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Luceno Michelle

Ilagan Hannah Melissa

1

Ethical Issues in Nursing

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Values and ethics

Values and ethics are inherent in allnursing acts.A value is a strong personal belief; an ideal

that a person strives to uphold. Your values reflect cultural and social

influences, relationships and personalneeds. Vary among people and develop

and change over time.

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What is Ethics?

Branch of philosophy concerned withdetermining right and wrong in relation topeople’s decisions and actions.

Morals and ethics are often usedinterchangeably but morals are oftenstated as private, personal standards of what is right and wrong, ethics reflect acommitment to standards beyond personalpreferences.

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Nursing Ethics

An expression of how nurses ought toconduct themselves. Refers to ethicalstandards that govern and guide nurses ineveryday practice such as “being truthfulwith clients” “respecting clientconfidentiality” and “advocating on behalf of the client.”

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What does a code of ethics do?

Gives guidance for decision making about

ethical matters by providing a set of valuesthat are basic to nursing practice.

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 The Code of Ethics

Provide rules of ethical or moral behavior forevery circumstance.

Offer guidance about which values shouldtake priority or how they can be balanced inpractice.

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Values and The Code of Ethics

Primary values that are central to ethicalnursing practice.

 The 7 values include:1. Providing safe,

2. Compassionate competent and3. Ethical care,4. Promoting health and well-being,5. Promoting and respecting informed

decision-making,6. Maintaining privacy and confidentiality,7. Promoting justice and being accountable

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Definition of NursingStandardsDescribes the desirable and achievable

level of performance expected of registered nurses in their practice againstwhich performance can be measured

Benchmark for assessing the professionalconduct of all registered nurses.

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Legal Implications in

Nursing Practice

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Law

“The sum total of rules & regulations bywhich a society is governed.

As such, law is created by people & exists to

regulate all persons”

GUIDO, 2001

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Functions of the Law inNursingIt provides a framework for establishing

which nursing actions in the care of clientsare legal.

It differentiates the nurse’s responsibilitiesfrom those of other health professionals.

It helps establish the boundaries of independent nursing action.

It assist in maintaining a standard of nursing practice by making nursesaccountable under the law.

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Sources of LawSources of LawConstitutional lawLegislation law (Statutory law)

Administrative law

Common law

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Constitutional Law

 The supreme law of a country.

Creates legal rights & responsibilities and afoundation of a system of justice.

Legislation law (Statutory law)

Enacted by any legislative body

 The regulation of nursing is a function of statelaw

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Administrative law

It creates rules & regulations to enforce thestatutory laws.

Common Law

Laws evolving from court decisions.

Interpreting & applying the constitutional orstatutory law.

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Licensure

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Licensure

Is a legal permit that a government agencygrants to individuals to engage in thepractice of a profession & to use aparticular title.

Nursing Licensure is mandatory

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For a profession or occupation to obtain theright to license its members, it generally

must meet3 criteria:

1.  There is a need to protect the public’s

safety or welfare2.  The occupation is clearly delineated as a

separate, distinct area of work.

3.  There is a proper authority to assume the

obligations of the licensing process e.g.board of nursing

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Grounds for Revocation of license

Incompetent nursing practice

Professional misconduct

Conviction to a crime

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Patient Safety Goals:

1. Improve the process of Patient Identification2. Eliminate wrong-site, Wrong Patient & Wrong

Procedure Surgery3. Improve the effectiveness of Communication

among Caregiver4.

Improve the Safety of High Alert Medications5. Improves Safety in Infusions Pumps6. Improve the effectiveness of Clinical Alarm

systems7. Reduce the risk of healthcare-acquired

infections8. Accurately & completely reconcile

medications across the continuum of care9. Reduce the risk of patient harm resulting from

falls

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Nursing Documentation

Your License may depend on it!Your License may depend on it!

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"if it's not documented it wasnot done"

 To avoid litigation, health care providersmust comply with established standards of standards of 

carecare.

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Prudent NurseKnowledgeSkill

Care

Diligence

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 Process

Record events and observations in thepatient’s medical record in an objective andclear manner.

Document the specific facts, and carefullyrecord the time of each entry as accuratelyas possible.Avoid finger pointing and personal attacks

on the physician.

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 The Basics

Chronology: Date and TimeClient HistoryInterventions: Medical, Social and LegalObservations: Objective and SubjectiveOutcomesClient and Family ResponseAuthorship: Your Signature and Credentials

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LegibilityHand writtenCursivePrint

Computerized Typed notesClicks

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Date & Time

Sequence of EventsLapse in Time

Late Entries

Blocked TimeMilitary vs Standard Time

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Subject & Objective

SeeHear

Feel

“Think”

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Changes in Health Status

 Your actionsClients response

Client outcomes

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 Your Signature

Full nameCredentials

 Job title

Initials

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Client Education

FamilySignificant Other

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Phone Calls

Phone RecordPhone Orders

Pager Response

DocumentationFacility Policy

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“Read Back”

Date and time of callPhysician's name and "T/O" to indicate order

Verbal order, written word-for-wordDocumentation that you've read back theorder, to be sure you heard it correctly

Documentation that you've transcribed itaccording to your facility's policy

 Your name

C t i d

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ComputerizedDocumentation

Easier form of communication

Legible

As legal as when you manually chart

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Make Documentation Easier

 The Do’s The Don’ts

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 The Do’s

Correct ChartReflect the Nursing ProcessWrite LegiblyPermanent Black InkComplete / Concise / AccurateMedicationsRouteClient’s response

Precautions / Preventive MeasuresSide railsRestraints

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Nursing ProceduresName of procedureWhen it was performedWho performed itHow it was performedHow well the client tolerated itAdverse reactions

Phone callsHealth Care Team visits

Don’t wait to Chart

Client refusalsClient’s subjective data

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DO’s

Medication omission

Late Entry

Not ApplicableCharting FrequencyFacility P&P / Standards

Approved abbreviations & symbols

Discharge instructionsCommonly misspelled words

Look-a-Like / Sound-a-Like

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 The Don'ts

ComplaintsOpinions

Altering the Record

Adding InformationDating the entryDates / Times conflict

Inaccurate Information.

Destroying records

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Chart for someone elseChart Opinions

Use Negative Language

Leave empty lines / spacesWrite in the margins

Make reference to incident reports

h k

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When you make aMistake

White out / Eraser

 The word “Error”

Correct the Entry

Oops

Sad Faces

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