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Ethics/Legal
Ch. 4/5 Nsng 105
| Question | Answer |
|---|---|
| ETHICS/LEGAL CH. 4/5 NSG 105 What are the three types of laws pertaining to nursing | Common laws, statuatory laws, regulatory laws |
| what are common laws | based on judicial decisions or case law procedent, created by courts when ind legal cases are decided |
| what is statuatory law | rules codified by legilative bodies of govt, usually federal/state level Ex. ADA Am. Disabilities Act and Nurse Practice Acts, good place to start a lobby |
| the Nurse Practice Acts est what regulatory agency | State Board of Nursing, set rules, regulations, guidelines |
| What power does the STate Board of Nursing have | revoke, suspend nurse license |
| What is a misdemeanor | crime does not inflict serious harm, has monetary fine, brief imprisonment of 1 yr or less |
| what is a felony | serious offense with sig harm and prison more than a 1 yr |
| What is a tort What are the two categories | civil wrong acts or missions against a person or person's property. Intentional, unintentional |
| What are intentional torts | deliberate acts that violate another person's rights. Ex. assualt/battery |
| What is an example of assault in nsg | harmful/offensive threat threaten to restrain pt when pt refused consent |
| what is ex. of battery | touching w/o consent Pt. consented to knee surgery of rt knee and left knee got operated on |
| What is a type of unintentional act in nsg | negligence, conduct that falls below standard of care in/out of hospital(est by law) |
| What is an ex. of negligence | malpractice |
| What is malpractice | failure to use that degree of care that a reasonable nurse would use under the same or similar circumstances |
| Standards of care are defined by these 4 things | 1. State Nurse Practice Acts 2. state and fed hospital licensing laws and accreditation rules 3. professional and specialty org. 4. written policies and procedures of nurse's health care facility |
| Who or when are nurse's notes first thing reviewed | by an attorney when a lawsuit if filed, therefore, have documentation thorough, accurate, timely manner |
| Where are occurence reports kept or not | Not in pt medical record |
| Risk mgmt involves | id'ing possible risks, analyzing them, acting to reduce the risks, evaluating the measure taken to reduce the risks |
| What are ultimate goals of risk mgmt and quality assurance | pt. safety and improved care |
| what are never events | preventable errors, i.e. falls, UTI's, pressure ulcers |
| Why do Good Samaritan Laws exist | to encourage nurses and other health care providers to assist in emergency situations, offer legal immunity and limit liability |
| What are the three states that have enacted "failure to act" laws | LA, MN, VT |
| what is informed consent | pt's agreement to allow something to happen, i.e.surgery, based on full discolsure of risks,benefits, alternatives, consequences of refusal |
| what is required when getting informed consent from pt | pt needs to know all relevant info to make decision, pt is capable of understanding, pt actually gives consent |
| When performing nursing care, is informed consent necessary | no, but necessary to explain to explain what you are doing and ensure pt accepts care given |
| When is a written consent necessary | when pt is going to have invasive medical procedure, like surgery, all routine treatment, chemotherapy, research study |
| What is the nurse not responsible for when preparing a pt for an invasive procedure that requires consent | providing info about procedure and obtaining pt informed consent, mentally/physically competent, legally an adult, given voluntaryily, |
| what does a nurse need to be responsible for when a procedure needs consent | Witnessing pt signature on consent form, but not legally responsible for obtaining consent |
| If pt refuses consent or does not understand procedure what should a nurse do | have them sign a witnessed rejection and get Dr to explain procedure again |
| What if pt is unconscious | obtain consent from person legally authorized to give consent |
| What if an emergency situation | can provide care w/o consent as long as not evidence exists to indicate pt or legal representative would refuse treatment |
| what are regulatory laws | created by adm bodies (state board of nursing) |
| what is civil law | protect ind rights. Violation = money to injured party |
| what are common negligent acts | 1. med errors result in injury 2. IV errors-infiltration/phlebitis 3. burns by equip,bathing,spills 4. Falls 5. failure to use aseptic tech 6. error in needle, sponge count 7. fail to give report 8. fail to monitor pt condition 9. fail to notify D |
| What 4 things does the Nurse Practice Act define | 1.scope of nursing practice 2. expanded nursing roles 3. educational req. 4. distinguish b/n nsng & med. practice |
| What does NCLEX stand for | National Council Licensure Examination |
| Pt's Bill of Rights | See handout |
| When is a DNR only legal | when signed by physician, and order is written, not verbal |
| Who is liable for improper or unlawful restaints | nurse and health care facility |
| What are the two standards to define death and dying | cardiopulmonary and whole brain |
| Is it lawful for a competent person refuse nutrition or lifesaving food | Yes, the Supreme Ct hold it up |
| What are some directives that allow a pt to state their wishes on death and dying | Living wills, power of attorney |
| What is diff b/n living will and power of attorny | LW: instruct health care provider to withhold/withdraw life sustaining procedure for terminally ill POA: designates who is able to give consent when pt can't |
| What is needed for either of these documents to be official | 2 witnesses, not a relative or health care provider |
| What does the Pt Self-Determination Act say | req. inst. to inquire if pt has adv directive, give info on them, doc. if pt states has one. |
| With a signed consent for organ donation, what is different regarding family decisions | inst will honor family wishes even if against pt organ donation consent, AND provider that declares death can't be involved in removal or organs |
| When a health care provider approaches family re organ donation what is the proper order | 1. spouse 2. adult son/daughter 3. parent 4. adult brother/sister 5. g-parent 6. guardian |
| Nurse is responsible for carrying out care except when | order is in error, violates hospital policy, harmful to pt |
| What if you are to work in facility that has inadequate nurse:pt ratio | req. to accept assignemt, but document in writing, ALWAYS keep a copy and NEVER walk out |
| Reporting obligations includes things like | child/spousal/elder abuse, gunshot wounds, attempted suicide, certain communicable diseases, unsafe or impaired professional |
| When is a fetus protected | 3rd trimester - 28 weeks |
| Know difference b/n values, morals, bioethics | Values: personal belief regarding ideas, custom, objects, reflect cultural/social influences, systems of ethics grows from shared values |
| What are morals | Morals: judgment about beh, reflect character of social setting |
| What are bioethics and what are they now called | Bioethics: study of ethics w/in field of health care, clinical ethics |
| what is critical in resolving ethical issues as a nurse | skill and confidence in one's own point of view as part of process |
| What is autonomy | person's independence, self-determination, self reliance |
| what does justice refer to | fairness or equity |
| what is fidelity | faithfulness, strive to keep promises |
| what is beneficence | actively seeing benefits, promotion of good, can pose risk to pt well being or dignity, must weigh pt best interest over self interest ex: child immunizations |
| what is nonmaleficence | actively seeing to do NO harm. Consider potential for harm even when necessary to promote health Ex: bone marrow transplant might provide cure, but long term suffering |
| How does Codes of Ethics help guide health care professionals | set of principles that generally accepts by all members of profession. Act as guidelines in conflicts/disagreements ANA-Am Nurses Assoc ICN-Intern'l Council of Nurses |
| What are some common codes of ethics for nurses | responsibility, accountability, respect for confidentiality, competency, judgement, advocacy |
| What are the 4 fundamental responsibilities | 1. promote health 2. prevent illness 3. restore health 4. alleviate suffering |
| What are the 4 princial elements in the ICN(Int'l Code of Nurses) | 1. Responsibility to the people with info, confidentiality, protect vulnerable pop, protect natural env. |
| What is the 2nd ICN principle | 2. Nurses and Practice, in maintaining competence using judgement, maintain standards of personal conduct, ensure safety of scientific advances |
| What is 3rd and 4th ICN principle | 3. Nurses and Profession 4. Nurses and Coworkers |
| What is Deontology | defines actions as right/wrong based on "right making characteristics", use of justice, autonomy, beneficence |
| when is an act ethical | when act is just, respects autonomy, provides good |
| what is diff b/n utilitarianism and deontology | Utilitarianism measures effect or consequences that act will have Deontolgy focuses less on consequences and more on pure principle |
| What are the prcessing steps in resolving ethical dilemmas | Gather all relevant info, not all is ethical issue 2. examine own values/opinions 3. state problem clearly 4. consider courses of action 5. negotiate outcome 6. evaluate action |
| What is first state to pass mandated staffing ratios | CA |
Created by:
palmerag
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