NURM-101 Values, Legal and Ethics Exam Review

ANA Code of Ethics

Guidelines to assist nurses when conflicts/disagreements arise

1. Responsibility - Being dependable and trustworthy by patient

2. Accountability - Owning up to your actions

3. Competency - Your education (which changes all the time) 

4. Judgment - Making determinations based on your ethics

5. Advocacy - Always give your patient enough information to make their own decision

Patient Rights

• To see + copy health record

• To update health record

• To request mistake corrections

• To get a list of disclosures from health care institutions aside from disclosures made for treatment, payment, and operations

• To request restrictions on certain uses or disclosures

• To choose how to receive health information

HIPAA

Regulations regarding a patient’s privacy and electronic medical records

• Dictates who can see patient’s info and requires training

Ethical Dilemmas

2 moral principles are conflicting and the right answer is unclear

Principles (Ethical)

Rules of conduct agreed to by a particular group

Civil Law

Protects individual rights and personal freedoms, including laws relating to contracts and practicing

Duty to Care

Obligation to adhere to the proper standards of care

Duty to Warn

Obligation to report if a patient is a threat to themselves of others

Morals

Judgment of behavior likely to reflect the character of the social setting

Values

Personal belief about the worth you hold for an idea/custom/object

• Reflects cultural and social influences 

• Standard to guide one’s behavior

Advanced Directive

Document detailing medical decisions you want if you can’t make them directly

Advanced Directive purposes

• Indicate who makes decisions for patient if they can’t

• Indicate kinds of medical treatments patient wants or doesn’t

• Indicate how comfortable patient wants to be

• Indicate how the patient wants to be treated by others

• Indicate what the patient wants loved ones to know

Types of Advanced Directives

1. Living Will

2. Durable Power of Attorney

Obligation to Report

Have to report suspected abuse, neglect or restraints even

Nurse Practice Acts

Tells nurse what they are allowed to do within their scope of practice

Developed by each STATE BOARD OF NURSING

Living Will

Your decision for what you want to happen to you if you can’t make a decision for yourself

Durable Power of Attorney

Deciding who makes decisions if you can’t anymore

POLST form

Physician Order for Life Sustaining Treatment, form/medical order indicating patient’s wishes that is used in a medical situation

• Carried on patient at all times

DNI

Do Not INTUBATE

Terminal weaning

Person can be gradually withdrawn from ventilator

Active euthanasia

Caused by an act

Passive euthanasia

Caused by withholding something

Just Culture

Reporting errors considered near misses to a manager

Near misses

Preventing injury, encouraging colleagues to report these events and help them avoid it in the future

Essential Values to Nurse

• Altruism - Concern for welfare and well-being of others

  • Understanding patient culture and beliefs

• Autonomy - Let patients act for themselves

  • Give them proper information before acting

• Human Dignity - Protecting privacy

• Integrity - Honest to patient

• Social Justice - Treat everybody fairly

Nursing Ethics

Formal study of ethical issues that arise in nursing and of analysis used by nurses to make ethical judgments

Ethical/Moral Distress

Occurs when nurse knows the right thing to do but personal/institutional factors make it difficult to follow correct course of actions

Steps to Process Ethical Dilemma

1. Is this an ethical dilemma?

2. Gather all relevant info

3. Examine + determine own values and opinions on issue; Push them aside if they impede decision making 

4. Articulate problem

5. Consider possible courses of action

6. Negotiate outcome

7. Evaluate action

Nursing Process Steps

• Assess situation/Gather data

• Diagnose (identify) the problem

• Plan

• Implement decision

• Evaluate your decision