Professional ethics for nursing students

By :
Fikre Bojola
Email:fikrebojola94@gmail.com
Professional ethics
1

Course contents
 Foundation of nursing practice
 Philosophy of nursing practice
 Health ,illness and health care system
 Communication
 Ethico-legal aspect of nursing practice
 Analysis of ethical dilemma
 Patient bill of right
 Ethical theory
 Controlled substance
 Disclosure
2

Introduction
Ethics Vs morality ??
3

Introduction
Ethics: Greek word “ethos”-custom or characters
 A branch of philosophy dealing with standards of
conduct and moral judgment
 The standard that govern the conduct of a person,
especially a member of a profession
 It refers to a method of inquiry that assists people to
understand the morality of human behavior (i.e. it is
the study of morality)
 It is an activity; it is a way of looking at or
investigating certain issues about human behavior
4

Continued
 Ethics refers to the practices or beliefs of a certain
group (i.e. nursing ethics, Physicians' ethics)
 Ethics is concerned what ought to be, what is right, or
wrong, good or bad
 It is the base on moral reasoning and reflects set of
values
 It is a formal reasoning process used to determine right
conduct
 It is professionally and publicly stated
5

Morality:
 Are principles and rules of right conduct
 It is private or personal
 Commitment to principles and values are usually
defended in daily life
 The function of morality is "to combat the deleterious
consequences of human sympathies"
6

Types of ethics
Descriptive: -
 It is the description of the values and beliefs of various cultural,
religious or social groups about health and illness
Normative: -
 A study of human activities in an attempt to identify human
actions that are right or wrong and good and bad qualities
 In nursing normative ethics addresses: scope of practice of
different categories of nurses and, level of competence expected
Analytical: -
Analyzes the meaning of moral terms
It seeks the reasons why these action or attitudes are either wrong
or right
7

Unit one
Foundation of nursing practice
Definition of Nursing
 Is a deliberate action, a function of the practical
intelligence of nurses and action to bring about
humanely desirable conditions in persons and their
environments.
 As a practice discipline nursing's scientific body of
knowledge is used to provide an essential service to
people, that is to promote ability to affect health
positively
 It is an art and science
8

Historical development of nursing
 It is difficult to trace the exact origin of the
nursing profession.
 However, moral action is the historical basis for
the creation, evolution and practice of nursing.
9

Nursing in ancient civilization
 The early record of ancient civilization offers little
information about those who care for the sick.
 During this time beliefs, about the cause of disease
were embedded in superstition and magic and thus
treatment often involved magical cures.
 Ancient Egyptians developed community planning
and strict hygienic rules to control communicable
diseases.
 The first recorded Nurses were seen.
10

cont…
 In the Babylonian civilization, there were references
to tasks and practices traditionally provided by nurses.
 Nurses are mentioned occasionally in old Testament
as women who provide care for infant, for the sick
and dying and as midwives who assisted during
pregnancy and delivery
11

Cont…
 In ancient Rome, care of the sick and injuries was
advanced in Mythology and reality.
 Although medicine as a science was developed there
was little evidence of establishing a foundation for
nursing.
12

Cont…
 The ancient Greeks gods were believed to have special healing
power.
 In 460 BC Hippocrates born and credited with being the
Father of medicine.
 He proved that illness had natural cause and not to be of a
religious or magical cause
 Hippocrates first proposed such concepts as physical
assessment, medical Ethics, patient – centered care and
observation and reporting.
 He emphasized the importance of patient care that contributed
a lot for the groundwork of nursing.
13

Cont…
 In ancient India, male nurses staffed early Hospitals
and women served as midwives and nursed ill family
members.
14

Nursing in the middle Ages
 During this time, monasticism and other religious
groups offered the only opportunities for men and
women to pursue careers in nursing.
 It was the Christian value of "love thy neighbor as the
self" that had a significant impact on the development
of western nursing..
 The principle of caring was established with Christ’s
parable of Good Samaritan providing care for a tired
and injured stranger
15

Cont…
 In the third and fourth centuries several wealthy
matrons of Roman empire, including Marcella,
Fabiola and Paula, converted to Christianity and used
their wealth to provide house of care and healing (the
fore runner of hospital) for the poor, the sick and
homeless
16

Cont…
 Women were not the sole providers of nursing service
in the third century in Rome.
 There was an organization of men called the
parabloani Brotherhood.
 This group of men provided care to the sick and dying
from the great plague in Alexandria.
17

Dark age of nursing
 In this period Monasteries were closed and the work of
women in religious order was nearly ended.
 The few women who cared for the sick during this time
were prisoners or prostitutes who had little or no training
in nursing.
 Because of this, nursing was considered as the most
minimal of all tasks, and had little acceptance and
prestige.
18

The development of modern Nursing
Three images influenced the development of modern
nursing.
 Ursuline Sisters of Quebec organized the first training
for nurses.
 Theodore Flender revived the deaconess movement
and opened a School in Kaiserwerth, Germany, which
was training nurses.
 Elizabeth Fry established the institute of Nursing
Sisters.
19

 But in the latter half of eighteenth century Florence
nightingale the founder of modern nursing changed the form
and direction of nursing and succeeded in establishing it as a
respected profession
 She was born to wealthy and intellectual family in 1820
 In spite of opposition from her family and restrictive societal
code for affluent young English woman to be a nurse
Nightingale believed she was "called” by God to help others
and to improve the wellbeing of mankind.
20

Common terminologies
1.Altruism – Regard for others. As a theory of action,
this can be descriptive (i.e., that people do, at least
sometimes, appear to act in other than self-regarding
ways).
2.Autonomy – The principle of respect for persons and
of individual self-determination
3.Beneficence – Moral principle that one should help
others further their important and legitimate interests.
21

Cont….
4.Confidentiality – The principle that one should
keep one's promises about information disclosure
5. Duty – Action, or an act, that is due by moral or legal
obligation
6.Fidelity – The principle that one should keep one's
promises.
7. Justice – Commonly described as fairness,
22

Cont…
8.Morality (ethics) - the science of human duty; the
rules of human conduct.
9.Non-maleficence – Moral principle that one
should refrain from harming others ("first, do no
harm").
10. Rights –create parallel duties on the part of
others, or on society as a whole.
11.Veracity – The principle that one should tell the
truth ("honesty is the best policy").
23

Unit two
LAW AND NURSING PRACTICE
Applying an understanding of the legal frame work
24

OBJECTIVE
 At the end of this presentation students should
become familiar with the basics of legal aspects
of professional Nursing practice.
25

INTRODUCTION
 Nursing practice is governed by many legal
concepts.
 Knowledge of laws that affect Nursing practice is
needed to ensure Nurse’s decisions and actions in
work area and also it will protect the Nurse from
liability.
26

LAW
DEFINITION
“The sum total of rules and regulations by which a
society is governed. As such, law is created by
people and exists to regulate all persons”
27

FUNCTIONS OF LAW IN NURSING
 It provides a framework for which Nursing
actions in the care of clients are legal.
 Protect clients’ rights
 It helps to make boundaries of independent
Nursing action.
 It assists in maintaining a standard of Nursing
practice by making Nurses accountable under the
law
28

How to Protect yourself
___________________________
1. Know your state laws affecting Nursing
practice.
2. Follow your state’s Nurse practice act rules &
regulations.
3. Deliver safe, competent Nursing care.
4. Develop & use your critical thinking abilities &
skills.
29

SOURCES OF LAW
SOURCES OF LAW
CONSTITUTION
LEGISLATION
( STATUTES)
ADMINISTRATIVE
NURSE PRACTICE
ACT
COMMON LAW
31

CONSTITUTIONAL LAW
 It is the supreme law of the country
 Fundamental law written or unwritten, that
establishes the character of government by
defining the basic principle to which a society
must conform.
32

LEGISLATION ( STATUATORY
LAW )
 Laws enacted by any legislative body are
called statutory laws.
 A written law passed by a legislature on the
state or federal level.
(Legislature: an officially elected or otherwise
selected body of people vested with the
responsibility & power to make laws for a
political unit, such as a state or unit.HR)
33

Administrative Law
 When a state legislature passes a statute, an
administrative agency is given authority to
create rules & regulations to enforce the
statutory laws.
E.G.: State boards of Nursing writes rules
and regulations to enforce & implement
Nurse practice act, which was created by
statutory law.
34

Common law
 Laws evolving from court decisions are
referred to as common law.
 Law developed by judges through decision of
courts and similar tribunals.
35

TYPES OF
LAW
PUBLICLAW PRIVATE LAW
CRIMINALLAW CONTRACTLAW TORTLAW
36

Types of law
 Publiclaw: it refers to the body of law that deals
with relationship between individuals and the
government and the governmental agencies.
Important segment of public law is criminal law.
Which deals with safety and welfare of the public.
E.g.: theft, manslaughter (crime of killing human
being, homicide etc., )
37

…..
 Privatelaw or civil law: It is the body of the law that
deals with relationship among private
individuals.
 It is againclassifiedin to contract lawand tort law
 Contract law : is the enforcement of agreements
among private individuals.
 Tort law: It defines and enforces duties and rights
among private individuals that are not based on the
contractual agreement. E.g.: INVASION OF
PRIVACY, ASSAULT AND BATTERY
38

SelectedCategoriesof lawaffectingNurses
Category
CONSTITUTIONAL
STATUTORY ACT
CRIMINAL
Example
Equal Protection
Nurse Practice Act
Sexual Harassment laws
Theft, Homicide, Sexual assault
Active euthanasia (painless killing of pts
suffering from incurable disease)
Illegal Possession of Controlled drugs
39

….
CONTRACTS
TORTS
Nurse and client
Nurse and employer
Nurse and insurance
Negligence/malpractice
Invasion of privacy
Assault and battery
Abandonment
40

Regulation of nursing practice
 Regulation for Nursing practice helps to bring
a standard in Nursing care and thus to
protect the public. Below lists helps to
regulate.
1. Nurse Practice act
2. Credentialing
3. Standards of care
41

1. NURSE PRACTICE ACTS
 Each country has a Nurse practice act, which
protects the public by legally defining and
describing the scope of Nursing practice and
it is also legally control Nursing practice
through licensing requirements.
 But acts differ from country to country.
42

2. CREDENTIALING
 Credentialing is the process of determining
and maintaining competence in Nursing
practice.
Credentialing process helps to maintain
standards of practice & accountability for
educational preparation of its members.
1. Licensure
2.Certification
3. Accreditation
43

Licensure
 A license is a legal permit that a government
agency grants to individual to engage in the
practice of profession & to use a particular
title.
 Each country has its own method to grant or
maintain and revoke the licensure.
 However a Nurse can practice any where
within the country with her state’s licensure.
This is known as mutual recognition model.
44

Certification
 Certification is the voluntary practice of
validating that an individual Nurse has met
minimum standards of Nursing competence .
45

Accreditation
 It is the function of a state board of
Nursing is to ensure that schools
preparing Nurses maintain minimum
standard of education.
46

3.STANDARD OF CARE
 Standard of care are the skills and learning
commonly possessed by members of a
profession.
 These standards are used to evaluate the
quality of care Nurses provide and, therefore,
become legal guidelines for Nursing practice.
47

…
 It can be internal – job description, education,
policy & procedures
external – Nurse practice act, Professional
organizations
It is important for a Nurse remain competent
through reading professional journals and
attending continuing education and in-service
programs.
48

Legal roles of nurses
1. Provider of service
2. Employee or contractor for service
3. citizen
50

1. Provider of service
 The Nurse is expected to provide safe &
competent care.
 Nurse is liable to his/her action.
 Liability is the quality or state of being legally
responsible for one’s obligations and to make
financial restitution for wrongful act.
For example: A Nurse can refuse a task if
the Nurse will feel that it may harm the client
and it can be reported to the supervisor
51

2. Employee or contractor for service
 It vary among practice settings.
 A independent Nurse practitioner has an
independent contractual relationship with the
client.
 Nurse who is employed by an agency works
as an representative of the agency.
cont…
52

…
 The Nurse in the role of employee or
contractor for service has obligations to the
employer, the client, and other personnel.
 Nursing care provided must be within the
limitations and term specified.
53

3. citizen
 The rights & responsibilities of a Nurse in the
role of citizen are the same as those of any
individual under the legal system.
 A right is a privilege or fundamental power
 A responsibility is the obligation associated
with the right
54

SELECTED LEGAL ASPECT OF NURSING PRACTICE
 INFORMED CONSENT
 DELEGATION
 VIOLENCE, ABUSE & NEGLECT
 CONTROLLED SUBSTANCES
 ABORTIONS
 DEATH & REALTED ISSUES
 SEXUAL HARASSEMENT
55

INFORMED CONSENT
It is an agreement by a client to accept a
course of treatment or a procedure after being
provided complete information, including the
benefits and risks of treatment, alternative to
the treatment, and prognosis if not treated by a
health care provider.
56

…
 Obtaining informed consent is a
responsibility of the person performing the
procedure. Nurse is a witness.
 Witnessing with a signature it shows that
client gave consent voluntarily, signature
authentic, client appears competent to give
signature.
57

Informed consent INCLUDES:
 Explanation of procedure
 Explanation of risks, anticipated discomfort
 Explanation of alternatives
 Client has right to refuse
 Client must be competent and of legal age
 It is the physician’s duty to obtain informed
consent
 It is the Nurse’s duty to verify that client was
informed
58

DELEGATION
 Delegation is defined as “ transferring a
competent individual the authority to perform
a selected Nursing task in a selected
situation”.
59

VIOLENCE, ABUSE & NEGLECT
 Violent behavior can include domestic violence,
child abuse, elder abuse, and sexual abuse.
 Neglect is the absence of care necessary to
maintain the health & safety of a vulnerable
individual such as a child or elder.
 To use wrongly or improperly or to hurt or injure
someone.
60

CONTROLLED SUBSTANCES
 Controlled substances mainly include stimulants,
depressants, narcotics, hallucinogens etc.,
 Misuse of these leads to criminal penalties.
61

ABORTIONS
 To save the life of the woman Yes
 To preserve physical health Yes
 To preserve mental health Yes
62

DEATH & REALTED ISSUES
 Nurses role in legal issues related to death is
prescribed by the laws of the region and the
policies of the health care institution.
 Beliefs and attitudes about deaths, its causes
and the soul also vary among cultures
63

SEXUAL HARASSEMENT
 Sexual harassment is defined as
“unwelcome sexual advances, requests for
sexual favors, and other verbal or physical
conduct of a sexual nature.”
64

Areas of potential liability in Nursing
 Nursing liability is usually involved with Tort
law.
 It is important for a Nurse to know the
differences between malpractice
(unintentional Torts) and Intentional Torts.
65

CRIMES & TORTS
 A crime is an act committed in violation of
public (criminal) law and punishable by a fine
or imprisonment.
 Crimes are punished through criminal action
by the state against an individual.
 It may be in terms of imprisonment or by a
fine.
66

…
 Crimes again classified into FELONY and
MISDEMEANOR
 Felony is a crime of a serious nature, such as
murder, punished by a term in prison.
 A misdemeanor is an offense of a less
serious nature and is usually punishable by a
fine or short term jail sentence, or both.
67

…
 A tort is a civil wrong committed against a
person or a person’s property.
 In other words, the person or persons
claimed to be responsible for the tort are
sued for the damages.
 Torts are again classified into unintentional
tort and intentional tort.
 A tort is similar to crime but crimes involve breach of
duties toward the society in general.
68

UNINTENTIONAL TORT
 Negligence and malpractice are examples of
unintentional torts.
 Negligence is misconduct or practice that is
below the standard expected of an ordinary,
reasonable, and prudent person. Such
conduct places another person at risk for
harm.
69

Common Acts of Negligence
 Burns
 Objects left inside the patient’s body
 Falls of elderly
 Falls of children
 Failure to observe and take appropriate
action as needed
70

Specific Examples of Negligence
 Failure to report observations to attending
physicians
 Failure to exercise the degree of diligence
which the circumstances of the particular
case demands
 Mistaken identity
 Wrong medicine, wrong concentration, wrong
route, wrong dose
71

Malpractice
 Malpractice is “professional negligence” that
is, negligence that occurred while the person
was performing as a professional.
72

Common Malpractice Allegations
 Failure to maintain safety
 Improper technique/treatment
 Failure to monitor and report
 Medication errors
 Failure to follow policy/procedures
 Poor documentation
 Improper use of equipment
73

There are 6 elements must be present for a
case of Nursing malpractice to be proven.
1. Duty: The Nurse must have a relationship
with the client that involves providing care
and following an acceptable standard of
care.
74

…
2. Breach of duty: Standard of care that is
expected in the specific situation but that the
nurse did not observe.
3. Foreseeability: A link must exist between
the Nurse’s act and the injury occurred.
4. Causation: It must be proved that harm
occurred as a direct result of Nurse’s failure
to follow the standard of care.
75

5. Harm or injury: The client must
demonstrate some type of harm or injury (
physical, financial, or emotional)
6. Damages: If malpractice caused the injury,
the Nurse is held liable for damages that may
be compensated.
76

INTENTIONAL TORTS
 The defendant executed the act on purpose
or with intent.
There are mainly 5 intentional torts which is
related with Nursing
1.Assault
2.Battery
3.False Imprisonment
4. Invasion of privacy
5.Defamation
77

…
1. Assault: It is an attempt or threat to touch
another person unjustifiably.
e.g.: a Nurse who threatens a client with an
injection for refusing an oral medicine.
2.Battery: is the willful touching of a person
that may or may not harm. E.g.: a Nurse
threatens and gives an injection without
consent.
78

…
3. False imprisonment: It is the unjustifiable
detention of a person without legal warrant or
confine the person.
e.g.: not allowing a person to go LAMA or
insisting a client to confine on bed
4. Invasion of privacy: It injures the feeling of
a person and does not take into account the
effect of revealed information on the standing
of the person in the community.
79

5. Defamation: It is a communication that is
false, or made with a careless disregard for
the truth. e.g.: a Nurse writes in her Nurse’s
notes that a physician is incompetent or
telling a client that her colleague is
incompetent.
80

LOSS OF CLIENT PROPERTY
 Loss of client property, dentures, jewelry,
money etc.,
 Nurses are expected to take reasonable
precautions to safeguard client’s property
81

UNPROFESSIONAL CONDUCT
 It includes incompetence or gross
negligence, conviction for practicing without
a license, falsification of client record, and
illegally obtaining, using, or possessing
controlled substances.
82

LEGAL PROTECTION IN
NURSING PRACTICE
1. Good Samaritan act
2. Professional liability Insurance
3. Carrying out a physician order
- Question any order a if the client’s condition
has changed
- Question any order that is illegal, unclear, or
incomplete.
83

….
4. Providing CompetentNursing Care
5. Record keeping
6. The incidentreport
84

REPORTING, CRIMES, TORTS, AND
UNSAFEPRACTICES
 Nurses may need to report Nursing
colleagues or other health professional for
practices that endanger the health and safety
of clients.
85

UN-3
Apply ethical concepts to the clinical
practice
86

Objectives
 Understand Ethical theories
 Understand Ethical principles
 Resolving ethical dilemmas
 Understand Discontinuing treatment
 Compare Ethics vs moral
87

Ethical theories and concepts
 Ethical theories considered as lenses that
help us to view an ethical problem.
 Different theories can be useful because they
allow us to bring different perspectives in to
our ethical discussions or deliberations.
88

There are four ethical theories:
 Deontology / Duty or rule-Based theory
 Teleology / Utilitarian Theories
 Intuitionism
 The ethics of caring
89

Deontology (Duty or rule-Based theory)
 rightness or wrongness of an action depends
on the nature of the act rather than its
consequences.
 you are acting rightly when you act according
to duties and rights.
 uses duties and rights for evaluating an
action.
E.g. informed consent
90

Teleology (utilitarian or end based theory)
 It looks to the consequences of an action in
judging whether that action is right or wrong.
 Right action is that which has greatest utility
or usefulness.
 No action in itself is good or bad, the only
factors that make actions good or bad are
the outcomes, or end results.
91

Intuitions/common sense
 The notion that people inherently know what
is right or wrong.
The ethic of caring (case based theory)
 It is based on relationships.
 stresses courage, generosity, commitment,
and responsibility.
 Caring is a force for protecting and
enhancing client dignity.
92

Major Ethical principles of Nursing
1. Autonomy
2. Beneficence
3. Non-maleficence
4. Justice
93

Autonomy.
 Autonomy is the promotion of independent
choice.
 self-determination and freedom of action.
 It is the basis for the client's right to self-
determination.
94

Value of autonomy
 Respection
 Determining personal goals.
 Deciding on a plan of action.
 Freedom to act upon the choices
95

Four factors for violations of patient autonomy
1. Assuming that patients have the same
values and goals as us
2. Failure to recognize that individuals’ thought
processes are different
3. Assumptions about patients’ knowledge
base
4. Focus on work rather than caring
96

Beneficence
 doing or promoting good.
 base for all health care providers
 groundwork for the trust that society places
It has three components:
 Promote good
 Prevent harm
 Remove evil or harm
97

Non-maleficence
 It means to avoid doing harm.
 It is to avoid causing deliberate harm, risk of
harm and harm that occurs during the
performance of beneficial acts.
 Non-maleficence also means avoiding harm
as a consequence of good.
 In that cases the harm must be weighed
against the expected benefit
98

Justice
 Justice is fair, equitable and appropriate
treatment.
 It is the basis for the obligation to treat all
clients in an equal and fair way.
 Just decision is based on client need and
fair distribution of resources.
99

Others include
 Veracity, Confidentiality, Fidelity & Rules
10
0

What are Controlled
Substances?
 Controlled substances are drugs
which are regulated by federal and
state law.
 The production, possession,
importation, and distribution of
these drugs is strictly regulated or
outlawed, although many may be
dispensed by prescription only.
10
2

,,,
 The basis for the regulation is to control the
danger of addiction, abuse, physical and
mental harm, the trafficking by illegal means,
and the dangers from actions of those who
have used these substances.
10
3

Controlled Substance
Schedules
 The substances are listed in five categories,
or schedules, according to their
characteristics, such as dangerousness,
medical usage and addictive properties.
 The Schedules are denoted as I – V, with
Schedule I being the most dangerous and
the highest potential for abuse and Schedule
V being the least dangerous and lowest
potential for abuse.
10
4

Schedule I
 A high potential for abuse.
 Have no currently accepted medical
use in treatment in the U.S.
 Lack of accepted safety for use of
the drug or other substance under
medical supervision.
10
5

Some examples
of substances listed in schedule I are:
– heroin,
– lysergic acid diethylamide (LSD)
– marijuana (cannabis)
– peyote, methaqualone
– 3,4‐methylenedioxymethamphetamine (“ecstasy”)
10
6

Schedule II
– The drug or other substance has a high
potential for abuse.
– The drug has a currently accepted for medical
use with severe restrictions.
– Abuse of the drug may lead to severe
psychological or physical dependence.
10
7

Examples of Schedule II Drugs:
 Cocaine,
 Amphetamines,
 Pentobarbital,
 Etorphine, fentanyl, codeine,
and many other opioids.
10
8

Schedule III
 The drug has a potential for abuse less than the
drugs or other substances in schedules I and II.
 The drug /substance has a currently accepted for
medical use.
 Abuse of the drug /substance may lead to
moderate or low physical dependence or high
psychological dependence.
 Examples of Schedule III Drugs: barbiturates,
hydrocodone, ketamine
10
9

Schedule IV
 The drug has a low potential for abuse
relative to the drugs or other substances in
schedule III.
 The drug substance has a currently
accepted for medical use.
 Has limited physical or psychological
dependence relative to the drugs or other
substances in schedule III.
– Examples of Schedule IV drugs: diazepam,
phenobarbital, butorphanol, phenobarbital
11
0

Schedule V
– has a low potential for abuse relative to other
– The drug has a currently accepted medical use
– Abuse of the drug may lead to limited physical
dependence or psychological dependence
relative to others.
 Examples of Schedule V drugs:
buprenorphine, diphenoxylate, codeine cough
syrup
11
1

Reading Assignment
Discuss about:
1. Incident report.
2. Legal protection for Nurses.
3. Legal roles and responsibilities in Nursing
practice.
11
2

Nurse’s Bill of Rights
 Nurses have the right to practice in a manner
that fulfills their obligations to society and to
those who receive nursing care.
 Nurses have the right to practice in
environments that allow them to act in
accordance with professional standards and
legally authorized scopes of practice.
11
3

,,,
 Nurses have the right to a work environment
that supports and facilitates ethical practice,
in accordance with the Code of Ethics for
Nurses and its interpretive statements.
 Nurses have the right to freely and openly
advocate for themselves and their patients,
without fear of retribution.
11
4

,,,
 Nurses have the right to fair compensation
for their work, consistent with their
knowledge, experience, and professional
responsibilities.
 Nurses have the right to a work environment
that is safe for themselves and their patients.
 Nurses have the right to negotiate the
conditions of their employment, either as
individuals or collectively, in all practice
settings.
11
5

,,,
 Nurses have the right not to be abused in
any form by physicians, pharmacists,
administrators or nursing directors.
 Nurses have the right not to be exploited and
abused by being floated to areas of practice
that they are not familiar with.
 Nurses have the right to refuse any
assignment that they feel is unsafe.
11
6

Nurses responsibility
Has responsibility of keeping moral principles
(Beneficent, Fidelity, confidentiality, Honesty
& all other positive characters
 Dependability- truth worth
 Kindness and firmness
 Humanity and justice
 Adaptability- adjusted to new condition
 Assertiveness- confident
 Nurses Uniform
11
7

….
– Observing and recording patients’ behavior.
– Cooperating with other healthcare professionals
– Maintaining reports of patients.
– Changing patient’s care as directed
– Adhering with the protocols, norms, rules.
– Maintaining personal hygien and safe working.
– Conducting research for improving the nursing
practices and healthcare outcomes.
11
8

Put Joy, Love, Hope, Laughter and
Gratitude in Each Day
1. Name 3 things you feel grateful for today
2. Think of something that has brought you a
sense of joy (Make your top ten list)
3. Who do you love that you can reach out to
today? (Call them!)
4.What made you laugh today? (Share it!)
11
9

Patient Bill of Rights
Unit - Four
12
0

Patient has right:
 Not be treated without consent
 Decide on treatment options
 To be treated with their select
 Confidentiality of statements made to a physician during
treatment
 Insurance in case of malpractice.
 for considerate and respectful care.
12
1

,,
• To obtain information concerning diagnosis, treatment,
and prognosis.
• Identity of physicians, nurses, and others involved in
their care
• To know the immediate and long-term financial
implications of treatment choices
• To refuse a recommended treatment or plan of care
12
2

,,
– The patient has the right to review the records
pertaining to his/her medical care, except when
restricted by law.
– The patient has the right to be informed of
hospital policies and practices that relate to
patient care, treatment, and responsibilities.
12
3

Discussion
 What is Informed consent???????
 List responsibility of patient
12
4

Open Disclosure
 Open disclosure is the open discussion of
incidents that result in harm to a patient while
receiving health care with the patient, their
family, carers and other support persons.
12
6

Principles of open disclosure
1. Open and timely communication
If things go wrong, the patient, their family
and carers should be provided with
information about what happened in a timely,
open and honest manner.
2. Acknowledgement
 All adverse events should be acknowledged
to the patient, their family and carers as soon
as practicable.
12
7

Principle…
3. Apology or expression of regret
As early as possible, the patient, their family
and carers should receive anapology or
expression of regret for any harm that
resulted from an adverse event.
4. Supporting, and meeting the needs and
expectations of patients, their family and
carer(s)
12
8

Principles…
6. Integrated clinical risk management and
systems improvement
Outcomes of these reviews should focus on
improving systems of care and be reviewed
for their effectiveness.
12
9

Principles….
7. Good governance
Open disclosure requires good governance
frameworks, and clinical risk and quality
improvement processes. Through these
systems, adverse events should be
investigated and analysed to prevent them
recurring.
 Good governance should include internal
performance monitoring and reporting.
13
0

Key elements of the open disclosure process
 Detecting and assessing incidents
 Signalling the need for open disclosure
 Preparing for open disclosure
 Engaging in open disclosure
 Providing follow-up
 Completing the process
 Maintaining documentation
13
1

Key components of open disclosure discussions
 Introductions; Name & role
 Saying sorry expression of regret is given
including the words ‘I am’ or ‘we are sorry’.
 Factual explanation: A factual explanation
of the adverse event is provided
 Personal effect of the adverse event
 Plan agreed and recorded An open
disclosure plan is agreed on and recorded
13
2

,,,,
Pledge to feed back
 The patient, their family and carers are given
information about how feedback will be
provided on the investigation findings.
 Offer of support an offer of support to the
patient, their family and carers should be
given
13
3

Professional ethics for nursing students

Recommended

Recommended

More Related Content

Similar to Professional ethics for nursing students

Similar to Professional ethics for nursing students (20)

Recently uploaded

Recently uploaded (19)

Professional ethics for nursing students