Nursing History and Ethics

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Questions and Answers

What did Florence Nightingale view nursing as?

A career path that required minimal education

A job that demanded theoretical knowledge

A profession that required specialized skills

A call to service (correct)

What is considered nursing's first code of ethics?

The Nightingale Pledge (correct)

The Code for Professional Nurses

The CCHN Standards

The Code of Ethics for Registered Nurses

What is the main difference between morals and values?

Morals are unwritten, while values are written rules

Morals are absolute, while values are relative

Morals are societal, while values are personal (correct)

Morals are personal, while values are societal

What organization developed the first known international code of ethics for nursing in 1954?

International Council of Nurses (ICN) Signup and view all the answers

What is the current code of ethics for nursing that was updated in 2017?

The Code of Ethics for Registered Nurses Signup and view all the answers

What is the name of the standards that CHNs also apply, updated in 2019?

The CCHN Standards Signup and view all the answers

What is a key aspect of advocacy in the CNA code of ethics?

Respecting informed decision-making Signup and view all the answers

According to Cristoffel's Conceptual Framework for Advocacy, what is the second stage?

Strategy Stage Signup and view all the answers

What is the primary principle of the Harm Principle?

To prevent harm to others Signup and view all the answers

What is the core belief of Animism?

Life exists in all objects and spirits Signup and view all the answers

What is the focus of Indigenous healing philosophy?

Restoring balance Signup and view all the answers

What is the focus of communitarian theories in ethics?

History, tradition, and moral communities Signup and view all the answers

What is the name given to the petroglyphs by the First Nations people of Ontario?

The Rocks that Teach Signup and view all the answers

What is the term used to refer to the First Nations, Inuit, and Métis Peoples in Canada?

Indigenous Signup and view all the answers

Which ethical theory is based on feminist theory and emphasizes the morality of responsibility in relationships?

The ethic of care Signup and view all the answers

What is the main goal of distributive justice?

Allocating benefits and burdens based on need Signup and view all the answers

What is the primary reason the petroglyph site is considered sacred?

Because of the rock site itself Signup and view all the answers

What is the purpose of the CNA code of ethics?

To provide guidance for ethical relationships and decision-making Signup and view all the answers

According to the Practical Framework for Advocacy, what should one do when acting in the patient's best interests?

Act in accordance with the patient's wishes and instructions Signup and view all the answers

What is the principle that recognizes that a variety of means exist to achieve public health needs?

Principle of Least Restrictive Means Signup and view all the answers

What is an important ethical obligation that nurses face?

Maintaining confidentiality Signup and view all the answers

What is advocacy in community health nursing?

Applying information and resources to effect systemic changes Signup and view all the answers

Who can be an advocate?

Everyone Signup and view all the answers

What is the emphasis of virtue ethics?

Practical reasoning applied to character development Signup and view all the answers

What is the goal of egalitarian distributive justice?

Ensuring equal rights and treatment for all Signup and view all the answers

What is the purpose of accountability in nursing practice?

To take ownership of one's actions Signup and view all the answers

What is the term used to acknowledge the rights of Indigenous Peoples in the Constitution Act?

Aboriginal Signup and view all the answers

What is the preferred way to identify Indigenous Peoples in Canada?

Through their specific and preferred ways of being identified Signup and view all the answers

Which Indigenous cultural group is originating from the Northwest Territories and Nunavut?

Inuit Signup and view all the answers

What is the definition of a Métis person?

A person who self-identifies as Métis Signup and view all the answers

What percentage of the Canadian population is Indigenous?

4.9% Signup and view all the answers

What is the largest group of Indigenous Peoples in Canada?

First Nations Signup and view all the answers

What was the estimated population of Indigenous people before European contact?

500,000 Signup and view all the answers

What was the result of European contact on the Indigenous population?

The population decreased to 102,000 Signup and view all the answers

What is the primary purpose of a nursing code of ethics?

To clarify the values and guidelines of ethical conduct in nursing practice Signup and view all the answers

What is the main focus of ethical decision making?

The process of how ethical decisions are made Signup and view all the answers

What is the purpose of the Oberle and Raffin ethical reflection model?

To guide nurses in making ethically sound decisions Signup and view all the answers

What is the principle of veracity in nursing practice?

Telling the truth and being honest with patients Signup and view all the answers

What is the primary focus of consequentialism?

The outcomes or consequences of the action Signup and view all the answers

What is the principle of distributive justice in healthcare?

Distributing benefits and burdens fairly within society Signup and view all the answers

What is the primary focus of principlism?

The specific obligations of healthcare professionals Signup and view all the answers

What is communitarianism in ethics?

A rejection of abstract, universal moral principles Signup and view all the answers

What is the principle of nonmaleficence in healthcare?

To do no harm or evil Signup and view all the answers

What is the primary focus of social justice in healthcare?

Distributing benefits and burdens fairly within society Signup and view all the answers

What is the primary focus of family health promotion?

Holistic focus including biological, psychological, sociological, cultural, and spiritual factors Signup and view all the answers

Which characteristic is common in healthy families?

Teaching respect for others Signup and view all the answers

How do determinants of health impact the family?

All of the above Signup and view all the answers

What is essential for effective family communication?

Listening to all family members Signup and view all the answers

Why is family affirmation important?

To support and validate all family members Signup and view all the answers

What was one of the main goals of the Indian Act, first enacted in 1876?

To appropriate Aboriginal lands and assimilate Aboriginal people Signup and view all the answers

What was the impact of the Constitution Act of 1876 on First Nations communities?

It removed them from their homeland to reserve lands Signup and view all the answers

What is one of the persistent and ongoing effects of colonization on Indigenous peoples?

Dislocation from traditional lands and lifestyles Signup and view all the answers

What was the purpose of the residential school system?

To assimilate Indigenous children into European culture Signup and view all the answers

How many residential schools were identified within the Indian Residential School Settlement Agreement (IRS)?

139 Signup and view all the answers

What was the estimated number of Indian children who attended residential schools?

150,000 Signup and view all the answers

Who became responsible for the health, education, and social services of First Nations and Inuit people in 1939?

The Canadian federal government Signup and view all the answers

What is a service offered to Indigenous peoples under Non-Insured Health Benefits (NIHB)?

All of the above Signup and view all the answers

What is a characteristic of primary health care services offered to Indigenous peoples in isolated and remote communities?

They usually include emergency care Signup and view all the answers

How does the health status of Indigenous peoples in Canada compare to that of the general Canadian population?

It is worse Signup and view all the answers

What is vulnerability defined as in the context of vulnerable populations?

Susceptibility to negative events and poor health due to socioenvironmental factors Signup and view all the answers

What is a common characteristic of vulnerable populations?

They experience multiple cumulative risks and are particularly sensitive to them Signup and view all the answers

What is resiliency defined as?

The ability to successfully cope with a threat of hardship or adversity Signup and view all the answers

What is absolute poverty?

A measure of poverty based on insufficient financial resources to meet basic living expenses Signup and view all the answers

What is a consequence of poverty on health?

Higher rates of chronic diseases and conditions Signup and view all the answers

What is a barrier to accessing healthcare for the poor?

Geographic location Signup and view all the answers

What is a characteristic of the homeless population?

Homelessness is often transient or episodic Signup and view all the answers

What is a type of poverty?

All of the above Signup and view all the answers

What is a negative effect of poverty on women?

They make up a greater part of the country's poor Signup and view all the answers

What is a potential solution to poverty?

Basic Income Guarantee (BIG) Signup and view all the answers

Approximately how many individuals are estimated to be homeless in Canada?

150,000 to 300,000 Signup and view all the answers

What type of homelessness refers to people living on the streets or in parks?

Absolute homelessness Signup and view all the answers

What is a risk factor for becoming homeless?

Having a low income Signup and view all the answers

What health concern is common among homeless individuals?

Tuberculosis Signup and view all the answers

What is the role of a community health nurse (CHN) when working with vulnerable clients?

To create a trusting environment and show respect and concern Signup and view all the answers

What type of preventive service involves providing affordable housing and job-training programs?

Primary prevention Signup and view all the answers

What is the goal of tertiary prevention?

To restore and enhance functioning Signup and view all the answers

Why is it difficult to determine the exact number of homeless individuals in Canada?

Because census data are collected through enumeration of people who have addresses Signup and view all the answers

What is a characteristic of hidden homelessness?

Sleeping in vehicles or couch surfing Signup and view all the answers

What is the role of Cathy Crowe, a nurse in Toronto?

Advocating for homeless individuals Signup and view all the answers

What is a possible reason for the increased vulnerability of Indigenous populations to chronic and infectious diseases?

Low socioeconomic status Signup and view all the answers

What is the estimated difference in life expectancy between Indigenous peoples and the rest of the Canadian population?

5-14 years Signup and view all the answers

What was the purpose of residential schools in Canada?

To assimilate and colonize Aboriginal people Signup and view all the answers

What is the term for the treatment of individuals or groups as outside, as insignificant or peripheral?

Marginalization Signup and view all the answers

What is the term for the differences in health that could be avoided if reasonable action were taken?

Health inequities Signup and view all the answers

What is an example of an intermediate determinant of health for Indigenous populations?

Education systems Signup and view all the answers

What is the term for the intergenerational grief resulting from historical abuses?

Intergenerational trauma Signup and view all the answers

What is an example of a proximal determinant of health for Indigenous populations?

Health behaviors Signup and view all the answers

What is the term for the differences in health services and in health status among certain population groups?

Health disparities Signup and view all the answers

What is an example of a group that is considered vulnerable in Canada?

All of the above Signup and view all the answers

Study Notes

History of Nursing and Ethics

Florence Nightingale saw nursing as a call to service and believed that nurses should be people of good character, giving enduring morals and values to the profession of nursing.

Code of Ethics

1893: The Nightingale Pledge was considered nursing's first code of ethics.
1950: The Code for Professional Nurses was adopted by the American Nurses Association (ANA) and revised five times.
1954: The first known international code of ethics for nursing was developed by the International Council of Nurses (ICN), adopted in Canada.
1980: The Canadian Nurses Association (CNA) Code of Ethics was developed, revised, and updated three times by 2002, and finally entitled Code of Ethics for Registered Nurses.

Nursing Ethics

Morals: Shared and generational societal norms about what constitutes right or wrong conduct.
Values: Standards or qualities that are esteemed, desired, considered important, or have worth or merit (e.g., competent, compassionate care).

Ethical Decision Making

Ethical decision making: The process of how ethical decisions are made.
Ethical issues: Moral challenges facing the nursing profession.
Ethical dilemmas: Puzzling moral problems in which morally justified reasons for both taking and not taking a certain course of action are envisioned.
Ethical decision-making framework: Uses problem-solving processes to guide ethically sound decisions.

Theories of Ethics

Consequentialism: Decision-based on outcomes or consequences.
Utilitarianism: A well-known consequentialist theory that appeals exclusively to outcomes or consequences in determining which choice to make.
Deontology: Based on the premise that persons should always be treated as ends in themselves and never as mere means to the ends of others.
Principism: Healthcare professionals have specific obligations that exist because of the practices and goals of the profession.
The 4 Ethical Principles:
- Respect for Autonomy: Based on human dignity and respect for all.
- Nonmaleficence: "Do no harm" or "do no evil."
- Beneficence: "To do good" or an obligation to care for others.
- Distributive Justice: Fair distribution of benefits and burdens within a society based on needs and contributions.

Communitarian Theories

Virtue Ethics: Focuses on practical reasoning applied to character development.
Caring and the Ethic of Care: Based on feminist theory, emphasizes a belief in the morality of responsibility in relationships.
Feminist Ethics: Supports critical thinking and focuses on issues such as gender, power, and socioeconomic status.

Advocacy

Definition: The application of information and resources to effect systemic changes that shape the way people in a community live.
For Community Health Nursing: Advocacy is intended to benefit aggregates, e.g., to reduce death or disability in groups of people.
For Public Health Nursing: Advocacy is intended to benefit aggregates, e.g., to reduce the occurrence or severity of public health problems.

Indigenous Peoples of Canada

Animism: The belief that life exists in all objects, from rocks and trees to lakes and mountains, or inanimate objects and spirits of the dead.
Indigenous Views of Health: Sickness is seen as immoral, reckless, and/or offensive behavior.
Petroglyphs Provincial Park: Sacred site for Indigenous peoples, featuring ancient rock carvings.

Historical Context of Indigenous Peoples

The term Indigenous refers to the First Nations, Inuit, and Métis Peoples in Canada.
First Peoples is another collective term used to refer to the original inhabitants of Canada.
The Indian Act: First enacted in 1876, still current in Canadian law, reflecting government policies of assimilation of Aboriginal people in Canada and appropriation of Aboriginal lands.

Impacts of Colonization

Persistent and ongoing effects of colonization include:
- Dislocation from traditional lands and lifestyles.
- Policies of cultural or linguistic suppression and forced assimilation.
- Industrial processes degradation of traditional lands.
- The impacts of interpersonal and institutional racism.

Health Status of Aboriginal Peoples

Health status of Indigenous people in Canada falls below that of the general Canadian population.
Indigenous people have higher rates of chronic and infectious diseases.
Possible reasons for increased vulnerability of Indigenous population:
- Biological susceptibility.
- Rural and remote lifestyle.
- Health practices.
- Low socioeconomic status that limits access to social determinants of health.
- Lack of culturally appropriate health education programs.### Historical Abuses and Intergenerational Grief
The "Sixties Scoop" (1960s-1980s) involved taking children from Indigenous families and placing them in non-Indigenous families, leading to intergenerational grief and affecting mental, physical, emotional, and spiritual well-being.

Indigenous Determinants of Health

Proximal determinants: health behaviors, physical environments, employment, income, social status, education, and food security.
Intermediate determinants: health care systems, education systems, community infrastructure and resources, environmental stewardship, and cultural continuity.
Distal determinants: colonialism, racism, social exclusion, and repression of self-determination.

Truth and Reconciliation

The federal government officially apologized to Aboriginal peoples for their role in establishing and maintaining residential schools.

Aboriginal Resilience

Despite the disruption of family and culture, there is evidence of resilience in extended family kinship systems and transmission of language and culture.

Vulnerable Populations

Definition: susceptibility to negative events, specific at-risk populations more susceptible to poor health due to socioenvironmental factors.
Characteristics: often experience multiple cumulative risks, underserved and disadvantaged, fewer resources for promoting health and treating illness.
Examples: one-parent families, people with disabilities, children, visible minorities, Indigenous persons, those with lower socioeconomic status, and older adults.

Health Disparities and Inequities

Health disparities: wide variations in health services and health status among certain population groups.
Health inequities: differences in health that could be avoided if reasonable action were taken, considered unfair and socially unjust.

Marginalization and Vulnerability

Marginalization: treatment of individuals or groups as outside, insignificant, or peripheral.
Marginality: outside of mainstream discourse.
Sources of marginality: gender, physical fitness, social status/class/income, ethnicity, skin color, religion, marital status, language, age, and education/career.

Resilience and Vulnerability

Definition: ability to cope with threats of hardship or adversity.
Support needs to be provided to those with decreased resilience to enhance coping skills and provide a greater sense of personal autonomy.

Poverty

Definition: insufficient financial resources to meet basic living expenses.
Approaches: absolute poverty, relative poverty, subjective poverty.
Types: crisis poverty (temporary), persistent poverty (chronic).
Poverty is a major factor in health inequality: chronic conditions, infant morbidity and mortality, shorter life expectancies, and more complex health problems.

Homelessness

Definition: lack of permanent housing, estimated 150,000 to 300,000 individuals in Canada.
Types: absolute homelessness, sheltered homelessness, hidden homelessness.
Risk factors: lack of affordable housing, poverty, mental health issues, substance abuse, unemployment, immigration, violence, and being an ex-offender.

Health Concerns and Homelessness

Increased risk for: substance abuse, mental illness, HIV/AIDS, tuberculosis, sexually transmitted infections, unplanned pregnancies, seizures, chronic obstructive pulmonary disease, musculoskeletal disorders, skin and foot problems, and malnutrition.

Nursing and Vulnerable Populations

Community health nurses (CHNs) need to be aware of the unique needs of vulnerable clients at every age.
Assessment should include: living environment, neighborhood surroundings, perceptions of socioeconomic resources, congenital and genetic predisposition to illness, preventive health needs, and stress.
CHNs should create a trusting environment, show respect, compassion, and concern, and coordinate services and providers.

Primary, Secondary, and Tertiary Prevention

Primary prevention: affordable housing, housing subsidies, effective job-training programs, employer incentives, preventive health care services, safer-sex education, and birth control services.
Secondary prevention: early diagnosis, prompt treatment, and limitation of disability.
Tertiary prevention: restoring and enhancing functioning, promoting psychosocial rehabilitation programs.

Family Health

Definition: the health of a family system that is ever-changing and encompasses a holistic focus including biological, psychological, sociological, cultural, and spiritual factors.
Characteristics of healthy families: good communication, affirmation and support, respect for others, and valuing teaching respect.

Indigenous Determinants of Health and Family

The determinants of health impact the family, and family health is influenced by colonialism, racism, social exclusion, and repression of self-determination.

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Description

This quiz covers the history of nursing, focusing on Florence Nightingale's contributions and the development of codes of ethics in the nursing profession.

Nursing History and Ethics

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Questions and Answers

What did Florence Nightingale view nursing as?

What is considered nursing's first code of ethics?

What is the main difference between morals and values?

What organization developed the first known international code of ethics for nursing in 1954?

What is the current code of ethics for nursing that was updated in 2017?

What is the name of the standards that CHNs also apply, updated in 2019?

What is a key aspect of advocacy in the CNA code of ethics?

According to Cristoffel's Conceptual Framework for Advocacy, what is the second stage?

What is the primary principle of the Harm Principle?

What is the core belief of Animism?

What is the focus of Indigenous healing philosophy?

What is the focus of communitarian theories in ethics?

What is the name given to the petroglyphs by the First Nations people of Ontario?

What is the term used to refer to the First Nations, Inuit, and Métis Peoples in Canada?

Which ethical theory is based on feminist theory and emphasizes the morality of responsibility in relationships?

What is the main goal of distributive justice?

What is the primary reason the petroglyph site is considered sacred?

What is the purpose of the CNA code of ethics?

According to the Practical Framework for Advocacy, what should one do when acting in the patient's best interests?

What is the principle that recognizes that a variety of means exist to achieve public health needs?

What is an important ethical obligation that nurses face?

What is advocacy in community health nursing?

Who can be an advocate?

What is the emphasis of virtue ethics?

What is the goal of egalitarian distributive justice?

What is the purpose of accountability in nursing practice?

What is the term used to acknowledge the rights of Indigenous Peoples in the Constitution Act?

What is the preferred way to identify Indigenous Peoples in Canada?

Which Indigenous cultural group is originating from the Northwest Territories and Nunavut?

What is the definition of a Métis person?

What percentage of the Canadian population is Indigenous?

What is the largest group of Indigenous Peoples in Canada?

What was the estimated population of Indigenous people before European contact?

What was the result of European contact on the Indigenous population?

What is the primary purpose of a nursing code of ethics?

What is the main focus of ethical decision making?

What is the purpose of the Oberle and Raffin ethical reflection model?

What is the principle of veracity in nursing practice?

What is the primary focus of consequentialism?

What is the principle of distributive justice in healthcare?

What is the primary focus of principlism?

What is communitarianism in ethics?

What is the principle of nonmaleficence in healthcare?

What is the primary focus of social justice in healthcare?

What is the primary focus of family health promotion?

Which characteristic is common in healthy families?

How do determinants of health impact the family?

What is essential for effective family communication?

Why is family affirmation important?

What was one of the main goals of the Indian Act, first enacted in 1876?

What was the impact of the Constitution Act of 1876 on First Nations communities?

What is one of the persistent and ongoing effects of colonization on Indigenous peoples?

What was the purpose of the residential school system?

How many residential schools were identified within the Indian Residential School Settlement Agreement (IRS)?

What was the estimated number of Indian children who attended residential schools?

Who became responsible for the health, education, and social services of First Nations and Inuit people in 1939?

What is a service offered to Indigenous peoples under Non-Insured Health Benefits (NIHB)?

What is a characteristic of primary health care services offered to Indigenous peoples in isolated and remote communities?

How does the health status of Indigenous peoples in Canada compare to that of the general Canadian population?

What is vulnerability defined as in the context of vulnerable populations?

What is a common characteristic of vulnerable populations?

What is resiliency defined as?

What is absolute poverty?

What is a consequence of poverty on health?

What is a barrier to accessing healthcare for the poor?

What is a characteristic of the homeless population?

What is a type of poverty?

What is a negative effect of poverty on women?

What is a potential solution to poverty?

Approximately how many individuals are estimated to be homeless in Canada?

What type of homelessness refers to people living on the streets or in parks?

What is a risk factor for becoming homeless?

What health concern is common among homeless individuals?

What is the role of a community health nurse (CHN) when working with vulnerable clients?

What type of preventive service involves providing affordable housing and job-training programs?

What is the goal of tertiary prevention?