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NC #7
Concepts of Nursing Ethics and Law
| Question | Answer |
|---|---|
| When do moral & ethical dilemmas surface? | When there is a conflict between tow or more standards of right and wrong |
| Define morals | Standards of right and wrong that shape human character |
| Define ethics | Refers to values that influence a persons behavior and the individual feelings about what is right or wrong |
| Define ethical dilemma | Situation that does not have a clear right or wrong answer |
| What are five principles of nursing ethics? | Do no harm (Non-maleficence), Do good (Beneficence), Freedom to choose (Autonomy), Loyalty (Fidelity), Justice (Fair to all) |
| What is the purpose of Nursing Code of Ethics? | To promote trustworthy, accountable nurses |
| What are the steps for making ethical decisions? | Identify the main issue, ask good questions & find the answers, select your plan of action, identify the necessary steps to realize that option, act, monitor & assess the impact of your actions, respect for people, all pt should be treated as individuals |
| What are some examples of ethical nursing behavior? | Consider multiple view points, involve people with divers perspectives, weigh feasible options (evaluate each option), examine the impact and make any necessary corrective actions |
| What is "refusal to treat"? | When a nurse encounters a patient whose care requires something that conflicts with personal moral beliefs |
| What do nurse have a duty to report? | Nurses that perform outside the standards of care |
| Identify the various ways nursing practice is regulated? | State Board of Nursing & Nurse Practice Act |
| What does the State Board of Nursing do? | Made of professionals and public members, regulatory body for nurses who practice in its jurisdiction |
| Who selects the members of SBON? | Governor |
| Who adheres to the NPA? | Nurses in that particular state |
| Who sits on the OBN? | Six RN's, 3 LPN's & 2 public members |
| How many years do nurse members serve on the board? | Five years |
| What is the main purpose of the BON? | Safeguard the public by ensuring that nurses all meet the same licensing standards |
| What are the consequences of violating the NPA? | Denial, revocation, or suspension of license or certificat |
| Define liability | Legal responsibility |
| Define fraud | A deliberate deception for the purpose of personal gain and usually prosecuted as a crime |
| Can you apply for a LPN position even though you have not taken the exam? | No |
| If you have been arrested, but it's been expunged, do you have to check the box on OBN application that says "have you been arrested"? | Yes |
| Define accountability | Being responsible for one's own actions |
| Define advocate | One who defends or please a cause or issue on behalf of another (as a pt advocate, we are not their legal representative, but are to help maintain their rights & preferences) |
| Define euthanasia | Letting a patient die or assisting in his/her death |
| Define liable | Legally responsible |
| Define malpractice | Failure to meet legal duty, thus causing harm to another |
| Define medical record | Laws govern the collection, maintenance, and disclosure of information |
| Define verdict | A legal decision |
| What do standards of care along with scope of nursing practice do? | Give direction |
| Ignorance does not decrease ________? | Liability |
| What are professional boundaries? | Acts in patients best interest, respects the patients dignity, refrain from engaging in activities that lead to personal benefit at the patients expense, avoid personal relationships w/patients, focus on achieving client wellness |
| What do you do if your personal values conflict with nursing law? | You are required to follow the law |
| What does the Patients Bill of Rights do? | Promotes the publics understanding of their rights & responsibilities as consumers of health |
| Who enacted the Patients Bill of Rights and when? | American Hospital Association / 1972 |
| What is an action a PN takes to protect patient rights? | Know patient rights and take action to ensure they have those rights |
| What are the five basic purposes for accurate and complete written records? | Written communication, permanent record for accountability, legal record of care, teaching, research and data collection |
| Who does the original health record belong to? | The facility/institution or physician |
| What is informed consent? | Refers to full disclosure of the facts that the patient needs to man an intelligent (informed) decision before any invasive treatment or procedure |
| Does the patient have the right to refuse treatment after everything has been explained to them? | Yes |
| Does the patient have the right to refuse to listen to what is being told to him/her? | Yes |
| Who is responsible for explaining the procedure that is going to be performed? | Healthcare provider performing the procedure |
| What is the nurses role in the informed consent process? | Nurse reinforces the information the provider gave and witnesses the signature of consent forms |
| What are some factors that would hinder a patient from giving informed consent? | Patient under the influence of mind-altering medications (ex: narcotics within 4hrs of consent) |
| When does informed consent occur? | When the patient has a full understanding of the treatment or procedure and understands the benefits, risks, and alternatives to treatment |
| Who can legally sign the consent form? | Patient, next of kin, or legal guardian |
| In an emergency, who can give consent if family/next of kin can not be located? | Physician treating patient |
| What can you be charged with if a patient refuses treatment, but treatment was given anyway? | Civil battery |
| What is Civil battery? | Unlawful touching of a person; intent to harm is not necessary |
| If someone is going to be a living donor, who signs the consent form? | Donor |
| If someone is a non-living donor, who signs the consent form? | Next of kin or legal guardian |
| What is an Advance Directive? | Signed & witnessed document providing specific instructions for health care treatment in the event the person is unable to make these decisions personally at the time they are needed |
| What are the two types of Advance Directives? | Living Will & Durable POA for Healthcare |
| What is a living will? | Written document that directs treatment in accordance with a patient's wishes in the event of a terminal illness o condition, usually witnessed by two people (not related) |
| What is a Durable POA for Healthcare? | Designates an agent to make health care decisions on the patients behalf based on the patients wishes |
| What is a health care proxy? | Patient appoints another person to make decisions for the clients medical care if the client is no longer capable of making those decisions |
| What is a "DNR"? | "Do Not Resuscitate" order; instructs medical personnel not to resuscitate he patient (NO CPR if heart or breathing stop) Even if you don't agree w/DNR, you must follow order |
| What does the Patient Self-Determination Act require? | Institutions maintain written policies and procedures regarding advance directives (including the use of life support if incapacitated) |
| True or False: The nurses role is to support the patient's decision; be a patient advocate | True |
| What is malpractice? | Failure to meet a legal duty, thus causing harm to another |
| What is the negligence? | The commission (doing) of an act or omission (not doing) an act that a reasonably prudent person would have performed in a similar situation, thus causing harm to another |
| What is performing a skill that you are not qualified to perform or having a patient do the opposite of what the physician ordered, which causes the patient harm, called? | Malpractice |
| What is leaving the floor/facility without letting anyone know or having someone take over your patients called? | Abandonment |
| What is duty? | Exist - the nurse-patient relationship establishes a duty, defined by the standards of care |
| What is breach of duty? | Practical Nurse fails to follow or perform professional duties in a reasonable, prudent manner |
| Define harm? | (does not have to be physical injury) patient suffers from practical nurse's breach of duty |
| What are some strategies to stay out of disciplinary action and out of court? | Know your NPA and follow it, stay within your scope of practice, know your standards of care and stay within them |
| What is your best defense against a lawsuit? | Provide compassionate, competent nursing care. Also, promote a good nurse-patient relationship, one base on trust and respect |
| What does HIPAA stand for? | Health Insurance Portability and Accountability Act |
| What is abandonment? | Wrongful termination of providing patient care |
| What is an interstate compact? | Allows multistate practice of nursing |