Professional Adjustment Ppt

Professional AdjustmentProfessional Adjustment

Roberto C. Sombillo RN, RM, Roberto C. Sombillo RN, RM, MANMAN

Profession

A calling in which members profess to have acquired special knowledge, by training or experience or both, so that they may guide, serve or advice others in that special field

Characteristics of a profession

Special Education

Code of ethics

Research Orientation

Autonomy, Authority, Accountability

Body of knowledge

Service Orientation

Professional organization

Professional Nursing

The performance for salary or remuneration, of professional nursing service, particularly that of diagnosing and treating human responses and potential health problems.

Legal Basis of Professional Nursing Practice

Republic Act 9173 or the nursing law of 2002

> Defines nursing, set standards for the nursing profession and give guidance in the scope of practice.> Contains general statements of appropriate nursing actions> Goal: protection of the general public

As a registered nurse, which of the following As a registered nurse, which of the following can be performed within the meaning of the can be performed within the meaning of the Nursing Act of 2002?Nursing Act of 2002?

1. Internal examination during labor and delivery in 1. Internal examination during labor and delivery in the absence of ante natal bleedingthe absence of ante natal bleeding

2. Suturing of perineal lacerations 2. Suturing of perineal lacerations 3. Nursing care of pregnant mothers during labor 3. Nursing care of pregnant mothers during labor

and deliveryand delivery4. Administration of medications and therapies 4. Administration of medications and therapies

including IVincluding IVa. 1,2,3a. 1,2,3b. 1,3,4b. 1,3,4c. 2,3,4c. 2,3,4

Answer: BAnswer: B

Petra chose nursing as her life-long career. Petra chose nursing as her life-long career. It is necessary that she must understand It is necessary that she must understand this profession as to guide her practically this profession as to guide her practically and professionally as a nurse. Which and professionally as a nurse. Which among the following phrases best among the following phrases best describes what professional nursing is all describes what professional nursing is all about?about?

a. A nurse has always experienced proper a. A nurse has always experienced proper community health trainingcommunity health training

b. Has independence towards the proactive of her b. Has independence towards the proactive of her nursing professionnursing profession

c. Always observe ethical and professional practicec. Always observe ethical and professional practiced. Provide diligent care for all regardless of their d. Provide diligent care for all regardless of their

financial statusfinancial status

Answer: CAnswer: C

To avoid legal embarrassment, the To avoid legal embarrassment, the nurse should do the following?nurse should do the following?

a. He must have basic knowledge a. He must have basic knowledge regarding the new Philippine Nursing regarding the new Philippine Nursing LawLaw

b. He is aware of the laws affecting nursesb. He is aware of the laws affecting nurses

c. Upgrade one’s skills and competence c. Upgrade one’s skills and competence as a nurseas a nurse

d. All of the aboved. All of the above

Answer: DAnswer: D

Carmelita is a nurse who just passed the Carmelita is a nurse who just passed the local licensure examination for nurses. local licensure examination for nurses. She knows that professional practice of She knows that professional practice of nursing involves all the following, except:nursing involves all the following, except:

a. Administration of intravenous injection after a. Administration of intravenous injection after completion of trainingcompletion of training

b. Motivation of individuals, families and b. Motivation of individuals, families and communitiescommunities

c. Undertaking consultation servicesc. Undertaking consultation services

d. Participation in teaching, guidance and d. Participation in teaching, guidance and supervision of studentssupervision of students

Answer: CAnswer: C

Common Law

is derived from principles or social mores rather than from rules and regulations. It consists of broad, interpretative principles based on reason, traditional general and common sense.

Nursing Jurisprudence

Department of law which comprises all the legal rules and principles affecting the practice of nursing the study and interpretation of rules and principles and their application in the regulation on the practice of nursing

Law

Are rules and regulations established by a governing authority (sovereign power) to institute and maintain orderly coexistence by commanding what is right and prohibiting what is wrong.

Functions of Law in the Society

1. define relationships among members of a society and state which activities ate permissible or not

2. describe what forces maybe applied to maintain rules and by when is to be applied.

3. provide solutions to problems4. refine relationship between person

and group when conditions of life change.

Basic Principle of Law

• Based on concern for justice and fairness• Characterized by change• Actions are judged on basis of universal standards of what is similarly trained, reasonable and prudent person would done rather in similar circumstances• Each individual has right and responsibilities

Types of Law

Law govern the relationship of private individuals with government.

Public Law

Refers to the body of law that deals with relationship between individual and the government and the governmental agencies. An important segment of public law is criminal law which deals with actions against the safety and welfare of the public Examples are homicide, manslaughter and theft.

Private Law or Civil Law

Is the body of law that deals with relationship among private individuals. It can be categorized into a variety of legal specialties such as contract law and tort law

Contract law involves the enforcement of agreements among private individuals

Torts laws define and enforce and enforce duties and right among private individuals that are not based on contractual agreement.

Sources of Law

Constitution

The constitution of the Philippines is the supreme law of the country. It established the general organization of the government, grants certain powers to the government, and places limits on what government may do. The constitution created legal rights and responsibilities and the foundation for a systems of justice.

Legislation (Statutory law)

Laws enacted by any legislative body are called statutory laws.

Administrative Law

When a state legislature passes a structure, an administrative agency is given the authority to create rules and regulation to enforce the statutory laws.

Functions of law in the profession

Provides a framework for establishing what nursing actions in the care of patients are legal.

Delineates the nurse’s responsibilities from those of other professionals.

Helps to establish the boundaries of independent nursing actions.

Assists in maintaining a standard of nursing practice by making nurses accountable to the law.

Nurses and legal offenses

Crimes

Actions/behaviors which violate law and is punishable by fine, imprisonment or death

There 2 types according to severity: felonies and misdemeanor

Felonies

Relatively serious offenses punishable by imprisonment, fines or even death. Offenders lose their civil rights.

Misdemeanor Is less serious crime punishable by fine and short-term jail sentence.

Board Question!Board Question!

When the law attaches the capital When the law attaches the capital punishment, the felony is punishment, the felony is considered:considered:

a. gravea. grave

b. less graveb. less grave

c. light felonyc. light felony

Answer: AAnswer: A

Which of the following is a grave Which of the following is a grave felony?felony?

a. Guilty of committing euthanasiaa. Guilty of committing euthanasia

b. Untidy appearance while on dutyb. Untidy appearance while on duty

c. Reporting a wrong doing of a colleaguec. Reporting a wrong doing of a colleague

Answer: AAnswer: A

Felony is considered consummated when:Felony is considered consummated when:a. All the elements necessary for its execution are a. All the elements necessary for its execution are

presentpresent

b. The offender performs all the acts of execution b. The offender performs all the acts of execution which would produce the felony as a which would produce the felony as a consequence but nevertheless do not produce consequence but nevertheless do not produce it by reason of causes independent of the will it by reason of causes independent of the will of the perpetratorof the perpetrator

c. The offender commences the commission of a c. The offender commences the commission of a felony and does not perform all the acts of felony and does not perform all the acts of execution which should produce the felonyexecution which should produce the felony

d. None of thesed. None of these

Answer: AAnswer: A

Criminal liabilities can be classified according to:

Manner of commission Dolo – deceit; deliberate intent

Culpa - fault; product of imprudence, negligence, lack of foresight or skills

Stage of execution

Consummated – all elements for execution of the crime has been completed

Frustrated – offender performs everything as intended but fails due to external causes

Attempted – overt actions to commit crime has been commenced, but the elements were not completed due to reactions other than this own spontaneous desistance.

Degree of participation

Principals – direct part in the execution of a crime; cooperate in committing an act which crime will not be accomplished

Accomplice – cooperate in execution of offences by previous/stimulation acts

Accessories – profit or assist offenders to profit from crime; conceals, destroy the body of crime, effects, instruments to prevent discovery of crime; harbor, conceals, and assists in escape of principal with abuse of authority

Board Question!Board Question!

Situation: Vivian is two months Situation: Vivian is two months pregnant. Her friend Donna referred her pregnant. Her friend Donna referred her to Sandra, an abortionist. Vivian without to Sandra, an abortionist. Vivian without the consent of Carlo had an abortion.the consent of Carlo had an abortion.

If those involved be charged legally, If those involved be charged legally, who is considered as the principal of the who is considered as the principal of the crime?crime?a. Viviana. Vivianb. Sandrab. Sandrac. Donnac. Donna

Answer: BAnswer: B

Who is to be charged as an Who is to be charged as an accomplice?accomplice?

a. Donnaa. Donna

b. Sandrab. Sandra

c. Vivianc. Vivian

Answer: AAnswer: A

A nurse becomes liable as an A nurse becomes liable as an accomplice in an abortion if she:accomplice in an abortion if she:

a. performs the acta. performs the act

b. refers the pregnant mother to b. refers the pregnant mother to abortionistabortionist

c. conceals the evidence of the crimec. conceals the evidence of the crime

Answer: BAnswer: B

If during the investigation, the If during the investigation, the pieces of evidence were not found pieces of evidence were not found because Carling, the maid of because Carling, the maid of Juaning burned it. Carling is Juaning burned it. Carling is considered as:considered as:

a. Accomplicea. Accomplice

b. Accessoryb. Accessory

c. Principalc. Principal

d. Co-Principald. Co-Principal

Answer: AAnswer: A

Contract- An agreement between two or more persons upon sufficient consideration to do or not to do some lawful act.

- One binds self with respect to other give something or to render some service.

- An agreement which creates an obligation

- Can be written or oral

Expressed contract

When two parties discuss and agree orally in writing to its terms

Implied contract

- One in which there has been no discussions between parties, but the law considers that a contract exists - Law ascribes an objective intention to enter a contract “facio ut des” ( I do that you may give)

Elements of a valid contract

Agreement/ Mutual consent – contracts must be binding for both parties Legal Subject matter – nothing in the contacts is contrary to law or public order

Cause of the obligation which is established

Contractual capacity – parties are eligible to enter a contract

Objects of contracts

• All things which are within the commence of man

• All rights which are transmissible

• Future inheritance

Prerequisites in entering a contract

Be of legal age

Be sound of mind

Not under the influence of intoxicating substances or fear of bodily harm

Mentally competent

Termination of Contract

Most nurse – patient contracts end when

• Treatment is complete• Bills • Has been paid • Waiver to discharge against medical advise has been signed

An agreement between two or more An agreement between two or more persons to do or not to do a persons to do or not to do a particular thing is known as:particular thing is known as:

a. agreementa. agreement

b. contractb. contract

c. subpoenac. subpoena

Answer: AAnswer: A

A contract is:A contract is:a. A bond gathered by a nurse from the a. A bond gathered by a nurse from the

patientpatient

b. A document that permits two person to b. A document that permits two person to offer the same servicesoffer the same services

c. A written agreement between the nurse c. A written agreement between the nurse and the patientand the patient

d. An agreement which creates an d. An agreement which creates an obligationobligation

Answer: DAnswer: D

When a patient enters a doctor’s When a patient enters a doctor’s clinic for treatment, this is an clinic for treatment, this is an example of:example of:

a. formal contracta. formal contract

b. implied contractb. implied contract

c. single contractc. single contract

Answer: BAnswer: B

Which of the following statement is Which of the following statement is false about an implied contact?false about an implied contact?

a. Its agreement is presumeda. Its agreement is presumed

b. Its agreement is inferred from the acts b. Its agreement is inferred from the acts of the partiesof the parties

c. It must still have consent by the partiesc. It must still have consent by the parties

d. It is a formal contractd. It is a formal contract

Answer: DAnswer: D

A verbal agreement where one A verbal agreement where one undertake to render service to undertake to render service to another in which either party another in which either party agrees to give for a fee or agrees to give for a fee or renumeration is enforceable:renumeration is enforceable:

a. Formal written contracta. Formal written contract

b. Contract that is null and voidb. Contract that is null and void

c. Form of an informal contractc. Form of an informal contract

d. Form of an implied contractd. Form of an implied contract

Answer: DAnswer: D

Legal offense

Breach of Contract

is the failure to perform an agreement whether expressed or implied, without cause

Legal excuse or defense Torts

• A civil wrong committed against a person or property, excluding breach of contact, which calls for compensation in damages• The wrongdoing can be inflicted by commission or omission • Can be intentional or unintentional

See Intentional Torts Table

Unintentional Torts

Negligence

Doing an act which a prudent person would not do or not taking an act which a prudent person would do in the same situation

Can be considered as grave felony if done with obvious disregard of the safety of others, or indifference to injury that is bound to fallow one’s act, specifically when it results to injury or death

Nurses are liable for poor outcomes if and only if there conduct is negligent.

Gross Negligence/ Reckless ImprudenceInvolves extreme breach of care, in which the damage caused was not immediate or danger is not evident or manifested

Simple NegligenceManifesting lack of precaution in which the damage caused was not immediate or the danger is not evident or manifested.

Malpractice

Professional negligence Failure to meet the standards of

acceptable care which results to harm to other person

Negligence that occurred while the person was performing as a professional

Elements of Negligence and Malpractice

1. Duty

2. Breach of Duty

3. Foreseeability & Causation

4. Harm or injury

5. Damages

Doctrines Applicable To Negligence Suits

Respondeat Superior

“let the master answer for the subordinates”

where an agent acts through the agency of another (superior), the latter is himself acting through the former

Res Ipsa Loquitor

• “ the thing speaks for itself”

• when a thing which has caused an injury is shown to be under the management of the party charge with negligence, the accident is as such as in the ordinary course of thing will not happen if those who have such management used proper care, the accident itself affords reasonable evidence in the absences of an explanation by the parties charge that is those from the want of proper care.

Three elements

(1) the event would have not occurred if the nurse exercised prudent care,

(2) the accident occurred within exclusive control of the nurse,

(3) no voluntary action was done by the injured party.

Force Majeure

• “irresistible or superior force”

• no one shall be held liable for negligence done due to an event that human prudence cannot foresee, prevent or control

• pertains to act of God and of nature

Situation: Nurse Robert is the scrub nurse in the Situation: Nurse Robert is the scrub nurse in the surgical team which performed exploratory surgical team which performed exploratory laparotomy. Dr. Leonard was the surgeon, Nurse laparotomy. Dr. Leonard was the surgeon, Nurse Cha was the circulating nurse and Dr. Siony was Cha was the circulating nurse and Dr. Siony was the anesthesiologist. After the operation, the the anesthesiologist. After the operation, the patient complained of severe abdominal pain patient complained of severe abdominal pain while in the recovery room. X-ray showed a while in the recovery room. X-ray showed a mosquito forceps left in the patient’s abdomen.mosquito forceps left in the patient’s abdomen.

The nurses are considered guilty based on the The nurses are considered guilty based on the doctrine of:doctrine of:a. Res ipsa loquitura. Res ipsa loquiturb. Respondeat superiorb. Respondeat superiorc. Force majeurec. Force majeure

Answer: AAnswer: A

The thing speaks for itselfThe thing speaks for itself

The doctrine of respondent superior The doctrine of respondent superior applies:applies:

a. Where the injury occurs while the servant is a. Where the injury occurs while the servant is not within the legitimate scope of his not within the legitimate scope of his authorityauthority

b. When the injury occurred in the course of his b. When the injury occurred in the course of his employmentemployment

c. When the injury occurred outside the c. When the injury occurred outside the commerce of mancommerce of man

d. When the instrumentality was with in the full d. When the instrumentality was with in the full control of the servantcontrol of the servant

Answer: BAnswer: B

The test for liability under the The test for liability under the doctrine of respondent superior is doctrine of respondent superior is the:the:

a. Power of master servanta. Power of master servant

b. Inquire itselfb. Inquire itself

c. Extent of damage causedc. Extent of damage caused

d. Circumstances surrounding the actd. Circumstances surrounding the act

Answer: AAnswer: A

The nurses were guilty of professional The nurses were guilty of professional negligence, which of the following are the negligence, which of the following are the elements of the act?elements of the act?

1. existence of a duty on the part of the person 1. existence of a duty on the part of the person chargedcharged

2. failure to meet standards of care2. failure to meet standards of care3. foreseeability of harm resulting from failure to 3. foreseeability of harm resulting from failure to

meet standardsmeet standards4. the power to control over the circumstances4. the power to control over the circumstances

a. 1,2,4a. 1,2,4b. 1,3,4b. 1,3,4c. 1,2,3,4c. 1,2,3,4

Answer: DAnswer: D

The following are possible penalty The following are possible penalty of the act except:of the act except:

a. revocation of licensea. revocation of license

b. life imprisonmentb. life imprisonment

c. monetary penaltyc. monetary penalty

Answer: AAnswer: A

The professional license that has The professional license that has been revoked means:been revoked means:

a. suspension to practice nursinga. suspension to practice nursing

b. removal of license numberb. removal of license number

c. cancellation of the licensec. cancellation of the license

Answer: AAnswer: A

A nurse who executes a doctors A nurse who executes a doctors order, which to her honest belief or order, which to her honest belief or judgment may endanger the life of judgment may endanger the life of the patient can be accused of:the patient can be accused of:

a. Malpracticea. Malpractice

b. Accessoryb. Accessory

c. Accessoryc. Accessory

d. Criminal negligenced. Criminal negligence

Answer: DAnswer: D

Negligence means failure to:Negligence means failure to:a. Observe the behavior of an a. Observe the behavior of an

unscrupulous personunscrupulous person

b. Behave properly as a professional b. Behave properly as a professional nursenurse

c. Carry out one’s duties and functionc. Carry out one’s duties and function

d. Do what is supposed to dod. Do what is supposed to do

Answer: CAnswer: C

Definition of Terms

Murder – killing of another person other than relative with proven malice or premeditation

Parricide – killing of father, mother or child, whether legitimate or illegitimate, or any of his ascendants or descendants including the spouse.

Homicide – killing of any human creature. It is not necessarily a crime, committed without criminal intent and without criminal consequence.

Infanticide – killing a child less than 3 days of age

Abortion – expulsion of fetus so early that it has not yet acquired the power of sustaining independent life

Simulation of Birth – substituting one child to another, falsification of birth favoring adoption

Burglary – entry into building with intent to commit a theft or felony inside the building

Robbery – direct taking of property from another by the use of force, intimidation or fear

Arson – burning a building or structure with malicious intent

Rape – Forcible penetration of organ o copulation or any inanimate object to any body orifice of the offended party

Child molestation – engaging in any sexual act with a person under age 18

Drug charges – possession and/or trade of control substance

The essential element to determine The essential element to determine parricide is:parricide is:

a. Presence of the body of the crimea. Presence of the body of the crime

b. Kind of weapon usedb. Kind of weapon used

c. Part of victim’s body at which the c. Part of victim’s body at which the weapon is aimedweapon is aimed

d. The relationship of the offender with d. The relationship of the offender with the victimthe victim

Answer: DAnswer: D

Infanticide is the unlawful killing of Infanticide is the unlawful killing of an infant under:an infant under:

a. Three days olda. Three days old

b. Three months oldb. Three months old

c. Under 3 lbs. baby weightc. Under 3 lbs. baby weight

d. Three years oldd. Three years old

Answer: AAnswer: A

Any person who kills his father is Any person who kills his father is guilty of:guilty of:

a. Parricide a. Parricide

b. Murderb. Murder

c. Infanticidec. Infanticide

d. Abortiond. Abortion

Answer: AAnswer: A

Considerations to Criminal Liability

Justifying Circumstances (there is no crime in the eye of the law)

unlawful aggression on the part of the offended or injured party

reasonable necessity of the means employed by the offender

lack of sufficient provocation on the part of the offender

Exempting Circumstances (there is crime committed but no criminal on account of absence of free will or voluntariness)

imbecile or insane person, unless the latter has acted during a lucid interval

under nine years old

over nine and under fifteen years old (unless acted on discernment)

under the compulsion of an irresistible force

any person who while a performing a lawful act with due care, causes an injury by mere accident, without fault or intention of doing it

acting on impulse of an uncontrollable fear of an equal or greatly injury

failure to perform an act required by law when prevented by some insuperable cause

Mitigating Circumstances (penalty is lessened)

circumstances otherwise justifying or exempting

under 18 years of age; over 70 years old

offender had no intention to commit so grave a wrong as that committed

sufficient provocation or threat on the part of the offended party immediately preceded the act

the act was committed in the immediate vindication of a grave offense to the committing felony, his spouse, relatives whether legitimate or not

acted on impulse so powerful as naturally to have produced passion or obfuscation

surrendered himself or voluntarily confessed his guilt

• deaf, dumb, blind or other physical defects that restricts better communication

• illness that would diminish the exercise of his will power without however depriving him of consciousness of his acts

Aggravating Circumstances (penalty is increased)

advantage taken by the offender of his public possession

crime committed in contempt or with insult to public authorities

act committed with abuse of confidence or obvious ungratefulness

crime committed during conflagration, shipwreck, earthquake, epidemic or misfortune

crime committed in consideration of a piece, reward, or promise

crime committed by means of inundation, fire, poison, explosion, standing of a vessel or anything involving great waste or ruin

act committed with evident premeditation

fraud or disguise are employed

Circumstances or actions which are Circumstances or actions which are said to be in accordance with law is said to be in accordance with law is said to be:said to be:

a. Justifyinga. Justifying

b. Exemptingb. Exempting

c. Mitigatingc. Mitigating

d. Aggravatingd. Aggravating

Answer: AAnswer: A

All of the following are exempting All of the following are exempting circumstance except:circumstance except:

a. Imbecilea. Imbecile

b. 8 years oldb. 8 years old

c. performance of a lawful act c. performance of a lawful act

d. offender id deaf and dumbd. offender id deaf and dumb

Answer: AAnswer: A

When a politician takes advantage When a politician takes advantage of his power in the performance of of his power in the performance of lawful actions this is considered as:lawful actions this is considered as:

a. justifying circumstancesa. justifying circumstances

b. exempting circumstancesb. exempting circumstances

c. mitigating circumstancesc. mitigating circumstances

d. aggravating circumstancesd. aggravating circumstances

Answer: DAnswer: D

Which of the following is a Which of the following is a mitigating circumstances?mitigating circumstances?

a. Act committed during epidemic or a. Act committed during epidemic or calamitycalamity

b. Obeying a lawful order of the superiorb. Obeying a lawful order of the superior

c. Accidental killingc. Accidental killing

d. None of the above d. None of the above

Self-Protection of the Nurse

familiarity with the laws, code of ethics, rules and regulation, and standards of practice

clinical competence cultural sensitivity and respect self-awareness sound management concept of personal liability documentation/recording

Documentation

Principles of documentation

Records are legal documents and are admissible as evidence in a court of law

Nurses must accurately document each step of the Nursing Process in the client’s records

Records entries should be brief, accurate, legible chronologic, made on consecutive lines and appropriately signed

Falsification is illegal, including omission of relevant information

Incidents Reports

Purpose of incident reports:

to memorize in writing any unusual event at time of its occurrence by a person who was a direct personal witness. It is generally used for management and documentation purposes only.

The whole purpose of incident reporting is to LEARN from the mistakes and how to eliminate, reduce and manage the risks we have to deal with on a daily basis. It cannot be used as evidence in lawsuits.

What an incident report should contain

> The date> The place> The position of the individual reporting (not necessarily the name)> A description of the incident or issue> Whom it is reported to

What should be done to correct it

What has been done to correct it

A space for follow up reporting

The signature of the individual reporting

The date and time the reporting is received by the Risk Manager

> Action of the Risk Manager

Common situations that require Incident report • Break in aseptic technique• Incorrect sponge count in surgery• Medical – legal incident• Client or family refuses treatment as ordered and refuses to sign consent

* Client or family voices dissatisfaction with care and situation, cannot be or has not been resolve• Complication from diagnostic or treatment procedures ( e.g. blood sample stick, biopsy, x-ray, invasive procedure. Bronchoscopy)• Failure to report change in patient’s condition• Falls• Patient is burned

Each professional nurse must be legally Each professional nurse must be legally accountable in all his action which accountable in all his action which involves proper monitoring and recording. involves proper monitoring and recording. The legal implication of this is due to: The legal implication of this is due to:

a. That regardless if the nurse re recorded his a. That regardless if the nurse re recorded his observation or not, he shall still be observation or not, he shall still be accountable and liableaccountable and liable

b. If the nurse did not document anything, he b. If the nurse did not document anything, he shall be liableshall be liable

c. If it was not written although it was performed, c. If it was not written although it was performed, it is considered as not having been done at allit is considered as not having been done at all

d. Because a chart needs to be completed by d. Because a chart needs to be completed by handwritten wordshandwritten words

Answer: CAnswer: C

Nursing Ethics

Morality - usually refers to private, personal standard of what is right and wrong. Moral issues involve important social values and norms

Ethics – refers to a method of inquiry about the rightness or wrongness as a human actions; the practices or beliefs of a group; and the standards of moral behavior described in the group’s formal code of ethics

Bioethics – ethics as applied to “life situations “(e.g. decisions about euthanasia, prolonging life, abortion)

Nursing ethics – ethical issues that occur in the context of nursing practice – questions that must address with regard to their own actions

Values - freely chosen, long-lasting beliefs or attitudes about the worth of something (e.g. a person or an idea)

Value system – a personal set of beliefs on a continuum from most to least important, thus providing the basis for decisions and choices

Moral theories guide nurses in ethical decision making

Consequence based – judge the rightness of the action based on the consequences it produces (the end justifies the means)

Utilitarianism – views a good act as one that brings the least harm and the most good to the people “choose the lesser evil”

Principle based – emphasis on individual rights, duties and obligations. An action is moral if it follows an impartial, objective principle

Relationship based – stresses courage, generosity, commitment and the need to nurture and maintain relationships, promote the common good or the welfare of all group, rather than stressing the individual rights.

Bioethical Principles

Autonomy – from the Greek work “autos” meaning self and “nomos” meaning rule or law, thus refers to self law. Implies individual rights, privacy and choice.

Autonomy entails the ability to make a choice from external constraints.

Beneficence - the duty to do good and the active promotion of benevolent acts (e.g. goodness, kindness, charity)

Confidentiality – relates the concept of privacy.

Information obtained from an individual will not be disclosed to another unless it will benefit the person or there is a direct threat to the social good.

Double effect – a principle that may morally justify some actions that some may produce both good and evil effect.

Fidelity – promise keeping; duty to be faithful to one’s commitments and promises

Justice – fair, equitable and appropriate treatment according to what is due or owed to persons.

Nonmaleficence – the duty not to inflict as well as to prevent and remove harm.

Sanctity of Life – the perspective of that life is the highest good.

Thus all forms of life ,including mere biologic existence should take precedence over external criteria for judging quality of life.

Veracity – the obligation to tell the truth and not to lie or deceive others

Which of the following principles Which of the following principles apply to the action of the nurse to apply to the action of the nurse to refrain from discussing the refrain from discussing the condition of the patient with those condition of the patient with those who are not involved in his care?who are not involved in his care?

a. beneficencea. beneficence

b. non maleficenceb. non maleficence

c. autonomyc. autonomy

Answer: BAnswer: B