Week 8 & 9 Flashcards
CNA: Nursing values and ethical responsibilities:
- providing safe, compassionate, competent care
- promoting health and well-being
- promoting and respecting informed decision making
- honouring dignity
- maintaining privacy and confidentiality
- being accountable
- promoting justice
What is the purpose of the CNA?
- serves as a foundation for nurses’ ethical practice.
- provides guidance for ethical relationships.
- used in conjunction w professional standards, laws and regulations that guide practice
- protect the public and provide practice reference for RN’s in line w The registered nurses act.
CRNS standards and competencies:
- Professional responsibility and accountability
- knowledge based practice
- ethical practice
- service to the public
- self regulation
CNA emphasizes four major components:
- nurses and the client
- nurses and practice
- nurses and the profession
- nurses and global health
Bioethics:
- Bioethics investigates, critiques, and informs healthcare professionals in navigating ethical dilemmas.
- dilemmas may result from competing expectations, values, or duties.
- Autonomy: right to self-determination – basis for informed consent; focus on client’s needs, opinions, and preferences for care; right to be involved in decisions to the extent they are able
- Beneficence/Nonmaleficence: actions should “do good”; actions should “do no harm” benefit vs harm
- Justice: being fair and impartial - who receives resources?; being truthful
Concepts of ethical nursing practice: self disclosure
- Self disclosure must be in the best interest of the client; it is not about meeting the nurses’ needs
Nurse-client professional boundary:
- Invisible structure which protects rights, privacy, and functional integrity of the nurse-client relationship
- Aim: a professional helping therapeutic relationship; not a personal unprofessional relationship
- The nurse (not the patient) is responsible for setting the boundary
critical thinking characteristics:
- Attitude: Develops an analytical thinking ability; maintains an inquisitive mind set;
open-minded & flexible thinking process - Thought process: Reflective; combines existing knowledge & standards with new information; creative thinking; Recognizes when information is missing and seeks new information
discards irrelevant information; - Skills: Organized and methodical reasoning
Diligently seeks new information
revises actions based on new input
evaluates solutions & outcomes
Barriers to thinking critically and reasoning ethically:
- Attitudes and habits : my way is better”; cognitive barriers such as stereotypes
- Cognitive dissonance: mental discomfort you feel when there is a discrepancy between what you believe and new information - conflict
- personal values vs. professional values: personal values become a part of self-concept
education helps us acquire a professional value system. be careful our personal values do not obstruct care for a client who holds differing values
Ethical problem:
Ethical Dilemma:
- inadequate staffing, end of life issues, inappropriate resource allocation.
Ethical distress:
Moral Courage:
Using the ethical decisional models:
- Obtain information: involve all the people implicated in the ethical situation including clients, family, care givers/health providers
- Establish if an ethical committee exists
- Identify conflicted ethical values in each case
- Apply existing organizational processes to react to an ethical situation
Oberle and Raffin Ethical model:
- Assess the ethics of the situation
- Reflect on and review potential actions
- Select an ethical action
- Engage in ethical action
- Reflection and review ethical action
Interpersonal Conflict:
An expressed struggle between at least two interdependent people who perceive incompatible goals, scarce resources, or interference in the achievement of their goals.
Conflict:
Disagreement arising from differing values, needs, attitudes resulting in frustration in achieving goals. Result is stress or tension
conflict triggers:
- Criticism
- Feeling Entitled (you give this but i dont give anything back).
- Perceived Lack of Fairness
- More Perceived Costs Than Rewards
- Different Perspectives – The Big Six (power and decision making, social issues, personal flaws, distrust, intimacy in relationships, distance in relationships)
- Stress and Lack of Rest
- Dialectical tension (wanting connection but wanting to be alone)
Conflict process:
source, beginning, middle, end, aftermath
Pseudo-conflict:
Conflict triggered by a lack of understanding and miscommunication.
Simple conflict:
Conflict that stems from different ideas, definitions, perceptions, or goals.
Ego conflict:
Conflict that is based on personal issues; conflicting partners attack on another’s self-esteem.
interpersonal power:
degree to which a person can control/influence another (people use power to achieve their aim in conflict).
Compliance Gaining:
action/communication one person takes to get the conflict partner to comply with one’s own goal (persuasion)
Conflict management styles:
Avoidance
Accommodation
Competition
Compromise
Collaboration
destructive conflict
- Each person has a win-lose attitude
- Damages the relationship
- lack of willingness to compromise and see others perspectives.
Constructive conflict:
- Builds new insight
- Establishes a new pattern
- Strengthen the relationship
Other-orientation and conflict management:
Stop: Stop making your arguments and concentrate on your partner’s points.
Look: Monitor emotions by observing nonverbal cues.
Listen: Concentrate on details, main points, and tone, and what the other person is saying.
Imagine: Imagine how you would feel in the other person’s place.
Question: Question for more information.
Paraphrase: Paraphrase to confirm understanding.
Conflict management skills:
- manage your emotions
- manage information
- manage goals
- manage the problem
interprofessional conflict:
role ambiguity
real and perceived power hierarchy
differing goals
differing values, styles, personality traits
Incivility:
- Discourteous speech or behavior in violation of expected norms, with intent to harm
- Derogatory comments, dismissive points of view, not sharing information, not responding to communication, rude verbal and nonverbal behavior
- Nursing: violation of Code of ethics and CRNS competencies
Reactions to hurtful words:
-Active verbal response (reactive statement)
-Acquiescent response (cry, apologize)
-Invulnerable response (ignore, silent, laugh)
LOW LINE
listen, offer, wait, look, incline, nod, express
Manage your own anger:
Reframe self-talk – look at situation as misunderstanding, accidental, clumsiness
Listen non-defensively – reframe criticism as a problem or challenge
Self-awareness – Am I engaging in incivility?
Deliberately calm yourself – breath, count, time out
Don’t revisit past injustices
Work on one issue at a time
