Fundamentals of Nursing

Nurse Practice Act

A state law that regulates the practice of nursing and defines the scope of nursing practice to protect public health and safety.

Scope of Practice

The range of responsibilities and duties that a nurse is qualified to perform, as defined by the Nurse Practice Act.

Code of Ethics

A list of written statements describing ideal behavior and moral principles guiding nursing practice. Ensures integrity, safety, competence, and personal/professional growth.

American Nurses Association (ANA) code of ethics:

Establishes guidelines that stress the importance of nurses participating in continuing education and evidence-based practice. Applies to very person who enters the nursing profession, regardless of their level of degree.

Beneficence

The act of doing what is good and right for the patient. This Ethical principle encompasses charity and kindness, which require actions by the nurse to benefit others.

Nonmaleficence

Doing no harm (intentional or unintentional). Nurses must provide care that reflects standards to avoid or minimize risk to the patient, healthcare team, or organization

Justice

Fairness and impartiality. Nurses must make impartial, fair decisions regarding patient care without regard to a patient’s race, age, orientation, or economic status.

Accountability

Accepting the responsibility for one’s personal actions

Autonomy:

The ethical principle demonstrated when a nurse accepts the patient as a unique person with the right to his own opinions, values, beliefs, and right to make his own decisions.

Fidelity

The practice of being faithful to a person, belief, or cause. It involves keeping one’s promises. In nursing, fidelity involves being true to the profession and honoring the responsibility of providing safe, competent, high-quality nursing care.

Veracity

The principle of truth-telling. It requires nurses to be honest in their interactions with patients and colleagues.

Ethical Dilemmas

A conflict when a nurse must choose between two or more ethically right looking questions.

Ethics committee

Multidisciplinary group within a healthcare facility made of doctors, nurses, lawyers and other hospital personnel that debate ethical issues and called on to offer advice, protect patients, and avoid legal conflicts.

Role of a nurse

Provide bedside care, wound care, administer prescribed meds, monitor client status, reporting and documentation. (Regardless of the license the nurse maintains these)

Functions of the LPN

Collaborator, Delegator (to CNA or PCA), Educator and Advocate

Liability

Legal responsibility for actions or omissions in patient care

Tort

A violation of civil law; A wrong against an individual or his or her property - patient can sue for compensation

Negligence

Misconduct or practice below expected standard that places another person at risk of harm ; Failing to do something a reasonable nurse or LPN would do

Malpractice

Injury, loss, or damage to a patient because of failure to provide a reasonable standard of care; causing harm as a result to negligence

Felony

A crime, typically one involving violence; Will potentially impact your ability to be licensed by the nursing board

Assault

Purposely threaten physical harm to an individual

Battery

Touching an individual without consent

False Imprisonment

Preventing a person from leaving or restricting their movement within a facility

Slander

Affecting someone’s professional reputation; gossip

Libel

Written words about another that are untrue and damage a person’s reputation; same as slander but leaving a paper trail

Good Samaritan Act

Legal rules that protects people who help in emergencies, as long as you act in good faith and within your scope of practice

HIPAA

Provides confidentiality for patient and protects their health information/privacy

Original use for HIPAA

Allowed workers keep their health insurance when changing or losing jobs. Communication between health insurances.

Written permission

Granted by the patient or their legal representative to allow medical treatment or surgical procedures

Informed Consent

The patient or legal guardian has had the procedure or surgery explained to them and is aware of the risk and benefits

Who is responsible for providing the explanation of a surgery or treatment?

The physician, nurse or LPN is there as witness to the explanation

Advanced Directive

A written document that provides guidelines for making medical decisions in the event the patient becomes incapacitated and is unable to make his or her wishes known

Health Care Proxy

The patient’s designated person to make health care decisions for them should they become incapacitated or unable to make decisions

Living Will

Document that allows patients to state their wishes for end-of-life care in case they become incapacitated

DNR (Do not resuscitate)

Instructions to medical personnel not to revive a patient if breathing or heartbeat has stopped

Reporting Patient Abuse

Federal Law has made it mandatory to report child or elder abuse; As a health care provider you are a mandatory reporter

What happens if you fail to report abuse?

Failure to report abuse can result in fines, actions against one’s license (i,e. suspension) or imprisonment.

Incident report

Written account of an unusual, potentially injurious event involving a client, employee or visitor. MUST NOT BE INCLUDED IN PATIENT’S CHART. Meant to be kept factual and objective without any assumptions, opinions or conclusions.

Abandonment

When the nurse-patient relationship is terminated without making reasonable arrangements with an appropriate person so that nursing care by others can be continued