Nursing Law and Ethics Quiz

Legal Principles in Nursing

• Laws dictate societal conduct
• Healthcare professionals face civil and criminal liability based on case specifics
• Standards of care outline the legal requirements for nursing, describing acceptable minimum practice.
• The Turkish Nurses Association (TNA) formulates standards for nursing practice, policy statements, etc.
• A tort is a civil wrong against a person or property
• Torts are categorized as intentional, quasi-intentional, and unintentional
• Intentional torts include actions like assault and battery (hitting someone) or defamation (damaging one's reputation).
• Quasi-intentional torts include situations where harm is not intended but someone still committed a wrong (e.g., invasion of privacy).
• Unintentional torts are typically accidental, such as mistakes (e.g., negligence, like giving the wrong medication).

Civil and Common Law Issues in Nursing Practice

• Consent: Signed consent forms are mandatory for routine treatment, hazardous procedures (e.g., surgery), and research.
• Patients sign general consent forms upon hospital admission.
• Separate consent forms are required for specialized procedures.
• Nurses must understand state laws and their institution's policies on consent.
• Informed Consent: A patient's agreement to a procedure after receiving relevant information about it, including risks.
• Without informed consent, a patient can sue for negligence.
• Informed consent only valid in emergency cases.

Civil and Common Law Issues in Nursing Practice: Torts

• Assault: Threat of physical harm to patient (even without actual contact) is considered assault. It is important to ensure that no action is attempted against the patient without their consent.
• Battery: Intentional touching without consent, involving actions that exceed the scope of patient consent. e.g., a surgical procedure performed beyond the consent (e.g., a tonsillectomy instead of an appendectomy).
• Invasion of Privacy (Quasi-Intentional Tort): Release of a patient's medical information to unauthorized persons (e.g., family, employer, news media) is an invasion of privacy. Patient medical information can only be shared with healthcare providers for treatment.

Civil and Common Law Issues in Nursing Practice: Torts

• Negligence (Unintentional Tort): Conduct that falls below a standard of care.
• Examples include failing to stop at a stop sign (in a car) or mistaking a medication.
• Malpractice: One type of negligence. It includes factors like a nurse having a duty to perform, failing to fulfill that duty to the patient, causing patient injury, and the actions to be the cause of the injury.

Civil and Common Law Issues in Nursing Practice: Torts Statistics

• Common causes of medical malpractice claims (2017-2021): diagnosis-related, treatment-related, anesthesia-related or surgery-related issues.

Theoretical Foundations of Nursing

• Theory-Based Nursing Practice: Crucial for designing and implementing nursing interventions.
• Expertise in nursing comes from knowledge and clinical experience.
• Nurses use well-developed theories to guide patient care.
• Nursing theories provide a framework that explains nursing, what nurses do and why.
• They differ from other disciplines (e.g. medicine).
• These theories guide nursing practice at a concrete level.

Purpose of Nursing Theories

• To provide direction for practice, education, and research.
• To guide patient care and problem-solving.
• To offer a basis for reflections and improvements within nursing practice.

History of Nursing Theories

• Early nursing theories (late 1800s) emphasized education.
• Florence Nightingale defined nursing in her Environmental Theory as utilizing a patient's surroundings to facilitate recovery.
• In the 1950s, a consensus emerged that nursing needed to be validated by scientific knowledge.
• Hildegard Peplau's Interpersonal Relations Theory centered on nurse-client relationships.
• Virginia Henderson established the Nursing Need Theory, focusing on patient independence meeting 14 fundamental needs.

Classification of Nursing Theories

• Grand Theories: Broad concepts regarding nursing.
• Middle-range Theories: Address specific phenomena in nursing
• Practice-Level Theories (Micro-range theories): Very specific, daily nursing actions focused on practical steps and daily procedures.

The Nursing Metaparadigm

• This is the "theory of theories" in nursing, offering a means to comprehend the core aspects of nursing.
• These concepts provide boundaries, common viewpoints among the field's members, and a focal point to guide actions.

Thinking about Nursing Practice

• Considering practices of various nurses (like school, emergency, or psychiatric nurses), what is the common thread uniting them?

The Nursing Metaparadigm

• Person: The individual central to nursing care. (Individuals, patients, families, communities are all considered people).
• Environment: Internal and external factors influencing a client. (Internal and external conditions such as families, friends, home, pollution, and the setting for healthcare).
• Health: The degree of wellness or well-being experienced by a patient. (Degree of wellness or well-being).
• Nursing: The actions taken by nurses to support health and recovery. (Actions that nurses take to support health and recovery) Note: these differ based on theory).

The Domain of Nursing

• Nursing is the diagnosis and treatment of human responses to actual or potential health problems.
• Nurses assess patient responses to illnesses and develop relevant diagnoses (e.g., fatigue, activity intolerance, and ineffective coping).

Grand Theories in Nursing

• Scope: Broad concepts.
• Example: Nightingale's Environmental Theory, focusing on environment's role in healing, focusing on fresh air, light, and cleanliness.
• Example: Orem's Self-Care Deficit Theory, emphasizing patient independence and helping fulfill self-care needs.

Middle-Range Nursing Theories

• Scope: Limited scope, focusing on specific phenomena in nursing.
• Example: Benner's Novice-to-Expert Theory details how nurses grow and learn.
• Example: Pender's Health Promotion focuses on encouraging patients to adopt healthy behaviors (e.g. exercise and nutrition).

Practice-Level Nursing Theories

• Specificity: Very specific nursing actions.
• Example: Wound Healing Theory outlining precise steps and procedures.
• Example: Postpartum Depression Theory to support and care for mothers experiencing postpartum depression.

Nursing Theorists - Florence Nightingale

• Overview: Environment affects health outcomes.
• Emphasizes hygiene, ventilation, cleanliness for effective patient recovery.
• Key Concepts: Cleanliness, fresh air, light, holistic approach.
• Implications for modern nursing: Infection control, design of hospitals, patient safety.

Nursing Theorists - Hildegard Peplau

• Theory: Interpersonal Relations.
• Defines nursing as an interpersonal process of therapeutic communication between the patient and the nurse.

Nursing Theorists - Virginia Henderson

• Theory: Nursing Need.
• Focuses on patient independence and assisting with fundamental needs.

Nursing Theorists - Faye Abdellah

• Theory: 21 Nursing Problems.
• Shifts from disease-centered to patient-centered care.
• Aims to address patient needs and family care, especially for the elderly and families.

Nursing Theorists - Ida Orlando

• Theory: Nursing Process.
• Emphasis on validating subjective inferences through patient communication.

Nursing Theorists - Myra Levine

• Theory: Conservation Model.
• Views nursing as human interaction maintaining health.

Nursing Theorists - Joyce Travelbee

• Theory: Human-to-Human Relationship Model.
• Highlights nursing's role in supporting patients and communities during health struggles and towards hope.

Nursing Theorists - Betty Neuman

• Theory: System Model.
• Focuses on the client as a system addressing variables affecting responses to stressors.

Nursing Theorists - Sister Callista Roy

• Theory: Adaptation Model.
• Examines how individuals adapt to changes in health and environment, promoting holistic nursing care
• Emphasizes health promotion and adaptation mechanisms.

Nursing Theorists - Dorothea Orem

• Theory: Self-Care Deficit.
• Focuses on helping individuals maintain self-care.

Nursing Models - Maternal Role Attainment

• Addresses maternal identity development. Recognizes the interconnected development process between the mother and her newborn.

Nursing Models - Self-Efficacy

• Emphasizes belief in one's ability to manage their health, with personal factors playing the greatest role.

Nursing Models - Life Perspective Rhythm

• Uses concepts of nursing, person, health, and environment to label and identify nursing concepts. It aims to enhance developmental processes towards health.

Nursing Models - Health Promotion

• A complementary model to healthcare protection that emphasizes increasing the patient's well-being. It addresses individual characteristics, experiences, behavior-related cognitions, affects, and their influencing outcomes.

Nursing Models - 14 components of Virginia Henderson's Need Theory

• This theory includes 14 basic needs that nurses should enable patients to meet, encompassing activities like eating, sleeping, and maintaining a safe environment.

Nursing Models - Activities of Living by Roper-Logan-Tierney

• Model emphasizes 12 activities of living that nurses must support patients with, encompassing aspects of maintaining a safe environment, communication, and death and dying.

Nursing Models - Gordon 11 Functional Health Patterns

• Utilized by many nursing education institutions, this model categorizes patient data collection using 11 health patterns (e.g., health perception and managing health, nutritional and metabolism, elimination, activity and exercise, cognitive and perceptual experience, sleep and rest , self-perception and self-concept, relations and role, sexuality and reproduction systems, coping with stress, and values).

Continuing Evolution of Nursing Theory

• Contemporary nursing practice is founded on both legal concepts and theoretical frameworks.
• Theories developed by key nursing theorists strongly influence contemporary nursing, practice, education and research.
• A clear comprehension of these concepts enhances nursing practice and patient outcomes.
• Continual learning and application of these principles are essential for the progression of the field.