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Nursing Code of Ethics

Discussion for MAN - Bioethical Principles in Nursing
by

Jenny Cabanto

on 5 August 2013

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Transcript of Nursing Code of Ethics

Surprises!
Nursing Code of Ethics
But about
connecting
with your audience
Jennylyn C. Cabanto, RN
(American Nurses Association)
Arellano University
Florentino Cayco Memorial School of Graduate Studies
Masters of Arts in Nursing
SY 2013-2014

RH 313
August 3, 2013

Nursing Code of Ethics
Nursing Code of Ethics
Topics
ETHICS
is an integral part of the foundation of nursing.


Nursing encompasses the
prevention
of illness, the
alleviation
of suffering and the
protection,

promotion
, and
restoration
of health in the care of individuals, families, groups, and communities.


Nurses act to change those aspects of social structures and detract from health and well-being. Individuals who become nurses are expected not only to adhere to the ideals and moral norms of the profession but also to
embrace
them as part of what it means to be a nurse.
PURPOSES
• It is a succinct statement of the ethical obligations and duties of every individual who enters the nursing profession
• It is the profession’s
nonnegotiable
ethical standard.
• It is an expression of nursing’s own understanding of its
commitment to society

Provision
The nurse, in all professional relationships, practices with
compassion
and
respect
for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems
1.1 Respect for human dignity
• respect for the inherent worth, dignity, and human rights of
every
individual


needs
and
values
of all persons in all professional relationships

1.2 Relationship to patients
• establish relationship and delivers nursing services with respect for human needs and values, and
without prejudice

• consider
lifestyle
,
value system
and
religious beliefs
in planning health care w/ and for EACH patient

• consideration

agreement but
respecting
patient as a PERSON

1.3 The nature of health problems
• the
worth
of a person is not affected by disease, disability, functional status, or proximity to death

• the measures nurses take to care for the patient enable the patient to live with as much physical, emotional, social, and spiritual well-being as possible
• Aims of Nursing Care:

maximize
the values that the patient has treasured in life and extends supportive care to the
family
and
significant others
meeting the comprehensive needs of patients and their families across the continuum of care

1.4 The right to self-determination

autonomy
– basis for
informed
consent
in healthcare

• patients have the
MORAL
and
LEGAL right
to determine what will be done with their own person

to be given
accurate
,
complete
, and
understandable information
in a manner that facilitates an informed judgment
to be assisted with the weighing
benefits
,
burdens
, and available
options
in their treatment, including the choice of
no treatment
to
accept
,
refuse
, or
terminate
treatment without deceit, undue influence, duress, coercion, or penalty
to be given necessary
support
throughout the decision-making and treatment process.

1.5 Relationship with colleagues
and others
• nurse maintains
compassionate
and
caring
relationship with colleagues and others with a commitment to the
fair treatment
of individuals, to
integrity-preserving
compromise, and to
resolving conflict.
Provision
The nurse’s primary commitment is to the
patient
, whether an
individual
,
family
,
group
, or
community
2.1 Primacy of the patient’s interests
• any plan of care must reflect the fundamental uniqueness of the individual patient

• participation of patient in planning care

• recognition of the
patient’s place
in the family or other networks of relationship

• when conflict persists, the nurse’s
commitment
remains to the identified patient
2.2 Conflict of interest for nurses
• nurses strive to resolve such conflicts in ways to ensure patient
safety
, guard the patient’s best
interests
and preserve the professional
integrity
of the nurse

• Example of conflict: changes in health care financing and delivery systems

• Conflicts of interest may arise in any domain of nursing activity including clinical practice, administration, education, or research.

2.3 Collaboration
• concerted effort of individuals and groups to attain a shared goal

• requires mutual trust, recognition, and respect among the healthcare team, shared decision making about patient care, and open dialogue among all parties who have an interest in and a concern for health outcomes.

2.4 Professional Boundaries
• when acting within one’s role as a professional, the nurse recognizes and maintains boundaries that establish appropriate limits to relationships.

Provision
The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.
3.2 Confidentiality
3.3 Protection of participants in research
3.4 Standards and review mechanisms
3.5 Acting on questionable practice
3.6 Addressing impaired practice
• nurses must be vigilant to
protect
the patient, the public and the profession from
potential harm
when a colleague’s practice, in any setting, appears to be impaired

• in a situation where a nurse suspects another’s practice may be impaired, the nurse’s duty is to take action designed both to
protect patients
and to
assure
that the impaired individual receives
assistance
in regaining optimal function

• if impaired practice poses a threat or danger to self or others, regardless of whether the individual has sought help, the nurse must take action to report the individual to persons authorized to address the problem
3.1 Privacy
• the nurse
safeguards
the patient’s right to
privacy
• the need for healthcare does not justify unwanted intrusion in the patient’s life
• physical privacy

• the rights, well-being, and safety of the individual patient should be the primary factors in arriving at any professional judgment concerning the disposition of confidential information received from or about the patient, whether
oral
,
written
or
electronic.
• each individual has the right to
choose
whether or not to
participate
in research

informed consent:
nature of participation, potential harms an benefits, and available alternatives to taking part in the research
• nursing is responsible and accountable for assuring that only those individuals who have demonstrated the
knowledge
,
skill
,
practice experiences
,
commitment
, and
integrity
essential to professional practice are allowed to enter into and continue to practice within the profession
• the nurse has a responsibility to
implement
and
maintain
standards of professional nursing practice
• as an advocate for the patient, the nurse must be alert to and take appropriate
action
regarding any instances of
incompetent,

unethical
,
illegal
or
impaired practice
by any member of the health care team or the health care system or any action on the part of others that places the rights or best interests of the patients in jeopardy
Provision
The nurse is
responsible
and
accountable
for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligation to provide optimum patient care

• nursing practice includes
direct care

activities
, acts of
delegation
, and other responsibilities such as teaching, research, and administration
• the nurse retains
accountability
and
responsibility
for the quality of practice and for conformity with standards of care
4.1 Acceptance of accountability and responsibility
4.2 Accountability for nursing judgment and action

accountability
means to be
answerable
to oneself and others for one’s own actions

• nurses are accountable for judgments made and actions taken in the course of nursing practice, irrespective of health care organizations’ policies or providers’ directives.

4.3 Responsibility for nursing judgment and action

responsibility
refers to specific accountability or liability associated with the performance of duties of a particular role.

• acceptance of role (education, knowledge, competence, extent of experience)

4.4 Delegation of Nursing Activities
• the nurse must make reasonable efforts to assess individual competence when assigning selected components of nursing care to the other healthcare workers

• nurses functioning in management/administrative roles and nurses functioning in educator/preceptor roles

Provision
The nurse owes the same duties to self as to others, including the responsibility to preserve
integrity
and
safety
, to maintain
competence
, and to continue
personal
and
professional

growth
5.1 Moral self-respect
• moral respect accords moral
worth
and
dignity
to all human beings irrespective of their
personal attributes
or
life situation


self-regarding
duties refer to realm of duties that primarily concern oneself and include professional growth and maintenance of competence, preservation of wholeness of character, and personal integrity
5.2 Professional growth and maintenance of competence
• continual professional growth, particularly in knowledge and skill, requires commitment to lifelong learning. Such learning includes, but is not limited to, continuing
education
,
networking
with profession colleagues,
self-study
, professional
reading
,
certification
, and seeking
advanced degrees
.
5.3 Wholeness of character
• encompasses
relationships
with patients

• nurses have both personal and professional identities that are neither entirely separate, nor entirely merged, but are
integrated
(in the process of becoming a professional, the nurse embraces the values of the profession, integrating them with personal values)
• in situations where the patient requests a personal opinion from the nurse, the nurse is generally free to express an informed personal opinion as this preserves the
voluntariness
of the patient and maintains appropriate professional and moral boundaries
5.4 Preservation of integrity

threats:
economically constrained health care environment; to deceive a patient, to withhold information, or to falsify records, as well as verbal abuse from patient or co-workers

• nurses have a duty to remain
consistent
with both their personal and professional values and to accept compromise only to the degree that it remains an integrity-preserving compromise.

Provision
The nurse participates in
establishing
,
maintaining
, and
improving
health care
environments
and conditions of
employment
conducive to the provision of quality health care and consistent with the
values
of the profession through individual and collective action.
6.1 Influence of the environment on moral virtues and values

virtues
are habits of character that predispose persons to meet their moral obligations; that is, to do what is
right
• compassion, patience, skill = morally good nurse
• all nurses have a responsibility to
create
,
maintain
, and
contribute
to environments that support the growth of virtues and excellences and enable nurses to fulfill their
ethical obligations
6.2 Influence of the environment on ethical obligations
• all nurses, regardless of role, have a responsibility to create, maintain, and contribute to environments of practice that support nurses in fulfilling their ethical obligations
6.3 Responsibility for the health care environment
• the nurse is responsible for contributing to a
moral environment
that encourages respectful interactions with colleagues, support of peers, and identification of issues that need to be addressed

• nurses should
not remain
employed in facilities that routinely violate patient rights or require nurses to severely and repeatedly compromise standards of practice or personal morality
• environments of practice:
observable features
– working conditions, written policies and procedures setting out expectations for nurses; and
less tangible characteristics -
informal peer norms.
Provision

The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development.
7.1 Advancing the profession through active involvement in nursing and in healthcare policy
• leadership/mentorship roles or on committees within their places of employment
• self employed nurses : serve as role models for professional integrity
• nurse educators : enhance students’ commitment to professional and civic values
• nurse administrators:_____________
7.2 Advancing the profession by developing, maintaining, and implementing professional standards in clinical, administrative, and educational practice
• it is the responsibility of nurses to identify their own scope of practice as permitted by professional practice standards and guidelines, by state and federal laws, by relevant societal values, and by the Code of Ethics.
7.3 Advancing the profession through knowledge development, dissemination, and application to practice
• the nursing profession should engage in scholarly inquiry to identify, evaluate, refine, and expend the body of knowledge that forms the foundation of its discipline and practice
Provision
The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs
8.1 Health needs and concerns
• the nurse has a responsibility to be aware not only of a specific health needs of individual patients but also of broader health concerns such as world hunger, environmental pollution, lack of access to health care, violation of human rights, and inequitable distribution of nursing health care resources
8.2 Responsibilities to the public
• nurses, individually and collectively, have a responsibility to be knowledgeable about the health status of the community and existing threats to health and safety

• nurse supports initiatives to address barriers to health such as poverty, homelessness unsafe living conditions, abuse and violence, and lack of access to health services.
Provision
The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice
9.1 Assertion of values
• it is the responsibility of a professional association to communicate and affirm the values of the profession to its members.
9.2 The profession carries out its collective responsibility through professional associations
the contract between the profession and society is made explicit through such mechanisms as:
a. The Code of Ethics for Nurses
b. the standards of nursing practice
c. the ongoing development of nursing knowledge derived from nursing theory, scholarship, and research in order to guide nursing actions
d. educational requirements for practice
e. certification, and
f. mechanisms for evaluating the effectiveness of professional nursing actions
9.3 Intraprofessional integrity
• one fundamental responsibility of a professional association is to promote awareness of and adherence to the Code of Ethics and to
critique
the activities and ends of the professional association itself
9.4 Social reform
• it is the responsibility of a professional nursing association to speak for nurses collectively in
shaping
and
reshaping
health care within our nation, specifically in areas of health care policy and legislation that affect accessibility, quality, and the cost of health care

• health should be understood as being
broader
than delivery and reimbursement systems, but extending to health-related
sociocultural issues
such as violation of human rights homelessness, hunger, violence, and the stigma of illness.
Full transcript