autonomy
making choices for yourself; self-determinance
justice
decisions made to be fair
fidelity
striving to keep promises
paternalism
goes against ethical principles. deciding for someone what is best for them.
beneficence
actively seeking to do good
nonmalefience
actively seek to do no harm
veracity
truthfulness
nursing process: assessment (ethical practice)
- gather data
- what is the problem?
- what are the subjective and objective indicators from the client, from you and from others involved?
- what are your own personal beliefs, biases, fears, values, concerns, about the situation?
nursing process: diagnosis (ethical practice)
- must distinguish ethical dilemmas from questions of procedure, legality or medical diagnosis
- is this an ethical dilemma?
- does it have one or more of these characteristics?
- -cannot be resolved solely through review of scientific data?
- -one cannot easily make a decision about the problem
- -the answer is the problem will have a profound impact on several areas
nursing process: planning (ethical practice)
- list all possible actions
- include the risks and benefits associated with each action
- avoid dualistic thinking (thinking there is only one way)
nursing process: intervention (ethical practice)
- remember that not doing anything is also an interventions with consequences
- is everyone who has a stake in the decision in agreement?
- have you consulted with all pertinent parties?
- are you clear on why you are choosing this action
nursing process: evaluation (ethical practice)
- once the action is taken, what consequences can you expect?
- after the intervention, are the consequences as you predicted or did something happen that no one thought about
- did you need to reverse your course of action?
- is there a new dilemma?
confidentiality
- fundamental to the nurse-patient relationship is the professional obligation to respect patient confidentiality
- is the duty of the professional who has received confidential info in trust to protect that information and disclose it to others only with permission, or when rules or laws allow its disclosure.
- whenever possible, nurses must uphold confidentiality
when are nurses not supposed to uphold confidentiality
- when harm might result to the patient or others
- when statute law or legislation requires disclosure (ie. suspected child/elder abuse, infectious disease, info for workers compensation boards, court order)
- When nurses are required to disclose info for a particular purpose, they disclose only the amount of info necessary for that purpose for that purpose and inform only those necessary
- legally, the betrayal of a patients confidence falls under professional misconduct and may result in discipline by the nurses professional association
how do you know what is confidential?
all knowledge is considered confidential unless otherwise stated by a patient
critical thinkers
- think for themselves
- challenge existing beliefs and actions
- think outside the box
- always ask questions
- explore alternatives to accepted ideas and ways of thinking
- do not mindlessly accept ideas presented to them
- problem solvers
- self-monitoring
- welcome and seek out feedback
- routinely reflect on their own thoughts
critical
means requiring careful judgement
thinking
means having an opinion, reflecting, pondering, calling to mind, remembering, forming a mental picture, reasoning
critical thinking
purposeful mental activity in which ideas are produced and evaluated, plans are made, and desired conclusions determined
BCCNP standard 4 ethical practice
the LPN understands, upholds, and promotes the ethical standards of the nursing profession.
- demonstrates honesty and integrity at all times
- represent self clearly and accurately with respect to name, title and role
- respects and protects client worth, dignity, uniqueness, and diversity
- protects clients info and maintains privacy and confidentiality
- recognizes, respects and promotes the clients right to be informed and make informed choices
- begins, maintains and ends nurse-client relationships in a way that puts the clients needs first.
- identifies the effect of own values, beliefs and experiences when providing nursing care
- identifies ethical issues, recognizes potential conflicts, takes action to prevent or resolve them by communicating with health care team and consulting with appropriate people; and evaluates effectiveness of actions.
- makes decisions about the allocation of resources under ones control based on the needs of the client.
- recognizes and respects the contribution of others on the health care team
- treats colleagues, students and other workers in a respectful manner
nurses obligations in ethical decision
- maximize client well being
- balance the clients needs for autonomy with family members responsibilities for clients well being.
- support each family member and enhance the family support system
- carry out agency policy
- protect other clients well being
- protect the nurses own standard of care
ethical dilemma
an ethical situation in which there is no acceptable action, the choices are made from equally unacceptable alternatives and no action at all is considered an action
ethical decision making models
- requires deliberate, systemic thinking
- requires incorporation of conflicting ideas
- a 7 step process in text book
- use nursing process
