Pro Nurse Exam II

Deontology

carrying out one's duty and/or obligation

Utilitarianism

what brings about the greatest good for the greatest number of people

Consequentialism

dependent on the consequences (outcome)

Hedonism

Get pleasure/avoid pain

Virtue Ethics

The middle ground between vices

Dualism

Idea that spirit and body are separate

Nonmaleficence

Do no harm

Autonomy

Respect for right of person to determine their own actions

Beneficence

Do good

Justice

To provide what is right and fair

Fidelity

Honoring one's commitments

Confidentiality

Protection of privacy

Informed Consent

patients must be told enough to enable them to choose whether they want treatment/procedure

*Written consent is NOT informed consent

Veracity

Telling the truth

Ordinary Care

Morally obligatory; basic care to preserve life

Extraordinary Care

Morally optional; exceeds what is 'basic care'

Double-effect principle

Minimize risks of harm whenever possible

Risks/benefits

Consideration of potential negative and positive outcomes

Burdensome

Physical, psychological, financial burdens that may arise from care

Effective

Likely to achieve desired outcomes in patient care

Not burdensome

Care that does not impose excessive strain on the patient

Confirming a client going to surgery has signed a consent form

A necessary step to ensure informed consent and legal compliance.

Refusing to disclose information about a client to the media

A practice that upholds client confidentiality and privacy.

Nursing Code of Ethics

A codified moral standard of nursing practice for all settings.

Obligatory ethics for nurses

Ethical standards that are required and non-negotiable in nursing.

Normative moral guidance

The fundamental concern of a code of ethics for nursing to provide direction on ethical behavior.

Provision #1

The nurse practices with compassion and respect for every person.

Nurse-to-patient relationship

Provisions 1-3 that outline the ethical obligations of nurses towards their patients.

Nurse-to-nurse relationship

Provision 5 that emphasizes the ethical interactions among nursing professionals.

Nurse-to-profession relationship

Provision 7 that addresses the responsibilities nurses have towards their profession.

Nurse-to-global community relationship

Provision 10 that highlights the nurse's role in addressing global health issues.

Moral Identity Formation

Process of becoming: think, act, feel like a nurse.

Virtues in nursing identity

Grounded in compassion, caring, kindness, responsiveness, attentiveness, attunement, integrity, trustworthiness, and more.

Ethical practice

GOOD PRACTICE that includes meeting the patient as a person and preserving dignity and personhood.

Patient advocacy

Empowerment of patients and self-empowerment for good nursing practice.

Advance Directives (ADs)

communicate client's wishes if they become unable to do so.

Components of Advance Directives

Legal documents including Living Will and Durable Power of Attorney (DPOA) for health care.

Living Will

Wishes for treatments such as CPR, ventilation, artificial food and nutrition.

Durable Power of Attorney (DPOA)

Designates a surrogate for health care decision-making.

Code of Ethics for Nurses

Contains the standards for ethical practice by nurses.

What are the elements of RN Scope and Standards of Practice?

They describe a competent level of nursing practice and professional performance common to all registered nurses.

What is the purpose of Nurse Practice Acts?

Nurse Practice Acts regulate the practice of nursing and define the scope of practice for nurses.

What is the significance of the Nursing Code of Ethics?

It provides ethical guidelines that govern nursing practice and decision-making.

What are the two main types of law relevant to health care?

Criminal law and tort law.

What is the difference between criminal law and tort law?

Criminal law prohibits acts that endanger property or people, while tort law addresses wrongful acts that cause harm to individuals.

What constitutes malpractice in nursing?

Malpractice is negligence on the part of a health care professional that fails to meet the prevailing standard of care.

What are the four elements required to prove negligence in nursing?

1) Professional duty of care, 2) Breach of duty, 3) Causation, 4) Harm.

What is the role of the American Nurses Association (ANA) in nursing practice regulation?

ANA provides the foundation for nursing practice regulation, including scope and standards of practice.

What is the highest tier of nursing regulation?

Self-determination, which involves self-regulation and accountability in nursing practice.

What is the purpose of institutional policies and procedures in nursing?

They direct nursing practice at the institutional and systems levels.

What are the Standards of Practice in nursing?

They are authoritative statements of the duties expected of all registered nurses, including assessment, diagnosis, and evaluation.

What is omission

Omission refers to the failure to perform an action that should have been taken.

What is commission

Commission refers to performing an action that should not have been taken.

What is the significance of understanding scope and standards for nursing practice?

It ensures that nurses provide safe, competent care and understand their legal and ethical responsibilities.

What is the role of the Boards of Nursing?

They provide legislative and regulatory authority for nursing practice, including licensure.

What is the main goal of the Board of Nursing (BON)?

To protect the health of the public from harm or errors done by nurses.

What does the Nurse Practice Act (NPA) define?

It defines the practice of professional nursing, sets minimum educational qualifications for licensure, determines legal titles for nurses, and provides for disciplinary action.

Who establishes the Nurse Practice Act?

The Nurse Practice Act is established by the state's legislative branch.

What authority does the Board of Nursing have regarding nursing licenses?

The BON can deny or grant licensure, suspend or revoke a nursing license, and apply disciplinary action.

What is the Nurse Licensure Compact (NLC)?

The NLC allows RNs to practice across state lines using their home state license.

What is the Enhanced Nurse Licensure Compact (eNLC)?

The eNLC standardizes licensure requirements across states to facilitate easier practice across state lines.

What is the role of the National Council of State Boards of Nursing (NCSBN)?

The NCSBN advocates for and strengthens BON functions, promotes quality and safety in nursing, and conducts research on nursing practice issues.

What are the four main functions of the Nurse Practice Act?

1) Define professional nursing practice, 2) Set minimum educational qualifications, 3) Determine legal titles for nurses, 4) Provide for disciplinary actions.

What should a nurse refer to when determining if a task is within their scope of practice?

The agency policy and procedure, Board of Nursing guidance, Nurse Practice Act, and NCSBN Scope of Practice Decision Tree.

What are some key responsibilities of the Board of Nursing?

Updating members on changes to the Nurse Practice Act, enforcing licensure requirements, and suggesting changes to the Nurse Practice Act.

What is the difference between a policy and a procedure in nursing?

A policy is a formal guideline for consistent decisions, while a procedure provides step-by-step directions for performing a skill or activity.

What should nurses do to protect themselves legally?

Keep their license current, seek help for mental health issues, and document thoroughly.

What is the importance of malpractice insurance for nurses?

It protects against risks associated with higher patient acuity, errors in delegation, and expanded liabilities.

What is the purpose of the Scope of Practice Decision Tree?

To help nurses determine whether a task is within their scope of practice.

What must a nurse do when practicing telehealth?

Be licensed in each state in which they practice.

What should nurses do regarding continuing education?

Adhere to requirements for skill validations, yearly updates, and in-services.

Delegation

Transfer of duties or tasks

APRN

Advanced Practice Registered Nurse (masters, doctoral)

RN

Registered Nurse (2 year & 3 year ADN, 4 year BSN)

LPN

Licensed Practical Nurse (1 and 2 year AA/AS)

AP

Assistive Personnel (unlicensed, Nurse Aide and similar)

MD, DO

Medical Doctor, Doctor of Osteopathy

PA

Physician Assistant

Medical orders

NOT delegation

Transfer of authority and responsibility

What delegation IS

Transfer of accountability

NOT apart of delegation

Handoff

Transfer of patient care RN-RN, RN-LPN, LPN-LPN

Scope of nursing practice

Defines activities only a nurse can perform

Five Factors to Assess When Deciding to Delegate

1) Predictability of outcome 2) Potential for harm 3) Complexity of care 4) Need for problem solving 5) Level of patient interaction

RN Delegation Responsibilities

1) Assess and plan: When, What, Congruence with policy, procedure, Nurse Practice Act.

Delegatee Responsibilities

1) Accept only delegated responsibilities they are trained and educated to perform, feel comfortable to do given the specific circumstances and patient's condition.

RN Downward Delegation

RN TO LPN: LPNs participate in but do not establish the nursing plan of care.

Accountability in Delegation

Only the licensed nurse can determine if the task can be delegated to someone else.

Substandard/Unsafe Care

Care that does not meet legal standards, where nurses are not permitted to passively observe.

Act Immediately

A directive for nurses to take prompt action when they encounter substandard care, including reporting and documenting the situation.

Concrete, Timely Feedback

Essential for effective communication and improvement in delegation practices.

Provision #2

The nurse's primary commitment is to the patient

Provision #3

The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.

Provision #4

The nurse has authority, accountability, and responsibility for nursing practice

Provision #5

The nurse has the responsibility to maintain competence, and continue personal and professional growth.

Provision #6

The nurse improves the ethical environment of the work setting and conditions of employment

Provision #7

The nurse advances the profession through research and professional standards development,

Provision #8

The nurse collaborates with other health professionals to protect human rights and reduce health disparities.

Provision #9

The profession of nursing must articulate nursing values, maintain the integrity of the profession

Provision #10

Nursing organizations should advocate for human and environmental health, well-being, and flourishing within the global community