)false
A
Both statutory and common laws have civil and criminal components.
A)true
B)false
A
Civil law protects private and property rights.
A)true
B)false
A
Torts are violations of civil law in which an individual has been wronged. Malpractice is a tort.
A)true
B)false
A
Criminal law protects people from conduct injurious to the public welfare and provides for punishmem of people who break these laws
A)true
B)false
A
Statutory Law is Passed by a legislative body
A)true
B)false
A
Common Law is Derived from previous court cases
A)true
B)false
A
Civil Law Protects private and property rights
A)true
B)false
A
Criminal Law ;Protects people from conduce injurious to the public welfare and provides punishment for people who break these laws
A)true
B)false
A
Torts are Violations of civil law in which an individual has been wronged
A)true
B)false
A
Intentional tort is an Assault, Battery, False imprisonment and Abandonment
A)true
B)false
A
Unintentional tort is an Malpractice and Negligence
A)true
B)false
A
Nurse Practice Acts
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The legal definitions and scope of practice of registered and practical/vocational nurses are in each state’s nurse practice act. These are statutory law (enacted by the state legislatures).
A)true
B)false
A
It is important for nurses to understand the extent of their responsibilities when they practice nursing in their state
A)true
B)false
A
These laws vary from one state to another. They usually include:
- Definitions of nursing and the various types of nurses
- Requirements for educational preparation for each type of nursing
- Conditions for revoking a license
- A statement about the state agency (the Stare Board of Nursing) that has jurisdiction over nurses
True
Psychiatric Hospitalization
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Voluntary admission for mental illness treatment is similar to medical hospitalization. The client signs a routine form requesting admission to the hospital and may leave at any time. Ideally, all treatment should be on a voluntary basis. However, mental illnesses are sometimes characterized by symptoms that make it impossible for affected clients to understand their condition or need for treatment.
A)true
B)false
A
Involuntary admission, or commitment, means that the client is hospitalized without the individual’s consent. The rules regulating involuntary commitment are based on state laws and vary among the states
A)true
B)false
A
The basic criteria for involuntary commitment to psychiatric treatment facilities usually include that the client muse be mentally ill and (as a result of this mental illness) be:
- Dangerous to self or others
- In need of treatment
- Unable to provide for own basic needs
True
An emergency psychiatric hospitalization is indicated when a person appears to be dangerous to self or others and refuses treatment. States can allow a brief (2- to 5-day) involuntary hospitalization for further evaluation and allow time for a court hearing on determining the need for a longer commitment
A)true
B)false
A
The states usually require that by the time the emergency hospitalization period has elapsed, mental health providers (usually psychiatrists) must petition the court for an extended commitment if they decide that the client needs further treatment. This extended involuntary hospitalization is called civil commitment.
A)true
B)false
A
Civil commitmencs may vary in length of time, but may not last more than 1 year. If a client’s condition improves during the commitment period, the client may be discharged.
A)true
B)false
A
OUTPATIENT COMMITMENT
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Outpatient commitment is a court order requiring the mentally ill person to take medication and to comply with a treatment plan as a condition of release from the hospital.
A)true
B)false
A
Outparient commitment reduces rehospitalization, increases client compliance with medication, and decreases violence. However, outpatient commitment is not available in all states
A)true
B)false
A
CONDITIONAL RELEASE
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Conditional release is another type of involuntary commitment available in some states. In this system, the committed client is released from the hospital on the condition that he or she participate in treatment in the community. This can be a day treatment or medication management program. A client who fails to comply with the conditions is rehospitalized.
A)true
B)false
A
Legal Rights for Mental Health Clients
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People with mental illnesses are vulnerable to abuse and mistreatment. To protect the mentally ill, the U.S. Congress passed the Mental Health Systems Act of 1980, which passed into law the Universal Bill of Rights for Mental Health Patients.
A)true
B)false
A
CIVIL RIGHTS
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People who are voluntarily hospitalized for mental health treatment retain all their civil rights. Clients have the right go vote, hold office, conduct business, hold licenses, and practice their professions. States may abridge the rights of people who are committed. In some states, committed clients retain all their civil rights, including the right to refuse treatment.
A)true
B)false
A
Right to Least Restrictive Treatment Alternative
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