Ethical Principles in Community Health Nursing

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Questions and Answers

What is ethics primarily concerned with in the context of community health nursing?

Legal ramifications of healthcare actions

Patient satisfaction metrics

Moral principles and rules of conduct (correct)

Aptitude and skills of nurses

What does moral dilemma in community health nursing often involve?

Balancing professional boundaries with client relationships (correct)

Choosing the best medical treatment

Determining the cost of care services

Managing healthcare facilities

What is the main duty of healthcare practitioners according to ethical principles?

Preservation of life and protection of bodily integrity (correct)

Collecting patient feedback for improvement

Ensuring patient compliance with treatment

Maximizing profits for healthcare organizations

What is moral uncertainty in the context of nursing practice?

Unsureness about which moral principle to apply Signup and view all the answers

How do ethical issues in community health arise?

When decisions conflict with society's moral principles Signup and view all the answers

According to George Washington Carver, what happens when motives are wrong?

Nothing can be rightfully done Signup and view all the answers

What ethical issue arises from a close relationship between the nurse and the community?

Manipulation and boundary issues Signup and view all the answers

Which of the following is an ethical consideration in nursing practice?

Adherence to regulations and legal standards Signup and view all the answers

What is moral distress experienced by nurses?

Being aware of the right actions but being constrained by organizational rules. Signup and view all the answers

How is moral outrage defined in the context of nursing?

A feeling of frustration when witnessing unethical behavior. Signup and view all the answers

What does the principle of autonomy in nursing emphasize?

The respect for patients' rights to make their own health decisions. Signup and view all the answers

Which scenario illustrates a challenge to patient autonomy?

A doctor making decisions for a patient without consent. Signup and view all the answers

What is the relationship between ethical and legal responsibilities in nursing?

Ethical standards dictate what nurses ought to do, while legal standards dictate what they must do. Signup and view all the answers

Which ethical principle denotes the commitment to do no harm?

Non-maleficence Signup and view all the answers

Which factor contributes to moral distress in healthcare settings?

Excessive workload and perceived incompetence of colleagues. Signup and view all the answers

What does beneficence in nursing ethics prioritize?

The commitment to promote well-being and act in the patients' best interests. Signup and view all the answers

What approach might community health nurses use when advocating for mandatory vaccinations despite public resistance?

Utilizing paternalistic approaches Signup and view all the answers

Which principle refers to the actions that benefit others and promote good?

Beneficence Signup and view all the answers

What ethical principle emphasizes the importance of not causing harm to patients?

Nonmaleficence Signup and view all the answers

In the context of smoking cessation, how might community health nurses limit a smoker's choices?

Offering only information on quitting without acknowledging personal choice Signup and view all the answers

When is it acceptable for a nurse to make decisions on behalf of a client?

When the client lacks decision-making capacity Signup and view all the answers

Which principle is considered more binding than beneficence in nursing practice?

Nonmaleficence Signup and view all the answers

What is the focus of a detrimental benefit analysis in the context of healthcare?

To weigh the benefits against the potential harms Signup and view all the answers

In community health practices, what is a primary responsibility of nurses related to patient care?

To help avoid causing harm while promoting good Signup and view all the answers

What principle emphasizes the nurse's responsibility to maximize the health of the population?

Principle of Accountability Signup and view all the answers

Which ethical perspective prioritizes the morality of actions based on whether they are right or wrong independent of their consequences?

Deontology Signup and view all the answers

What is one of the four fundamental responsibilities of nurses as outlined in the ICN Code of Ethics?

Alleviate suffering Signup and view all the answers

According to the American Nurses Association (ANA) Code of Ethics, who is the primary commitment of a nurse directed towards?

The patient, whether individual, family, or community Signup and view all the answers

What does the principle of advocacy in nursing primarily focus on?

Ensuring client safety Signup and view all the answers

Which ethical theory emphasizes the role of virtues like honesty and compassion in decision-making?

Virtue Ethics Signup and view all the answers

What is a key factor in the application of Principlism in nursing practice?

Knowledge of ethical principles Signup and view all the answers

What does the ANA's code of ethics provide for nurses?

A standard of conduct and behaviors Signup and view all the answers

What does the formal principle of justice assert?

Equals should be treated equally, and unequals differently. Signup and view all the answers

Which aspect is NOT included in the model for fidelity?

Maintaining professional decorum Signup and view all the answers

What is meant by fiduciary responsibilities in nursing?

It is the trust-based relationship with patients. Signup and view all the answers

What does veracity mean in the context of nursing?

Being truthful and honest in dealings. Signup and view all the answers

Under which condition can confidentiality be violated?

When a patient reveals plans for self-harm or harm to others. Signup and view all the answers

What are the four criteria of the principle of double effect?

Morally good action, intended good effect, evil resulting is unintended, good achieved not by evil. Signup and view all the answers

Why is confidentiality important in health care?

It encourages patients to seek help when needed. Signup and view all the answers

Which type of promise requires explicit communication in nursing?

Explicit promises. Signup and view all the answers

What is the primary purpose of maintaining professional boundaries in nursing?

To protect the integrity of the nurse-patient relationship Signup and view all the answers

Which of the following is an example of a boundary violation?

Giving a patient personal gifts in return for their appreciation Signup and view all the answers

What does crossing a professional boundary typically involve?

Engaging in brief, thoughtless interactions that serve therapeutic needs Signup and view all the answers

In the context of professional boundaries, what does 'countertransference' refer to?

The nurse feeling romantic feelings towards the patient Signup and view all the answers

Which scenario would be considered a boundary crossing?

Revealing personal life details to the patient Signup and view all the answers

What is a consequence of a boundary violation in nursing?

Confusion regarding the needs of the nurse and the client Signup and view all the answers

Select an action that helps in setting professional boundaries?

Refraining from making personal judgments about the patient Signup and view all the answers

What is sexual misconduct in the context of professional boundaries?

Making sexual advances or inappropriate remarks towards the patient Signup and view all the answers

Study Notes

Ethical Principles of Community Health Nursing Practice

Ethics is a system of moral principles and rules of conduct recognized for a particular class of human actions or a particular group of people.
Ethical considerations involve evaluating the morals or principles of goodness behind an action.
This includes determining the rightness or wrongness before the action occurs, and whether it aligns with professional or practice standards, particularly within the nursing profession.
Ethical considerations in community health nursing practice lead to complex legal and ethical issues. Example includes the selling of drugs and toxins, or asking payment for services rendered in barangay health centers.
According to George Washington Carver, once motives are wrong, nothing can be right, and there is no right way to do a wrong thing.
Healthcare practitioners are responsible for preserving life and health, protecting bodily integrity, and respecting human dignity.
Ethical issues occur when a decision or activity conflicts with societal moral principles. This may lead to legal conflicts due to possible alternatives breaching laws.
A common ethical dilemma in community health nursing is setting boundaries with clients, especially when care providers may become manipulative, or the community becomes overly attached to the nurse.
Moral uncertainty/conflict happens when a nurse isn't sure which moral principle to apply, a typical situation during a pandemic, where nurses struggle with making unbiased and fair decisions for all patients.
Moral distress happens when a nurse knows the right action but organizational constraints prevent them from taking it, usually due to conflicting ideas with other care providers. Examples include excessive workloads, and working with incompetent colleagues.
Moral outrage is a behavioral response to an immoral act by another healthcare provider, where the nurse feels incapable of intervening. An example of this in the context of Covid-19 is frustration from the high-risk treatments and care needed for front-line workers.
As a nurse, you must practice within the moral standards of the nursing profession and the context of legal laws. Nurses need knowledge, judiciousness, and consideration when performing their duties and responsibilities.
Key ethical principles include autonomy, beneficence, non-maleficence, justice, veracity, and fidelity.
Autonomy refers to freedom of action. This includes the provision of informed consent, freedom of choice, and the right to refuse treatment.
Community health nurses may lead educational campaigns to promote healthy behaviors. Examples include vaccinations, practicing safe sex, and smoking cessation. In some cases, they may use paternalistic approaches, believing these actions are in the best interest of the community.
Instances involving paternalism restrict patient autonomy. Examples include the provision of information or deciding on behalf of a client when developmental issues and health challenges prevent them from deciding for themselves.
The nurse must respect the rights of the community and treat individuals as autonomous objects, with the right to make their own decisions.
Beneficence is acting in a way that benefits others. The nurse should apply hypothetical measures in order to ensure the best, and suitable measures for sick individuals.
Preventing or avoiding harm during community practices is considered a part of beneficence. This includes a duty to provide healthcare services to community people.
Non-maleficence is the principle of doing no harm. Healthcare practitioners should ensure that they do not harm patients while they provide care.
Justice involves treating equals equally. Equitable healthcare is provided to all community members.
Fidelity involves loyalty and faithfulness to commitments. Nurses should be faithful to their promises to provide quality care to patients.
Fidelity concerns itself with explicit and implicit promises the nurse makes, keeping one's word of honor, loyalty, commitment and oaths and act in a reliable manner.
Fiduciary responsibilities refer to the contract of relationship between the nurse and patient. This relationship is based on trust and confidentiality amongst the participants.
Veracity involves truthfulness and honesty in all dealings with community members. Nurses should tell the truth and not misrepresent or deceive others.
Confidentiality involves safeguarding privileged information from public disclosure. Harm to self or others, or needing permission to share particular information is considered a violation of confidentiality or requiring to be communicated.

Duty-Based (Deontology)

Duty-based ethics focuses on the adherence to rules and obligations. Ethical choices are made based on duty rather than results/consequences of those choices.
A duty may involve responding to/ refusing certain demands/services, such as responding to an emergency or refusing a service delivery at an unapproved hour.

Virtue Ethics

Virtue ethics emphasizes the character of the decision-maker, and considers the ideal virtues to maintain when making choices.
Examples include honesty, courage, compassion, and service.

Principlism

Principlism involves applying ethical principles instead of theoretical approaches to evaluate actions. Nurses frequently use this approach in their practice. It involves using knowledge of ethical principles over ethical theories.

Ethics in Professional Nursing Practice

Nursing practices are governed by the International Council of Nurses (ICN), including their Code of Ethics, which provides guidance based on social values and needs, and correlates the four primary nursing responsibilities.
These fundamental responsibilities are: promoting health, preventing illness, restoring health, and alleviating suffering.
The American Nurses Association (ANA) Code of Ethics applies to all nurses, including ethical principles, standards of conduct, and behaviors. It is the profession's ethical standards and aims to establish the commitment of nursing professionalism to the community.
Key commitments/points involving ANA code of ethics consist of: primary commitment, compassion/respect, health welfare, accountability, knowledge/increase, healthcare environment, and commitment.

Professional Boundaries

Professional boundaries define the appropriate limits in a therapeutic relationship with a patient, involving refraining to obtain personal gain at the expense of the patient, and to avoid jeopardizing the therapeutic relationship.
Boundary violations involve unethical acts during therapeutic relationships that harm or exploit the patient. Examples involve exploitation, personal gain, including excessive self disclosure, secretive behavior, selective communication, becoming a “super-nurse”, singled-out client treatment, and the inability to protect a client.
Key terms associated with professional boundaries include: Boundaries, Crossings, Violations, Sexual Misconduct.
Methods to establish boundaries include: not discussing client information with others, maintaining separate work and personal contact numbers, avoiding additional favors beyond the role.
Considerations in setting boundaries: knowing yourself and your values, intervening in ethical questions, knowing the facility policy, understanding responsibilities regarding consent forms, respecting advanced directives.

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Description

This quiz explores the ethical principles that guide community health nursing practice. It examines moral considerations, decision-making processes, and the implications of ethical dilemmas faced by healthcare practitioners in their profession. Understand the complexities of ethics as they relate to preserving human dignity and integrity in healthcare settings.