Values, Ethics, and Legal Concerns

values

beliefs about worth of something; what matters; what someone considers to be good/best as well as bad

ideas, beliefs, or behaviors

values determine importance and worth of _____, ______, or ________

thoughts, feelings, actions

life principles help shape peoples _____, ______, and ______

value system

influences beliefs about human needs, health, and illness; practice of health behavior

values clarification

process people come to understand their own values and value system

values clarification

this process if beneficial to the nurse when it comes to caring for patients values; self reflection

values clarification

this process helps you as the nurse know where you stand in your beliefs and as you interact with patients new ideas become available to you

understand patient values

value conflicts are avoided when nurses take the time to …

altruism, autonomy, human dignity, integrity, social justice

5 values that epitomize a caring nurse; delineated in the Nursing Code of Ethics

Nursing Code of Ethics

set of principles that reflect the primary goal, values, and obligations of the profession

altruism

concern for the welfare of others

autonomy

respects the patient’s rights

human dignity

treat as being of worth

integrity

provides care based on the Code of Ethics

social justice

fairness; equal access to all

autonomy

we provide info to the patient so that they can make their own decisions

ethics

what is good and valuable for all people; up for debate

standards of conduct and moral judgment

ethics often deals with…

universal application; all situations

professional ethics involve principles and values with ______ ________ and standards of conduct to be maintained in ____ ___________

personal and societal ethics

two types of ethics

DNR

example of a hospital policy that is guided by ethics

ethical conduct

we base our practice on…

1. short statement of the ethical obligations and duties of every individual who enters the nursing profession

2. profession’s nonnegotiable ethical standard

3. expression of nursings own understanding of the commitment to society

3 main purposes of the nursing code of ethics

invite the public to trust in us as caregivers and professionals

what do the virtues of nursing do for us to the public?

competence, compassionate, subordination of self interest to patient interest, self-effacement, trustworthy, conscientious, intelligence, practical wisdom, humility, courage, integrity

what are some of the most common listed virtues of nursing? (11)

utilitarianism

theory of ethics that says you should be focusing on the greatest good for the greatest number of people; focuses on the effect of an action

deontology

theory of ethics that says you should focus on the rights of the individual; does not consider the greater good or consequences of specific actions on others

immunizations, experimental drugs

what are two examples of utilitarianism

person has right to be treated where they want even if they will spread their illness to others

example of deontology

beneficence

doing good or promoting good on behalf of others

nonmaleficence

avoidance of doing harm; preventing harm to others

autonomy

respect for a person’s right to make their own decisions

justice

fairness; equal access

veracity

telling the truth; commitment to honesty

fidelity

commitment to keeping promises

beneficence

which principle based approach gos along with utalitarianism?

trying the least invasive option first

nonmaleficence is doing no harm…this includes…

deception; unprofessional, incompetent, unethical, or illegal physician practice/nurse practice; beginning-of-life issues; end of life issues; privacy/confidentiality/social media

examples of ethics problems

ethics committee

nurses strong background in interpersonal communication allows us to contribute unique knowledge about the patient and family to the discussion. this makes us great candidates to participate in _______

advocacy

protection and support for another person’s rights

2018

was the “Year of Advocacy”

support patient’s right to make decisions

how do nurses value patient advocacy?

statutory law and administrative law

two types of laws that are guidelines for practice

statutory law

created by elected legislative bodies (US Congress and State Legislatures) and determine our standards of care

Nurse Practice Acts

what is the main example of Statutory Law?

our standards of care (legal scope of practice) and licensure requirements

what do Nurse Practice Acts determine?

Administrative Law

this type of law is where the state legislatures give authority to state boards of nursing

State Boards of Nursing

rules and regulations for us nurses are established by the….

protect the public from harm

why do state boards of nursing put rules and regulations into place?

administrative law/state boards of nursing

enforces standards of care

regulatory law

how we are disciplined for not following guidelines; ex. can revoke license

felony

it is a ____ to practice without a license

adminstrative law

regulatory law is also known as

Nurse Practice Act

what is the most important law effecting our practice?

legal scope of practice

what does the nurse practice act define for us?

Standards of Care

minimum requirement for providing safe patient care

credentialing

professional competence is ensured and maintained this way

accreditation, licensure, certificate

3 main ways we credential the nursing practice

accredidation

educational programs are evaluated

CCNE - commission on collegiate nursing education

who does accreditation?

licensure

the NCLEX is our what?

certification

done to demonstrate advanced proficiency in nursing - CCRN

criminal law

this type of law (not medicine specific) helps prevent harm to society and provides punishment

felony

charge that means > 1 year prison sentence

misdemeanor

lesser crime that typically results in a fine or < 1 year in prison

torts

what is another name for civil law?

civil law

type of law (not medical specific) that usually results in payment not punishment

assault, battery, defamation of character, false imprisonment

examples of intentional torts

assault

threat of harm; NOT physical

battery

touching without consent; following up on threats

slander

oral defamation of character

libel

printed defamation of character

false imprisonment

we are not allowed to keep patients in the hospital; if we do it is called

AMA

what type of form do patients sign to leave the hospital against advice?

if patient is under influence of drugs, alcohol, or is at risk to harm themselves or others; make sure to document meticulously

when is it acceptable to restrain a patient?

negligence, malpractice

examples of unintentional torts

negligence

practice below standards of care; something a reasonable person would not do

malpractice

nurse acted outside scope of practice or standard of care; intent to injure need not be shown

• being prepared for clinical

• notify clinical instructor if you feel unprepared to carry out a nursing procedure

• NEVER ATTEMPT IF UNSURE OF CORRECT STEPS

legal responsibilities of a student nurse

improper technique or treatment, medication errors, failure to monitor and report, improper use of equipment

examples of malpractice

Never IV push electrolyte meds, always dilute

example of something that could cause malpractice (specific IV example)

• respect legal boundaries of practice

• follow institution’s policies and procedures

• owning personal strengths and weaknesses

• evaluating proposed assignments

• keep current in nursing knowledge and skills

• respect patient’s rights

• careful documentation

Safeguards to Competent Practice

NO

does the ANA approve of euthanasia?

True

True or False: nurses are ethically prohibited from administering medical aid in dying medication, yet they must be comfortable supporting patients with end-of-life conversations, assessing the context of a medical aid in dying request, advocating optimized palliative and hospice care services, and knowing about aid in dying laws and how they affect practice

good samaritan laws

protect health care professionals practicing within standards of care; provide legal immunity after providing appropriate assistance in an emergency; may require nurses in some states to stop and help in an emergency (but not yet in Ohio)