CH 4: Ethics, Standards, and Nursing Framework

Beneficence

The duty to do good, benefit the patient or community, and take steps that reduce harm (guides helpful, recovery-focused interventions and advocacy)

Biopsychosocial framework

A holistic model that considers biologic, psychological, and social factors as separate but interacting influences on health (Prevents the nurse from reducing a mental-health problem to only symptoms, biology, or environment)

Clinical judgment

The nurse’s evidence-based conclusion about what is happening, what matters most, and what action is safest (supports risk decisions, priorities, interventions, and evaluation)

Fidelity

Faithfulness to professional duties, obligations, and promises (trust grow when the nurse follows through and does what was stated)

Justice

Fair and equitable treatment and distribution of health resources, with attention to those who have greater needs (mental-health access, dignity, and resource allocation are justice issues)

Nonmaleficence

The duty not to intentionally harm and to reduce unavoidable risks as much as possible (requires the least harmful and safest reasonable approach)

Nursing Process

A structured method for care: assessment, diagnosis, outcomes identification, planning, and implementation, and evaluation (it organizes clinical judgment and the six PMH standards of practice)

Paternalism

Making decisions for another person because the professional believes they know what is best (may be justified temporarily when capacity or immediate safety is seriously impaired, but can conflict with autonomy and recovery)

PMH-APRN (psychiatric-mental health advanced practice registered nurse)

A graduate-prepared psychiatric-mental health advanced practice registered nurse who provides advanced direct care within role, setting, and state law (may provide psychotherapy, advanced assessment, consultation, and prescriptive care when authorized)

PMH-RN (psychiatric-mental health registered nurse)

A registered nurse who uses the nursing process and therapeutic relationship to care for people with mental-health or co-occurring substance-use concerns (Provides assessment, safety, milieu care, teaching counseling interventions, medication care, and coordination within RN scope)

Reflection

Ongoing self-evaluation through observing, monitoring, and judging one’s own and others’ behavior (Improves self-awareness, nurse-patient interactions, medication care, and coordination within RN scope)

Respect for autonomy

Respecting a person’s right to make voluntary, informed decisions and protecting privacy (The nurse assesses decision-making capacity, provides relevant information, avoids coercion, and supports self-determination)

Scopes and standards of practice

Professional descriptions of what nurses do and the responsibilities for which they are legally, professionally, and ethically accountable (Keeps practice safe and clarifies the boundaries of RN and APRN roles)

Veracity

The duty to tell truth with judgment and sensitivity (Supports trust; the nurse gives accurate information and avoids false reassurance or promises)