Ethics For Nursing Students

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Presentation about ethics and nursing, geared toward nursing students in ADN and PN programs

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  • Nursing ethics is concerned with actions in relation to the vital and fundamental goals of preserving and enhancing life (Husted & Husted, 2001). Ethics can be summarized as doing the right thing, at the right time, for the right reason. The is not easily understood; the clinical skills necessary for fulfillment of the nurse’s role oftentimes is the main focus in both academia and practice. Nursing as a discipline should seek congruence with ethics and practice. The conceptualization of nursing historically has intermingled with the moral and ethical considerations of agency, responsibility, relationships, and virtue (Liaschenko & Peter, 2004).
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  • Autonomy-Patients have a right to self-determine. The nurse has the responsibility to respect a patient’s choices, even if she or he does not agree with them. Some conditions exist that override the concept of autonomy. Example: A patient who is infected with TB can be put in isolation to prevent the spread of the disease (Greater good).Justice-Equal medical treatment for the same diagnosis. No discrimination based on race, gender, age, marital status, economic status. Example-The patient with BC/BS gets the same treatments as the patient who has Medicaid. Fidelity-Nurse’s faithfulness to the tenets of the profession. Sometimes there are dilemmas. Example: A nurse who is asked to work overtime must weigh her fidelity to the unit and coworkers against fidelity to patients to give the best care possible. This would be difficult if the nurse is overtired. Beneficience-Doing good. Good care dictates that the nurses treats the patient holistically, taking into account the patient’s beliefs, feelings, and wishes. Nurses must decide what is good for the patient. Example: Starting an IV, even though it hurts. Nonmaleficence-Not harming the patient. Closely related to beneficience. Protection from harm for vulnerable populations. Example: The abused child. A nurse has the ethical responsibility to notify authorities in cases of suspected abuse. Veracity-Telling the truth about a patient’s illness. Example-Nurses feel uncomfortable dealing with ‘the bad news’. But it is a ethical obligation to be truthful to our patients.
  • Ethical issues of particular concern to nurses and other health care providersinclude: privacy, confidentiality, access to healthcare, and informed healthdecisions. Major ELSI concerns include:2· Stigma, discrimination, stereotyping, and misuse of genetic data topromote racism.· Lack of access to discoveries for research purposes - throughpatenting of genes.· Simplistic view of humans as assemblage of genes.· Attribution of behavioural and social ills to genes.· Lack of respect for individuals, families and populations.Other concerns related to implications for privacy, access to care, anddiscrimination based on genetic information are growing. Examples ofconcerns and unresolved questions include: · Privacy and confidentiality of genetic information. Individualsown and control their genetic information and are entitled to privacyof genetic data just as other personal health data.· Misuse of genetic information by insurers, employers, courts,schools, adoption agencies, and the military, among others. Thereare major concerns about who should have access to personalgenetic information, and how will it be used.· Stigmatisation and discrimination due to an individual's geneticdifferences. There are concerns about use of personal geneticinformation to marginalize and discriminate people based on theirgenes.· Reproductive issues including adequate and informed consent andthe use of genetic information in reproductive decision-making. Thechallenge for healthcare personnel is to counsel parents about risksand limitations and about new reproductive technologies.· Uncertainties associated with gene tests for susceptibilities andcomplex conditions (e.g., heart disease, diabetes, and Alzheimer'sdisease). Should testing be performed when no treatment isavailable or when interpretation is unsure? Should children be testedfor susceptibility to adult-onset diseases?· Conceptual and philosophical implications regarding humanresponsibility, free will versus genetic determinism, and concepts ofhealth and disease. Do our genes influence our behaviour, and canwe control it? What is considered acceptable diversity? Where is theline drawn between medical treatment and enhancement?· Health and environmental issues concerning genetically modified(GM) foods and microbes. Are GM foods and other products safe forhumans and the environment? How will these technologies affectdeveloping nations' dependence on industrialized nations?· Commercialisation of genetic products including property rights(patents, copyrights, and trade secrets) and accessibility of data andmaterials. Will patenting genetic materialsAs a nurse, you often have access to documents and or patient’s valuablesincluding those that can be used for the purposes of identity theft. Make surethat local policies for protecting information and valuables are understood andrigorously followed.High demand and poor supply have resulted in a growing illegal trade inorgans, especially in developing countries, such as Brazil, India and SouthAfrica. In some cases people may be forced to sell an organ as a means ofattempting to alleviate their own poverty. China addressed the demand fororgans by legally removing organs and tissue from executed prisoners. Nurses can play an important role in relation to advising people to avoid lifechoices that increase the risk of chronic diseases leading to organ failure. Inaddition, nurses can educate the public on the value of donating organs afterdeath.This is a rapidly expanding field and it is import for nurses to keep pace withchanges and actively engage in the ethical issues associated with organsupply and new technologies that play a part in reducing the demand forreplacement human organs. Organ theft is unethical and every effort to stopsuch practice should be pursued, including advising suspected victims toreport the assault to the authorities.
  • Obtain as much information as possible about the situation. Know the patient’s wishes, the family’s wishes, and the physical or emotional problems causing the dilemma. After collecting the information, the nurse needs to bring it together to form a clear picture of the dilemma. State the dilemma in a short statement. This will help narrow down the opposing ethical principles that are causing the dilemma.What are the course of action? Which ethical principle will take precedence? Determine the advantages and disadvantages of each course of action. Who will be affected by each action? This helps to narrow down viable options.Make a decision using the available standards and codes of ethics. This is the most difficult part.
  • Ethics For Nursing Students

    1. 1. Safeguarding Your Ethical Responsibility Lorraine Kelley, MSN, BSHA-HIS, RN &
    2. 2. Objectives • Know the definition of and differences between the terms: Ethics, Values, Morals, & Laws • Discuss Code of Ethics: ANA and ICN • Discuss ethical principles and concepts • Name the steps in the ethical decision-making process and apply it • Discuss Nursing Standards
    3. 3. Ethics • In health care, actions related to preserving and enhancing life • Doing the right thing, at the right time, for the right reason • Ensure individual’s rights are protected • A system of morals for a group
    4. 4. Values • Concepts that give meaning to an individual’s life • Derived from social norms, religion and family • Help the individual make decisions and take certain actions • Value conflicts are part of life • Example: Work versus sick child
    5. 5. Morals • Fundamental standards of right & wrong • Learned in childhood • In accordance with group’s norms, customs, & traditions • Example: Mormonism
    6. 6. Laws • Rules of social conduct to protect society • Fairness & Justice • Laws protect rights of individuals • Enforceable by authority • Example: Euthanasia is illegal
    7. 7. 1. The nurse practices with compassion and & respect for the dignity, worth, & uniqueness of every individual 2. Primary commitment is to the patient (community, group, or population) 3. Promotes & advocates to protect the health, safety, & rights of the patient 4. Responsible & accountable for nursing practice 5. Owes same duty to oneself as to others ANA Code of Ethics
    8. 8. ANA Code of Ethics, cont’d 6. Improves health care environments and employment 7. Participates in advancement of the profession 8. Collaborates with other health care professionals to meet health needs 9. The profession of nursing is responsible for articulating nursing values, maintaining the integrity of nursing practice, & shaping social policy
    9. 9. International Council of Nurses (ICN) 1. Nurses and people 2. Nurses and practice 3. Nurses and the profession 4. Nurses and co-workers
    10. 10. Ethical Principles & Concepts Autonomy-Self determination, freedom Justice-Fairness to all people. Equal treatment Fidelity-Faithful to commitments made to self and others Beneficience-Doing good Nonmaleficence-Do not harm Veracity-Truthfulness CAN YOU THINK OF EXAMPLES?
    11. 11. The point of the ethical principal to “do no harm” is an agreement to reassure the public that in all ways the health care team not only works to heal patients but agree to do this in the least painful and harmful way possible. Which principle describes this agreement? A. Beneficence B. Nonmaleficence C. Accountability D. Respect for Autonomy Beneficence Nonm aleficence Accountability RespectforAutonom y 0% 0%0%0%
    12. 12. Areas of Ethical Dilemmas • Genetics and Genomics (DNA sequencing & structure) • Protecting against identity theft • Technology • Organ donation/transplantation
    13. 13. A precise definition for the word quality is difficult to articulate when it comes to quality of life. Why? (Select all that apply.) A. Quality of life is measured by potential income, and average income varies in different regions of the country. B. Individual experiences influence perceptions of quality in potentially different ways, making consensus difficult. C. Placing measurable value on elusive elements such as cognitive skills, ability to perform meaningful work, and relationship to family is challenging. D. Community values are subject to change, and communities influence definitions of “quality.” Qualityoflife ism easure... Individualexperiencesin... Placingm easurablevalu... Com m unityvaluesare su... 0% 0%0%0%
    14. 14. 1. Collect, analyze, & interpret information 2. State the ethical dilemma 3. Consider the courses of action 4. Consider advantages and disadvantages of course of action 5. Make a decision Sound like the Nursing Process & Critical Thinking? Steps to Ethical Decision Making
    15. 15. Nursing Standards • Form basis of competent, high-quality safe care • “Yardstick” for legal actions • Skill, care, & diligence • Fidelity to profession • TJC, ANA, state law, facility policies • Incompetence, gross negligence, negligence, malpractice
    16. 16. What is the best example of the nurse practicing patient advocacy? A. Seek out the nursing supervisor in conflicting procedural situations B. Document all clinical changes in the medical record in a timely manner C. Work to understand the law as it applies to an error in following standards of care D. Assess the patient's point of view and prepare to articulate it Seekoutthenursingsup... Docum entallclinicalch... W orkto understand the... Assessthe patient'spoint.. 0% 0%0%0%
    17. 17. The ANA code of nursing ethics articulates that the nurse “promotes, advocates for, and strives to protect the health, safety, and rights of the patient.” This includes the protection of patient privacy. On the basis of this principal, if you participate in a public online social network such as Facebook, could you post images of a patient's x-ray film if you deleted all patient identifiers? A. Yes because patient privacy would not be violated as long as the patient identifiers were removed B. Yes because respect for autonomy implies that you have the autonomy to decide what constitutes privacy C. No because, even though patient identifiers are removed, someone could identify the patient based on other comments that you make online about his or her condition and your place of work D. No because the principal of justice requires you to allocate resources fairly Yesbecausepatientpriva.. Yesbecauserespectfor... No because,even thoug... No because theprincipal.. 0% 0%0%0%
    18. 18. Group Activity Using the provided ethical dilemmas, use the decision-making process to determine the best course of action. Use the provided flow chart. Share with the class.
    19. 19. American Nurses Association. ANA Code of Ethics. Retrieved from www.ANA.org Husted, G. L., & Husted, J. H. (2001). Ethical decision making in nursing and healthcare (3 ed.). New York, N.Y.: Springer Publishing. Liaschenko, J., & Peter, E. (2004). Nursing ethics and conceptualizations of nursing: profession, practice and work. Journal of Advanced Nursing, 46(5), 488-495. doi:10.1111/j.1365- 2648.2004.03011.x International Council of Nursing (2012). ICN Code of Ethics. Retrieved from http://www.icn.ch/images/stories/documents/about/ic ncode_english.pdf International Council of Nursing (2010). International Council of Nursing. (2010). Genetics and Genomics. Retrieved from http://www.icn.ch/publications/ethics Potter, P., Perry, A., Stockert, P., & Hall, A. (2013). Fundamentals of nursing. 8th Ed. Elsevier Mosby. St. Louis, MO. References

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