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38 Cards in this Set

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________ sets the standard for practicing ethics in nursing.
It is considered the Blueprints for _____________.
It is adopted by members of the profession.
the ANA Code of Ethics,

ethical decision making
Professional Ethics
a code of behavior that governs conduct.

It guides the professional in determining behavior, conduct, and decision making.

a set of standards for behavior that govern proper conduct related to professional behaviors. These behaviors have moral overtones-- that is, what is right or wrong regarding professional conduct.
Morals
refer to one’s personal conviction about the rightness or wrongness (morality) of an act.

Culture/customs can cause different beliefs about what is considered "right." There are often different customs among age groups .
Ethics
The study of philosophical beliefs about what is considered right or wrong in a society

Has to do with the right to do an act vs. the right thing to do
What are the important ethical concepts we must practice as nurses?
Nonmaleficence
Autonomy
Justice
Confidentiality
Beneficence
Verocity
Fidelity

(Remember NAJBVF... Normally A Judge Can Be Very Fair )
Beneficence
promoting good for the clients under the nurse’s care (a primary goal)

One of the oldest requirements for health care providers

Difficulty lies in what exactly is “good?”
“Good” care requires that the health-care provider take a holistic approach to the client, including the client’s beliefs, feelings, and wishes as well as those of the client’s family and significant others.
Confidentiality
Maintaining Privacy
What does HIPAA stand for?
Health Insurance Portability and Accountability Act
Fidelity
Observance of the loyalty and commitment to the client

Main support for the concept of accountability

Faithfulness or loyalty to agreements and responsibilities accepted as part of the practice of the profession, to do know wrong to client
Veracity
principle of truthfulness, to tell the truth (except when doing so would seriously harm the client’s ability to recover or would produce greater illness)

Principle requires health-care provider to tell the truth and not deceive or mislead intentionally.
Nonmaleficence
“Do No Harm” intentionally or unintentionally
Opposite side of the concept of beneficence
-Often violated in the short term to produce a greater good in the long term treatment of the client. Example- A client may undergo a painful and debilitating surgery to remove a cancerous growth to prolong his life
Which ethical principle is the ANA #1 principle?
Justice
Which ethical principle requires health-care providers to protect from harm those who cannot protect themselves?
Nonmaleficence
Justice
treating others fairly and equally
Underlies the 1st statement of ANA Code of Ethics for nurses (The nurse provides services with respect for human dignity and the uniqueness of the client unrestricted by by considerations of social or economic status, personal attributes, or the nature of health problems)
Autonomy
right to make one’s own decisions about health-care even if the health-care provider does not agree with those decisions. Some limitations exist, such as being forced to seek medical treatment for tuberculosis or to be confined into isolation to prevent a disease from spreading.
Describe the ethical decision making process
An ethical decision-making process provides a method for nurses to answer key questions about ethical dilemmas and to organize their thinking in a more logical and sequential manner.

Chief goal of the ethical decision making process is to determine right and wrong in situations where clear demarcation are not readily apparent.

Ethical Decisions must be made when opposing ethical beliefs occur within the same situation
What are the steps of the ethical decion making process?
1. Collect, Analyze, and Interpret the Data (identify ethical dilemma)

2 State the Dilemma

3. Consider the Choices of Action

4. Analyze the Advantages & Disadvantages of Each Course of Action

5. Make the Decision and Act on It
What are the important concerns of the Collect, Analyze, and Interpret the Data step ?
CLIENT’S WISHES, the client’s family’s wishes, the extent of physical or emotional problems causing the dilemma, the physician’s beliefs about health care, and the nurse’s own orientation to issues concerning life & death

Example issue: Decision to enact a No resuscitation order
What is involved with stating the ethical dilemma?
• Identify whether the problem directly involves the nurse or is it a problem that can be resolved only by the client, client’s family, physician, or the DPOAHC.
• Ethical issues often involve a question of conflicting rights, obligations, or basic ethical principles.
• In general, the principle that the competent client’s wishes must be followed is indisputable.
• Additional questions can arise when the family’s wishes conflict with those of the client, especially when the client has become unresponsive.
What is involved with considering the choices of action?
Without consideration of their consequences, list all possible courses of action that can be taken to resolve the dilemma. Brainstorming activity
This may require input from outside sources such as colleagues, supervisors, or even experts in the ethical field. Refer to facility’s policy and procedure manual to decide which issues can be referred to an ethics committee.
What is involved with analyzing the courses of action?
•Evaluate consequences of each action
•The nurse should be able to narrow the realistic choices of action.
•Major factor in deciding would be choosing the appropriate code of ethics. The -ANA Code of Ethics should be part of many client-care decisions affected by ethical dilemmas.
Expain what is implied by making your decision and acting on it.
It's the most difficult part—making the decision, following through with acion, and then living with the consequences.

By definition, ethical dilemmas produce differences of opinion, and not everyone will be pleased with the decision.
How should we handle a seriously controversial issue?
A collaborative decision made by the client, physician, nurses, and family about a seriously controversial issue like no-resuscitation is ideal and tends to produce fewer complications in the long term resolution of such questions.
What is the definition of an ethical dilemma?
a situation that requires choosing between two equally unfavorable alternatives. There is no correct solution.
Discuss the nurse's role in an ethical dilemma?
Nurses are problem solvers by definition and use the nursing process as a systematic step-by-step approach to resolve problems that deal with a client’s health and wellbeing.

The nurse’s role in an ethical dilemma is to decide what needs to be done to get to the patient’s desired outcome
Tort
civil wrong committed against a person or property.
Intentional Torts
Assault
Battery
False imprisonment
Defamation of character
Breach of confidentiality
Unintentional Torts
Negligence & Malpractice
Assault
Attempt or threat of touch
threatening behavior
Battery
Actual contact without consent-explain any touch to patient first
Defamation of Character
Harm a person’s reputation-slander & libel w/malicious intent
False imprisonment
Restraint without Permission
Breach of Confidentiality
Not maintaining privacy
Not maintaining HIPPA
Negligence
an act or omission to act that breaches the duty of due care & results in or is responsible for a person’s injury.
Duty: outline of standard care-are you competent?
Breach of duty: did something you shouldn’t have or didn’t do what you should have.
Cause in fact- was the error truly what caused the damage or was the event unavoidable?
Proxibmate cause-someone else caused harm but were you in a situation to make a change
Damage- consequence of omission or commission of the act
Malpractice
Demonstration of unreasonable skill with resulting injury, loss or damage to client. (Is that what a reasonale & prudent nurse would have done?)
DTO
danger to others
DTS
danger to self
Describe Critical Thinkers/Critical Thinking
•Critical thinkers are disciplined, they don’t jump to conclusions.
•Critical thinking see linkages and complexities.
•They are rational and base their decisions on fact and evidence, not on emotions.
•Creative thinking is exploring new ideas and thinking outside the box.
•Critical thinkers are honest, open minded, active, and skeptical.