Nursing Code of Ethics and Principles

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Questions and Answers

What is the first step in addressing an ethical dilemma?

Decide on a solution

Clearly identify the ethical dilemma (correct)

Review the decision

Identify possible solutions

Which of the following principles should be applied to ethical solutions?

Focusing only on the team's majority opinion

Respecting client’s autonomy (correct)

Ensuring legal issues are ignored for flexibility

Respecting financial costs over client preferences

Why is it important to include all relevant individuals in resolving an ethical dilemma?

To simplify communication within the team

To limit the number of opinions that could confuse the process

To ensure the solution is popular among team members

To gather diverse perspectives and expertise (correct)

What should be done after deciding on a solution to an ethical dilemma?

Review the decision and ensure all factors have been considered Signup and view all the answers

What is a common ethical issue faced in healthcare concerning patients?

Medically/physician-assisted death Signup and view all the answers

Which ethical principle involves the obligation to respect a client's right to make their own decisions, including the refusal of care?

Autonomy Signup and view all the answers

What is the main focus of the ethical principle of beneficence?

Doing good for clients Signup and view all the answers

Which value emphasizes the importance of treating each individual with respect and ensuring equality?

Human dignity Signup and view all the answers

In the context of nursing ethics, what does fidelity refer to?

Following through on commitments made to clients Signup and view all the answers

What characteristic defines an ethical dilemma in nursing?

Critical choice with no ethically acceptable solution Signup and view all the answers

Which of the following is NOT one of the six ethical principles outlined in the content?

Utilitarianism Signup and view all the answers

Which professional core value prioritizes selfless actions for the benefit of clients?

Altruism Signup and view all the answers

What obligation do nurses have under the ethical principle of nonmaleficence?

Avoiding actions that cause harm Signup and view all the answers

Which step of the ethical decision-making process involves identifying the ethical issues at stake?

Defining the dilemma Signup and view all the answers

What is the primary goal of the Code of Ethics for nursing professionals?

To outline rules and obligations for ethical practice Signup and view all the answers

What is the primary purpose of the Emergency Medical Treatment and Labor Act (EMTALA)?

To ensure all clients have a medical screening evaluation. Signup and view all the answers

What principle should nurses follow regarding social media use?

Maintain the confidentiality of client interactions. Signup and view all the answers

What does informed consent require from the healthcare provider before a procedure?

Details about the procedure, risks, benefits, and alternatives. Signup and view all the answers

What is implied consent?

Consent inferred from a client’s actions. Signup and view all the answers

Which type of law pertains to compensating victims for harm caused by negligence?

Tort law Signup and view all the answers

Good Samaritan laws provide what type of protection?

Protection for well-intentioned emergency care. Signup and view all the answers

What is a key element of advance directives?

They can specify wishes for medical treatment. Signup and view all the answers

What is required to establish criminal liability for a nurse?

Demonstrating intent to harm or an error that causes harm. Signup and view all the answers

What is the ethical concern surrounding genetic testing?

Client autonomy and understanding of testing implications. Signup and view all the answers

Which of the following constitutes a violation of HIPAA regulations?

Sharing client information on a personal social media account. Signup and view all the answers

What type of reporting is mandated for maltreatment and dangerous diseases?

Mandatory reporting Signup and view all the answers

What does 'just culture' in nursing emphasize?

Accountability and correction rather than punishment. Signup and view all the answers

What is the responsibility of nurses regarding a client’s advance directive?

Explain the directive's meaning and importance. Signup and view all the answers

What is the main consequence of having a high client to nurse staff ratio?

Increased mortality rates Signup and view all the answers

Which of the following is a necessary action when delegating tasks as a nurse?

Knowing the limits of the state's Nurse Practice Act Signup and view all the answers

What constitutes a breach of nursing practice?

Falsifying health records Signup and view all the answers

Which of the following is NOT a recommended strategy to reduce nurse fatigue?

Encourage long shifts without breaks Signup and view all the answers

What is the main legal requirement for maintaining client confidentiality?

HIPAA regulations Signup and view all the answers

What effect does nurse fatigue have on client care?

Increases the risk of medication errors Signup and view all the answers

Which of the following behaviors could indicate substance use disorder in a nurse?

Prolonged and frequent trips to the restroom Signup and view all the answers

What is a consequence of breaching client confidentiality?

Civil penalties and disciplinary action Signup and view all the answers

Which standard describes the competent level of care expected from a registered nurse?

Standards of Nursing Practice Signup and view all the answers

What practice is crucial to avoid falsification of health records?

Providing honest and complete documentation Signup and view all the answers

Study Notes

Code of Ethics

Developed by the ANA
Outlines rules, ideals, duties, and obligations for nursing professionals
Has 9 provisions
- Provide compassionate care and respect each client
- Recognize each client and treat with dignity
- Advocate for client rights and needs
- Promote and protect client health and safety

6 Ethical Principles

Autonomy:
- Respect clients' right to make decisions
- Right to refuse care
Beneficence:
- Do good and minimize harm
- Examples: fall precautions, additional care/support
Nonmaleficence:
- Do no harm
- Examples: avoid giving meds to which client is allergic
Veracity:
- Tell the truth; provide accurate information to client
- Disclose errors to client and provider
Fidelity:
- Keep promises
- Follow through with promises

Values

Define what is important
Guide behaviors and responses toward others
Examples: altruism, human dignity, integrity, autonomy, social justice

Ethical Decision Making

Process of evaluating and choosing options ethically
Ethical Dilemma: situation with no clear right or wrong solution
8 steps for ethical decision-making:
- Is there an ethical dilemma?
- Identify the ethical dilemma
- Identify possible solutions
- Apply ethical principles to solutions
- Include all relevant individuals and factors
- Decide on a solution
- Review the decision
- Put decision into action and evaluate

Ethical Issues in Healthcare

Allocation of scarce resources
Late termination of pregnancy
Medically assisted death
Termination of care
Treating clients in prison
EMTALA (Emergency Medical Treatment and Labor Act):
- Clients cannot be turned away from the ED due to insurance or financial status
- All clients must have a medical screening evaluation
- Must stabilize if needed
- Transfer when needed
HIPAA (Health Insurance Portability and Accountability Act):
- Protects client insurance coverage and private information
- Only client and individuals involved in direct care should have access to information

Maintain professional boundaries when communicating with clients.
Separate personal and professional information.
Use privacy settings.
Advocate for client rights.

Genetic Testing

Examine client DNA to identify genetic markers
Used to identify hereditary diseases
Can be done prenatally
Genetic Information Nondiscrimination Act (GINA): protects clients from discrimination based on genetic information
Respect client autonomy and right to test

Legal Standard

Evidence presented must convince a reasonable person of defendant's guilt.

Criminal Law

Deals with illegal actions and punishments.
Prove intent or error that led to harm.

Civil Law

Deals with disputes between individuals or organizations
Victim can be awarded compensation

Tort Law

Type of civil law dealing with compensating victims of harm
Unintentional Torts: Ex: negligence, malpractice causing harm
Intentional Torts: Ex: assault, battery, defamation

How to Protect from Civil and Criminal Action

Put client first
Follow rules, guidelines, policy, and procedures
Be knowledgeable about the nurse practice act
Review employer's protection

Formal written permission to provide care
Required for invasive procedures (surgery)
Client must be competent to make a voluntary decision

Procedure/treatment name
Who will perform the procedure
Procedure purpose
Procedure description
Expected outcomes
Benefits/risks/alternatives
Client's right to refuse and consequences

Agreement by the client through actions
Client has right to withdraw implied consent

Advance Directive

Legal documents of a person's wishes regarding medical treatment
- Living Will: describes treatment preferences for when incapacitated
- Durable Power of Attorney: designates another person to make decisions if incapacitated

Nurse Role for Advance Directives

Explain what an advance directive is and why documentation is important.
Provide clients opportunity to discuss advance directives with family.

Good Samaritan Laws

Protect people providing aid in emergencies

Whistleblowing

Formal reporting on illegal, unethical or wrongdoing practices.
Federal and state guidelines exist for protection.

Mandatory Reporting

Reporting physical, neglect, verbal, sexual, financial, or educational maltreatment.
Report concerns for protecting client health and well-being.

"Just Culture"

Acknowledges possibility of mistakes and focuses on correction rather than punishment

Breach of Nursing Practice

Failure to maintain acceptable standard of care.
Breaches in client confidentiality.
Falsification of health records.

Standards of Nursing Practice

Explain standards and scope of practice.
Focus on a competent level of care.
Include Professional Performance standards, communication, and collaboration.
Align with scope and standards of practice

Lack of Confidentiality

Not only ethically bound but also legally obligated to maintain client privacy (HIPAA).
Consequences for violations can include disciplinary action

Falsification of Health Records

Documentation must be accurate and truthful.
Misleading/inaccurate/incomplete/failure to document.

Nurse Fatigue

Physical and psychological exhaustion affecting nursing practice
Negative effects on nurses and clients
- Increased risk of errors
- Decreased clinical judgment
- Increased client mortality

Substance Use Disorder Among Nurses

Impaired nurses pose danger to themselves and clients as care diminishes
Errors occur
Nurses have easy access to controlled substances
Encouraged to report use suspicion
Changes in job performance (frequent trips to restroom)
Negative effects on the client.

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Description

This quiz explores the American Nurses Association's Code of Ethics, which includes essential rules, ideals, and obligations for nursing professionals. It highlights six key ethical principles and valuable values to guide nursing practice, emphasizing the importance of compassion, respect, and integrity in patient care.