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?

    <p>International Council of Nurses (ICN)</p> Signup and view all the answers

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

    <p>The Code of Ethics for Registered Nurses</p> Signup and view all the answers

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

    <p>The CCHN Standards</p> Signup and view all the answers

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

    <p>Respecting informed decision-making</p> Signup and view all the answers

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

    <p>Strategy Stage</p> Signup and view all the answers

    What is the primary principle of the Harm Principle?

    <p>To prevent harm to others</p> Signup and view all the answers

    What is the core belief of Animism?

    <p>Life exists in all objects and spirits</p> Signup and view all the answers

    What is the focus of Indigenous healing philosophy?

    <p>Restoring balance</p> Signup and view all the answers

    What is the focus of communitarian theories in ethics?

    <p>History, tradition, and moral communities</p> Signup and view all the answers

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

    <p>The Rocks that Teach</p> Signup and view all the answers

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

    <p>Indigenous</p> Signup and view all the answers

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

    <p>The ethic of care</p> Signup and view all the answers

    What is the main goal of distributive justice?

    <p>Allocating benefits and burdens based on need</p> Signup and view all the answers

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

    <p>Because of the rock site itself</p> Signup and view all the answers

    What is the purpose of the CNA code of ethics?

    <p>To provide guidance for ethical relationships and decision-making</p> 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?

    <p>Act in accordance with the patient's wishes and instructions</p> Signup and view all the answers

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

    <p>Principle of Least Restrictive Means</p> Signup and view all the answers

    What is an important ethical obligation that nurses face?

    <p>Maintaining confidentiality</p> Signup and view all the answers

    What is advocacy in community health nursing?

    <p>Applying information and resources to effect systemic changes</p> Signup and view all the answers

    Who can be an advocate?

    <p>Everyone</p> Signup and view all the answers

    What is the emphasis of virtue ethics?

    <p>Practical reasoning applied to character development</p> Signup and view all the answers

    What is the goal of egalitarian distributive justice?

    <p>Ensuring equal rights and treatment for all</p> Signup and view all the answers

    What is the purpose of accountability in nursing practice?

    <p>To take ownership of one's actions</p> Signup and view all the answers

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

    <p>Aboriginal</p> Signup and view all the answers

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

    <p>Through their specific and preferred ways of being identified</p> Signup and view all the answers

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

    <p>Inuit</p> Signup and view all the answers

    What is the definition of a Métis person?

    <p>A person who self-identifies as Métis</p> Signup and view all the answers

    What percentage of the Canadian population is Indigenous?

    <p>4.9%</p> Signup and view all the answers

    What is the largest group of Indigenous Peoples in Canada?

    <p>First Nations</p> Signup and view all the answers

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

    <p>500,000</p> Signup and view all the answers

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

    <p>The population decreased to 102,000</p> Signup and view all the answers

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

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

    What is the main focus of ethical decision making?

    <p>The process of how ethical decisions are made</p> Signup and view all the answers

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

    <p>To guide nurses in making ethically sound decisions</p> Signup and view all the answers

    What is the principle of veracity in nursing practice?

    <p>Telling the truth and being honest with patients</p> Signup and view all the answers

    What is the primary focus of consequentialism?

    <p>The outcomes or consequences of the action</p> Signup and view all the answers

    What is the principle of distributive justice in healthcare?

    <p>Distributing benefits and burdens fairly within society</p> Signup and view all the answers

    What is the primary focus of principlism?

    <p>The specific obligations of healthcare professionals</p> Signup and view all the answers

    What is communitarianism in ethics?

    <p>A rejection of abstract, universal moral principles</p> Signup and view all the answers

    What is the principle of nonmaleficence in healthcare?

    <p>To do no harm or evil</p> Signup and view all the answers

    What is the primary focus of social justice in healthcare?

    <p>Distributing benefits and burdens fairly within society</p> Signup and view all the answers

    What is the primary focus of family health promotion?

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

    Which characteristic is common in healthy families?

    <p>Teaching respect for others</p> Signup and view all the answers

    How do determinants of health impact the family?

    <p>All of the above</p> Signup and view all the answers

    What is essential for effective family communication?

    <p>Listening to all family members</p> Signup and view all the answers

    Why is family affirmation important?

    <p>To support and validate all family members</p> Signup and view all the answers

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

    <p>To appropriate Aboriginal lands and assimilate Aboriginal people</p> Signup and view all the answers

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

    <p>It removed them from their homeland to reserve lands</p> Signup and view all the answers

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

    <p>Dislocation from traditional lands and lifestyles</p> Signup and view all the answers

    What was the purpose of the residential school system?

    <p>To assimilate Indigenous children into European culture</p> Signup and view all the answers

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

    <p>139</p> Signup and view all the answers

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

    <p>150,000</p> Signup and view all the answers

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

    <p>The Canadian federal government</p> Signup and view all the answers

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

    <p>All of the above</p> Signup and view all the answers

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

    <p>They usually include emergency care</p> Signup and view all the answers

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

    <p>It is worse</p> Signup and view all the answers

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

    <p>Susceptibility to negative events and poor health due to socioenvironmental factors</p> Signup and view all the answers

    What is a common characteristic of vulnerable populations?

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

    What is resiliency defined as?

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

    What is absolute poverty?

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

    What is a consequence of poverty on health?

    <p>Higher rates of chronic diseases and conditions</p> Signup and view all the answers

    What is a barrier to accessing healthcare for the poor?

    <p>Geographic location</p> Signup and view all the answers

    What is a characteristic of the homeless population?

    <p>Homelessness is often transient or episodic</p> Signup and view all the answers

    What is a type of poverty?

    <p>All of the above</p> Signup and view all the answers

    What is a negative effect of poverty on women?

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

    What is a potential solution to poverty?

    <p>Basic Income Guarantee (BIG)</p> Signup and view all the answers

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

    <p>150,000 to 300,000</p> Signup and view all the answers

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

    <p>Absolute homelessness</p> Signup and view all the answers

    What is a risk factor for becoming homeless?

    <p>Having a low income</p> Signup and view all the answers

    What health concern is common among homeless individuals?

    <p>Tuberculosis</p> Signup and view all the answers

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

    <p>To create a trusting environment and show respect and concern</p> Signup and view all the answers

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

    <p>Primary prevention</p> Signup and view all the answers

    What is the goal of tertiary prevention?

    <p>To restore and enhance functioning</p> Signup and view all the answers

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

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

    What is a characteristic of hidden homelessness?

    <p>Sleeping in vehicles or couch surfing</p> Signup and view all the answers

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

    <p>Advocating for homeless individuals</p> Signup and view all the answers

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

    <p>Low socioeconomic status</p> Signup and view all the answers

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

    <p>5-14 years</p> Signup and view all the answers

    What was the purpose of residential schools in Canada?

    <p>To assimilate and colonize Aboriginal people</p> Signup and view all the answers

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

    <p>Marginalization</p> Signup and view all the answers

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

    <p>Health inequities</p> Signup and view all the answers

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

    <p>Education systems</p> Signup and view all the answers

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

    <p>Intergenerational trauma</p> Signup and view all the answers

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

    <p>Health behaviors</p> Signup and view all the answers

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

    <p>Health disparities</p> Signup and view all the answers

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

    <p>All of the above</p> 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.

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