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NSG 1400 Becoming Nurse > Weeks 10-13: Patient Rights, Improving Safety, Consent, Rights of Nurses & End of Life > Flashcards

Weeks 10-13: Patient Rights, Improving Safety, Consent, Rights of Nurses & End of Life Flashcards

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1
Q

What is Informed Consent?

A

Informed Consent is the hallmark of patient autonomy, allowing individuals to choose the direction of their healthcare based on full understanding.

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2
Q

What are the rights of persons regarding healthcare?

A

Persons have the right to choose their healthcare direction, grounded in autonomy, embedded in legislation, and protected by ethical standards.

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3
Q

What are the ethical and legal obligations of nurses regarding informed consent?

A

Nurses must ensure clients give consent based on full understanding of the care being provided.
Legally and ethically person has right to chose

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4
Q

What constitutes valid/informed consent?

A

Valid consent requires clients to have autonomy, receive information, and have their rights respected.
1. Clinets have the rights to autonomy and reiceve info to make choice
2. healthcare provdiers have duty to inform of risks and benefits
3. Team responded to questions and provide clarification as required
4. Client must demonstrate a fully understanding and can still refuse treatment.

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5
Q

What are the criteria for informed consent?

A

Informed consent must be voluntary without pressure, the person must be competent ( the capacity to) , referable to treatment and provider, and informed about necessary information.

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6
Q

How do nurses guide the informed consent process?

A

Nurses confirm legal and mental capability, ensure adequate time for discussion, demonstrate compassion, and advocate for clients.

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7
Q

What are the types of consent?

A

Types of consent include expressed consent (e.g., ‘okay, go ahead’) and implied consent (e.g., preparing for an injection).

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8
Q

Can patients revoke their consent?

A

Yes, patients can revoke or withdraw consent at any time, even after treatment has begun.
Always have permmission and legal respon to give consent based oon full understanding
Higher risk = more consent needed

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9
Q

What are the limitations of autonomy in informed consent?

A

Autonomy may be limited if the client is incapable of making decisions, poses harm to themselves or others, or in emergencies.
Incompetent adults, dementia, children

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10
Q

What are the legal aspects of informed consent?

A

Lack of consent can lead to negligence, and treatment without prior consent is not allowed unless the patient is unable to consent.
Battery: TORT provisisons to be made ( without consent care cannot be given unless unable to consent or near death)

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11
Q

What is competency in the context of informed consent?

A

Competency means a person is presumed capable unless there are reasonable grounds to suggest otherwise.
Capacity may vary

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11
Q

What are advanced directives?

A

Advanced directives allow individuals to specify their informed choices regarding care in advance of needing such care.

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12
Q

What does it mean to assess a client’s capacity?

A

Assessing capacity involves determining if the client can understand and acknowledge the consequences of their healthcare decisions.
Continue to provide chances for clients to make informed choices

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13
Q

Who can be a substitute decision-maker?

A

Substitute decision-makers can include next of kin, proxies identified in advance, or court-appointed individuals.
Provinces have laws and advanced directves must follow wishes by clinent

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14
Q

What are the consent challenges for children?

A

Children mature enough to understand a situation have the right to give consent.
Spouse–> children> parent> court
POA
- Person with mental illness may not be able to consent
- emergency cases

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15
Q

What is the legal age for consent in Canada?

A

There is no universally accepted legal age for consent in Canada; it varies case-by-case.

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16
Q

What rights do nurses have?

A

Nurses have rights including conscientious objection, protection from discrimination, and a safe work environment.

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17
Q

What is the right to conscientious objection?

A

Nurses have the right to decline participation in actions that conflict with their moral beliefs.

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18
Q

What are the responsibilities of employers regarding discrimination?

A

Employers must structure work conditions to minimize discrimination based on race, gender, religion, and other factors.

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19
Q

What is the role of UNA?

A

UNA represents nurses in bargaining, settling disputes, and addressing concerns about safe staffing.
Professional Responsbility Commitee: gives chance to raise conerns about safe staffing.

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20
Q

What is professional accountability for nurses?

A

Nurses are accountable to their profession, regulatory body, patients, and employers, with ethical and legal responsibilities being paramount.

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21
Q

Occupational Safety and Health

A
  1. Workers have the right to refuse work in unsafe cirmumstances unless: risk is inherent , refusal leading to danger, safety risks
  2. Employers have the responsibility to minimize the risks
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22
Q

Communicable Dieseases

A
  • Nurses have legal obligation to all paitents
  • Employers must have safety pre.
23
Q

Healthy Work Enviroment

A

Ensure ressources and structures can provide support for nurses
Maximize nurse wellbing and performance and societial outcomes.

24
Q

Labor Relations

A

Collective Barganing–> employers-unions–> agreement to improve working conditions protect nurses

25
Q

Summary

A

Nurses have right to be treated with resepect, safe enviorment to pratice, as nurses have paitent obligations so does employers
- Nurses must be aware of their rights and acquire knowledge to address issues.

26
Q

What are some of the challenges around end of life?

A
  • The person and family are often overwhelmed by the complexity of the process and the extent of choices
  • Highly challenging and emotionally charged time
  • Complicating descion making and leads to misunderstandings
27
Q

Legal and ethical challeneges around end of life

A
  1. Nurses are moral egnts asnd play a large role in: providing compassionate care for familities, comforting paitents, supporting families, ensure that the prcoess of dying is dignfied and respectful, minimzie suffering pain, respect wishes of person
  2. Nurses faciliate commuication through: listening, sharing, questioning, clarifying, ensuring process is dignified and respectful.
28
Q

Goals of care designation

A
  • Extending life: life sustaining treatments; resucuitation
  • Medical Care
  • Palliative Care / Comfort care pain management and control
  • Do not Rescustataion DNR
  • MAID
29
Q

End of life choices ( Resucusitation)

A
  • Cardiopulmonary resusictation CPR: a routine intervention unless the paitent or the family has refused this in advanced and no CPR order is documented: Exception during active chocking if unaware of their care
  • Do not Resucsciate DNR is borader than no cardiopulmonary resusictation CPR, such as ventilation, antibotic therapy, treatment
  • Person may agree to lfie saving interventions but not CPR
  • Certain regulation
30
Q

Pallaitive care

A
  • Goal is to maximize comfort and enhance quality through relieveing symptoms and pain
  • No resusictation is used and pain meds are often provided.
31
Q

Advanced Care : 3 Goals

A

Resuscitation: keep alive through CPR and other measures like medications. ICU ( specialized care to care for very ill, ventilation for air) prolong life and restore health
Medical care: prolong life and control without use of ICU and resuscitation. Health conditions are not as extensive with care. Team provides tests for treatable problems, blood transfusion, antibiotics, surgery.
Comfort Care: relieve symptoms and maximize comfort. Relieve pain, illness, and the goal is to give comfort during life. Resuscitation is not used and instead the goal is to maximize comfort and happiness.
( Divided into goals of care designations which are much more specific in the 3 categories )

32
Q

MAID

A
  • Adminstration of substance to a competent person, at their request to cause death.
  • Assisting a person to commit sucide is illiegal unless fallin within the provisions of the law related to MAID
  • Role of nurses: support, educate, and respond to questions and concerns.
33
Q

Active Euthanasia

A
  • Painless death, involves an intentional action to end pain and suffering and to ensure a peacful death.
  • Legislation: Bill C-14 MAID established in 2016
  • Exceptions to the crimnal code gave physican’s and nurse praticoners the authoity to adminster a substance in order to cause death.
  • Establishing requirements for elegibility, reporting, and outlines role of providers.
34
Q

What is the criteria of MAID

A
  • Age 18 or older
  • Serious , incurable condition
  • Physcial or pschological suffering is intolerbale, cannot be relieved under conditions under client acceptance
  • Natural death is forseeable
  • Client must be capable of making their own choices
  • Demonstrate voluntary request and no coerion
  • Provide infomred, conscientious consent and have all inofmration regaring alternative methods to relieve pain
  • 2 clinicans sepreate acess criteria
35
Q

Death and Dying

A
  • Minimze suffering
  • Compassionate care
  • respectiing the different perspectives about death and dignity
  • Prescene during the time of death
  • Comfort to the client and family : share all information - questioning, clairfyig and lisetning
  • Faciliate traditional pratices, respect cultural diversity

Death is defined as brain dead and the cessation of brain function

36
Q

Cultural beleifs about death

A

**- Respectful understanding of another’s cultures can create trust and openess of nurse- paitent relationship. **
- Maintain rituals, pratices allows a sense of accetance of dying process
- Accomdodate clients. family requests
- Do not assume , always ask
- Ensure dying process is dignifed

37
Q

Indigenous views on end of life

A
  • Varying beleifs and values exists within Indigenious
  • No assumptions made
  • Explore vaues, beleifs, wishes
  • Circle of life includes birth, death, and. after-life with certain cermonies.
38
Q

What are the challenges regarding organ donations ?

A
  • Advanced request made by client to donor registry
  • Substiute descion maker either spouse, child etc give consent
  • Family descion often takes prioity: regardless of signature of card
  • If organ donation sucitable: family should be approached for consent.
  • health-care providers should never assume family would decline and they have the right to make own choices
39
Q

How can we increase organ donations

A
  • Non-heart beating organ donation: in situtations such as withdrawl of life support and failed CPR
  • Recorded consieration: documentations that staff concidered making the request for donation to families.
40
Q

Malpratice Insurance

A

Provides a defence for nurses involved in lawsuit

41
Q

Why is documentation so important

A

Allows for a chronoligcal record as well as acts as a legal document

42
Q

Right to Dignity

A
  • Treat others with respect, focus on their needs, talk
43
Q

Personal health info

A

Right to keep confedential
- Provide ind with acess rights
- Health professionals have a lgeal and ethical obligation to maintain it

44
Q

Paitent Rights

A
  1. Right to privacy and confidentiality: paitent privacy during examination, acess to info protected.
  2. Acess to health information: When diagnosis is not communicated, nurses must adocate
  3. Right to freedom from harm
45
Q

Rights of older adults

A

Advanced planning: nurses support clients in future needs and setting up advanced directive
Intervene with impairments

46
Q

LGBTQ Communities

A

Paitent focused care
refrain from assumtions and respect names , pronouns

47
Q

Indigenious Ways

A
  • Respect traditonal healing ways and be respectul of past trauma
48
Q

Mentally Ill

A

Legislation across two countries and protect paitents from suffering
1. Those who are not threat to themselves: admission and dischrage is voluntary
2. Those who pose a threat to themselves: safeguards in place

49
Q

Paitent centered safey culture

A
  • Relibale technologies
  • Evidence informed pratice
  • ADPIE
50
Q

Paitent Incident Safety

A

Harmful incident: paitent becomes hurt
near miss: could have happened

51
Q

Incident Report

A

System of ensuring care by idenifying hazards and prevent harm.
- Idenifty risks
- Analyze
- Acting to reduce them

52
Q

Goal of care Choices

A
  1. Extending life
  2. Medical care
  3. Palliative/Comfort care
  4. Pain Management
  5. DNR
  6. MAID
53
Q

End of Life Resuscitation

A

CPR: routine intervention unless otherwise documented
DNR: broader than no CPR, encompasses no ventilation or therapies

54
Q

What are the main goals of care?

A
  1. Resuscitation care: keep alive through CPR and other measures to prolong life
  2. Medical Life: prolong life without use of resusitation
  3. Comfort Care: relieve symtpoms and maximize comfort.
55
Q

Pallaitive care

A

Provides a holistic approach to relieve ain and suffering
Symptom management and alliavate pain

NSG 1400 Becoming Nurse (10 decks)

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