Professionalism in Healthcare PDF

Attitude:-  is a way of feeling or acting toward a person, thing, or situation.  Always think before you speak You need a good attitude Show that you enjoy your work.  Listen to others.  Be willing to learn. Stay busy and use your time well. statements signal a bad attitude:- “That's...

Attitude:-  is a way of feeling or acting toward a person, thing, or situation.  Always think before you speak You need a good attitude Show that you enjoy your work.  Listen to others.  Be willing to learn. Stay busy and use your time well. statements signal a bad attitude:- “That's not my resident (patient).” “I can't. I'm too busy.” “I didn't do it.” “I don't feel like it.” “It's not my fault.” statements signal a bad attitude:- “ “It's not my turn. I did it yesterday.” “Nobody told me.” “That's not my job.” “You didn't say that you needed it right Away.” “I did more than she (he) did.” statements signal a bad attitude:- “I'm tired of this place.” “Is it time to leave yet?” “Good luck. I had a horrible day.” “I work harder than anyone else.” “Don't blame me.”  Gossip gossip means to spread rumors or talk about the private matters of others Gossiping is unprofessional and hurtful. To avoid gossip:-  Remove yourself from where people are gossiping.  Do not make or repeat any comment that can hurt any person—patient or resident, family member, visitor, co-worker, fellow student, instructor.  Do not make or write false statements about another person.  Confidentiality:-  means trusting others with personal and private information. The person's information is shared only among staff involved in his or her care.  The person has the right to privacy and confidentiality. Agency, family, coworker,and student information also is confidential. Confidentiality  The person's information is private and personal.Share information only with the nurse or your instructor.  Do not talk about patients, residents, families, the agency, or co-workers when others are present.  Do not talk about them in hallways, elevators, dining areas, or outside the agency. Confidentiality:-  Patients, residents, and visitors are very alert to comments They think you are talking about them or their loved ones.  This leads to wrong information and wrong impressions about the person's condition.  Be very careful about what, how, when, and where you say things Confidentiality  Your family and friends may ask about patients, residents, families, or staff. For example, your mother says: “I heard my neighbor is in your nursing home. v You can say: ( I'm sorry, but I can't tell you about anyone in the center. It is unprofessional and against center policies. And it violates the person's right to privacy and confidentiality. Please don’t ask me about anyone in the center. Speech and Language:-  Your speech and language must be professional.  Some words used in home and social settings are not proper in class the clinical setting and at work. Speech and Language:-  Speak softly and gently.  Speak clearly. Hearing problems are common.  Do not shout or yell.  Do not fight or argue with a patient or resident, family member, visitor, co-worker, your instructor, or a fellow student. Courtesies:- A courtesy is a polite, considerate, or helpful comment or act. Courtesies take little time or energy. Address others by Miss, Mrs., Ms., Mr., or Doctor. Or use the name the person prefers. Do not call your instructor by his or her first name. Courtesies:- Say “please.” Begin or end each request with “please.” Say “thank you” when someone does something for you or helps you. Apologize. Say “I'm sorry” when you make a mistake or hurt someone. Personal Matters:- Personal Matters must not interfere with your job. Otherwise, care is neglected. You could lose your job.  To keep personal Matter out of the workplace: 1-Make phone calls during meals and breaks. 2- Do not let family and friends visit you on the unit. If they must see you, meet them during a meal or break. Personal Matters:- Personal Matters must not interfere with your job. Otherwise care is neglected. You could lose your job. To keep personal Matter out of the workplace:  Make phone calls during meals andbreaks.  Do not let family and friends visit you on the unit. If they must see you, meet them during a meal or break  Control your emotions. If you need to cry or express anger, do so in private. Get yourself together quickly and return to your work Personal Matters:- Personal Matters must not interfere with your job. Otherwise care is neglected. You could lose your job. Make appointments (doctor, dentist, lawyer, and others) for your days off. Do not use agency computers , printers, fax machines, copiers, or other equipment for your personal use. Do not take the agency's supplies (pens, paper, and others) for your personal use. Do not discuss personal problems.  Saudi German Health Makkah​​ Personal Matters:-  Do not borrow money from or lend it to co-workers or fellow students. This includes meal money and bus or train fares. Turn off personal phones and other electronic devices.  Do not send or check e-mails, text messages, or other electronic messages Meals and Breaks:-  Meal breaks are usually 30 minutes. Other breaks are usually 15 minutes.  Meals and breaks are scheduled with some staff always on the unit.  some staff always on the unit.Staff on the unit cover for the staff away on break.  INRODUCTION As a student and a nursing assistant, you must act and function in a professional manner. Professionalism involves following laws, being ethical, having good work ethics, and having the skills to do your work. Ethics deals with right and wrong conduct. It involves choices and judgments about what to do or what not to do. An ethical person does the right thing Work ethics deals with behavior in the workplace. Certain behaviors (conduct), choices, and judgments are expected. Work ethics involves: How you look What you say How you behave How you treat and work with others Health, Hygiene, and Appearance Patients, residents, families, and visitors expect you to look, act, and be healthy. For example, a person must stop smoking. Yet because you smoke, you and your clothes smell of smoke. If you do not look or smell clean, people wonder if you give good care. Your health, hygiene, and appearance need careful attention.  Your Health To learn and give safe and effective care, you must be physically and mentally healthy. The following affect your health:- Diet. You need a balanced diet. Eat a good breakfast. To maintain your weight, balance calorie intake with your energy needs. Sleep and rest. Most adults need 7 to 8 hours of sleep daily. Fatigue, lack of energy, and being irritable mean you need more rest and sleep. Body mechanics. You will bend, carry heavy objects, and move and turn persons. Exercise. Exercise promotes muscle tone, circulation, and weight control. Your eyes. Have your eyes examined. Wear needed eyeglasses or contact lenses. Have good lighting for reading and fine work. Smoking. Smoke odors stay on your breath, hands, clothing, and hair. Hand washing and good hygiene are needed.  Your Health To learn and give safe and effective care, you must be physically and mentally healthy. The following affect your health:- Drugs. Some drugs affect thinking, feeling, behavior, and function. Working under the influence of drugs affects the person's safety and yours. Take only prescribed drugs in the prescribed way. Alcohol. Alcohol is a drug that affects thinking, balance, coordination, and alertness. Never go to work under the influence of alcohol. Do not drink alcohol while working. Alcohol affects the person's safety and yours. Your Hygiene Your hygiene needs careful attention. Bathe daily. Use a deodorant or antiperspirant to prevent body odors. Brush your teeth often—upon awakening, before and after meals, and at bedtime. Use mouthwash to prevent breath odors. Shampoo often. Keep fingernails clean, short, and smoothly and neatly shaped. Your Appearance How you look affects what people think about you and the agency. If staff or students are clean and neat, people think the agency is clean and neat. They think the agency is unclean when staff or students are messy and unkempt. People also question the quality of care given Professional Appearance Practice good hygiene. Follow the dress code of your agency or training program for: Uniforms Jewelry Shoes Hair Nails, make-up, and fragrances Uniforms Wear required uniforms. Uniforms fit well and are modest in length and style. Keep uniforms clean, pressed, and mended. Wear a clean uniform and clean under-garments daily. Wear appropriate under-garments for your body shape and uniform. Under-garments are clean and fit properly. Under-garments are the correct color for your skin tone. Wear clean socks or stockings that fit well. Change them daily. Wear your name badge or photo ID (identification) according to the dress code. Cover tattoos (body art) with your uniform. Jewelry Wear only allowed jewelry. Wedding and engagement rings may be allowed. Do not wear rings that can scratch a person. Bracelets are not allowed. They can scratch a person. Necklaces and dangling earrings are not allowed. Confused or combative persons and young children might pull on them. One set of small, simple earrings is usually allowed. Do not wear jewelry in visible piercings— eyebrows, nose, lips, cheek, tongue, or other sites. Wear a wristwatch with a second (sweep) hand  Shoes Wear shoes that fit, are comfortable, give needed support, and have slip-resistant soles. Do not wear sandals or open-toed shoes. Wear clean shoes. Wash or replace shoes and laces as needed. Hair Have a simple, attractive hair-style. Hair is off your collar and away from your face. This includes men with long hair. Use simple pins, barre es, hair ties, clips, bands, or other devices to keep long hair up and in place. This includes men with long hair. Keep beards and mustaches clean and trimmed. Nails, Make-Up, and Fragrances Keep fingernails clean, short, and smoothly and neatly shaped. Long or jagged nails can scratch a person. Do not wear nail polish. Chipped nail polish may provide a place for microbes to grow. If nail polish is allowed, wear only a light colored polish. Do not wear non-natural nails. Fake and artificial nails and nail extenders are examples. Nails must be natural. Use make-up that is modest in amount and moderate in color. Avoid a painted and severe look. Do not wear perfume, cologne, or after-shave lotion. The scents (fragrances) may offend, nauseate, or cause breathing problems in patients and residents. Preparing for Work and attendance Being dependable is important as an employee To be dependable in the work setting, you must: Work when scheduled. Get to work on time. Stay the entire shift Teamwork Teamwork means that staff members work together as a group. Each person does his or her part to give safe and effective care. Teamwork involves: Working when scheduled. Being cheerful and friendly. Completing assignments. Helping others willingly. Being kind to others. Time management is the process of planning and controlling how much time to spend on specific activities. Good time management enables an individual to complete more in a shorter period of time, lowers stress, and leads to career succuss. Benefits of Time Management 1. Stress relief Making and following a task schedule reduces anxiety. As you check off items on your “to-do” list, you can see that you are making tangible progress. This helps you avoid feeling stressed out with worry about whether you’re getting things done. 2. More time Good time management gives you extra time to spend in your daily life. People who can time-manage effectively enjoy having more time to spend on hobbies or other personal pursuits. 3. More opportunities Managing time well leads to more opportunities and less time wasted on trivial activities. Good time management skills are key qualities that employers look for. The ability to prioritize and schedule work is extremely desirable for any organization. 4. Ability to realize goals Individuals who practice good time management are able to better achieve goals and objectives, and do so in a shorter length of time. Implications of Poor Time Management 1. Poor workflow The inability to plan ahead and stick to goals means poor efficiency. 2. Wasted time For example, by talking to friends on social media while doing an assignment, you are distracting yourself and wasting time. 3. Loss of control By not knowing what the next task is, you suffer from loss of control of your life. That can contribute to higher stress levels and anxiety. 4. Poor quality of work For example, having to rush to complete tasks at the last minute usually compromises quality. 5. Poor reputation If a client cannot rely on you to get something done on time, they will likely take their business elsewhere. Attendance Report to work when scheduled and on time. The entire unit is affected when just 1 person is late. Call the agency if you will be late or cannot go to work. Follow the attendance policy in your employee handbook. Poor attendance can cause you to lose your job. You must be dependable. Be ready to work when your shift starts Your Attitude You need a good attitude. Show that you enjoy your work. Listen to others. Be willing to learn. Stay busy and use your time well. You and your work are important and have value. Nurses, patients, residents, and families rely on you for good care. They want you to be pleasant and respectful. Always think before you speak. What do you think about these statements? “That's not my resident (patient).” “I can't. I'm too busy.” They are “I didn't do it.” represent bad “I don't feel like it.” “It's not my fault.” attuited “Don't blame me.” “It's not my turn. I did it yesterday.” “Nobody told me.” “That's not my job.” “You didn't say that you needed it right Gossip To gossip means to spread rumors or talk about the private matters of others. Gossiping is unprofessional and hurtful. To avoid gossip: Remove yourself from where people are gossiping. Do not make or repeat any comment that can hurt any person. Do not make or write false statements about another person. Do not send or post comments about others or the school or agency by e-mail, instant messaging, text messaging, video sites, social media, or other electronic means. Job Safety:-  You must protect patients, residents, families, visitors, coworkers, and yourself from harm Negligent acts affect the safety of others. Safety practices are presented throughout following guidelines :- 1- Understand the roles, functions, and responsibilities in your job description. 2- Follow agency rules, policies, and procedures. 3- Know what is right and wrong conduct. 4- Know what you can and cannot do. Job Safety:- 5- Help others willingly when asked. 6-Ask for any training you might need. 7- Report accurately—measurements, observations, the care given, the person's complaints, and any errors. 8- Be responsible for your actions Admit when you are wrong or make mistakes. Do not blame others. Do not make excuses. 9-Handle the person's property carefully and prevent damage. 10-Help others willingly when asked. Planning Your Work:- Apriority is the most important thing at the time. To set your priorities, decide:-  Who has the greatest or most life threatening needs.  What task the nurse or person needs done first.  What tasks need to be done at a certain time.  What tasks need to be done when your shift starts and at the end of your shift.  How long it takes to complete a task.  How much help you need to complete atask.  Who can help you and when. Planning Your Work:- Planning Your Work:-  Discuss priorities with the nurse.  Know the routine of your shift and nursing unit.  Follow unit policies for shift reports. In an end-of shift report, the nurse gives a report to the oncoming shift  List tasks that are on a schedule  Judge how much time you need for each person and task. Planning Your Work:-.  Identify when you will need help from a coworker.  Review your assignment sheet.  Gather needed supplies ahead of time.  Do not waste time. Stay focused on your work.  Leave a clean work area. Make sure rooms and utility areas are neat and orderly.  Be a self-starter. Have initiative. Ask others if they need help  Follow unit routines, stock supply areas, and clean utility rooms. Stay busy  Stress:-  Stress is the response or change in the body caused by any emotional, psychological, physical, social, or economic factor.  Stress is normal. It occurs every minute of every day and in everything you do. Stress:-  A stressor is the event or factor that causes stress. Many stressors are pleasant—a child playing, a party, laughing with family and friends, a nice day  Some are not pleasant illness, injury, family problems, death of loved ones, divorce, money concerns. School and some parts of your job are stressful. Stress:-  Prolonged or frequent stress threatens physical and mental health.  Some problems are often minor—headaches, stomach upset, sleep problems, muscle.  Others are life-threatening—high blood pressure, heart attack. Stress affects you, the care you give, the person's quality of life, and how you relate to coworkers.  Burnout:- Burnout is a job stress resulting:- 1-Being physically or mentally exhausted. 2-Having doubts about your abilities. 3-Having doubts about the value of your work. Burnout:-  Burnout can cause physical and mental health problems. They include fatigue, sleep problems, depression, anxiety, alcohol or substance abuse, heart disease, diabetes, stroke, and weight gain.  Problems can develop at home and with personal relationships. Causes of Burnout:- 1-Schedules, assignments, or workloads that find difficult. 2- Not being comfortable with your supervisor or co-workers. 3-Being harassed, bullied, or heavily criticized by your supervisor or a co-worker. 4-Conflicts with how problems and grievances are handled. 5-Having skills that are greater than or lesser than what the job requires. 6-Lacking emotional support at work, at home, or socially. Signs and Symptoms of Burnout:- Lack of energy Sense of dread about going to work; not wanting to go to work Sleep problems Forgetfulness Problems concentrating Frequent illness—infection, cold, influenza Signs and Symptoms of Burnout: Physical symptoms:  Chest pain  Rapid or irregular heartbeat Shortness of breath  Gastro-intestinal pain Dizziness  Fainting  Headaches  Loss of appetite Managing Stress:- To reduce or cope with stress: 1-Exercise regularly. Physical and mental benefits include cardiovascular health, weight control, tension release, emotional well-being, and relaxation. 2-Get enough rest and sleep. 3-Eat healthy. 4- Plan personal and quiet time for you. 5- Read, take a hot bath, go for a walk, meditate, or listen to music.6- Do what makes you feel good. Managing Stress:- Managing Stress:- To reduce or cope with stress: 7- Do 1 thing at a time. You may feel overwhelmed with demands. List each thing to do. Set priorities. 8- Do not judge yourself harshly. Do not try to be perfect or expect too much from yourself. 9-Give yourself praise. You do good and wonderful things every day. 10 Have a sense of humor. Laugh at yourself.Laugh with others. Spend time with those who make you laugh. 11- Have a social life that does not include coworkers. Managing Stress:- The health team (interdisciplinary health care team) involves the many health care workers whose skills and knowledge focus on the person's total care. The goal is to provide quality care. The person is the focus of care.  Health Team Members: Title Description Activities director/recreational Plans and directs recreation treatment programs to help therapist maintain or improve a person's physical, social, and emotional well-being. Audiologist Treats hearing, balance, and ear problems. Cleric (clergyman; clergywoman) Assists with spiritual needs. Clinical nurse specialist (CNS) Advanced practice registered nurse (APRN) who consults in a specialty. Geriatrics, critical care, diabetes, rehabilitation, and wound care are examples. Can prescribe drugs in some states.  Title Description Dental hygienist Cleans teeth and provides preventive care. Dentist Treats problems with the teeth, gums, and related parts of the mouth. Dietitian and nutritionist Assesses and plans for nutritional needs to promote health and manage disease. Teaches about diet and healthy eating. Home health aide/personal Assists persons in home se ings with daily activities—laundry, care aide bedmaking, grocery shopping, meals, hygiene, dressing, and grooming.  Title Description Licensed practical/vocational nurse (LPN/LVN) Provides nursing care and gives drugs under the direction of RNs and doctors. Medical or clinical laboratory Collects specimens. Performs tests on technologist/technician blood, urine, and other body fluids, secretions, and excretions. Medical records and health information Maintains the quality and security of technician medical records. Codes patient information for billing purposes. Medication assistant certified (MA-C) Gives drugs as allowed by state law under the supervision of a licensed nurse.  Title Description Nurse practitioner (NP) An APRN with specialized graduate education who diagnoses and treats common health problems. May prescribe some drugs and treatments. Nursing assistant Assists nurses and gives care. Supervised by a licensed nurse. Occupational therapist (OT) Assists persons to learn or retain skills needed for daily living and working Occupational therapy assistant Performs tasks and services as directed by an OT.  Title Description Pharmacist Fills drug orders and advises about safe prescription use. Consults with doctors and nurses about drug actions and interactions. Physical therapist (PT) Assists ill and injured persons with movement, pain management, and rehabilitation. Physical therapy assistant (PTA) Performs tasks and services as directed by a PT. Physician (doctor) Diagnoses and treats diseases and injuries.  Title Description Physician's assistant (PA) Performs exams, diagnoses, and provides treatments under a doctor's direction. Podiatrist Prevents, diagnoses, and treats foot, ankle, and lower leg problems. Radiographer/radiologic technologist Takes images using x-rays and other equipment. Registered nurse (RN) Assesses, makes nursing diagnoses, plans, implements, and evaluates nursing care. Supervises LPNs/LVNs and nursing assistants.  Title Description Respiratory therapist Assists in treating lung and heart disorders. Gives respiratory treatments and therapies. Social worker Deals with social, emotional, and environmental issues affecting illness and recovery. Coordinates community agencies to assist the person and family. Speech-language pathologist/speech therapist Diagnoses and treats communication and swallowing disorders. The Health Team Team members have different roles. They communicate often. You may have questions or concerns about a person and his or her care. Tell the team leader. The leader will communicate with health team members. A nursing assistant has passed a nursing assistant training and competency evaluation program (NATCEP). Nursing assistants perform delegated nursing tasks under the supervision of a licensed nurse.  Health Care Systems Agencies join together as 1 provider of care. A system usually has hospitals, nursing centers, home care agencies, hospice settings, and doctors' office. An ambulance service and medical supply store for home care are common. The system serves a community or larger region.  The goal is to meet all health care needs. A person uses system providers as needed. A health care system owns: 3 hospitals Doctors' offices Using a HealthCare System A home care service An ambulance service A medical supply store A nursing center  A patient sees a hospital emergency room doctor because of sudden dizziness and right-sided weakness. Admi ed to the hospital, the patient was having a stroke. After 2 weeks of rehabilitation, the patient returns home by ambulance. The family obtains needed care items from the medical supply store—hospital bed, wheelchair, and other items. The home care agency arranges for the patient's nursing needs. A nursing assistant will help with daily hygiene and grooming needs. A nurse will visit 3 times a week. Because of another stroke, the patient is taken to the hospital by ambulance. After hospital care and rehabilitation, the patient and family agree to nursing center care.  Organization An agency has a governing group called the board of trustees or board of directors. The board makes policies. The focus is safe care at the lowest possible cost. Local, state, and federal laws are followed. An administrator manages the agency. He or she reports directly to the board. Directors or department heads manage certain areas. For example, A director of nursing manages the nursing department. A human resources director handles personnel matters such as hiring staff. A social services director meets the social needs of the person and family Nursing team Those who provide nursing care—RNs, LPNs/LVNs, and nursing assistants. Registered nurse (RN) A nurse who has completed a 2-, 3-, or 4-year nursing program and has passed a licensing test. licensed practical nurse (LPN) A nurse who has completed a practical nursing program and has passed a licensing test; called licensed vocational nurse (LVN) in California and Texas. Nursing assistant A person who has passed a nursing assistant training and competency evaluation program (NATCEP); performs delegated nursing tasks under the supervision of a licensed nurse.  Registered Nurses A registered nurse (RN) has completed a 2-, 3-, or 4-year nursing program and has passed a licensing test. *Community college programs—2 years *Hospital-based diploma programs—2 or 3 years *College or university programs—4 years Graduates take a licensing test offered by their state board of nursing. They receive a license and become registered after passing the test. RNs must have a license recognized by the state in which they work. RNs assess, make nursing diagnoses, plan, implement, and evaluate nursing care. They provide care and delegate nursing care and tasks to the nursing team. -RNs follow the doctor's orders. -They may delegate them to other nursing team members. -RNs do not prescribe treatments or drugs. -However, RNs can become clinical nurse specialists or nurse practitioners. Depending on state law, these RNs have limited diagnosing and prescribing functions. RNs work as: -Charge or staff nurses, -Nurse supervisors or managers, -DONs, -Agency administrators, -Instructors. Those and other career options depend on education, abilities, and experience.  Licensed Practical Nurses and Licensed Vocational Nurses A licensed practical nurse (LPN) has completed a practical nursing program and has passed a licensing test. Hospitals, community colleges, vocational schools, and technical schools offer programs. Programs are 10, 12, or 18 months long. Some high schools offer 2-year programs. Graduates take a licensing test for practical nursing LPNs/LVNs are supervised by RNs and doctors. They have fewer responsibilities and functions than RNs do. They need less supervision when the person's condition is stable and care is simple. They assist RNs with acutely ill persons and complex procedures. Nursing Assistants A nursing assistant has passed a nursing assistant training and competency evaluation program (NATCEP). Nursing assistants perform delegated nursing tasks under the supervision of a licensed nurse.  Title Description Clinical nurse specialist (CNS) Advanced practice registered nurse (APRN) who consults in a specialty. Geriatrics, critical care, diabetes, rehabilitation, and wound care are examples. Can prescribe drugs in some states. Licensed practical/vocational nurse Provides nursing care and gives drugs (LPN/LVN) under the direction of RNs and doctors.  Title Description Nurse practitioner (NP) An APRN with specialized graduate education who diagnoses and treats common health problems. May prescribe some drugs and treatments. Nursing assistant Assists nurses and gives care. Supervised by a licensed nurse.  Roles and Responsibilities OBRA, nurse practice acts and other state laws, and legal and advisory opinions direct what you can do. To protect persons from harm, you must understand what you can do, what you cannot do, and the legal limits of your role. This is called scope of practice or range of functions. Licensed nurses supervise your work. You perform nursing tasks related to the person's care. A nursing task is nursing care or a nursing function, procedure, skill, or activity. Often you function without a nurse in the room. At other times you help nurses give care.  Rules for Nursing Assistants You are an assistant to the nurse. A nurse assigns and supervises your work. You report observations about the person's physical and mental status to the nurse. Report changes in the person's condition or behavior at once. The nurse decides what is done or not done for a person. You do not make these decisions. Review directions and the care plan with the nurse before going to the person. Perform only the nursing tasks that you are trained to do. Ask a nurse to guide and assist you if you are not comfortable performing a nursing task. Perform only the nursing tasks that your state and job description allow. The range of functions for nursing assistants varies among states and agencies. Before performing a nursing task make sure that: Your state allows nursing assistants to do so. It is in your job description. You have the education and training to do so. A nurse is available to answer questions and to guide and assist you as needed. Role Limits Never give drugs. This includes drugs given: -Orally, rectally, vaginally, and by injection -By application to the skin, eyes, ears, and nose -Directly into the bloodstream or through an intravenous (IV) Nurses give drugs. Many states allow nursing assistants to give some drugs after completing a state-approved medication assistant training program. The function must be in your job description. And you must have the necessary supervision.  Role Limits Never insert tubes or objects into body openings. Do not remove them from the body. You must not insert tubes into the person's bladder, esophagus, trachea, nose, ears, bloodstream, or surgically created body openings. Exceptions to this rule are the procedures you will study during your training. Giving enemas is an example. To give enemas, the task must be in your job description. And you must have the necessary supervision. Never take oral or phone orders from doctors. Politely give your name and title, and ask the doctor to wait for a nurse. Promptly find a nurse to speak with the doctor.  Role Limits Never tell the person or family the person's diagnosis or medical or surgical treatment plans. This is the doctor's responsibility. Nurses may clarify what the doctor has said. Never diagnose or prescribe treatments or drugs for anyone. Doctors, physician's assistants, and some advanced practice nurses diagnose and prescribe. Never supervise others including other nursing assistants. This is a nurse's responsibility. You will not be trained to supervise others. Supervising others can have serious legal problems.  Role Limits Never ignore an order or request to do something. This includes nursing tasks that you can do, those you cannot do, and those beyond your legal limits. Promptly and politely explain to the nurse why you cannot carry out the order or request. The nurse assumes you are doing what you were told to do unless you explain otherwise. You cannot neglect the person's care. Your job description reflects your state's laws and rules. An agency can further limit what you can do. However, no agency or nurse can expand your range of functions beyond what your state's laws and rules allow. Nursing Assistant Standards All NATCEPs include the range of functions required by OBRA. Some states allow other functions. NATCEPs also prepare nursing assistants to meet the following standards  Performs nursing tasks within the range of functions allowed by the state's nurse practice act and its rules. Is honest and shows integrity. (Integrity involves following a code of ethics. Accepts or refuses nursing tasks based on his or her education and training and the nurse's directions. -Is accountable for his or her behavior and actions while assisting the nurse and helping patients and residents. -Assists the nurse in observing patients and residents. Also assists in identifying their needs. -Communicates: Progress toward completing nursing tasks Problems in completing nursing tasks Changes in the person's status  Asks the nurse to clarify what is expected when unsure. Uses educational and training opportunities as available. Practices safety measures to protect the person, others, and self. Respects the person's rights, concerns, decisions, and dignity. Functions as a member of the health team. Helps implement the care plan. Respects the person's property and the property of others. Protects confidential information unless required by law to share the information.  Job Description The job description is a document that describes what the agency expects you to do. It also states educational requirements and your job title. Always obtain a written job description when you apply for a job. Ask questions about it during your job interview. Before accepting a job, tell the employer about: Functions you did not learn Functions you cannot do for moral or religious reasons Clearly understand what is expected before taking a job. Do not take a job that requires you to: Act beyond the legal limits of your role. Function beyond your training limits. Perform acts that are against your morals or religion. No one can force you to do something beyond the legal limits of your role. Sometimes jobs are threatened for refusing to follow a nurse's orders. Often staff obey out of fear. That is why you must understand: Your roles and responsibilities What you can safely do The things you should never do Your job description The ethical and legal aspects of your role  Types of Health Care Agencies Nursing assistants work in many settings. Some work in doctors' offices and clinics. Most work in the following agencies: Hospitals Hospitals provide emergency care, surgery, nursing care, x-ray procedures and treatments, and laboratory testing. Respiratory, physical, occupational, speech, and other therapies are provided. Hospital care is either in-patient or out-patient. In-patient care—health care a person receives when admitted to an agency. At least 1 over-night stay is involved. Out-patient (ambulatory) care—medical or surgical care received when a person is not admitted to an agency. The person does not stay over-night.  Hospital patients have acute, chronic, or terminal illnesses. Acute illness is an illness of rapid onset and short duration. The person is expected to recover. A heart attack is an example. Chronic illness is a long-term health condition that may not have a cure. The illness can be controlled and complications prevented with proper treatment. Arthritis is an example. Terminal illness is an illness or injury from which the person will not likely recover. The person will die. Cancers not responding to treatment are examples.  Rehabilitation and Sub-Acute Care Agencies Hospital stays are often short. Some people do not need hospital care but are too sick or disabled to go home. Care needs fall between hospital care and long-term care. Along with rehabilitation, complex equipment and care measures are often needed. Some hospitals and long-term care centers have rehabilitation and sub-acute care units. Others are separate agencies. Many persons are able to return home. Others need long-term care. Long-Term Care Centers Some persons cannot care for themselves at home but do not need hospital care. Long-term care centers are designed to meet their needs. Care needs range from simple to complex. Medical, nursing, dietary, recreation, rehabilitation, and social services are provided. Persons in long-term care centers are called residents. They are not patients. The center is their short- or long- term home. Most residents are older. Many have chronic diseases, poor nutrition, memory problems, or poor health. Not all residents are old. Some are disabled from birth defects, accidents, or disease. Hospital patients are often discharged while recovering from illness or surgery. Some need home care. Others need long-term care until able to go home. Others need end-of-life care Nursing Centers. A nursing center (nursing facility, nursing home) provides medical, nursing, dietary, recreation, rehabilitation, and social services. Skilled nursing facilities (SNFs) provide complex care for severe health problems. SNF residents need time to recover or rehabilitation. Others never go home.  Memory Care Units. A memory care unit is designed for persons with Alzheimer's disease and other dementias. Such persons suffer increasing memory loss and confusion. Over time, they cannot tend to simple personal needs. Wandering is common. The unit is usually closed off from other parts of the center. The closed unit provides a safe setting where residents can wander freely. Assisted Living Residences An assisted living residence (ALR) provides housing, personal care, support services, health care, and social activities in a home-like setting to persons needing some help with daily activities. Some ALRs are part of nursing centers or retirement communities. The person has a room, an apartment, or a cottage. Three meals a day and 24-hour supervision are provided. So are housekeeping, laundry, social, recreational, transportation, and some health care services. Help is given with personal care and drugs.  Mental Health Centers Some persons have problems with life events. Others present dangers to themselves or others because of how they think and behave. Out-patient mental health care is common. Some need short-term or long-term in-patient care. Home Care Agencies Health care services are provided to people where they live. Services range from health teaching and supervision to bedside nursing care. Physical therapy, rehabilitation, and food services are common. Hospitals, health care systems, public health departments, and private businesses offer home care. People of all ages need home health care. Some persons need end-of-life care at home.  Hospices A hospice is a health care agency or program that promotes comfort and quality of life for the dying person and his or her family. Hospice patients no longer respond to treatments aimed at cures. Usually they have less than 6 months to live. The physical, emotional, social, and spiritual needs of the person and family are met. The focus is on comfort, not cure. Children and pets can visit. Family and friends can assist with care. Hospice care is provided by hospitals, nursing centers, and home care and hospice agencies. Health Care Systems Agencies join together as 1 provider of care. A system usually has hospitals, nursing centers, home care agencies, hospice settings, and doctors' offices. An ambulance service and medical supply store for home care are common. The system serves a community or larger region. The goal is to meet all health care needs. A person uses system providers as needed.  Using a Health Care System A health care system owns: hospitals Doctors' offices A home care service An ambulance service A medical supply store A nursing center A patient sees a hospital emergency room doctor because of sudden dizziness and right-sided weakness. Admitted to the hospital, the patient was having a stroke. After 2 weeks of rehabilitation, the patient returns home by ambulance. The family obtains needed care items from the medical supply store—hospital bed, wheelchair, and other items. The home care agency arranges for the patient's nursing needs. A nursing assistant will help with daily hygiene and grooming needs. A nurse will visit 3 times a week. Because of another stroke, the patient is taken to the hospital by ambulance. After hospital care and rehabilitation, the patient and family agree to nursing center care. OBJECTIVES Define the key terms and key abbreviations in this chapter. Identify which nurses can delegate nursing tasks. Describe the delegation process. Explain your role in the delegation process. Describe the Five Rights of Delegation for nursing assistants. Explain how to accept or refuse a delegated task. Explain how to promote PRIDE in the person, the family, and yourself. KEY TERMS accountable To answer to one's self and others about his or her choices, decisions, and actions - Delegate - To authorize or direct a nursing assistant to perform a nursing task - Delegated nursing responsibility - A nursing task that a nurse transfers to a nursing assistant when it does not require a nurse's professional knowledge or judgment - Delegation - The process a nurse uses to direct a nursing assistant to perform a nursing task; allowing a nursing assistant to perform a nursing responsibility that is beyond the nursing assistant's usual role and not routinely done by the nursing assistant - Nursing task Nursing care or a nursing function, procedure, skill, or activity - Routine nursing task A nursing task that is part of a nursing assistant's routine job description and commonly assigned to the nursing assistant; a nursing task that was learned in a nursing assistant training and competency evaluation program (NATCEP)  Saudi German Health Makkah Key Abbreviations Abbreviations Meaning APRN Advanced practice registered nurse LPN Licensed practical nurse LVN Licensed vocational nurse NATCEP Nursing assistant training and competency evaluation program RN Registered nurse Promoting Safety and Comfort: Who Can Delegate Safety Delegation requires a nurse's knowledge and judgment. Routine nursing tasks and delegated nursing responsibilities must be: Within the nurse's scope of practice. For example, pulling out loose teeth is not within a nurse's scope of practice. The nurse cannot tell you to pull out a person's loose tooth. Within the nursing assistant range of functions allowed by your state. For example, your state does not allow nursing assistants to cut toenails. The nurse cannot delegate cutting toenails to you.  Listed in your job description. For example, your state allows nursing assistants to give enemas. The task is in your job description. The nurse can delegate the task to you. The nurse must know the tasks allowed by your job description. You must know what you can and cannot do (Chapter 3).You must refuse a task that you were not trained to do. You also must refuse a task that is: Beyond the nurse's scope of practice Beyond the nursing assistant range of functions allowed by your state Not in your job description Safety Routine nursing tasks and delegated nursing responsibilities must be allowed by your state and in your job description. If not learned in your NATCEP or something you do not do often, the agency must: Provide needed education and training about the task. Evaluate your ability to perform the task safely. Some nursing responsibilities cannot be delegated to you. They include: The nursing process (Chapter 8) Performing assessments Developing care plans Evaluating responses to care Providing education (teaching) to the person and family Performing nursing tasks that require a nurse's professional knowledge and judgment Making delegation decisions Supervising others Taking oral or phone orders from doctors or APRNs Giving drugs Inserting intravenous (IV) catheters (Chapter 32)  Delegation Process For safe delegation, the person's needs, the nursing task, and the staff member doing the task must fit (Fig. 4-1). Delegation Process Delegation decisions must result in the best care for the person. Otherwise the person's health and safety are at risk. To make delegation decisions, the nurse follows a process Assessment of Needs The nurse needs to understand the person's needs. The nurse needs to know your knowledge, skills, and job description. To assess the person's needs, the nurse answers these questions. What are the person's needs? How complex and urgent are they? How can they vary? What are the most important long-term and short-term needs? How much judgment is needed to meet the person's needs and give care? How predictable is the person's health status? How does the person respond to health care?  What problems might arise from the task? How severe might they be? What actions are needed if a problem occurs? How complex are the needed actions? What emergencies might arise? How likely might they occur? How involved is the person and family in health care decisions? How will delegating the task help the person? What are the risks? To assess your knowledge and skills, the nurse answers these questions. What knowledge and skills are needed to safely perform the task? What is in your job description? What are the conditions affecting the task? What is expected after the task? What problems might the person develop during the task? What problems can arise from the task? The nurse decides if you can safely perform the task. It must be safe for the person and you. If unsafe, the nurse stops the delegation process. If safe for the person and you, the nurse continues the delegation process. Communication This step involves the nurse and you. The nurse must give you clear and complete directions about: How to perform and complete the task What observations to report and record When to report observations What patient or resident concerns to report at once Priorities for tasks What to do if the person's condition changes or needs change Before performing a delegated task, discuss the task with the nurse (Fig. 4-3). Make sure that you: Ask questions about the task and what you are expected to do. Tell the nurse if you have not done the task before or not often. Ask for needed training or supervision. Re-state what is expected of you. Re-state what patient or resident concerns to report to the nurse. Explain how and when you will report progress in completing the task. Know how to call the nurse for an emergency. Know what to do during an emergency.  After completing a task, report and record the care given. Also report and record your observations. Guidance and Assistance The nurse supervises your work. The nurse must be available to guide and assist you as needed. The nurse: Observes the care you give as needed. Makes sure that you complete the task correctly. Observes the person's condition and response to care. The frequency of the nurse's observations depends on: The person's health status and needs If the person's condition is stable (not likely to change) or unstable (likely to change)  If the nurse can predict the person's responses and risks to care The setting where the task occurs The resources and support available If the task is simple or complex The nurse follows up on problems or concerns. For example, the nurse takes action if: You did not complete the task in a timely manner. The task did not meet expectations. There is a change in the person's condition. The nurse is alert for possible changes in the person's condition. With your help, the nurse can act before the person's condition changes. Depending on the person's needs, the nurse might need to assist you with the task. Or the nurse can decide to perform the task. After you complete the task, the nurse may review and discuss what happened with you. This helps you learn. If something similar happens again, you have ideas about how to adjust. Follow Up and Feedback To follow up means to review and take needed action. The nurse decides if the delegation was successful. The nurse answers these questions. Was the task done correctly? Did the person respond as expected? Was the result as desired? Was the result good or bad? Did you and the nurse have timely and effective communication? What went well? What were the problems?  Does the care plan need to change Did the nurse give feedback? Feedback means to respond. The nurse tells you what you did correctly and about any errors. Feedback helps you learn and improve the care you give. Your Role in Delegation You must protect the person from harm. You have 2 choices when delegated a task. You either accept or refuse a task. The Five Rights of Delegation for Nursing Assistants - The Right Task - The Right Circumstance - The Right Person - The Right Directions and Communication - The Right Supervision and Evaluation The Right Task Does your state allow you to perform the task? Is the task in your job description? Were you trained to do the task? The Right Circumstance Do you have experience with the task given the person's condition and needs? Do you understand the purposes of the task for the person? Can you perform the task safely under the current circumstances? Do you have needed equipment and supplies? Do you know how to use the equipment and supplies? The Right Person Are you comfortable performing the task? Do you have concerns about performing the task? The Right Directions and Communication Did the nurse give clear directions and instructions? Did you review the task with the nurse? Do you understand what the nurse expects? The Right Supervision and Evaluation Is a nurse available to answer questions? Is a nurse available if the person's condition changes or if problems occur? Did the nurse evaluate the result? Accepting a Task When you agree to perform a routine nursing task or a delegated nursing responsibility, you are responsible for your actions. What you do or fail to do can harm the person. You must complete the task safely. Ask for help if you are unsure or have questions. Report to the nurse what you did and your observations. Refusing a Task You have the right to refuse and not accept a delegated task. You should refuse when: The task is beyond the range of functions for nursing assistants allowed by your state. The task is not in your job description. You were not trained to do the task. The task could harm the person. The person's condition has changed.  You do not know how to use the supplies or equipment. Directions are not ethical or legal. Directions are against agency policies. Directions are not clear or complete. A nurse is not available to guide and assist you as needed. Use common sense. This protects you and the person. Ask yourself if what you are doing is safe for the person. Never ignore an order or a request to do something. Share your concerns with the nurse. For tasks within the legal limits of your role and in your job description, the nurse can help increase your comfort. The nurse can: Answer your questions. Demonstrate the task.  Show you how to use supplies and equipment. Help you as needed. Observe you doing the task. Check on you often. Arrange for needed training. Do not refuse a task because you do not like it or do not want to do it. You must have sound reasons. Otherwise, you place the person at risk for harm. You could lose your job. Focus on Communication Refusing a Task A nurse may delegate a task that was not part of your training. The task is in your job description. You can say: I know this task is in my job description, but I did not learn it in school. Can you show me what to do and then observe me doing it? That would really help me. Focus on Pride Personal and Professional Responsibility You must communicate delegation concerns to the nurse. If uncertain about your ability to safely perform a delegated task, tell the nurse. Take pride in protecting the person from harm. You are also responsible for keeping your skills up to-date. See “Maintaining Competence” in Chapter 3. Rights and Respect Feedback helps you learn and improve in your role as a nursing assistant. Receive feedback in a respectful manner. Listen carefully. Have good eye contact. Consider ways you can improve. Avoid arguing or being defensive. Thank the nurse for the feedback. Independence and Social Interaction Delegation experiences promote positive interactions when staff: Communicate openly. Trust each other. Help and encourage each other. Work toward a common goal. Delegation and Teamwork Examples of delegated nursing responsibilities may include procedures related to: Urinary catheters (Chapter 28) Enemas (Chapter 29) Nutritional support and IV therapy (Chapter 32) Measuring blood glucose (Chapter 38) Wound care (Chapter 40) Oxygen therapy (Chapter 43) Delegation and Teamwork Before performing a responsibility, make sure that: delegated nursing Your state allows you to perform the task. The procedure is in your job description. You have the necessary education and training. The agency has determined that you are competent to perform the task safely. You review the task with the delegating nurse. The delegating nurse is available to answer questions and to guide and assist you as needed. Ethics and Laws Nurses are legally responsible for making safe and ethical delegation decisions. You are responsible for your decision to accept or refuse a task and for completing the task. Focus on Pride: Application How do staff relationships affect the delegation process? How do positive interactions benefit the nursing team and person? LEARNING OUTCOME: Upon completion of this lecture, you should be able to: -List the different types of health care agencies. Introduction: Some agencies have a narrow focus. Surgery centers are an example. Surgeries and medical procedures are done in a non-hospital setting.The person returns home the same day or the next day. Other agencies have many purposes and services. The purposes of health care are -Health promotion. -Disease prevention. -Detection and treatment of disease. -Rehabilitation and restorative care. Types of Healthcare Setting. Hospitals Long-term care centers (nursing homes, nursing facilities, nursing centers) Memory care facilities Home care agencies; home health care agencies Surgery centers Doctors' offices Hospices Adult day-care centers Continue..... Clinics Assisted living residences Urgent care centers Board and care homes Rehabilitation and sub-acute carefacilities Centers for persons with mental health disorders Centers for persons with intellectual and developmental disabilities Drug and alcohol treatment centers Crisis centers for rape, abuse, suicide, and other emergencies 1-Hospitals Hospitals provide emergency care, surgery, nursing care, x-ray procedures and treatments, and laboratory testing. Respiratory, physical, occupational, speech, and other therapies are provided. Hospital care is either in-patient or out-patient.( In-patient care—Out-patient (ambulatory) care) In-patient care—health care a person receives when admission.At least 1 over-night stay is involved. Out-patient (ambulatory) care—medical or surgical care received when a person is not admitted to an agency. The person does not stay over-night 2-Long-Term Care Centers Some persons cannot care for themselves at home but do not need hospital care. Long-term care centers are designed to meet their needs. Care needs range from simple to complex. Medical, nursing, dietary, recreation, rehabilitation, and social services are provided.Persons in long-term care centers are called residents. They are not patients. Many have chronic diseases, poor nutrition, memory problems, or poor health. Not all residents are old. Some are disabled from birth defects, accidents, or disease. Hospital patients are often discharged while recovering from illness or surgery. Someneed home care. Others need long-term care until able to go home. Others need end-of-life care. Nursing Centers. A nursing center (nursing facility, nursing home) provides medical, nursing, dietary, recreation, rehabilitation, and social services. Skilled nursing facilities (SNFs) provide complex care for severe health problems. SNF residents need time to recover or rehabilitation. Others never go home. 3-Memory care facilities A memory care unit is designed for persons with Alzheimer's disease and other dementias (Chapter 53). Such persons suffer increasing memory loss and confusion. Over time, they cannot tend to simple personal needs. Wandering is common. The unit is usually closed off from other parts of the center. The closed unit provides a safe setting where residents can wander freely. 4-Home Care Agencies Health care services are provided to people where they live. Services range from health teaching and supervision to bedside nursing care. Physical therapy, rehabilitation, and food services are common. Hospitals, health care systems, public health departments, and private businesses offer home care. People of all ages need home health care. 5-Surgery center To offer comprehensive surgical treatment for various cases Surgeries are described as: Elective surgery—done by choice to improve life or well-being. It is not life- saving. Joint replacement surgery and cosmetic (plastic) surgery are examples. The surgery is scheduled in advance. Urgent surgery—needed for health. It can be delayed for a few days. Sometimes cancer surgery and coronary artery bypass surgery are delayed for a few days. Emergency surgery—done at once to save life or function. The need is sudden and not expected. Vehicle crashes, stabbings, and bullet wounds often require emergency surgery. 6-Hospices A hospice is a health care agency or program that promotes comfort and quality of life for the dying person and his or her family. Hospice patients no longer respond to treatments aimed at cures. Usually they have less than 6 months to live. The physical, emotional, social, and spiritual needs of the person and family are met. The focus is on comfort, not cure. Children and pets can visit. Family and friends can assist with care. Hospice care is provided by hospitals, nursing centers, and home care and hospice agencies. 7-Adult Day Care. Many children work even though the parent cannot stay alone. Adult day-care centers provide meals, supervision, and activities. Transportation, rehabilitation and dementia care are common. Requirements vary. Some require the ability to walk. A cane or walker is allowed. Others allow wheelchairs. Most require some self-care abilities. Card games, board games, movies, crafts, dancing, walks, exercise groups, and lectures are common activities. Some provide bowling and swimming. All activities are supervised. Needed help is given.Some day-care centers are inter-generational. Children and older persons are in the same center. 8-Assisted living residences Help residents with activities of daily living (ADLs).it offers 3 meals a day Help with ADL—bathing, dressing, grooming, toileting, eating, walking Housekeeping, laundry, and maintenance A 24-hour communications system for an emergency or to call for help 24-hour security Transportation Social, educational, recreational, and spiritual services Help with shopping, banking, and money management Some health services Exercise and wellness programs Medication (drug) management or help taking drugs Supervision for persons with memory problems or other disabilities 9-Board and Care Homes. Board and care homes (group homes; residential care facilities) are often private, single-family homes. The homes have been adapted for group living. Rooms are private or shared. Homes are for older persons or for people with certain problems. Dementia, mental health disorders, and intellectual and developmental disabilities are examples. Homes house 4 to 10 people or more. Personal care and meals are provided. Nursing and medical care are usually not provided on-site. 10-Rehabilitation centers Rehabilitation can frustrate the person, you, and the health team. Besides helping with care, teamwork is also about giving emotional support. Talk about your feelings. Team members can help you control or express your feelings. You may need to assist with other patients or residents for a while. Continue.......... 11 Centers for persons with intellectual and developmental disabilities 12 Drug and alcohol treatment centers 13 Crisis centers for rape, abuse, suicide, and other emergencies  Introduction This presentation discusses the Code of Conduct for health professionals in Saudi Arabia. It emphasises the importance of ethical behaviour, professionalism, and the responsibilities that healthcare providers must uphold to ensure quality care and patient safety. The Purpose o The Saudi Commission for Health Specialties (SCFHS) has a detailed Code of Ethics outlining the ethical standards and best practices for Saudi healthcare professionals in Saudi Arabia. o The Code of Conduct establishes a framework for ethical healthcare practice. o It serves to guide health professionals in making ethical decisions, ensuring that they adhere to the highest standards of integrity and professionalism A-Devotion and Feeling the Worship of Allah (SWT): o Among the values a healthcare practitioner should possess is earnest devotion to Allah (SWT), perceiving His presence through sincere spiritual commitment “I created the Jinn and mankind only that they might worship Me” (Adh-Dhariyat, 51:56). o Consequently, if Allah (SWT) did not create mankind other than to worship Him; then worship of Allah (SWT) is in all our deeds, including what we do as healthcare practitioners making it one of the most mandated duties. A- Devotion and Feeling the Worship of Allah (SWT): o The messenger of Allah (PBUH) said, “The reward of deeds depends upon the intentions and every person will get the reward according to his intentions.”1 o Therefore, it is up to each individual Muslim healthcare practitioner to have devotion in all his/her deeds for the sake of Allah (SWT) and perceive the presence of Allah (SWT) in all his/her activities, plus understand that he/she will be judged for every small and big act he/she has done Devotion and Feeling the Worship of Allah (SWT). B- Demonstration of the Best of Manners Truthfulness: o Truthfulness is the main trait of a faithful person, as Allah (SWT) said in the Holy Quran":O you whom have believed, fear Allah and be with those who are true.” (Tawba, 9:119). o Truthfulness is not only about telling the truth, it is also about the truth of the intention, and truth in the deed performance as well. o Thus, it includes all human relations. It is not appropriate for someone who is a role model to others, in knowledge and honesty, to be accused of lying let alone being known as a liar. o Of course, there is no doubt that the healthcare practitioner, whom people seek due to their calamities of pain and sickness with complete trust in his/her deeds and words, should not be found otherwise [a liar]. o If found to be a liar, his/her knowledge and skills will not help him/her restore the lost trust. B- Demonstration of the Best of Manners Honesty and Integrity : o Healthcare practitioner is entrusted with human souls and bodies; thus, he/she should reflect upon it appropriately. o Allah (SWT) said, describing the faithful: “and who are keepers of their pledge And their covenant” (Mu’minun, 23:8) B- Demonstration of the Best of Manners Humbleness and Respect: For others, Healthcare practitioners should be humble and never display arrogance towards his/her patients or demean them, whatever their position. He/she has to respect all those he/she deals with, including the patients and/or their family members. This puts him/her in a more respectful status. And whoever humbles him/herself for the sake of Allah (SWT), He will raise his/her position. The messenger of Allah (PBUH) said, “He, whoever has even a weight of a mustard seed of arrogance in his heart, will not enter paradise.” 1  B- Demonstration of the Best of Manners Patience and Forbearance: The medical profession is a challenging and hard career. Healthcare practitioners deal with different types of people in the community which requires a high level of patience, forbearance and tolerance. A patient healthcare practitioner tolerates the behaviour of his/her patients and excuses the annoyance of some [patients] considering their pain and illness. Healthcare practitioners should not confront the patients’ irritability with anger or retaliation by stopping to treat a patient who has used inappropriate language, or by dereliction in fulfilling the patient’s right to full care.  B- Demonstration of the Best of Manners Passion and Love: Healthcare practitioners should be loving, passionate and lenient towards his/her patients as well as refrain from insulting them by saying what could make them weak or lose hope. A successful healthcare practitioner considers the psychological state of his/her patient, and uses ways that would help them get rid of illusions by delivering the truth about their illness in a considerate manner with diligence and accuracy that suits the level of the patient’s understanding, intellectual and psychological abilities.  B- Demonstration of the Best of Manners Moderation and Fairness: Moderation is considered one of the basic principles that Islam calls for - no surfeit and no negligence. ” Thus We have appointed you a middle nation, that you may be witnesses against mankind, and that the messenger may be a witness against you.” (Baqarah 2:143). Therefore, a healthcare practitioner should be fair and unbiased in treating his/her patients. This is because they submit their affairs to the healthcare practitioner, based on their trust in him/her and their need for his/her advice as well as service. It is not permissible for a healthcare practitioner to abuse this trust and look down on the patients’ rights, whether it is the right to appropriate medical care or in terms of financial costs that overburden the patient, patient’s guardian or employer.  C- Self-accountability Self-accountability: Healthcare practitioners have to judge themselves before being judged by others, or having their mistakes widely publicized. Self-accountability includes everything, even the smallest of blunders and lapses. For example, to compliment some people at the expense of others (even to a small extent), irrationally give advantage or delay, be late for his/her patients’ appointments, or speak irresponsibly. D- Avoidance of Trivialities and Pettiness Avoidance of Trivialities and Pettiness: It is not appropriate for a healthcare practitioner to indulge in affairs that are religiously objectionable or socially unacceptable, like backbiting, tale-bearing, talking too much, arguing, laughing too much, or saying socially unacceptable words - especially while performing his/her duties. It is also preferable for a healthcare practitioner to refrain from the behaviours of brutality, though it may not be religiously prohibited, such as chewing gum while working, untidy appearance, wearing strange and socially unacceptable clothes, which may be acceptable in other countries other than the Kingdom.  Core Values o The core values of the Code include Respect, Integrity, Compassion, And Accountability. o These values are essential for fostering trust between health professionals and patients, as well as promoting a positive healthcare environment. Professional Integrity: o Health professionals are expected to demonstrate professional integrity by being honest, transparent, and accountable in their actions. o Upholding integrity is crucial for maintaining the trust of patients and the community. Patient-Centered Care: o Health professionals must prioritize the needs and preferences of patients, ensuring that they are treated with dignity and respect throughout their healthcare journey.  Core Values Confidentiality: o Maintaining confidentiality is a fundamental principle of the Code. o Health professionals must protect patient information and only share it with authorized individuals, ensuring that patient privacy is respected at all times. professional development : o Continuous professional development is essential for health professionals. o The Code encourages ongoing education and training to enhance skills, knowledge, and competence, ensuring the delivery of high-quality healthcare.  Core Values Cultural Sensitivity: o Health professionals must practice cultural sensitivity by respecting the diverse backgrounds of patients. o Understanding cultural differences fosters effective communication and improves the overall quality of care provided.  Core Values Ethical Decision-Making: o The Code provides guidelines for ethical decision-making. o Health professionals are encouraged to evaluate situations carefully, considering the implications of their actions on patient care and the broader community.  Core Values Accountability: o Health professionals must be accountable for their actions. o The Code establishes that professionals should accept responsibility for their decisions and behaviours, ensuring that they meet the expectations of their role.  Monitoring Compliance o To ensure adherence to the Code, there are mechanisms for monitoring compliance. o Regular assessments and evaluations help maintain the standards of practice and uphold the integrity of the healthcare profession. o In conclusion, the Code of Conduct for health professionals in Saudi Arabia is vital for promoting ethical practice, enhancing patient care, and fostering trust within the community. o Upholding these standards is essential for the future of healthcare.  Introduction o This presentation explores the impact of Saudi legislation on healthcare delivery. o We will discuss key examples of recent laws and their implications for the healthcare system, focusing on how these changes affect access, quality, and efficiency in service provision. o The Saudi healthcare system is a mix of public and private services. o Recent legislation aims to enhance healthcare access and quality. o Understanding its structure is crucial to grasping the impact of new laws on healthcare delivery. Key Legislation: Vision 2030 Saudi Arabia's Vision 2030: includes reforms aimed at improving healthcare services. o This initiative promotes privatization, enhancing the role of the private sector in providing quality care and increasing efficiency in service delivery.  Health Insurance Health Insurance Law: o The Health Insurance Law mandates coverage for all citizens and residents. o This legislation aims to increase access to healthcare services, reduce out-of-pocket expenses, and improve overall health outcomes for the population Impact on Healthcare Workforce Quality and Safety Regulations:  New quality and safety regulations have been implemented to enhance patient care.  These regulations focus on standardizing practices and ensuring that healthcare facilities meet specific safety standards, ultimately improving patient trust.  Ex: facemask in critical areas. Telemedicine Legislation: o The rise of telemedicine in Saudi Arabia has been supported by new legislation. o This has enabled healthcare providers to offer services remotely, thus improving accessibility for patients, especially in rural areas.  Impact on Healthcare Workforce Key Legislation: Vision 2030 Workforce Regulations:  Legislation has also focused on the healthcare workforce.  New policies aim to attract and retain skilled professionals, ensuring that the workforce is adequately trained and able to meet the demands of a growing population.  Recent laws have emphasized public health initiatives such as vaccination programs and health awareness campaigns.  These initiatives are crucial for preventing diseases and promoting overall community well-being. Challenges and Future Implications Key Legislation: Vision 2030  Despite positive changes, challenges remain in implementing new legislation.  Issues such as resource allocation, training, and public awareness need to be addressed to ensure effective healthcare delivery.  The ongoing evolution of Saudi legislation will continue to shape the healthcare landscape.  Future implications may include further privatization, enhanced technology integration, and a stronger focus on patient-centred care. Ethics is knowledge of what is right conduct and wrong conduct. Ethics involves choices or judgments about what should or should not be done. An ethical person behaves and acts in the right way. He or she does not cause another person harm. Ethical behavior also involves not being prejudiced or biased. To be prejudiced or biased means making judgments and having views before knowing the facts. Judgments and views often are based on one's values and standards. They are based on culture, religion, education, and experiences. The person's situation and yours may be very different. For example:  Children think their mother needs nursing home care. In your culture, children care for older parents at home. An older man does not want life-saving measures. You believe that everything must be done to save a life. Do not judge the person by your values and standards. Do not avoid persons whose standards and values differ from your own. Ethical problems involve choices. What is the right thing to do? For example: A co-worker is in an empty room drinking from a cup. You smell alcohol. The co-worker asks you not to tell anyone. A resident has bruises all over her body. She told the nurse that she fell. She tells you that her family is very mean to her. She asks you not to tell the nurse. Agencies have policies about medical records and who can see them. Policies address: Who records When to record Ink color (paper charting) Abbreviations How to make and sign entries How to correct errors Some agencies allow nursing assistants to record observations and care. Others do not. Follow your agency's policies. Professional staff involved in a person's care can review charts. Cooks and laundry, housekeeping, and office staff do not need to read charts. Some agencies let nursing assistants read charts. If not, the nurse shares needed information.  You have an ethical and legal duty to keep information confidential. If not involved in the person's care, you have no right to read the person's chart. Doing so is an invasion of privacy. Patients and residents have the right to the information in their medical records. The person or the person's legal representative may ask to see the chart. Tell the nurse. The nurse handles the request. Legal Aspects Ethics is about what you should or should not do. Laws tell you what you can and cannot do. A law is a rule of conduct made by a government body. The U.S. Congress and state legislatures make laws. Enforced by the government, laws protect the public welfare.  Criminal laws are concerned with offenses against the public and society in general. An act that violates a criminal law is called a crime. If found guilty of a crime, the person is f ined or sent to prison. Murder, robbery, stealing, rape, kidnapping, and abuse (p. 45) are crimes. Civil laws are concerned with relationships between people. Contracts and nurse practice acts are examples. A person found guilty of breaking a civil law usually has to pay a sum of money to the injured person. Tort comes from the French word meaning wrong. Torts are part of civil law. A tort is a wrong commi ed against a person or the person's property. Some torts are unintentional. Harm was not intended. Intentional torts are done on purpose. Harm was intended. Some torts are also crimes.  What you do or do not do can lead to legal action if you harm a person or a person's property. You are legally responsible (liable) for your own actions. Sometimes refusing to follow the nurse's directions is your right and duty Unintentional Torts Negligence is an unintentional wrong. The negligent person did not act in a reasonable and careful manner. A person or the person's property was harmed. The person causing the harm did not intend or mean to cause harm. The person failed to do what a reasonable and careful person would have done. Or he or she did what a reasonable and careful person would not have done. Malpractice is negligence by a professional person. A person has professional status because of his or her education and the services provided. Nurses, doctors, dentists, and pharmacists are examples.  Intentional Torts Intentional torts are meant to be harmful and may be crimes. Defamation is injuring a person's name and reputation by making false statements to a third person. Libel is making false statements in print, in writing (including e-mail and text messages), through pictures or drawings, through broadcast (radio, TV, or video), posted on-line on websites, or through video sites and social media sites. Slander is making false statements through the spoken word, sounds, sign language, or gestures.  False imprisonment is the unlawful restraint or restriction of a person's freedom of movement. It involves: Threatening to restrain a person Restraining a person Preventing a person from leaving the agency Assault is intentionally a empting or threatening to touch a person's body without the person's consent. The person fears bodily harm. Threatening to “tie down” a person is an example of assault.  Battery is touching a person's body without his or her consent. The person must consent to any procedure, treatment, or other act that involves touching the body. The person has the right to withdraw consent at any time. Fraud is saying or doing something to trick, fool, or deceive a person. The act is fraud if it does or could harm a person or the person's property. Telling someone that you are a nurse is fraud. So is giving wrong or incomplete information on a job application. Invasion of privacy is violating a person's right not to have his or her name, photo, or private affairs exposed or made public without giving consent. You must treat the person with respect and ensure privacy. Only staff involved in the person's care should see, handle, or examine his or her body.  Analyzing medical terms: LEARNING OUTCOMES Upon completion of this session, you should be able to: Discuss the purpose of medical terminology. Recognize each of the four word parts of medical terms: prefixes, roots, suffixes, and combining forms. Define the commonly used prefixes, roots, and suffixes. Divide medical terms into word parts. Understand how word parts are put together to make medical terms. Recognize the importance of proper spelling, pronunciation, and use of medical terms.  Purpose of medical terminology : Medical terminology serves as the universal language that allows healthcare professionals to communicate effectively and accurately. This language consists of official terms and abbreviations that describe anatomy, bodily functions, diseases, diagnoses, treatments, procedures, and more. When you use simple words like “gut” and “cut”, Gut can refer to the stomach, small intestine, large intestine, or any part of your digestive system. If you have pain in one of these areas, you would want to be able to easily identify a single area and have all medical professionals recognize that specific area.  The term “cut” could mean just an incision, or in other cases it could mean cutting off a body part. For example, “She cut her hand” indicates an incision, but “Cut the hand distal to the wrist” could mean an amputation. Luckily medical terminology allows us to specifically identify places in the body and even what type of cut it is with words. MEDICAL TERM PARTS: : Nearly every medical term contains one or more roots. It may also contain one or more prefixes and one or more suffixes. When you start combining parts into words, you will also use a combining form of a root. This means a single medical term may consist of one part or several parts, but every part of a term behaves in one of three ways: root, prefix, or suffix. The word parts used in forming words: prefixes first, roots second, and suffixes lastly. such as nontraditional, contain all three word parts. The prefix is non- (not), the root is tradition (established customs or norms), and the suffix –al.  Some words contain only two parts, such as traditionist. Tradition is the root and–ist is the suffix that refers to “adhering to a system of beliefs or customs.” So, a traditionist is a person with established beliefs or customs. Other words contain other combinations, such as nontradionalist (the prefix non- = not; the root tradition = established customs or norm; the suffix-al = adjective form meaning relating to; and another suffix –ist = refers to adhering to a system of beliefs or customs). medical term that has two roots: psychopath (psycho and path). ANALYZING TERMS : Learning to pick out prefixes ,roots, suffixes. A combining form is simply a root that includes one or more vowels tacked onto the end of it to make a root–suffix combination pronounceable, as in the word psychology. The main root is psych (mind), and the suffix is -logy (study of).  Term prefix root suffix Term meaning cardialgia -algia (pain( pain in the heart; cardi (heart ( also, heart burn (adigestive disorder) cardiology cardio (heart ( -logy (study of( study of the heart and its disorders diagnosis dia- across; gnosis (Greek word discovery of the through Meaning cause of signs and ‘‘knowledge(” Symptoms psychopath psycho (mind;( path person with a (disease( serious mental disease  suffixes: -algia, -logy, and -itis. -algia = pain -logy = study of -itis = inflammation neur/o, which means nerve, you will know the meanings of neuralgia, neurology, and neuritis: neuralgia = pain in a nerve neurology = the study of the nervous system; also the specialty dealing with diagnosis and treatment of nervous system disorders. neuritis = inflammation of a nerve. Exercise: Intracranial: prefix = ________ root = ________ suffix = ________  Psychiatry = psych + iatr+ y specialty dealing with disorders of the mind (in this case they does not act as an adjective suffix) Psychiatric= psych + iatr + ic adjective form of psychiatry Psychiatrist= psych + iatr + ist specialist in psychiatry Geriatrics= ger + iatr + ics specialty in disorders of the elderly Pediatrician= ped +iatr +ician specialist in children’s disorders Word Root Meaning arthr/o joint card/i/o heart derm/o/ato skin gen/o origin, cause, formation hem/a/ato blood ;natal birth born os/teo bone  INRODUCTION As a nurse assistant, it is important for you to understand behaviors that could result in legal or disciplinary action being taken against you. There can be significant consequences if you commit one of these acts, ranging from disciplinary action being taken by your employer, to losing your job, to being arrested and tried in a court of law. In many cases, behaviors that result in legal or disciplinary action being taken against a nurse assistant are recorded on the nurse assistant’s record in the state registry. A record of having committed one of these acts can have a very negative impact on the nurse assistant’s ability to get another job in health care.  Abuse Abuse is the willful infliction of injury or harm on another. A person can commit abuse by actively doing something to another person (for example, by hitting the person or verbally tormenting or threatening the person). Failing to provide necessary care for someone who is dependent on others for that care is also a form of abuse. Abuse can take many forms Forms of Abuse Forms of Abuse Forms of Abuse Forms of Abuse Forms of Abuse  Abuse Even professional caregivers, like nurse assistants, are subject to on-the-job stress that can lead to abuse. How to manage:- Take advantage of the opportunity to attend counseling sessions if they are offered. Participating in activities that you enjoy outside of work, Taking time for yourself on a regular basis to relax and recharge, Creating an environment where co-workers pitch in to help one another. Ask a co-worker to cover for you and remove yourself from the situation. Take a few minutes to get your feelings under control. If you find a situation to be too difficult to manage appropriately, you may need to ask your supervisor to reassign you.  Assault and Battery Assault is an action that causes a person to fear being touched in a harmful or unwelcome way. For example, raising your hand as if to strike a person in your care, or making a statement that suggests you will physically harm the person (such as, “If you don’t stop trying to pull that IV line out I’m going to tie your hands behind your back!”) could be considered assault.  Assault and Battery Battery is actually touching another person in a harmful or unwelcome way. Hitting, pinching or slapping a person in your care would be considered forms of battery. The inappropriate use of physical restraints (devices used to restrict a person’s ability to move freely) is also considered a form of battery. Even beginning a procedure without obtaining the person’s verbal consent to do so could be considered a form of battery, because you would be touching the person in an unwelcome way.  Negligence Negligence is failure to do what a reasonable and careful person would be expected to do in a given situation. Examples of negligence include the following: A nurse assistant has been trained in how to use the mechanical lift (a device used to assist people with moving from one place to another). While using the lift to move a person from the bed to a chair, the nurse assistant fails to lock the brakes on the lift, resulting in injury to the person. A nurse assistant is helping a person to get out of bed. The person repeatedly tells the nurse assistant that he is feeling dizzy, but the nurse assistant encourages him to stand up anyway, because she does not have time to wait for the person’s dizziness to pass. The person stands up and then experiences a fall. A nurse assistant is asked to do a task that she has not been trained to do. Instead of declining to do the task, the nurse assistant attempts the task and causes injury to the person  Fraud Fraud is lying to gain profit or advantage. For example, a very problematic type of fraud in health care is Medicare fraud, which occurs when an individual or an organization seeks Medicare repayment for services that were not provided. Always document the care that you provide accurately and honestly. A health care worker can also commit fraud by misrepresenting his qualifications to others. For example, it would be fraudulent for a nurse assistant to tell a person in his care that he is a nurse, because he does not have the training or license necessary to practice as a nurse  Larceny Larceny is stealing. As a nurse assistant, you will have access to the personal belongings of the people in your care. This is especially true if you work in a long-term care or home setting. It is never acceptable to take something that belongs to someone else, even if the person does not seem to need the item. People who are elderly or ill are particularly at risk for having money or belongings stolen from them. Family members, friends, staff members or even other people receiving care in the facility may commit larceny. If you notice that items are missing, or if you see someone taking an item that belongs to one of the people in your care, you must report this to the nurse.  Larceny Larceny is stealing. As a nurse assistant, you will have access to the personal belongings of the people in your care. This is especially true if you work in a long-term care or home setting. It is never acceptable to take something that belongs to someone else, even if the person does not seem to need the item. People who are elderly or ill are particularly at risk for having money or belongings stolen from them. Family members, friends, staff members or even other people receiving care in the facility may commit larceny. If you notice that items are missing, or if you see someone taking an item that belongs to one of the people in your care, you must report this to the nurse.  CODE OF ETHICS Many professions also have codes of ethics that guide decision making and behavior for the people who practice that profession. For example, five ethical principles that are especially relevant to health care workers include the following: 1. Autonomy. Every person has the right to make decisions about matters that affect him personally.  CODE OF ETHICS 2.Justice. All people—regardless of race, religion, culture, sexual orientation, disability or ability to pay for services—deserve fair and equal treatment. 3. Beneficence. Health care workers are obligated to act in a way that promotes the well-being of those in their care.  CODE OF ETHICS 4. Nonmaleficence. Health care workers are obligated to avoid harming those in their care. 5. Fidelity. Health care workers are obligated to act in a way that is truthful and trustworthy. AVOIDING LEGAL AND ETHICAL DIFFICULTIES ON THE JOB  Nurse Assistant DO’s and DON’Ts DO be knowledgeable about the rights of the people in your care DO practice the five principles of care) with every person in your care DO be aware of legislation that protects the rights of the people receiving health care DO be aware of ethical principles that guide the actions of health care workers DO be familiar with your employer’s policies and procedures.  Nurse Assistant DO’s and DON’Ts DON’T perform tasks or make decisions that are outside of your scope of practice. DON’T accept gifts of personal belongings or money from those in your care or from their family members. ASSIGNMENTS AND CASE DISCUSSIONS 1.One of the friends you made during nurse assistant training is posting comments about situations and the people she cares for on a social networking site. Last night, she wrote “My thoughts and prayers are with the Miller family.” Would you say anything to your friend about her posts? Why or why not? 2. you are providing care for Miss Eller. She is dying. She says she would like for you to have a ring that belonged to her sister, who died last year. What should you say? 3.You see a co-worker slapping a person in her care. What should you do? 4. One of your home health clients tells you that he hides his pills and does not take them. He shows you his hiding place for the pills because he trusts you. What should you do?  5.You see a nurse assistant removing a watch belonging to one of the residents in her care from the resident’s bedside table drawer while the resident is attending an activity session. What are possible reasons the nurse assistant could be removing the watch? Are all of them necessarily unethical or illegal?  INRODUCTION As a nurse assistant, you will have a great deal of daily contact with the people in your care and their family members. Getting to know the people in your care as individuals and taking a genuine interest in them are things you can do to support them emotionally. A smile, a pat on the shoulder, and a willingness to listen lets the person know that you care, and that she is not alone  As a nurse assistant, many of your responsibilities will have to do with helping the people in your care with Activities of Daily Living (ADLs), such as eating, bathing, dressing, grooming, using the toilet and moving. Nurse assistants are also responsible for obtaining routine measurements (such as vital signs, height and weight); assisting with admissions, transfers and discharges; and maintaining a safe and clean environment Because of the amount of time you will spend with the people in your care, you may be the first to recognize a change in the person’s condition, or learn of a concern the person has. For example, you may notice that a person’s appetite has decreased, or a person may mention to you that she is worried about a surgical procedure she is scheduled to have the next day. When you share this type of information with the nurse, you promote quality ca