Nursing Ethics and Mohawk College Connection

Week 9: Professional Development I

• Module 9: Nursing Ethics

Land Acknowledgement

• Mohawk College is named after the Mohawk Nation.
• The Mohawk Nation is one of the Six Nations of the Haudenosaunee Confederacy.
• Mohawk College acknowledges the treaties (Between the Lakes Treaty, the Dish with One Spoon Wampum Agreement, and the Upper Canada Treaty Agreement).
• These agreements bind the college to maintaining healthy, reciprocal, and respectful relationships with Indigenous nations.
• The college values the ongoing contributions of Indigenous peoples and communities.

Agenda

• 01: Housekeeping
• 02: Learning Outcomes
• 03: Ethics
• 04: Consent & Confidentiality
• 05: Coming Up
• 06: Questions?

Housekeeping

• Week 9: Housekeeping
• Questions?

Case Scenario Assignment Part B

• Learning Plan (Part B):
• Building on Part A (Reflection submitted Week 5).
• Refer to Canvas for additional instructions.
• Individual Assignment.
• Due prior to start of class next week (Week 10).
• Late submissions will receive deductions.

Part B: Individual Learning Plan

• Reflect on how you might manage a situation, considering your knowledge and skills.
• Identify any knowledge or skill gaps.
• Reflect on scenarios that could harm a patient.
• Identify learning areas of improvement for practice.
• Develop an action plan to address identified areas of practice.
• Learning plans aid in maintaining nurses' competence (annual Quality Assurance requirement - College of Nurses of Ontario).
• Create a Learning plan outline including a learning goal and 3 learning activities with their corresponding timelines.

Part B: Individual Learning Plan- Steps

• Step 1: Assess your knowledge and skills needed to manage a clinical scenario. Identify any gaps you found in your practice.
• Step 2: How does your learning goal align with patient safety principles and current nursing best practices? Cite relevant, reputable and current scholarly sources.
• Step 3: Which Code of Conduct principles from the College of Nurses of Ontario does your learning goal align with? Give 2 examples.
• Step 4: How does your learning goal align with at least 3 entry-level competencies for Registered Practical Nurses?
• Step 5: Create 3 learning activities, outlining how you will complete the activities and your anticipated timeline.

Learning Outcomes

• 1: Discuss ethics as it relates to nursing practice.
• 2: Explore the ethical values and principles set by the College of Nurses of Ontario.
• 3: Use an ethical decision-making framework to examine ethical dilemmas.
• 4: Identify ethical issues in nursing practice.

Ethics

• Small Group Activity:
• Discuss how you define ethics.
• Identify ethical situations.

Understanding Ethics

• Values: Strong personal beliefs & ideals that a person or group believes are important.
• Ethics: The study of what constitutes right and wrong behavior based on an individual's or group's beliefs.
• Ethics: Reflects what matters most to a profession.
• Professional Values: Codes of Ethics are developed by governing bodies for nurses (and other professions).

Nursing & Ethics

• CNA Code of Ethics: A statement of nurses' ethical values and commitments to patients in several practice settings.
• The code guides nurses through practice, education, and policy decision-making.
• Nurses are bound to the code to serve and protect individuals.
• The code provides guidance for ethical relationships, responsibilities, behaviors, and decision-making.
• The code should be used in conjunction with professional standards and best practices.

Ethical Terms

• Responsibility: (Reliability, dependability, the ability to distinguish right from wrong, performing actions adequately and thoroughly).
• Advocacy: Acting on behalf of another.
• Advocacy: Recognizing systems' & societal structures' needs for improvement.
• Advocacy: Advocating for the elimination of social inequities.
• Accountability: Grounded in moral principles (fidelity and respect for others' dignity), being honest, demonstrating practice with integrity, accepting responsibility for one's actions and answers for actions taken.

Principles of Health Care Ethics

• Autonomy: Refers to freedom of decision-making and choice affecting one's life. Nurse's support clients in achieving their own health goals. Clients need to be competent to make rational decisions.
• Beneficence: Promoting the well-being or good of another. Decisions must be made to determine the benefits of treatment versus risks and considering the patient's interests more than the nurse's.
• Nonmaleficence: Avoiding harm or hurt when guiding decisions, especially new or controversial therapies. The actions taken by the nurse should cause the least harm possible.
• Justice: Treating all individuals fairly and equally, regardless of their condition or situation.

Ethics in Healthcare

• Health care teams form professional helping relationships with clients and have developed ethical standards to guide interactions.
• Regulated professions (like nursing) have codes of ethics provided by the governing body (i.e., CNA).

Codes of Ethics

• Codes of ethics relate applicable values to specific scenarios, especially in multidisciplinary teams.
• Provide guidance for decision-making regarding ethical matters.
• Serve as a means for self-evaluation and reflection for nurses in their ethical nursing practice.
• Helps nurses plan out actions and provides supportive rationales for decisions.
• Professional bodies (especially the CNO and CNA).

Canadian Nurses Association

• CNA Ethics in Nursing: https://www.cna-aiic.ca/
• The seven values of ethical responsibility.
  1. Providing safe, compassionate, competent and ethical care
  2. Promoting health and well-being
  3. Honouring dignity
  4. Maintaining privacy and confidentiality
  5. Promoting justice
  6. Being accountable

College of Nurses of Ontario

• CNO standards for ethics are important to nurses.
• Specific client-related values are outlined from a principle-based approach.

Small Group Activity (CNO & Ethics)

• Discuss each ethical value in detail according to CNO.
• Understand the importance of these values in nursing practice.

College of Nurses of Ontario — Ethical Value Sections

• 1. Ethical Well-being
• 2. Client Choice
• 3. Privacy & Confidentiality
• 4. Respect for Life
• 5. Maintaining Commitments to Clients

5. Maintaining Commitments to Oneself

• Nurses' recognition of their values & how they may differ from others' and maintaining their values while providing ethical care.

5. Maintaining Commitments to the Nursing Profession

• Nurses' upholding of standards within the profession. This also involves the promotion and growth of the profession itself.
• Nurses' commitment to regulating nursing and the role it has in protecting quality.
• Nurses' roles in self-regulation, taking responsibility and participating in standards.

5. Maintaining Commitments to Quality Practice Settings

• All nurses must support and promote quality practice settings.
• There are seven keys characteristics of quality settings in professional practice.
  1. Professional development systems
  2. Leadership
  3. Organizational supports
  4. Response systems facilities and equipment
  5. Communication systems
  6. Care delivery processes

6. Truthfulness

• Truthfulness in nursing practice by speaking or acting without intending to deceive.
• Providing complete information to clients.

7. Fairness

• Fairness involves allocating health care resources responsibly, considering health factors.
• The use of Canadian Health Act as a guideline.

Ethical Dilemmas

• Conflict between two sets of values. These principles are important for finding the best course of action for the patient.
• Ethical dilemmas are often challenging, but considering the principles of health care ethics may aid in finding the best course of action.

Resolving Ethical Conflicts

• Working through ethical situations is essential for providing care.
• It is not always possible to find a resolution that satisfies everyone.

Consent & Confidentiality

• Nurses have an ethical and legal obligation to obtain informed consent.
• Consent guidelines are discussed under both the Health Care Consent Act of 1996 and the Substitute Decisions Act of 1992.
• Practice guidelines sometimes do not support legislation, especially related to the mental health and dying acts.

Obtaining Consent

• Nurses are responsible for obtaining informed consent.
• The information shared must include details regarding treatment nature, benefits, risks and side effects, alternative options, and consequences from not undergoing treatment.

Health Care Consent Act (HCCA)

• Promote individual autonomy, enabling clear communication between healthcare practitioners and their clients.
• Consent is an ongoing process.

Substitute Decisions Act (SDA)

• Deals with decision-making about personal care and property, especially regarding those incapable of making decisions.
• Involves the appointment of decision-makers, often using Power of Attorney documents.

Obtaining Consent (Client not Capable)

• Assess client's capacity.
• Provide emergency treatment if needed when crisis admission occurs.
• Inform the client of Substitute Decision-Maker roles and responsibilities.
• Identify and approach a Substitute Decision-Maker.
• Obtain consent from the Substitute Decision-Maker.

Confidentiality

• Nurses have an ethical and legal obligation to maintain confidentiality and privacy of client health information.
• Ontario's privacy legislation (legislation acts like PHIPA or QOCIPA) supports the nurses' responsibility for confidentiality, setting standards, and protecting client health information.

Confidentiality Scenario

• A client with an acquired brain injury is being transferred to a new hospital for continuing care and in an unconscious state.
• The husband is to be informed/involved in the transfer.
• The health care plan must be shared with the new hospital. Insurance information (covering the transfer) needs to be shared with the insurance company.
• Identify the challenges of sharing information with these different parties.

This quiz explores the relationship between the Mohawk Nation and Mohawk College, focusing on the ethical responsibilities of nurses. Key topics include treaties, learning plans, client well-being, and professional responsibilities within nursing. Test your knowledge on these important concepts related to nursing ethics and cultural contexts.