This topic will be helpful for the Nursing students to know the legal and professional ethics

1. Professional ethics &
legal practice
By
Prof. Anandh Sam Perera

2. INTRODUCTION:
 Nurses often wonder; what approach in my relationship to my
client will achieve the most good? A quick response indicates a
superficial appreciation of the questions. The more effective
response means examining options for achieving good according
to various systematic sets of criteria or principles. This analysis
occurs before decision making.
 Ethical principles are important
concepts to consider when ethical
dilemmas arise.

3. MEANING:
 Ethics derives from the Greek word “ethos”,
refers to “customs, habitual usages, conduct and
character”,
 Ethics is a systematic approach to understanding,
analyzing, and distinguishing matters of right
and wrong, good or bad, admirable or adorable
as they exist along the continuum.

4. Nursing Code of ethics
 A code of ethics is a formal statement of a
group’s ideals and values.
 It is a set of ethical principles that
 is shared by members of the group
 Reflects their moral judgments over time
 Serves as a standard for their professional actions.

5. Purposes of code of ethics
 Inform the public about the minimum standards of the
profession and help them understand professional nursing
conduct.
 Provide a sign of the profession’s commitment to the public
it serves.
 Outline the major ethical considerations of the profession
 Provide general guidelines for professional behavior.
 Guide the profession in self regulation
 Remind nurses of the special responsibility they assume
when caring for the sick.

6. International council of nurses code for nurses
The fundamental responsibility of the nurse is four fold: to
promote health, to prevent illness, to restore health, to
alleviate sufferings.
Nurses render health services to the individual, the family
and the community and coordinate their services with those
of related groups.
The elements are:
– Nurses and people
– Nurses and practice
– Nurses and society
– Nurses and co-workers
– Nurses and the profession

7. Nurses and People:
– The nurse’s primary responsibility is to those people who
require nursing care.
– The nurse in providing care, promotes an environment in
which the values, customs and spiritual beliefs of the
individual are respected.
– The nurse holds in confidence personal information and
uses judgment in sharing this information.

8. Nurses and practice:
– The nurse carries responsibility for nursing practice and for
maintaining competence by continual learning.
– The nurse maintains the highest standards of nursing care possible
within the reality of a specific situation.
– The nurse uses judgment in relation to
individual competence when accepting and
delegating responsibilities.
– The nurse when acting in a professional
capacity should at all times maintain
standards of personal conduct which reflect
credit upon the profession.

9. Nurses and society:
– The nurse shares with other citizens the responsibility for
initiating and supporting action to meet the health and
social needs of the public.

10. Nurses and coworkers:
– The nurse sustains a cooperative relationship with
coworkers in nursing and other fields. The nurse takes
appropriate action to safeguard the individual when his
care is endangered by a coworker or any other person.

11. Nurses and the profession:
– The nurse plays the major role in determining and implementing
desirable standards of nursing practice and nursing education.
– The nurse is active in developing a core of professional knowledge.
– The nurse, acting through the
professional organization, participates
in establishing and maintaining
equitable social and economic working
conditions in nursing.

12. ETHICAL THEORIES:
Duty – oriented ethical theory:
It is a system of ethical thinking having the
concept of duty or obligation as a foundation.
DUTIES
RIGHTS
GOALS

13. Rights – oriented ethical theory:
It is a system of ethical thinking, having the concept of
rights as a foundation.
DUTIES
RIGHTS
GOALS

14. Goal – oriented ethical theory:
It is a system of ethical thinking having the
concept of maximizing the overall goal as its
foundation.
GOALS
DUTIES RIGHTS

15. Intuitionist ethical theory:
It is a system of ethical thinking that balances goals,
rights and duties, according to the situation.
GOALS
DUTIES
RIGHTS

16. ETHICAL PRINCIPLES:
 There are 6 ethical principles.
 Autonomy:
Autonomy = self – determination.
Autonomy is the ethical principle upholding
the exercise of personal choice.
 Beneficence:
Beneficence = doing good
- The principle of beneficence is the
ethical principle of upholding doing good.
Doing good, preventing harm and
removing harm are the essence of the
nurses’ obligation to clients.

17.  Non – maleficence:
Non – maleficence = avoiding harm
The principle of non – maleficence means
not inflicting harm on a person.
Justice:
Justice = fairness
Justice is the ethical principle
that upholds giving people their due
and treating them fairly.

18. Fidelity:
Fidelity = commitment
It is the ethical principle upholding
commitment or keeping of promises.
Totality and Integrity:
Person needs to be taken into consideration
when deciding which therapies, medications
or procedures a patient should undergo.

19. ESSENTIAL VALUES OF PROFESSIONAL
NURSES
 Accountability
 Advocacy
 Confidentiality
 Altruism
 Autonomy
 Human Dignity
 Integrity
 Social Justice

20. • Accountability:
– Integral to the practice of any profession is the inherent need to be
responsible for actions taken and for omissions.
– The professional nurse must be proactive and take all appropriate
measures to ensure that her own practice is not lacking, remiss, or
deficient in any area or way.
– Proactive measures are providing for self audit, examining the
quality of documentation, providing for peer review, establishing
open working relationships with the colleagues.

21.  Advocacy:
 The professional nurse has the duty to:
 Promote what is best for the patient
 Ensure that the patient’s needs are met
 Protect the patient’s rights

22. • Confidentiality:
– The patient’s privacy is consistent with the law as part of
the constitutional right to privacy
– The nurse should assure the patient of confidentiality,
discussed with the patient at the earliest opportunity.
– It is imperative to clearly understand the process of
informed consent and the legal standard for disclosure of
confidential patient information to others

23. • Altruism
"... a concern for the welfare and well-being of others. In
practice, altruism is reflected in the nurses concern for the
welfare of clients, other nurses, and other healthcare
providers" (Pearson, 2015)
– As the patient's advocate, it is important for the nurse to care about
and facilitate all forms of healing- not just physical.

24. • Autonomy
" Autonomy is the right to self- determination.
Professional practice reflects autonomy when the
nurse respects clients' right to make decisions about
their heath care," (Pearson, 2015).

25. • Human Dignity:
"Inherent worth and uniqueness of individuals and populations.
The nurse who values and respects all clients and colleagues
shows respect for human dignity" (Pearson, 2015).
"Nursing means to nourish or nurture and to nurse something
or someone is by definition to recognise and respond to
claims of worth" (Gallagher, Li, Wainwright, Jones, Lee,
2008).

26. • Integrity:
Through critical self-reflection and self-evaluation,
associations must foster change within themselves,
seeking to move the professional community
toward its stated ideals.

27. • Social Justice :
Nurses can demonstrate their commitment to up holding
social justice by respecting and treating all patients to the
best of their ability regardless of race, sexual orientation,
income level, disabilities, citizenship, etc. (Pearson, 2015)

28. • Legal Aspects of nursing

29. • Nursing practice is governed by many legal concepts.
• It is important for nurses to know the basics of legal
concepts, because nurses are accountable for their
professional judgments and actions.
• Accountability is an essential concept of professional
nursing practice and the law.
• Knowledge of laws that regulate and affect nursing practice
is needed for two reasons:
– To ensure that the nurse’s decisions and actions are consistent with
current legal principles.
– To protect the nurse from liability

30. General legal concepts
Law can be defined as “ those rules made by humans which
regulate social conduct in a formally prescribed and legally
binding manner. ( Bernzweig).
Functions of the Law in Nursing:
- It provides a framework for establishing which nursing
actions in the care of the clients are legal.
- It differentiates the nurse’s responsibilities from those of
other health professionals.
- It helps to establish the boundaries of independent nursing
action.
- It assists in maintaining a standard of nursing practice by
making nurses accountable under the law.

31. Sources of Law
 The three primary sources of law are constitutions, statues and
decisions of courts (common law)
 Constitutions:
– Constitutions establish the general organization of the federal governments,
grant certain powers to them, and place limits on what federal and state or
provincial governments may do.
– They create legal rights and responsibilities and are the foundation for a system
of justice.
 Legislation (statutes):
– Laws enacted by any legislative body are called statutory laws.
– When federal and state or provincial laws conflict, federal law supersedes.
Likewise, state or provincial laws supersede local laws.
– The regulation of nursing is a function of state or provincial law. State or
provincial legislatures pass statues that define and regulate nursing, that is nurse
practice acts. These acts, however, must be consistent with constitutional and
federal provisions.

32.  Common law:
– Laws evolving from court decisions are referred to as common law
or decisional laws.
– In addition to interpret and apply constitutional or statutory law,
courts also asked to resolve disputes between two parties.
– Common law is continually being adapted and expanded.
– In deciding specific controversies, courts generally adhere to the
doctrine of stare decisis – to stand by things decided – usually
referred to as “following precedent”.
– In other words, to arrive at a ruling in a particular case, the court
applies the same rules and principles applied in previous, similar
cases.

33. Types of laws
 Laws govern the relationship of private individuals with government
and with each other.
 Public law: it refers to the body of law that deals with relationships
between individuals and the government and governmental agencies.
An important sequence of public law is criminal law.
 Private or civil law: it is the body of law that deals with the
relationships between private individuals. It is categorized as contract
and tort law.
 Contract law: involves the enforcement of agreements among private
individuals or the payment of compensation for failure to fulfill the
agreement.
 Tort law: defines and enforces duties and rights among private
individuals that are not based on contractual agreement. Some
examples –applicable to nurses are negligence and malpractice etc.

34. Concept of crimes and torts:
CRIME:
• A crime is an act committed in violation of public (criminal) law and
punishable by a fine or imprisonment.
• Crimes are classified as either felonies (indictable offenses) or
misdemeanors (summary conviction offenses).
• A felony is a crime of a serious nature, such as murder, punishable
by a term in prison.
• A misdemeanor is an offence of a less serious nature and is usually
punishable by a fine or short – term jail sentence or both. A nurse
who slaps a client’s face could be charged with a misdemeanor.

35. TORT:
• A tort is a civil wrong committed against a person or a person’s
property. Torts are usually litigated in court by civil action between
individuals.
• Torts may be classified as unintentional or intentional
• Unintentional tort:
• Negligence and malpractice are the examples
• Negligence is misconduct or practice that is below the standard
expected of an ordinary, reasonable and prudent practitioner. Such
conduct places another person at risk for harm.
• Gross negligence involves extreme lack of knowledge, skill or
decision making that the person clearly
should have known would put others at
risk for harm.

36. • Malpractice is “professional negligence” that is,
negligence that occurred while the person was performing
as a professional. It applies to physicians, dentists, lawyers
and nurses.

37. • Intentional Torts:
• Four intentional torts are assault/battery, false imprisonment, invasion
of privacy and libel/slander
• Assault: is an attempt or threat to touch
another person unjustifiably
• Battery: is the willful touching of a
person that may or may not cause harm.
If a nurse followed through on a threat
and gave the injection without the client’s
consent is battery.

38. • False imprisonment: is the unlawful
restraint or detention of another person
against his or her wishes. It does not
require force, the fear of force to
restrain or detain the individual
is sufficient.
• Invasion of privacy: is a direct
wrong of a personal nature. It injures
the feelings of the person.

39. • Defamation: is a communication that is false or made with careless
disregard for the truth. Both libel and slander are wrongful actions.
• Libel: defamation by means of print,
writing or pictures. Writing in the nurses
note that a physician is incompetent
because he didn’t respond immediately
to call is an example of libel
• Slander: defamation by the spoken
word, stating unprivileged or false words
by which a reputation is damaged.
An example is a nurse to tell a client that
another nurse is incompetent.

40. Guidelines for reporting a crime, tort or unsafe practice
• Write a clear description of the situation you believe you should report.
• Make sure that the statements are accurate.
• Make sure that you are credible.
• Obtain support from at least one trustworthy person before filing the
report.
• Report the matter starting at the lowest possible level in the agency
hierarchy.
• Assume responsibility for reporting the individual by being open
about it. Sign your name to the letter.
• See the problem through once you have reported it.

41. INFORMED CONSENT
The doctrine of informed consent has become a fundamentally
accepted principle governing the relationship between professional
nurses and all other health care providers and patients.
Informed consent relates to the patients right to accept or reject
treatment by a nurse or any other health care provider.
In the majority of circumstances, informed consent is obtained for
medical or surgical procedures to be performed by the physicians.
Emancipated minors are individuals who are under age 18 and
married, or are parents of their own children, or are self-sufficiently
living away from the family domicile with parental consent
In case of a minor, informed consent would be obtained from the
legal guardian.
In the case of the individuals incapable of understanding medical
treatment issues, informed consent must be obtained through a
responsible person such as a guardian.

42. The nurse has the duty to verify that the physician has
explained each treatment in a language the patient can
comprehend. This enables the patient to make an intelligent
and informed decision and choice about whether to undergo
treatment.
The informed consent should be obtained before rendering
the treatment or performance of the procedure.
The nurse must document that the informed consent was
obtained and that the patient understood the information.
The informed consent should be obtained in the presence of
a witness.

43. The patient’s Bill of rights
A patient's bill of rights is a list of guarantees for those
receiving medical care. It may take the form of a law or a
non-binding declaration. Typically a patient's bill of
rights guarantees patients information, fair treatment,
and autonomy over medical decisions, among other rights.

44. THE RIGHT to receive considerate, respectful and compassionate
care in a safe setting regardless of your age, gender, race, national
origin, religion, sexual orientation, gender identity or disabilities.
THE RIGHT to receive care in a safe environment free from all forms
of abuse, neglect, or mistreatment.
THE RIGHT to be called by your proper name and to be in an
environment that maintains dignity and adds to a positive self-image.
THE RIGHT to be told the names of doctors, nurses, and all health
care team members directing and/or providing care.
THE RIGHT to have a family member or person of your choice and
your own doctor notified promptly of your admission to the hospital.
THE RIGHT to have someone remain with you for emotional support
during your hospital stay, unless your visitor’s presence compromises
your or others’ rights, safety or health. You have the right to deny
visitation at any time.
THE RIGHT to have your pain assessed and to be involved in
decisions about treating your pain.

45. THE RIGHT to be told by your doctor about your diagnosis and
possible prognosis, the benefits and risks of treatment, and the
expected outcome of treatment, including unexpected outcomes. You
have the right to give written informed consent before any non-
emergency procedure begins.
THE RIGHT to access protective and advocacy services in cases of
abuse or neglect. The hospital will provide a list of these resources.
THE RIGHT to agree or refuse to take part in medical research studies.
You may withdraw from a study at any time without impacting your
access to standard care.
THE RIGHT to communication that can be understandable. The
hospital will provide sign language and foreign language interpreters
as needed at no cost. Information given will be appropriate to the age,
understanding, and language. If there is any vision, speech, hearing,
and/or other impairments, additional aids will be provided to ensure
care needs.

46. THE RIGHT to be involved in your discharge plan. You can expect to
be told in a timely manner of your discharge, transfer to another
facility, or transfer to another level of care. Before your discharge,
you can expect to receive information about follow-up care that you
may need.
THE RIGHT to receive detailed information about your hospital and
physician charges.
THE RIGHT to have all communication and records about your care
are confidential, unless disclosure is permitted by law.
THE RIGHT to spiritual services.
THE RIGHT to give or refuse consent for recordings, photographs,
films, or other images to be produced or used for internal or external
purposes other than identification, diagnosis, or treatment.
THE RIGHT to voice your concerns about the care you receive.

47. Nursing standards:
Nursing standards are expectations that contribute to public protection.
They inform nurses of their accountabilities and the public of what to
expect of nurses. Standards apply to all nurses regardless of their role,
job description or area of practice.
The Professional Standards presents each of the four standards:
Standard 1: Professional Responsibility and Accountability
Standard 2: Knowledge-Based Practice
Standard 3: Client-Focused Provision of Service
Standard 4: Ethical Practice
Professional Standard is applied in four main areas of practice:
– Clinical
– Education
– Administration
– Research

48. • Standard 1: Professional Responsibility and Accountability :
Maintains standards of nursing practice and professional conduct
• Clinical Practice :
1. Is accountable and takes responsibility for own nursing actions and
professional conduct.
2. Functions within own level of competence, within the legally
recognized scope of practice and within all relevant legislation.
3. Assesses own practice and undertakes activities to improve practice
and meet identified learning goals on an ongoing basis.
4. Takes action to promote the provision of safe, appropriate and ethical
care to clients.
5. Advocates for and/or helps to develop policies and practices consistent
with the standards of the profession.
6. Maintains own physical, psychological and emotional fitness to
practice.
7. Maintains current registration.
8. Understands the role of the regulatory body and the relationship of the
regulatory body to one’s own practice.

49. • Education :
1. ensuring the appropriate supervision of students;
2. communicating the level of preparation of the student and the
objectives of the learning experience;
3. using standards of practice and evidence-based knowledge to
educate students; and
4. ensuring that nurses receive the appropriate education, support and
supervision when acquiring new knowledge and skills.
• Administration:
1. ensuring that mechanisms allow for staffing decisions that are in the
best interest of clients and professional practice;
2. ensuring the appropriate use, education and supervision of staff;
3. advocating for a quality practice setting that supports nurses’ ability
to provide safe, effective and ethical care; and
4. creating an environment that encourages ongoing learning.

50. • Research:
1. ensuring the safety and well-being of the client above all
other objectives, including the search for knowledge.
2. Conducts or participates in research to create or refine
evidence in the field of nursing science and/or other
sciences and humanities.

51. • Standard 2: Knowledge-Based Practice
Consistently applies knowledge, skills and judgment in nursing practice.
 Clinical Practice:
1. providing a theoretical and/or evidence-based rationale for all decisions;
2. being informed and objective about the various nursing roles and their
relationship to one another;
3. being informed about nursing and its relationships in the health care
delivery system;
4. understanding the legislation and standards relevant to nursing and the
practice area;
5. understanding the knowledge required to meet the needs of complex
clients;
6. having knowledge of how bio-psychosocial needs and cultural
background relate to health care needs;
7. knowing where/how to access learning resources, when necessary;
8. seeking and reviewing research in nursing, the health sciences and
related disciplines;
9. using research to inform practice/professional service; and
10. being aware of how practice environments affect professional practice.

52. • Education :
1. identifying and evaluating information sources that are useful for
professional practice;
2. promoting an environment that facilitates questioning and learning;
and
3. possessing/developing knowledge of teaching learning theories and
practices.
• Administration:
1. understanding how a practice environment can foster professional
growth and improve professional practice;
2. facilitating nurses to continually seek new knowledge;
3. knowing how to access resources to enable nurses to provide the
best possible care;
4. critically evaluating research related to outcomes and advocating for
its application in practice;
5. using relevant leadership and management principles; and
6. understanding and promoting nursing as as knowledge-based and
research-informed profession.

53. • Research:
1. identifying research methods useful to the nursing profession;
2. identifying resources to answer research questions; and
3. sharing knowledge gained through research. supporting and
evaluating practice through research;
4. facilitating the involvement of others in the research process;
5. ensuring that high standards are used in the research process;
6. communicating research findings to decision makers and others;
7. supporting and contributing to environments that encourage the
application of research findings to professional practice;
8. securing resources to explore nursing research; and
9. fostering an atmosphere of inquiry

54. Standard 3: Client-Focused Provision of Service :
Provides nursing services and works with others to provide health
care services in the best interest of clients.
 Clinical Practice:
1. Communicates, collaborates and consults with clients and other
members of the health care team about the client’s care.
2. Coordinates client care in a way that facilitates continuity for
the client.
3. Delegates appropriately to other members of the health care
team.
4. Provides appropriate regulatory supervision of student activities.
5. Instructs and guides other members of the health care team to
meet client care needs.
6. Participates in changes that improve client care and nursing
practice.
7. Reports incompetent or impaired practice or unethical conduct
to appropriate person or body.
8. Understands and communicates the role of nursing in the health
of clients.
9. Assists clients to learn about the health care system and
accessing appropriate health care services.

55. Education :
1. role-modelling therapeutic nurse-client relationships; and
2. identifying and supporting education related to
professional and therapeutic relationships.
Administration:
1. fostering an environment in which clients and nurses are
safe from abuse;
2. supporting the therapeutic nurse-client relationship;
3. promoting a philosophy of client-centered care and
collaborative relationships; and
4. advocating for systems of care that acknowledge and
support nurses in developing and maintaining therapeutic
relationships.
Research:
communicating knowledge of evidence-based, best-practice
guidelines related to caring and therapeutic relationships.

56. Standard 4: Ethical Practice
Clinical Practice:
1. Makes the client the primary concern in providing nursing care.
2. Provides care in a manner that preserves and protects client dignity.
3. Role-modeling positive collegial relationships;
4. Using a wide range of communication and interpersonal skills to
effectively establish and maintain collegial relationships
5. sharing knowledge with others to promote the best possible
outcomes for clients;
6. developing networks to share knowledge of best practices; and
7. demonstrating effective conflict-resolution skills.

57. Education :
1. Educates others to learn about ethical practice.
2. Educates others to provide care in a manner that preserves
and protects client dignity.
3. Facilitating the development of conflict-resolution skills;
and
4. Supporting nurses in developing skills to address any
unethical, unprofessional or unsafe behaviour of colleagues.
5. Educates others to protect client privacy and confidentiality
6. Implements educational activities that support the initiation,
maintenance and termination of nurse-client relationships in
an appropriate manner.

58. Administration:
1. Actively supports the creation of a practice environment
that enables nurses to meet their ethical obligations.
2. Promoting a work environment in which trust and respect
among all health care disciplines is expected;
3. Ensuring systems are in place to effectively reduce and
manage conflict between team members;
4. Supporting nurses to take action when clients are at risk of
harm from colleagues; and
5. Valuing and acknowledging nursing expertise and
contributions to the health care of clients.

59. Research:
1. Advocates for and participates in processes that promote
ethical and accountable research practices.
2. Ensures ethical guidelines are followed to protect research
participants.
3. Communicating knowledge of the research process and
relevant studies to other nurses and team members; and
4. Supporting nurses to participate in research studies.

60. Nursing Practice Act
 Nurse Practice Acts (NPAs) are laws in each state that are
instrumental in defining the scope of nursing practice.
 NPAs protect public health, safety, and welfare. This
protection includes shielding the public from unqualified
and unsafe nurses.
 In each state, statutory law directs entry into nursing
practice, defines the scope of practice, and establishes
disciplinary procedures.
 State boards of nursing oversee this statutory law. They
have the responsibility and authority to protect the public by
determining who is competent to practice nursing.

61. Purpose of NPA
NPAs include:
 Authority, power and composition of a board of nursing
 Education program standards
 Standards and scope of nursing practice
 Types of titles and licenses
 Requirements for licensure
 Grounds for disciplinary action, other violations and
possible remedies

62.  All states and territories have enacted a nurse practice act
(NPA). Each state’s NPA is enacted by the state’s
legislature. The NPA itself is insufficient to provide the
necessary guidance for the nursing profession, therefore,
each NPA establishes a board of nursing (BON) that has
the authority to develop administrative rules or
regulations to clarify or make the law more specific.
Rules and regulations must be consistent with the NPA
and cannot go beyond it. These rules and regulations
undergo a process of public review before enactment.
Once enacted, rules and regulations have the full force
and effect of law.

63. Ethical dilemmas in nursing
• Nurses face ethical dilemmas on a daily
basis regardless of where they practice.
No matter where nurses function in their
varied roles, they are faced with ethical
decisions that can impact them and their
patients. There is no “right” solution to an
ethical dilemma

64. What is an ethical dilemma
• It is a problem without a satisfactory
resolution. The significance of ethical
decision-making lays in the fact that
very different ethical choices regarding
the same ethical dilemma can be made
resulting in neither choice being a “right
or wrong” decision.

65. Types of dilemmas
• Pro-choice versus pro-life.
• Freedom versus control.
• Truth telling versus deception.
• Another dilemma involves the
distribution of resources.
• Empirical knowledge versus personal
belief.

66. • Pro-choice versus pro-life. This issue
affects nurses personally. Many of the
positions nurses assume in this dilemma are
influenced by their own beliefs and values.
How does a nurse care for a patient who has
had an abortion, when the nurse considers
abortion murder? Can that nurse with very
opposing values support that patient’s right
to choose her autonomy?

67. • Freedom versus control. Does a patient
have the right to make choices for one’s self
that may result in harm, or should the nurse
prevent this choice? For example, a patient
wants to stop eating, but the nurse knows
the consequences will harm the patient. Does
the nurse have the “right” to force the
patient to eat?

68. • Truth telling versus deception. This is
another issue that nurses may have to deal
with, especially when families want to deny
telling the patient the truth about the
medical condition. What should a nurse do
when a family insists telling the patient
the prognosis will cause harm? How can a
nurse know if this is true? Does the
patient have the right to know?

69. • Another dilemma involves the distribution of
resources. Who should get the limited resources?
For example, nurses working with patients that are
in a vegetative state; should these patients be left
on life support? Look at the cost of maintaining
these patients. These patients are consuming
resources that could be
used for patients in whom
such costly interventions, if
available, could save their lives.
What is the role of the
nurse when a family wants
to continue life support for
a medically futile family member?

70. Empirical knowledge versus personal
belief. In these dilemmas,
research based knowledge in
nursing practice is contrasted to
beliefs gained from such things as
religious beliefs. For example,
what should a nurse do when a
patient is admitted to the hospital
that desperately needs a
transfusion to live but has the
belief that transfusions are
unacceptable? The nurse knows
this patient will die without the
transfusion. How does that nurse
empathize with the patient’s
family who supports the family
member’s choice and still be
supportive of the patient’s and
family’s right to this decision?

71. Record Keeping
► A Good record keeping as an integral part of practice and
essential to the provision of safe and effective care.
► functions includes:
 Improving communication between healthcare professionals
 supporting delivery and continuity of patient care
 demonstrating clinical judgments and decision making
 identifying risk for patients
► Patient health records also have a function in improving
accountability and in so doing have a legal purpose in providing
evidence of the practitioners' involvement or interventions in
relation to patients or clients.