Chapter 04 ethical and legal issues affecting nursing assistant

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Ethical and Legal Issues
Affecting the Nursing Assistant

Edited by Brenda Holmes MSN/Ed, RN

Copyright © 2008 Delmar Learning. All rights reserved.

* Spell and define terms.
* Discuss ethical and legal situations in health care.
* Describe the legal and ethical responsibilities of the
nursing assistant concerning patient information.
* Describe tactful ways to refuse a tip offered by a
patient.
* Describe the legal responsibilities of a nursing
assistant.

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* Describe how to protect the patient’s right to
privacy.
* Define sexual harassment and give examples of
activities that may be perceived as being
sexually harassing.

*


* Ethical standards
* Guides to moral behavior
* People who provide health care
* Voluntarily agree to live up to these standards

*


* When these rules are not followed:
* Nursing assistant fails to live up to the promise to
give safe, correct care and to do no harm

*


* Legal standards are guides to lawful behavior
* When laws are not obeyed:
* Nursing assistant may be prosecuted and found liable for
injury or damage
* Legal guilt can result in the payment of fines or
imprisonment

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* At no other time in history have questions of
medical ethics been under such scrutiny

*


* Questions health care providers ask:
* When is life gone from a person on life support
systems?
* How much lifesaving effort should be given in
situations of terminal illness?

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* When does human life actually begin?
* How much assistance should be given to the
conception process?
* Should the body organs of a brain-dead person
be harvested for transplants for the living?
* Does an unborn baby have rights?

*


* Is assisting a patient before or after an
abortion right or wrong?
* Is euthanasia ever justified?
* Should animals be used in research of potential
value to human life?

*


* Should food and water be withheld to speed
death when a patient has expressed the desire
to have this action performed?

*


* Who makes decisions about removing life
support systems when there is no direct
expression of the patient’s wishes or there is
conflict within the family?

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* How will a choice be made when two or more
people could benefit from an organ transplant
but only one organ is available?

*


* How should the limited money available be
spent when many serious disease conditions
need to be researched?
* Who has the final authority over whether a
woman will carry a pregnancy to term?

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* Should marijuana be used for medicinal
purposes?

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* One of the most basic rules of ethics is that life
is precious.

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* Respect for each patient as a unique individual
is another ethical principle
* Uniqueness is shown by differences in:
* Age
* Race
* Religion
* Gender

*


* Uniqueness is shown by differences in:
* Sexual preference
* Culture
* Attitudes
* Background
* Response to illness

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* Do unto others as you would have them do unto you
* Implies your intent to provide proper care

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* Your good intentions are effective only when you act on
them
* To provide proper care:
* You also have the ethical responsibility to maintain
competence in your practice

*


* Treat others the way they want to be treated
* Platinum Rule
* Shifts focus from treating everyone alike to
providing highly individualized care

*


* Find out what patients want
* Give it to them, as much as possible, and in
keeping with their plans of care
* Use both principles to guide your practice

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* Discuss patient information only in appropriate
places
* Discuss patient information only with the
proper people

*


* Refer patient requests for information about
laboratory results, the patient’s condition, or
course of the illness to the nurse or physician.

*


* Let the nurse or physician relay information
about a patient’s death.
* Follow the ethical code to ensure respect of a
patient’s personal religious beliefs.

*


* Laws are passed by governments and are to be
obeyed by citizens.
* Anyone who fails to obey a law may be liable
for fines or imprisonment.

*


* You need not fear breaking laws if you are
careful to:
* Stay within your scope of practice
* Not overstep your authority
* Do only those things you have been taught
* Within the scope of your training

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careful to:
* Carry out procedures carefully and as you were
taught
* Keep your skills and knowledge up to date

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careful to:
* Request guidance from the proper person before
you take action in a questionable situation

*


careful to:
* Always keep the safety and well-being of the
patient a priority
* Make sure you thoroughly understand the
instructions for the care you are to give

*


careful to:
* Perform your job according to facility policy
* Stay within OBRA guidelines

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careful to:
* Maintain in-service requirements of OBRA
* Do no harm to the patient
* Respect the patient’s belongings

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* Nursing assistants
* Are educated care providers and are expected to
perform in certain ways

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* You would be guilty of negligence if you injured
a patient by:
* Not performing your work as taught
* Not carrying out your job in a conscientious
manner

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* Negligence may be accidental or deliberate
* It may be the result of an action or omission
* Failure to act
* In either situation, the patient is not given the
expected level of care

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* Restraining a person’s movement or actions
without proper authorization constitutes
unlawful or false imprisonment.

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* Assault
* Intentionally attempting to touch the body of a
person or even threatening to do so
* Battery
* Touching a person without that person’s
permission

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* Abuse
* Any act or failure to act that is non-accidental
and causes or could cause harm or death to a
patient
* Verbal abuse
* May be directed toward a patient or expressed
about a patient

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* Sexual abuse
* Use of physical means or verbal threats to force
a patient to perform sexual acts.

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* Physical abuse
* Does actual physical harm to a patient
* Psychological abuse
* Involves making a patient fearful of you
* Such as threatening not to respond when he or she
calls

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* Involuntary seclusion
* Involves separating a patient from other patients
against the patient’s will
* Misappropriation of property
* Involves taking or using the patient’s belongings
without permission

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* If you suspect a person in your care is being
abused by others
* Discuss this matter with your supervisor
* You are not responsible for determining
whether abuse has occurred

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*
* If you feel like your own tolerance level is being tested
* You need to find ways to safeguard the patient and release
your stress


* Failure to provide the services or care
necessary to avoid physical harm, mental
anguish, or mental illness.

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* Patients have a right to have their person and
personal affairs kept confidential.

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* Physical, verbal, or nonverbal actions or
advances that are unwelcome by the other
person.

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* This may be in the form of sexual advances,
requests for sexual favors, and other verbal or
physical conduct of a sexual nature.

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* Sexual harassment is illegal

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* Your facility will have policies and procedures
listing actions to take and penalties if
harassment occurs.

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* Upon being informed that an incident of sexual
harassment has occurred:
* Hospital is responsible for investigating the
situation
* During investigation:
* Facility must protect the victim from further
harassment

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