Nursing Ethics: Principles & Professional Values
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Questions and Answers

A client with limited financial resources presents to the emergency department in severe pain. According to the Emergency Medical Treatment and Labor Act (EMTALA), what is the hospital's initial obligation?

  • To inquire about the client's insurance status before providing any medical care.
  • To conduct a medical screening evaluation (MSE) to determine if an emergency medical condition exists. (correct)
  • To transfer the client to a public hospital, as they have limited financial resources.
  • To provide pain medication immediately, regardless of their ability to pay.

A nurse discovers that they made a medication error that could potentially harm a patient. Following ethical principles, what should the nurse do first?

  • Administer an antidote, if available, and then report the error discreetly.
  • Document the error in the patient's chart but wait to see if any adverse effects occur.
  • Immediately report the error to the nursing supervisor and the healthcare provider. (correct)
  • Consult with a colleague to determine the best course of action without informing the patient.

A patient refuses a life-saving blood transfusion due to religious beliefs. Which ethical principle is most applicable in guiding the nurse's actions?

  • Autonomy (correct)
  • Fidelity
  • Beneficence
  • Justice

During an ethical decision-making process, after identifying the ethical dilemma, what is the next critical step a nurse should take?

<p>Identify possible solutions and their potential consequences. (C)</p> Signup and view all the answers

A nurse promises a patient that they will return in 10 minutes to administer pain medication, but gets delayed assisting another patient with an emergency. The nurse does not return for 45 minutes. Which ethical principle did the nurse most likely violate?

<p>Fidelity (D)</p> Signup and view all the answers

A hospital is faced with a shortage of ventilators during a pandemic. Which ethical principle should guide the decision-making process regarding how to allocate these limited resources?

<p>Justice (A)</p> Signup and view all the answers

A nurse observes a colleague stealing medication from the medication room. According to the five professional values of nursing, which value should most strongly motivate the nurse to report this behavior?

<p>Integrity (A)</p> Signup and view all the answers

A client has a right to quality healthcare regardless of race, religion, sex, or gender is the concept of:

<p>Social justice (C)</p> Signup and view all the answers

A client arrives in the emergency department (ED) needing stabilization but requires transfer to another facility. According to regulations, what must be verified before the transfer?

<p>A physician or qualified medical professional has signed off on the transfer, indicating the benefits outweigh the risks. (C)</p> Signup and view all the answers

Which of the following actions by a healthcare provider would be considered a violation of informed consent principles?

<p>Failing to disclose alternative treatments or procedures available to the client, leading to a treatment decision. (A)</p> Signup and view all the answers

A client with a terminal illness has a Living Will and a Durable Power of Attorney for healthcare. If there is a conflict between the two, which document generally takes precedence?

<p>The Durable Power of Attorney for healthcare, as the designated agent can make real-time decisions. (C)</p> Signup and view all the answers

A nurse witnesses another nurse diverting narcotics for personal use. According to ethical and legal guidelines, what is the most appropriate initial action for the witnessing nurse?

<p>Report the incident to the appropriate supervisor or authority within the healthcare organization. (C)</p> Signup and view all the answers

A public health nurse is tracking the incidence of infectious diseases in the community. Which of the following diseases are required to be reported to public health authorities?

<p>HIV, Tuberculosis (TB), and Measles (A)</p> Signup and view all the answers

In a 'Just Culture' environment, a medication error occurs due to a system flaw. What approach would management MOST likely take?

<p>Investigate the system factors contributing to the error and implement changes to prevent recurrence. (A)</p> Signup and view all the answers

A registered nurse (RN) is delegating tasks to a licensed practical nurse (LPN). Which of the following represents the MOST important consideration when determining 'Right Circumstance'?

<p>Verifying the client's condition is stable and predictable, aligning with the LPN's scope of practice. (C)</p> Signup and view all the answers

A client is admitted to the emergency department after being found unconscious in a public park. The client has no identification, advanced directives, or known contacts. Which type of consent applies to the immediate, life-saving treatment the healthcare team provides?

<p>Implied Consent (C)</p> Signup and view all the answers

Flashcards

Code of Ethics

Duties and obligations a nurse is expected to uphold, guided by NALPN's nursing practice standards.

Autonomy (Ethical Principle)

Respecting a client's right to make their own healthcare decisions, including refusing care.

Beneficence

Doing good and acting in the best interest of the client by providing beneficial care.

Nonmaleficence

To do no harm. Avoid actions that could potentially hurt the client.

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Veracity

Providing truth and accurate information to clients.

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Fidelity

Keeping promises and commitments to clients.

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Justice

Providing impartial, fair, and equitable care to all clients.

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EMTLA

Ensures equal access to emergency care regardless of insurance/financial status. Requires medical screening and stabilization.

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Informed Consent

Formal permission granted with knowledge of possible consequences and alternatives.

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Implied Consent

Agreement to care shown by a client's actions, not formal consent.

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Advanced Directives

Legal documents outlining healthcare decisions.

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Good Samaritan Laws

Protects those who provide aid in emergencies.

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Whistleblowing

Reporting an organization's wrongdoing.

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Just Culture

Model of shared accountability and mindfulness.

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Types of Maltreatment

Physical, neglect, verbal/emotional, sexual, financial exploitation, educational maltreatment/neglect and lack of protection from harm.

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5 Rights of Delegation

Right task, circumstance, person, directions, and supervision.

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Study Notes

  • Nurses are expected to uphold the code of ethics, which includes their duties and obligations
  • PNs must adhere to the ideals, values, duties, and obligations outlined in the nursing practice standards set by the NALPN

Ethical Principles:

  • Autonomy requires nurses to respect clients' rights to make their own healthcare decisions, including refusing care
  • Beneficence means doing good and acting in the client's best interest by providing beneficial care
  • Nonmaleficence means to do no harm
  • Veracity means providing truthful and accurate information
  • Fidelity means keeping promises and commitments
  • Justice means providing impartial, fair, and equitable care to all clients

Five Professional Values of Nursing:

  • Altruism involves taking action to benefit someone else
  • Human dignity affirms that each individual has value, regardless of race, religion, sex, or gender and should be treated with respect
  • Integrity is defined as honesty and strong moral principles.
  • Social justice affirms every person's right to quality healthcare.

Ethical Decision Making:

  • First, assess if there is an ethical dilemma
  • Clearly identify the ethical dilemma, including who is affected
  • Identify possible solutions
  • Apply ethical principles to solutions
  • Include all relevant individuals and factors
  • Decide on a solution
  • Review the decision
  • Put the decision into action

Emergency Medical Treatment and Labor Act (EMTLA):

  • EMTLA ensures that everyone, regardless of insurance or financial status, has equal access to emergency medical care
  • All clients must have a medical screening evaluation (MSE)
  • If a hospital can't provide the necessary care, they must transfer the stabilized client to a facility that can
  • If the client can't be stabilized, a qualified medical professional must verify and sign off on the transfer, confirming that the benefits outweigh the risks
  • HIPAA relates to patient privacy and confidentiality
  • There are two key unintentional torts: negligence and malpractice
  • Informed consent is formal permission granted with the knowledge of possible outcomes and alternatives
    • This includes informing the patient of the proposed treatment or procedure
    • Who will do the procedure
    • What the purpose of the treatment is
    • The expected outcomes of the procedure
    • The benefits of the procedure
    • Possible risks associated with the procedure
    • The alternatives to the particular procedure
    • Risks and benefits associated with other alternatives to the proposed treatment
  • Clients have the right to refuse a proposed treatment or procedure
  • The provider is responsible for explaining the risks, benefits, and alternatives to the client; the nurse verifies this information was given
  • Implied consent is agreement to care demonstrated by the client's actions rather than explicit verbal or written consent
  • Advanced directives are legal documents detailing a client's healthcare decisions
    • Includes living wills
    • Durable power of attorney for healthcare
    • Organ donation forms
    • DNR/DNI orders
  • Good Samaritan laws exist to encourage people to provide aid in emergencies without fear of liability for well-intentioned actions
  • Whistleblowing is the act of reporting private information about an organization's wrongdoing or illegal activity

Nurses are required to report:

  • Physical maltreatment
  • Neglect
  • Verbal or emotional abuse
  • Sexual abuse
  • Financial exploitation
  • Educational maltreatment or neglect
  • Lack of protection from harm

Nurses are also required to report incidents of the following diseases:

  • Anthrax, Botulism, Chlamydia
  • Foodborne disease outbreak
  • Hepatitis A, B, and C
  • HIV,
  • Influenza,
  • Measles, Rubeola
  • TB
  • Zika virus

Rights of Delegation:

  • The 5 Rights of Delegation include:
    • Right task
    • Right circumstance
    • Right person
    • Right directions
    • Right supervision/evaluation

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Description

Nurses follow a code of ethics with duties and obligations set by the NALPN. Key ethical principles include autonomy, beneficence, nonmaleficence, veracity, fidelity, and justice. Professional values are altruism, human dignity, integrity and social justice.

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