Foundations of Nursing: Definitions, Legal & Ethical Concepts

Vocabulary flashcards covering key nursing definitions, legal concepts, professional socialization models, delegation principles, ethical theories, and regulatory frameworks to aid exam preparation.

Definition of Nursing

A description that differentiates nursing from other health occupations, guides education, informs policy, clarifies purpose, and sets boundaries.

Florence Nightingale – Environment Theory

Defines nursing as manipulating environment (air, warmth, cleanliness, diet, quiet) to aid reparative processes of the patient.

Dorothea Orem – Self-Care Deficit Theory

Defines nursing as providing direct assistance to individuals unable to meet self-care needs due to health situations.

Virginia Henderson – Nursing Need Theory

Defines the nurse’s unique function as assisting individuals (sick or well) in activities contributing to health, recovery, or peaceful death to promote rapid independence.

Hildegard Peplau – Interpersonal Relations Theory

Views nursing as a significant therapeutic interpersonal process aimed at personal and community growth.

Nurse Practice Act (NPA)

State statute that legally defines nursing practice, sets education standards, oversees licensure, protects titles, and enables disciplinary action.

Board of Nursing (BON)

State authority empowered by the NPA to regulate nursing practice, license nurses, and enforce disciplinary measures.

Professional Identity (Nursing)

Dynamic self-concept formed through education and clinical experiences, internalizing nursing knowledge, skills, values, and ethics.

Professional Socialization

Process by which nursing students adopt new knowledge, attitudes, and behaviors to think and act like nurses.

Cohen’s Stage 1 – Unilateral Dependence

Student relies on external authority for direction due to limited knowledge and experience.

Cohen’s Stage 2 – Negativity / Independence

Student’s critical thinking expands, leading to questioning of authority; termed cognitive rebellion.

Cohen’s Stage 3 – Dependence / Mutuality

Student evaluates ideas more rationally and begins collaborative learning with faculty and peers.

Cohen’s Stage 4 – Interdependence

Student integrates independence and mutuality, making collaborative professional decisions.

Benner Stage 1 – Novice

Nurse with little experience, relying on rules and guidelines for practice.

Benner Stage 2 – Advanced Beginner

Nurse with marginally competent skills who uses theory frequently and struggles with priorities.

Benner Stage 3 – Competent Practitioner

Nurse who is organized, sets goals, thinks analytically, and manages multiple tasks.

Benner Stage 4 – Proficient Practitioner

Nurse who views patients holistically, detects subtle changes, and easily sets priorities.

Reality Shock

Stress experienced when nursing ideals taught in school clash with actual work settings.

Common Law

Judge-made decisional law that evolves with court rulings.

Statutory Law

Formal legislation enacted by Congress or state legislatures.

Civil Law

Governs disputes between individuals over rights or duties; can involve monetary judgments or jail.

Criminal Law

Addresses unlawful acts against society; may involve trials, juries, and incarceration.

Administrative Law

Regulations created by government agencies under legislative authority.

Negligence

Failure to act as a reasonably prudent nurse would, resulting in potential harm.

Malpractice

Professional negligence where the standard of care is not met, causing patient injury.

Standard of Care

Basic minimum level of prudent nursing practice based on non-maleficence.

Commission (Legal)

An action the nurse performs that causes harm.

Omission (Legal)

Failure to perform an action that should have been done.

Elements of Negligence

Duty, breach of duty, proximate cause, and injury must all be proven.

Major Causes of Negligence

Failure to follow standards, use equipment responsibly, communicate, document, assess/monitor, or advocate.

Captain of the Ship Doctrine

Legal concept placing ultimate responsibility for patient care on the physician.

Respondeat Superior

Doctrine attributing employees’ acts to their employer (“let the master answer”).

Patient Self-Determination Act (PSDA)

Federal law supporting patients’ rights to informed consent and advance directives, emphasizing autonomy.

Delegation (Nursing)

Transfer of responsibility for performing a task while maintaining accountability for outcome.

Five Rights of Delegation – Right Task

Confirm the task is appropriate for delegation in the specific situation.

Five Rights – Right Circumstances

Assess patient condition, setting, complexity, delegate’s competence, and resources before delegating.

Five Rights – Right Person

Verify the delegatee is competent to perform the specific task.

Five Rights – Right Direction/Communication

Provide clear, specific instructions including patient identification, objectives, timeframe, and expected results.

Five Rights – Right Supervision/Evaluation

Ensure RN or licensed nurse can supervise, evaluate patient and task performance.

Informed Consent

Patient’s voluntary agreement to treatment after receiving sufficient information, having competence, and freedom from coercion.

Nurse’s Role in Informed Consent

Witness signature, verify voluntariness and comprehension, and relay patient questions to provider.

Confidentiality

Duty to protect private patient information in all settings, on- and off-duty.

HIPAA (1996)

Federal act mandating privacy and confidentiality of patient health information and granting record access.

Assault (Legal)

Threat or attempt to make bodily contact that causes fear of imminent harm.

Battery (Legal)

Actual unauthorized physical contact or treatment against a patient’s will.

Licensure Purpose

Protect public health, safety, and welfare through regulation of nursing practice.

Objectives of a Nurse Practice Act

Define nursing practice, BON authority, education standards, licensure requirements, protected titles, and disciplinary procedures.

State Board Sanctions – Probation

License remains active while nurse must meet conditions and avoid further complaints.

State Board Sanctions – Suspension

Temporary removal of license, after which practice may resume.

State Board Sanctions – Revocation

Permanent loss of nursing license for egregious or repeated unsafe practice.

Substance Use Diversion Programs

State BON initiatives for evaluation, treatment, and safe return to practice of impaired nurses.

NCLEX-RN

National licensure exam testing critical thinking and nursing competence; adaptive, 80-150 questions, 6-hour limit.

Next Generation NCLEX

Updated NCLEX format focusing on clinical judgment measurement and new scoring models.

Nurse Licensure Compact (NLC)

Agreement allowing nurses to practice in multiple member states with one multistate license.

Ethics (Definition)

Systematic study of right and wrong actions and the values guiding them.

Values (Ethical)

Beliefs or ideals individuals or groups use to guide behavior.

Morals

Standards of behavior established by society regarding right and wrong actions.

Bioethics

Application of ethical principles to health-care issues and biological sciences.

Kohlberg – Preconventional Level

Moral reasoning based on avoidance of punishment and personal gain; typical of children.

Kohlberg – Conventional Level

Moral reasoning based on conformity to social rules and seeking approval; common in adolescents/adults.

Kohlberg – Postconventional Level

Moral reasoning based on universal ethical principles and personal moral standards.

Autonomy (Ethical Principle)

Right of individuals to make their own decisions and determine actions.

Beneficence

Obligation to do good and promote the patient’s best interests.

Nonmaleficence

Duty to do no harm or minimize potential harm.

Justice (Ethical)

Fair and equal treatment; allocation of resources without discrimination.

Fidelity

Faithfulness to commitments and promises made to patients.

Veracity

Obligation to tell the truth and not deceive patients.

ANA Code of Ethics

Framework outlining nursing’s ethical values, duties, and professional obligations to society.

Ethical Decision-Making Steps

Clarify dilemma, gather data, identify options, make decision, act, evaluate.

Moral Courage – C.O.D.E.

Framework: Courage recognition, Obligations to honor, Danger management, Expression/action to uphold values.