Ethics/Legal

Vocabulary flashcards covering key concepts from the lecture on care delivery models, clinical judgment, delegation, ethics, and law.

Team nursing

Nursing delivery model in which an RN leads a team (RNs, LPNs, and nursing assistants) to coordinate patient care; the RN acts as the team quarterback.

Primary nursing

An old model where one RN is responsible for a patient from admission to discharge; less common now due to cost and staffing patterns.

Patient- and family-centered care

Care approach that partners with patients and families in decision making; RN leads and promotes bedside involvement and shared planning.

Case management

Coordination of health care services and resources across levels of care to prevent gaps; typically non-direct patient care.

Bedside shift report

Handoff conducted at the patient’s bedside to involve the patient and family and ensure continuity of care.

AIDET

A communication framework: Acknowledge, Introduce, Duration, Explain, Thank you.

Clinical judgment

Clinical decision-making skill that uses the nursing process and patient cues to determine actions.

Nursing process

A systematic method: Assess, Diagnose, Plan, Implement, Evaluate to guide patient care.

Initial patient contact

First in-person introduction and rapport-building to establish trust and a therapeutic relationship.

Nurse–patient relationship

Trusting, collaborative relationship between nurse and patient essential for effective care.

Priority setting

Determining which patient needs require immediate attention (high), intermediate, or low priority based on risk.

ABCs plus VL

High-priority focus on Airway, Breathing, Circulation; Vital Signs and Lab values (BL) are considered in urgent decisions.

Maslow’s hierarchy (nursing context)

Prioritize basic needs (safety, comfort, nutrition) before higher-order needs in patient care.

Five rights of delegation

Right task, Right circumstance, Right person, Right direction/communication, Right supervision/evaluation.

Delegation

Transferring responsibility for a task to a qualified person while the RN remains accountable for outcomes.

Competence

Proven ability to perform a skill through formal checkoffs and demonstrated proficiency.

Nurse Practice Act

State law defining nursing scope of practice; enforced by the state Board of Nursing; licensure is a privilege.

Nurse license compact (NLC)

Agreement allowing a nurse with a home-state license to practice in other compact states without a new license.

Board of Nursing

State regulatory body that licenses nurses, enforces the Nurse Practice Act, and investigates violations.

HIPAA (Health Insurance Portability and Accountability Act)

Federal law protecting patients’ privacy and the security of protected health information (PHI).

PHI (Protected Health Information)

Information about health status that must be safeguarded and disclosed only as permitted.

Privacy vs Confidentiality

Privacy protects information from disclosure; confidentiality means information disclosed in care stays within the care team.

Patient Self-Determination Act (PSDA)

Requires institutions to inform patients of their rights to make decisions, including advance directives.

Advanced directive

Legal documents (including living will and durable power of attorney for health care) detailing end-of-life wishes.

Living will

Type of advance directive outlining preferred end-of-life care when a patient cannot decide.

Durable power of attorney for health care

A legally designated surrogate who makes health decisions if the patient is incapacitated.

Code status

Orders indicating whether to perform resuscitation (full code) or to withhold resuscitation (DNR).

Organ donation (Uniform Anatomical Gift Act)

Laws governing organ donation; donor status, consent processes, and allocation guidelines (UNOS/OPT).

OSRA (Omnibus Budget Reconciliation Act)

Federal law protecting residents of long-term care facilities from inappropriate restraints and ensuring quality of life.

Restraints

Methods to restrict movement (manual, physical, mechanical, chemical); used only when less restrictive means fail and with orders and monitoring.

Nurse–patient autonomy

Respecting a patient’s right to make their own health decisions with appropriate information.

Informed consent

Patient agreement to a procedure after being informed of risks, benefits, alternatives, and consequences of refusal; witnessed.

Standards of care

Minimum level of acceptable care established by knowledge, practice, and evidence; guides nursing actions.

Duty of care

Nurse’s obligation to provide competent, compassionate care to patients.

Negligence

Failure to meet the standard of care resulting in harm to a patient.

Malpractice

Professional negligence by a nurse; harm plus damages due to breach of duty.

Informed consent witnessing

Nurse witnesses patient signature on consent and ensures the patient understands the procedure.

Abuse and neglect mandatory reporting

Nurses must report suspected abuse or neglect to appropriate authorities; hotlines exist for reporting.

Five rights of delegation (revisited)

Repeat reminder of the five essential elements to delegate safely: task, circumstances, person, direction, supervision.

Validity of scope of practice

Performing tasks only within your licensure and competency; overstepping can create legal risk.

Confidentiality breach

Disclosing patient information improperly; HIPAA violation; avoid discussing patient details in public spaces.

Ethics vs law

Ethics guide right vs wrong in care (autonomy, beneficence, nonmaleficence, justice) while law defines legally enforceable obligations.

Advocacy

Fighting for and supporting the patient’s rights and best interests in care decisions.

Professional autonomy

Nurses’ right to act based on professional judgment within established policies and scope.

Quality of life considerations in end-of-life care

Assess whether an intervention’s burden on the patient justifies its potential benefit, including respect for patient wishes.