Nursing Code of Ethics and Principles

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

Social Media & Confidentiality

• 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

Informed Consent

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

Information Provider Must Give to Client Before Consent

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

Implied Consent

• 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.

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.