Legal and Ethical Aspects of Nursing chpt 2 – Flashcards
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ethics
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the way one should behave ; how a person ought to act
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euthanasia
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assisted suicide
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laws
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reference of a rule, principle, regulation, established by gov to protect/ restrict people
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legal aspects of nursing
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the legal relationship that exists between the nurse and the patient is influenced by the existing laws, rules, adn regulations that govern nursing practice
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legal system
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complex set of rules and regulatons that has developed in response to the needs of society
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laws
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prescribe proper behavior in society; sanction acceptable behavior and prohibit unacceptable behavior -provides protection for all members of the health care system
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2 categories of law
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-criminal -civil both established in 1 of 2 ways: 1. federal, state, local governments develope statutory law 2. common, law or case law, evolves in reponse to specific legal questions that come before the court and usually follows precedent
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precedent
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previous ruling on an issue
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criminal law
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offensive to society in general detrimental to society as a whole involves public offenses (robbery/murder/assult) purpose: is to punish for crime and deter/prevent further crimes
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civil law
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violates person's rights detrimental to that individual offense that is against an individula purpose: to punish for the crime and deter and prevent further crimes
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Legal Process
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1. civil litigation = plantiff contacts an attorney 2. If litigation has case = plantiff writes complaint & files with court (complaint = defendant name, states facts, states legal issues, outlines damages) 3. Defendant is served a summons 4. Defendant hires attorney 5. attorney prepares / files an answer (answer = admittance or denial of defendant) 6. Discovery = allows both sides to interview witnesses / look over doc's (depositions taken = Q & A session under oath) 7. jury renders verdict 8. appeal can be requested
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plantiff
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complaining party
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civil litigation
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lawsuit in a civil court
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defendant
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person alleged to be liable
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damages
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compensationthat the plaintiff is seeking
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summons
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court order that notifies the defendant of the legal action
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constitution law
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due process, equal protection
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statutory law
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nurse practice act
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common law
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...
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administrative law
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...
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criminal law
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homicide, theft, uthenasia, etc
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answer
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detailed response to the charges outlined in the complaint
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discovery
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pretrial process allowing both sides to interview witnesses adn lok at documents
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deposition
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question and answer session under oath where attornies ask witness' questions relating to the lawsuit
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request for productin of documents and things
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policies adn procedures, standards of care, medical records, assignment sheets, personal files, etc
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verdict
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a decision based on: the facts of the case, evidence and testimony presented, credibility of the witnesses, laws pertaining to the issues
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appeal
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request a review of the decision (from higher court)
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outcome of litigation
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is never certain
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criminal trial
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questioning whether defendant is answerable for a crime againts the people
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criminal law trial process
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peoples attorney and defendants attorney present cases, judge or jury deliberate guilt or innocents. not guilty = free guilty = sentances
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sentencing
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penalty
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private / civil law
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tort or contract invasion of privacy, etc. between nurse and patient
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accountability
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being responsible for ones own actions
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liability
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legal responsibility
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nurse / patient relationship
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happens when you assume the responsibility of giving care to someon
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ombudsman
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patient advocate -conduct independant reviews / interviews when a patient calls to complain (want fairness, dignity, and respect for patient)
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assult
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intentional threat to cause bodily harm to another (does not have to be physical contact)
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battery
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unlawful touching of another person w/o informed consent
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competency
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legal presumption that perso @ age of majority can make own decisions unless proved otherwise (unless legally declared incompetent)
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defamation
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spoken / written statements made maliciously and intentionally to injure subjects reputation
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harm
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injury to person or person's property
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libel
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malicious or untrue writing about another then brought to attention of others
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malpractice
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failure to meet a legal duty, thus causing harm to others (professional negligence)
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negligence
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commission or omission of an act resulting in harm to others
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slander
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malicioius / untrue spoken words about another person
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tort
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wrongful doing against person or property ex: fraud, negligence, battery
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nursing liability
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failure to provide care to expected level of expertise
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advocate
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defends or pleads case on behalf of another
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nurse assumes responsibility for patient care
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legal and ethical obligations to safeguard the patient's interests
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standards of care
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define acts whose performance is required, permitted, or prohibited
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scope of nursing practice
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directions to you as a practicing nurse (obligations, permissions, prohibitations) -nurse is duty bound to know and follw -ignorance of does not absolve you from the liability
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Nursing State standards
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legal test is comparison with hypothetical actions under similar circumstances of a reasonably prudent nurse of sim edu and exp.
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prudent
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careful, wise
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Nurse Practice Act
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(laws formally defining and limiting the scope of nursing practice) sets edu requirements grounds for disciplining actions licensure requirements defines scope / limits
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licensure
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required to apply for once credentials recieved practice is legal can be taken away
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Need for Disciplinary actions in nursing
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- unprofessional conduct -conduct w/ neg effects -carrying out assignment incorectly -physical / verbal abuse -breach of confidentiality -improper delegation -inaccurate patient records -abandonment -failure to engage in continuing edu -leaving assignment w/o permission / approval
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interstate compact
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allows multistate practice of nursing. LVN / RN licensed in her or his home state, then privileges are granted to practice in other states that have signed theinterstate compact
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malpractice types
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ommison commission
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omission
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not doing and act
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commission
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doing an act
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Liability of malpractice
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1. duty exsists 2. breach of the duty 3. harm has occured
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duty exsists
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the nurse-patient relationship establishes a duty, defined by the standards of care
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breach of the duty
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failure to perform the duty in a reasonable, prudent manner
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harm has occured
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physical / emotional/ financial
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actual laws of conduct
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physical injury emotional injury financial injury
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patients bill of rights
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patients expectations regarding the health care services they receive
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patient self - determination act
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requires that institutions maintain written policies and procedures regarding advance directives -right to accept/ deny treatment -right to participate fully in health care related decisions
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HIPAA
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health insurance portability and accountability (1996) health care providers duty to protect the confidentiality of all health information
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informed consent
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patients right to make decisions regarding his or her health care EXCEPTIONS 1. patient deemed incompetant 2. married minors 3. emancipated mino 4. special needs minors
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Types of consent
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admission agreement blood transfusion research surgical special consents: organ donation photographing use of restraints autopsy
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3 Requirments of informed consent
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1. mental capacity 2. sign voluntarily 3. understand information (responsibility of health care provider to determine)
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doctrine of informed consent
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full disclosure of facts patient needs to make an intelligent (informed) decision prior to invasive treatment or procedure -in lamens terms includes: benefits risks alternatives consequences of refusing failure to secure this can result in civil/ technical battery
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confidentiality
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duty to protect info about pt no matter how you come to have that info on or off duty can result in legal liability
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Medical records
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are not public documents -all entries must be permanent, accurate, complete, and legible -black ink only -never make copies
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invasion of privacy
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legal concept involves persons right to be left alone and remain anonymous if he or she chooses -do not expose body parts unnecesarily -do not discuss patient inappropriately -do not disclose info about patient
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reporting abuse
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exception to right to privacy -required to report certain info/ incidence to authorities -health care professional is protected from liability
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Federal Child Abuse Prevention Treatment Act
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(1973) made to reporting of child abuse mandatory -failure to do so can result in prison / fines / both
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Acusation
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formal written statement of charges filed against license
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revoked
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license voided practice right has ended
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revoked / stayed / probation
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professional practice continues with specified terms
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Writ
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appeal of overturn decision of board of nursing
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IPN
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Intervention Project for Nurses -report substance / chem abuse report to supervisor --> IPN = investigation
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work place violence includes
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verbal emotional sexual physical threatening behavior
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How to avoid a lawsuit
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1. know standards of care 2. know your scope of practice 3.proper documentation
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Good Samaritan Laws
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provide immunity from liability to encourage assistance in emergencies occuring outside of a medical facility
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insurance
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only covers you while on duty @ facility types: 1. professional liability 2. personal
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Professional liability insurance
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insurance carried by facility for all employees 1. claims made policy 2. occurance basis policy 3. "tail" agreement
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personal liability insurance
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to cover nurse while off duty
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disciplinary defense insurance
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license protection insurance incase brought in front of the board of nursing
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letter from board of nursing aleging breaches recieved =
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seek legal representation
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what can happen to nurses' license
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-dismissed charge -investigation agreement -letter of reprimand -probation with stipulations (fines,etc) - mandated diversion program for drug/alchohol related or based on mental cond -suspension w/ stipulations -revocation of license
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ANA code of nursing
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governs nursing actions -compassion / respect -commitment -advocacy -accountability
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ethics
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values that influence a person's behavior and the individual's feelings and beliefs about right and wrong
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values
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personal beliefs about the worth of an object, idea, custom, attitude -vary among ppl and cultures -influence everyday decisions
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ethical dilemmas
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situations that do not have a clear right or wrong answer
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how to deal with ethical dilemmas
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1. asses situation completely 2. gather information 3. consider ethical principles 4. make decision
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respect
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all human life is sacred
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autonomy
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freedom of personal choice, right to be independent and make decisions freely
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beneficence
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doing good or acting for someone's good
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nonmaleficence
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do not harm act in patients best interest
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justice
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concept of what is fair -all pt's have right to nursing interventions
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codes of ethics
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not legally binding -serve as a way to regulate nurses' actions and give guidelines for ethical behavior (competent, trustworthy, accountable) help safeguard society
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NFLPN
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national federation of licensed practical nurses code to specify expectations of nurse: 1. know and function within scope of practice 2. maintain patient confidences 3. provide health care without discrimination 4. maintain high degree of professional / personal behavior 5. take an active role in the development of the LPN profession
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fidelity
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duty to do what one has promised to do
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veracity
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always tell the truth
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truth
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promotes trust in patient/ nurse relationship
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reporting unethical behavior
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duty to report if witnessed -document incident
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practitioner-assisted suicide
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= neglect -Illegal -has no constitutional right -ANA against (violation of nursing code of ethics) -PAS for (right to autonomy/ self determination)
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right to refuse treatment
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competent adults have the right even if death is certain outcome
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living will
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advanced directives when patient is incapacitated
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heath care proxy
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assign durable power of attorney to make decisions regarding medical treatment
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DNR
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do nor resuscitate orders - if ignored = battery physician writes DNR in med record (must be signed) nurse duty to follow orders
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Refusal of care by nurse
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do not abandon patient ask for reassignment -cannot refuse to provide care after objected procedure
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ethical committies
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developed / established policies and procedures to prevent and resolve dilemas
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standard of care
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if nurse named as defendent in malpractice lawsuit will be cleared if standards of care were followed
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walking out
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if facility is short staffed charge = abandonment
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floating nurse
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cant refuse assignment
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legal vs ethical
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legal responsibilities controlled by federal legislations vs that which is good for the individual
