Chapter 4 - Ethical and Legal Issues Affecting the Nursing Assistant

Chapter 4 - Ethical and Legal Issues Affecting the Nursing Assistant

1. Spell and define terms.

• Abuse: Any intentional act that causes harm or distress to another individual. In a healthcare context, it can refer to physical, emotional, sexual, or financial harm.

• Aiding and Abetting: The act of helping or encouraging another person to commit a crime or an unlawful act, making one complicit in that action.

• Assault: An intentional act that creates a reasonable fear of imminent harmful or offensive contact with another person. In healthcare, this could involve threatening behavior toward a patient.

• Battery: The intentional and unlawful physical contact with another person without their consent. In healthcare, this could include performing a procedure without consent.

• Boundaries: Limits that define appropriate interactions and relationships between healthcare providers and patients to maintain professionalism and avoid dual relationships.

• Coercion: The practice of persuading someone to do something by using force or threats, which undermines free will and autonomy, particularly concerning patient consent.

• Confidential: Information that is meant to be kept private and not disclosed to unauthorized individuals, especially regarding patient health information.

• Defamation: The act of communicating false statements about a person that injures their reputation. It can occur in spoken form (slander) or written form (libel).

• Ethical Standards: Guidelines that govern the behavior of healthcare professionals, ensuring actions align with moral principles and promote patient welfare.

• Euthanasia: The act of intentionally ending a person's life to relieve them from suffering, usually in the context of terminal illness.

• False Imprisonment: The unlawful restraint of an individual against their will, which can occur in healthcare settings if a patient is confined without justification.

• Health Insurance Portability and Accountability Act (HIPAA): A U.S. law that sets standards for protecting the privacy and security of individuals' medical records and other personal health information.

• Informed Consent: The process by which a patient is informed about the risks, benefits, and alternatives of a medical procedure or treatment and gives their voluntary agreement to proceed.

• Invasion of Privacy: The violation of a person's right to keep their personal information private, including unauthorized access or disclosure of health records.

• Involuntary Seclusion: The separation of a patient from others against their will, often used in a healthcare setting for safety but requiring strict justification and oversight.

• Legal Standards: Regulations and laws that govern the practice of healthcare, defining the duties and responsibilities of healthcare professionals.

• Liable: Legally responsible for one's actions or omissions, particularly regarding causing harm or injury to another person.

• Libel: A form of defamation that involves making false written statements about someone that damage their reputation.

• Malpractice: A form of negligence by a professional that results in harm to a patient due to failure to meet the accepted standards of care.

• Need to Know: A principle that limits access to confidential information to only those individuals who require it to perform their job duties.

• Neglect: The failure to provide necessary care or assistance to a person, which can result in harm or distress, especially in vulnerable populations like the elderly or disabled.

• Negligence: The failure to exercise the care that a reasonably prudent person would under similar circumstances, leading to unintentional harm or injury.

• OBRA (Omnibus Budget Reconciliation Act): A U.S. law that includes regulations aimed at improving the quality of care in nursing homes, including patient rights and standards of care.

• Physical Abuse: The use of physical force that results in bodily injury, pain, or impairment to another person.

• Platinum Rule: A principle that emphasizes treating others the way they want to be treated, rather than just how one would want to be treated (which is the Golden Rule).

• Professional Boundaries: The ethical limits that define the relationship between a healthcare professional and a patient, ensuring that interactions remain respectful and focused on the patient's welfare.

• Protected Health Information (PHI): Any information about health status, provision of healthcare, or payment for healthcare that can be linked to an individual, protected under HIPAA.

• Psychological Abuse: Emotional or mental harm caused to an individual, often through intimidation, threats, or manipulation.

• Relationship Danger Zone: A state in which professional boundaries may become blurred or compromised, leading to potential ethical or legal issues in the healthcare provider-patient relationship.

• Sexual Abuse: Any unwanted sexual activity or contact with another person, often involving coercion or manipulation, particularly vulnerable individuals.

• Sexual Harassment: Unwelcome sexual advances, requests for sexual favors, or other verbal or physical conduct of a sexual nature that creates a hostile or intimidating environment.

• Slander: A form of defamation that involves making false spoken statements about someone that damages their reputation.

• Social Networking Sites: Online platforms where individuals can create profiles, share content, and connect with others, which can pose risks to patient privacy if used improperly by healthcare professionals.

• Termination: The formal ending of a patient-provider relationship or employment, which may occur for various reasons, including non-compliance, ethical breaches, or mutual agreement.

• Theft: The unlawful taking of someone else's property with the intent to permanently deprive them of it, which can occur in healthcare settings.

• Verbal Abuse: The use of language to belittle, intimidate, or control another person, causing emotional harm or distress.

• Zone of Helpfulness: The appropriate range of behavior in professional relationships that fosters support and care for patients while maintaining necessary boundaries.

2. 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.

3. 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

4. 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.

5. 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.

6. 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.

7. 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.

8. Identify professional boundaries in relationships with patients and families.

• Confidenciality

• Clear communication

• Not accepting tips

• Avioding social media interactions 

9. 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. 

10. 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

11. State the purpose of the HIPAA laws.

• Restricts use and disclosure of patient information

• Makes facilities responsible for protecting PHI

• Protects all identifiable information

12. 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.