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wvc pro-con 1,22,23
wvc pro-con 1,22,23 fall 2010
| Question | Answer |
|---|---|
| Quality of life | Quality of life is central to many health care & ethical related discussions: futile care, DNR, cancer therapy, and provider assisted suicide are all related to quality of life. |
| The American Nurses Association (ANA) defined nursing as | the protection, promotion, & optimization of health, & abilities, prevention of illness injury, alleviation of suffering through the diagnosis & treatment of human response, & advocacy in the care of individuals, families, communities, & populations. |
| The client is the center of our practice, who or what does that involve? | Individual, Family, and/or Community |
| What are some example of a client's health care needs? | Experiences, Vulnerabilities, and Expectations |
| Professional Practice includes... | knowledge from social and behavioral sciences, biological & physiological sciences, and nursing theories. In addition nursing practice incorporates social values, professional autonomy, a sense of commitment & community. |
| Why are critical thinking (CT) essential to nursing? | Nurses need to be able to make clinical judgments regarding client health care needs bases on fact, experience, and standards for care. CT facilitates gaining knowledge, expertise, & life long learning. |
| Facts about Florence Nightingale | One of the first advocates for sanitation. Opened the first Nurses Training school (1860). Was the 1st practicing nurse epidemiologist. Was the Superintendent of the English General Hospitals in Turkey. |
| "The Lamp Lady" | F. Nightingale became know as "the lamp lady" for her efforts during the Crimean War (1853), by traveling to the battle field hospitals at night carrying her lamp. The sanitary, nutrition, & basic facilities in the battlefield hospitals were poor @ best. |
| Mary Mahoney | First professionally trained African American nurse. Devoted her practice to a fair & equal health among all: race, culture, color, background or religion. |
| Red Cross | In 1882 the U.S. Congress ratified the Red Cross after 10 years of lobbying by Clara Barton. Clara Barton tended to soldiers on the battlefields, cleaning wounds, meeting their basic needs, and comforting them in death. |
| Nursing in the early twentieth Century... | Movement toward a scientific, research-based defined body of nursing knowledge & practice. Nursing started being taught in Universities. 1901-Army Nurse Corps. 1908-Navy Nurse Corps. 1920- Specialty Nursing developed ie. nurse-midwife. |
| What does Demographic Changes(DC) mean? | (DC) affect the population ie.:Shift from rural areas to urban centers, increase in life span, higher incidence of chronic, longer-term illness, & increased incidence of disease (alcoholism & lung cancer). |
| How do nurses respond to Demographic Changes? | Nurses respond by exploring new methods to provide care, by changing nursing education, and by establishing practice standards. |
| The womans movement brought about many changes in society as women increasingly demanded economic, political, occupational, and educational equality. Resulting in a great sensitivity to the health care needs of women. What are some examples of changes? | There are health care specialties dealing with the needs of women. Obstetrical specialties address a range of female issues ranging woman's examinations to oncological subspeacialties & management of menopause. |
| Human Rights Movement | changed the way society viewed the rights of all members including: minorities, Pt with terminal illness, pregnant women, and older adults. Nurses were able to create a bill of rights for patients, allowing them to govern their own care. |
| Autonomy | refers to the commitment to include clients in decisions about all aspects of care |
| Beneficence | refers to taking positive actions to help others. Beneficence requires that the best interest of the client remain more important than self interest. |
| Non-maleficence | is the avoidance of harm or hurt. It is more than the will to do good, but also equal commitment to do no harm. |
| Justice | refers to fairness, Healthcare providers must strive for fairness in health care. The term is often used in regard to health care resources. |
| Code of ethics | is a set of guiding principles that all members of the profession accept. It is a collective statement about the group’s expectations and standards of behaviors. Serving as guidelines to assist the profession. |
| Fidelity | refers to the arrangement to keep promises. A commitment to fidelity supports the reluctance to abandon clients, even when disagreement occurs about decisions that a client makes. |
| Advocacy | refers to the support of a cause. As a nurse you are an advocate for health, safety & rights of your clients. You safe guard their rights to physical & auditory privacy. |
| Responsibility | refers to the willingness to respect obligations and follow through with promises. As a nurse you are responsible for your actions. |
| Accountability | refers to the ability to answer for one’s own actions. You learn to ensure that your professional actions are explainable to your client and your employer. |
| Confidentiality | legislation defines rights & privileges of clients for protection of privacy without diminishing care. |
| Value | is a personal belief about the worth of a given idea, attitude, custom or object that sets standards that influence behavior. |
| Value formation | development of values begins in childhood, shaped by experiences within the family unit. Variations in child rearing result variations in values & behaviors as the children grow up. |
| Deontology | The ethical study of morals, duties and rights with an approach that focuses on the rightness or wrongness of actions themselves, as opposed to the rightness or wrongness of the consequences of those actions. |
| Utilitarianism | The value of something is determined by its usefulness. AKA consequentialism because its main emphasis is on the outcome of the action. |
| Deontology VS utilarianism | the difference is that utilarianism will measure the effect an action will have. Deontology looks to the presence of principle regarding the action or outcome. |
| Ethics of care | the moral obligation of physicians, health care providers and nurses to incorporate notions of care into their professional behaviors. |
| Institutional resources on ethics | ethics committees support and facilitate the processing of ethical dilemmas. They serve to educate, make policy recommendations, and case consultation. |
| Futile care | refers to interventions that will unlikely produce benefit to the client. |
| Genetic screening | This poses an ethical issue for many, people are at issue with having the knowledge of a genetic condition and then making adjustments & some people prefer to not have the information before the symptoms begin. |
| Nursing shortage | The projected shortage of nursing poses an ethical issue regarding staffing ratios. California is the first state to implement mandatory nurse to client ratios. |
| Access to care | Most uninsured people in the US are the working poor (80%). The ethics central to this issue lie in the current insurance system that we use & allocating more funds toward prevention of disease. |
| Ethics and care for the aging adult | Many treatment plans for older adults only prolong life, as well as prolong suffering. Working to achieve dignity & comfort is important as medical goals. Also loss of autonomy as people age presents and ethical issue. |
| How is ethics different form legal issues? | Ethics has a broader base of interest and includes personal behavior, issues of character like kindness, tolerance, morality and generosity. |
| What is the study of ethics with the field of health care called? | Bioethics or clinical ethics |
| What does autonomy mean in regards to respecting our patients? | Autonomy represents an agreement to respect the patient's right to determine a course of action. In other words, respecting the patient's right to determine the course of their life. |
| What ethical principle is likely to come up in discussions about health care resources? | Justice Autonomy Independence; self-determination; self-reliance |
| What ethical principle requires that we put the patient's best interest over self-interest? | Beneficence |
| What ethical principle requires that we weigh benefits against potential harm to our patient? | Nonmaleficence |
| What refers to the execution of duties associated with a nurse's particular role. | Responsibility |
| What refers to the ability to answer for your actions? | Accountability |
| Are we allow to copy medical records or send them to their new doctor? | If we have the patient's consent. |
| What trait refers to a nurses ability to specific knowledge and skills to perform a task? | Competence |
| Making sure that we know about a drug before we administer it is an example of practicing what? | Competence |
| What refers to the ability to form an opinion or draw sound conclusions? | Judgment |
| What involves giving patients the information they need to make decisions and then supporting those decisions? | Advocacy |
| What is an ethical dilemma? | When the right thing to do is not clear. |
| How does Deontology work? | A decision is deemed ethical if it promotes justice, autonomy, fidelity, beneficence, and nonmaleficence. |
| What are some difficulties with Deontology? | Situations arise in which a person must choose between conflicting principles and people do not always agree on the definition of the principles. |
| How does Utilitarianism work? | When we determine the value of something by its usefulness- the greatest good for the greatest number of people. |
| What ethical system asks how ethical decisions will affect women? | Feminist Ethics |
| Which ethical system pays special attention to the nursing point of view and the nursing practice? | Ethics of caring |
| How does Ethic of care differ from other systems? | It focuses on relationships (caring) rather than applying universal principles that are analytical or intellectual |
| Name the 3 type of laws that govern nursing. | Statutory law, Administrative Law, and common law |
| Who enacts the Nurse Practice Acts? | state legislature |
| What agency functions under administrative law and regulates the practice of nursing through rules and regulations derived from the Nurse Practice Act? | State Boards of Nursing. |
| What are court decisions written by judges deciding a litigated case called? | common law |
| Informed consent is an example of what kind of law? | common law |
| What are the 2 kinds of statutes? | Criminal or civil |
| What are the 2 kinds of Criminal law? | felony or misdemeanor |
| What is a felony? | A serious offense that has a penalty of imprisonment for greater than a year or even death. |
| What is a misdemeanor? | A less serious crime that has a penalty of less than a year or a fine |
| What kind of law would a nurse break by misuse of a controlled substance? | Criminal law |
| What does JCAHO require in regards to nursing? | That hospitals fulfill standards with regard to nursing practice, like having written policies and procedures |
| What is the purpose of civil laws? | Civil laws protect individual rights. |
| What is a Tort? | A civil wrong for which the court compensates by money damages. |
| Differentiate between assault and battery. | Assault = threaten to harm …Battery = unwanted touching |
| What are the 2 types of torts and examples of each? | intentional = assault and battery and unintentional = Negligence – malpractice |
| Define Malpractice | Malpractice is defined as professional misconduct or unreasonable lack of skill. |
| In a malpractice suit what standard is used to determine if a nurse performed as any "reasonably prudent nurse"? | Nursing standards |
| What are legal guidelines for minimally safe and adequate nursing practice? | Nursing standards |
| What defines the scope and practice of nursing practice and expanded nursing roles, education requirements and differentiation between nursing and medical practice? | Nurse Practice Acts |
| What are some other professional organizations that define standards of nursing care? | American Nursing Association, JCAHO, Nursing Specialty organizations |
| What does the ANA do? | develop standards for nursing practice, policy statements and similar resolutions and describe the scope, function, and role of nurses as well as clinical practice standards |
| What do nursing specialty agencies do? | Define the standard of care for nurses to be certified in specialty areas |
| What defines the standards of care for nurses at a particular institution? | Written policy and procedures of the employing institution found on most nursing units |
| Why is it important to know and follow the institutions written policies and procedures in the case of a law suit? | Because it is one of the standards that will be used to judge negligence/ duty act/ competency |
| How will standards of care from the various sources be utilized in the case of a lawsuit? | To measure whether nursing actions were appropriate and reasonable according to the standards |
| How can we stay current on any new rules, regulations, or case law? | Read the current nursing literature in our area |
| What defines the scope and practice of nursing practice and expanded nursing roles, education requirements and differentiation between nursing and medical practice? | Nurse Practice Acts |
| What are some other professional organizations that define standards of nursing care? | American Nursing Association, JCAHO, Nursing Specialty organizations |
| Name the 9 most common negligent acts. | med errors; IV errors w/injury; Burns (equipment or spills); falls; absence of asepsis; surgical items in patient; incomplete report for oncoming shift; inadequate monitoring of pt.condition; failure to notify physician of sig. changes in pt. status |
| How does the court define negligence? | Failure to use that degree of care that a reasonable person would use under the same circumstances. You owed the pt. a duty. You breached that duty. The patient was injured as a result of the breach. |
| What is the patient's agreement to a procedure based on full disclosure of the risks, benefits, alternatives, and consequences of refusal? | Informed consent |
| What does informed consent documentation need to include? | patient and witness signature, date and time, verification of voluntary, fully informed signing |
| What is the nurse's responsibility in obtaining informed consent? | Obtaining a patient's informed consent is not our responsibility, but witnessing the patient’s signature is. |
| What do we do if the patient refuses treatment? | They need to understand the consequences of refusal. If they still refuse, written, signed, and witnessed refusal documentation is required. |
| What if the patient does not understand the procedures? | Notify the physician or health care provider and the nurse supervisor. |
| What law limits liability and offers legal immunity if a nurse stops to help at the scene of an accident as long as acts without gross negligence? | Good Samaritan Law |
| What must we have in order to practice in a state? | Licensure in that state |
| As student nurses who is responsible if we harm a patient? | We are responsible for all our actions that cause harm to patients. |
| Who shares liability if we are responsible as student nurses for injury to a patient? | our instructor, staff nurses working with us, the hospital or health care facility |
| What if we assigned a duty for which we are unprepared? | Refuse the duty |
| Can we perform things that we are learning at school while working as CNA? | No, only if they are included in the job description for a CNA. |
| When would we not carry out medical treatment ordered by a physician or health care provider? | When the order is in error, violates hospital policy, or is harmful to the patient. In these cases obtain further clarification from the provider. |
| What is the next step if the physician wants you to go ahead with an order that you think is potentially harmful to your patient? | Inform the nursing manager or supervisor and do not carry the order out if harm could come to the patient. |
| Why are written orders preferred to telephone orders? | Verbal or telephone orders leave possibilities for errors. |
| What if an emergency requires a telephone order? | The order needs to be written and signed by the provider as soon as possible (within 24 hours). |
| What if you are required to care for more patients than is safe due to staff shortage? | Notify nursing supervisor. Document and keep a copy of the documentation for yourself. |
| What if you become overwhelmed by the demands on you due to staff shortage and you walk out on your job? | Could be charged with abandonment. |
| What would we need to let the nursing supervisor know if you are required to "Float". | If you lack experience in caring for the type of patients on the new unit. |
| Give several examples of incidents that we are required to report or be held liable. | child, elder, spouse abuse, rape, gunshot wounds, attempted suicide, certain communicable diseases, unsafe or impaired professionals |
| Where do the standards of care that we are required to practice come from? | Nurse Practice Acts, guidelines of professional organizations, written policies and procedures of employing institutions |
| What are our responsibilities when performing procedures or carrying out physicians or health care providers orders? | We are responsible to carry out procedures correctly and to exercise professional judgment when carrying out provider's orders. |
| What are four criteria of informed consent? | 1. consenter is competent and of legal age 2. consent is voluntary. 3. consenter understands procedure, risk, benefits and alternatives. 4. all questions are answered |
| What are used to make quality improvements and provide risk management? | Occurrence reports – (chart the occurrence, but not that there is a filed occurrence report) |
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