Chapter 4 - Ethical and Legal Issues Affecting the Nursing Assistant

Abuse

Any intentional act that causes harm or distress to another individual.

Aiding and Abetting

The act of helping or encouraging another person to commit a crime or an unlawful act.

Assault

An intentional act that creates a reasonable fear of imminent harmful or offensive contact with another person.

Battery

The intentional and unlawful physical contact with another person without their consent.

Boundaries

Limits that define appropriate interactions between healthcare providers and patients.

Coercion

The practice of persuading someone to do something by using force or threats.

Confidential

Information that is intended to be kept private, especially regarding patient health information.

Defamation

The act of communicating false statements about a person that injures their reputation.

Ethical Standards

Guidelines that govern the behavior of healthcare professionals.

Euthanasia

The act of intentionally ending a person's life to relieve suffering.

False Imprisonment

The unlawful restraint of an individual against their will.

Health Insurance Portability and Accountability Act (HIPAA)

A U.S. law that sets standards for protecting the privacy of individuals' medical records.

Informed Consent

The process of informing a patient about the risks, benefits, and alternatives of a medical procedure.

Invasion of Privacy

The violation of a person's right to keep their personal information private.

Involuntary Seclusion

The separation of a patient from others against their will.

Legal Standards

Regulations that govern the practice of healthcare.

Liable

Legally responsible for one's actions or omissions.

Libel

A form of defamation involving false written statements about someone.

Malpractice

Negligence by a professional resulting in harm to a patient.

Need to Know

A principle that limits access to confidential information to only necessary personnel.

Neglect

The failure to provide necessary care or assistance to a person.

Negligence

The failure to exercise the care that a reasonably prudent person would.

OBRA (Omnibus Budget Reconciliation Act)

A U.S. law aimed at improving quality of care in nursing homes.

Physical Abuse

The use of physical force resulting in bodily injury.

Platinum Rule

Treating others the way they want to be treated.

Professional Boundaries

The ethical limits that define the relationship between healthcare professionals and patients.

Protected Health Information (PHI)

Any information about health that can be linked to an individual, protected under HIPAA.

Psychological Abuse

Emotional or mental harm caused to an individual.

Relationship Danger Zone

A state where professional boundaries may become blurred.

Sexual Abuse

Any unwanted sexual activity or contact.

Sexual Harassment

Unwelcome sexual advances or conduct creating a hostile environment.

Slander

A form of defamation involving false spoken statements.

Social Networking Sites

Online platforms that can pose risks to patient privacy.

Termination

The formal ending of a patient-provider relationship.

Theft

The unlawful taking of someone else's property.

Verbal Abuse

The use of language to belittle or intimidate another person.

Zone of Helpfulness

The appropriate range of behavior in professional relationships.

Discuss ethical and legal situations in health care.

• Legal standards are guides to lawful behavior. When laws are not obeyed:

•  Nursing assistant may be prosecuted and found liable for injury or damage.

• Ethical standards are guides to moral behavior.

Describe the legal and ethical responsibilities of the nursing assistant.

• Legal responsibilities:

  • Carry out procedures carefully and as you were taught.

  • Keep your skills and knowledge up to date.

• Ethical responsibilities: 

  • Respect for each patient as a unique individual is another ethical principle

Describe how to protect the patients’ right to privacy.

• Prevent body exposure.

• Knock on door before entering.

• Draw curtains when providing care.

• Leave when visitors are present.

Define abuse and give examples.

• Any act or failure to act that is nonaccidental and causes or could cause harm or death to a patient

• Example: breach of confidentiality, neglect, physical or sexual abuse.

Define neglect and give examples.

• Negligence is failure to exercise the degree of care considered reasonable under the circumstances. Simply put, it is carelessness, which may be caused by rushing or taking shortcuts. 

• An example: Failure to turn a patient, to perform hygiene, to assist with meals, and to provide water.

Define sexual harassment and give examples.

• Physical, verbal, or nonverbal actions or advances that are unwelcome by the other person

• example: giving an inappropriate comment and unnecessary physical contact.

Identify professional boundaries in relationships with patients and families.

• Confidenciality

• Clear communication

• Not accepting tips

• Avioding social media interactions

Explain why working in a virtual world affects patient boundaries.

• Posting information and taking and/or posting photos without proper permission is always a boundary violation. 

• Both facility and patient permission are needed.

• All employees must protect patient information from access by unauthorized persons.

• Patients expect health care workers to respect their dignity and act in their best interests. 

Give examples of boundary violations using the Internet and wireless media.

• Taking photos of patient

• Looking at patients records and undisclosed information

• Following patient on social media

State the purpose of the HIPAA laws.

• Restricts use and disclosure of patient information

• Makes facilities responsible for protecting PHI

• Protects all identifiable information

Explain why most facilities prohibit employees from posting work-related information on social networking sites. 

• Posting information and taking and/or posting photos without proper permission is always a boundary violation. 

• Both facility and patient permission are needed.

• All employees must protect patient information from access by unauthorized persons.