110 Final

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stephrigu
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110 Final
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2011-03-31 03:27:07
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  1. Morals
    personal standards of conduct derived from society expectations of behavior.
  2. Ethics
    systematic study of moral values such as autonomy, nonmaleficence, beneficence, justice, fidelity, veracity, confidentiality.
  3. Law
    rules and regulations established and promoted by a government to protect or to restrict the people.
  4. Respect for life
    Life is the most basic possession; respect for the value of life and quality of life
  5. Autonomy
    Freedom to choose one’s life plan and values
  6. Nonmaleficence
    Not inflicting harm
  7. Beneficience
    Taking positive steps to do good for the benefit of others
  8. Justice
    Treating others fairly
  9. Fidelity
    The duty to keep promises
  10. Veracity
    The duty to tell the truth
  11. Confidentiality
    The duty to protect privileged information
  12. Nurses decisions are______
    • based on ethical principles.
    • Our role is also to promote self-care and enhance SCA by assisting patients in clarifying their values.
  13. Nurses role
    • – shape responses to patient questions and statements
    • – motivate patients to examine personal thoughts and actions.
  14. Values clarification goes beyond expressing feelings to:
    • –gaining an awareness of personal priorities
    • –identifying unclear values
    • –resolving conflicts between values and behaviors
  15. What you need:
    • –time
    • –interest in others
    • –teaching skills
    • –self awareness
    • –non-judgmental listening skills
  16. Three steps to value clarification
    • –Choosing one’s beliefs and behaviors
    • –Prizing one’s beliefs and behaviors
    • –Acting on one’s belief
  17. Nurse Practice Acts include:
    • Definition of nursing
    • Requirements for licensure
    • Exceptions to the practice act
    • Actions or conditions that can result in loss of licensure
    • Administrative structure that implements and administers the practice act
    • Create the legal foundation and set the statutory boundaries for decision making for nurses.
    • Differ among states
  18. Statutory law
    • (created by legislative bodies eg U. S. Congress)
    • Types: criminal and civil•
    • Eg. State statutes are the Nurse Practice Acts
  19. Administrative law
    • (created by administrative bodies eg. BRN)
    • Eg. Duty to report to BRN incompetent nurse
  20. Common law
    • (based on previous court judgments)
    • Within each category federal, state and local laws may exist.
  21. Criminal law
    deals with conduct considered offensive to society as a whole
  22. Felony
    penalty ranges from at least one year imprisonment to death
  23. Manslaughter
    disconnecting life support systems without appropriate consent
  24. Negligent homicide
    working while under the influence of alcohol and causing a patient’s death.
  25. Misdemeanor
    • penalty fine or imprisonment less than one year
    • •alteration of medical records
    • •Battery (no major injury)
  26. Civil law
    concerned with legal rights and relationships that exist between private persons
  27. Tort
    civil wrong by one person against the person or property of another.
  28. pain and suffering?
    Person harmed may sue for monetary damages and may seek compensation for non-monetary damages (pain and suffering)
  29. Malpractice
    (part of civil law; common law also used here in court) violation of professional standard of care that results in injury to a patient.
  30. Required to sue for malpractice
    • –Duty = created by a professional relationship
    • –have a duty to meet the standard of care
    • –to act as a reasonably prudent professional working in similar circumstances
    • -Breach of duty
    • -Injury
    • -Causation
  31. Causation
    • –must show that the breach of duty caused the injury
    • –3 year statute of limitation in California with exceptions
  32. Intentional torts
    • Assault
    • Battery
    • False imprisonment
    • Fraud
    • Defamation (slander, libel,
  33. Unintentional Torts
    • Negligence
    • -Most common basis for lawsuits against nurses.
  34. Asault
    threatening or attempting to make contact without consent.
  35. Battery
    An assault that is carried out.
  36. False Imprisonment
    restraining without legal justification or consent.
  37. Fraud
    Purposeful misrepresentation that causes harm
  38. Slander
    spoken words
  39. Libel
    Written words
  40. Civil Malpractice
    • a form of negligence that addresses the negligent conduct of professionals including nurses.
    • •In court case such as malpractice
    • •Plaintiff is patient
    • •Defendant is the nurse or person being sued
    • •It is violation of a professional standard of care that results in injury to a patient.
  41. Negligence/Malpractice
    • •Leaving foreign object inside patient after surgery
    • •Failing to recognize and report significant changes
    • •Failing to ensure patient’s informed consent
    • •Carelessness with patient’s personal property
    • •Failing to respond to patient’s signal for service
    • •Failing to use adequate steps to prevent injury
    • •Failing to carry out orders for medications or treatments
    • •Failing to report own fatigue or illness
    • •Failing to recognize dangers inherent in an order
    • •Inattention to dying patient’s request for clergy, etc.
    • •Assigning others to responsibilities for which they have no education, experience, or license to perform
    • •Failing to take steps in emergency to protect the patient
    • •Failing to remove faulty equipment from use
    • •Failing to report staff member’s negligence that you witnessed
  42. Hospital Policies and Procedures
    • –Set allowable scope of practice within the institution
    • –May not expand the legal scope of practice
  43. Avoiding malpractice charges
    • •Avoid being rude or disrespectful
    • •Validate information with patient
    • •Include patient in planning and decision making
    • •Do not offer opinion on medical diagnosis
    • •Maintain confidentiality at all times
    • •Document verbal orders
    • •Do not correct or revise a medical record•Never treat without doctor’s order
    • •Understand order before doing anything
    • •Do not carry out an order you question
    • •Participate in surgical procedure only if proper consent is obtained
    • •Never force treatment on patient
    • •Be familiar with equipment you use
    • •Take precautions to prevent falls
  44. Your Legal Responsibility
    Nursing students are expected to perform as professional nurses would in providing safe patient care!
  45. Delegation of tasks
    Nurse retains responsibility for determining competency and retains responsibility for planning, implementing and evaluating care.
  46. Reporting requirements
    • –Co-worker incompetence
    • –Child abuse, elder abuse, domestic violence
    • –Communicable diseases (TB, HIV, STDs, chicken pox, hepatitis)
  47. Sexual misconduct indicators (Crossing the Line)
    • •Spend more time than is clinically necessary with a patient
    • •Made plans to see a patient when not on duty
    • •Dressed for work with a particular patient in mind
    • •Felt that others misunderstood or were too critical of a patient
    • •Made or kept secrets with a patient
    • •considered a certain patient to be “yours”
    • •Been guarded or defensive when questioned about your interaction or relationship with a patient
    • •Accepted gifts, letters or phone calls from a patient after he or she was discharged
    • •Chosen sides with a patient against family members
    • •Flirted with a patient
  48. Preventing sexual misconduct
    • Be aware of any sexual attraction you have toward a patient.
    • Discuss your feelings with a trusted supervisor or colleague.
    • Transfer the care of the patient to another nurse
    • Learn to recognize signs that a patient may be interested in forming a sexual relationship.
    • Establishing professional boundaries is your responsibility.
    • Respect patient dignity and privacy at all times.
    • Provide a professional explanation for all aspects of care.
    • Maintain clear, appropriate, and professional communication with patients.
    • Don’t discuss your personal problems or any aspect of your intimate life with patients.
    • Document and report observations of inappropriate behavior to supervisor and to state regulatory agency if necessary.
  49. Legal implications of medical records
    • –Medical records are evidence in legal actions!
    • –Medical records are considered highly credible and are given great weight in legal proceedings. –“Assessments should be documented objectively, indicating facts, observations, patient’s statements, and other measurable criteria.
    • –Subjective documentation should be avoided, because it states the writer’s conclusions without supporting facts and it allows a third party (such as attorney) to suggest any number of scenarios to clarify the subjective documentation.”
  50. Good Samaritan Statutes
    • Provide immunity for acts that might otherwise result in a claim of negligence when acts occur outside your place of employment.
    • Good Samaritan statutes were written with the hope that you will act.
    • Individuals who perform rescue as part of their job are legally responsible to help.
    • Others are protected by both common law and statutory law.
  51. Civil Law: Good Samaritan Statutes: Common law
    many cases over the years have supported the “good Samaritan”.
  52. Civil Law: Good Samaritan Statutes: Statutory Law
    • Statutory law: would have to prove
    • you owed the victim a duty to assist
    • you breached that duty
    • the victim was harmed
    • better than 50% probability that your actions caused the harm.
    • Gross negligence and intentional harm are not protected. i.e. intentional, reckless actions.
  53. Abuse
    Willful infliction of physical injury or mental anguish and the deprivation by the caregiver of essential service
  54. Forms of abuse
    • Physical abuse
    • Sexual abuse ~ incest
    • Emotional abuse
    • Neglect
    • Economic abuse
    • Spousal abuse ~ Domestic violence
  55. Physical abuse
    Deliberate violent action that inflicts pain and/or nonaccidental injury
  56. Sexual Abuse
    • Any type of sexual contact between an adult and anyone younger than 18, or between a significantly older child and a younger child.
    • If a family member sexually abuses another family member, this is called incest
  57. Emotional Abuse
    Deliberate and willful destruction or significant impairment of a person's sense of competence by battering the victim's self-esteem and inhibiting normal psychosocial development.

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