client rights
legal guarantees that clients have with regard to their health care.
each client has the right to
be informed and take an active role in all aspects of their care, accept, refuse, or request modification to the plan of care, and receive care from competent individuals who treat them with respect.
nurse's role if client decides to leave AMA
the nurse should notify the provider, and discuss potential risks associated with leaving prior to discharge, and document information provided to client and that the HCP was notified.
advocacy
refers to the nurse's role in supporting clients by ensuring that they are properly informed, their rights are respected, and that they are receiving the proper level of care.
essential components of advocacy
risk-taking, vision, self-confidence, articulate communication, assertiveness
consent is considered to be "informed" when the client has been provided and understands the following information
the reason needed, how it will benefit the client, the risks involved, other options available, the risk involved if client does not get the treatment.
nurse's role in the informed consent process is
to witness the client's signature on the form and ensure all information was provided to the client.
written consent is needed for
invasive procedure or surgery
individuals authorized to grant consent for another person
parent of a minor, legal guardian, court-specified representative, spouse or closest available
living will
legal document that expresses the client's wishes regarding medical treatment in the event the client becomes incapacitated and is facing end-of-life issues.
durable power of attorney
an individual who is authorized to make health care decisions for a client who is unable.
negligence
ex: nurse fails to implement safety measures for a client who is identified for risk of falling
malpractice (professional negligence)
ex: a nurse administers a large dose of medication due to a calculation error. the client has cardiac arrest and dies.
breach of confidentiality
ex: a nurse releases the medical diagnosis of a client to a member of the press
defamation of character
ex: a nurse tells a coworker that she believes a client has been unfaithful to the spouse
assault
ex: the conduct of one person makes another person fearful and apprehensive (threatening a client)
battery
ex: intentional and wrongful physical contact with a person that involves an injury or offensive contact (restraining a client & administering an injection against his wishes)
false imprisonment
ex: a person is confined or restrained against his will (using restraints on a competent client to prevent them from leaving the facility)
professional negligence
the failure of a person with professional training to act in a reasonable and prudent manner.
what should a nurse do if a coworker is suspected to be using drugs or alcohol while working?
they have the duty to report the coworker to appropriate management; at the time of the infraction- report to charge nurse
phone orders from physicians
nurses must transcribe the date and time the prescription was written, dosage, frequency, route, and their signature along with the provider who prescribed
incivility
defined as an action that is rude, intimidating, and insulting (teasing, joking, dirty looks, uninvited touching)
lateral violence
occurs between two individuals who are at the same level within the organization
bullying
persistent and relentless behavior, aimed at an individual who has limited ability to defend themselves.
ethics
based on an expected behavior of a certain group in relation to what is considered right and wrong
morals
the values and beliefs held by a person that guide behavior and decision making
ethical principles
standards of what is right or wrong with regard to important social values and norms.
autonomy
the ability of the client to make personal decisions, even when those decisions may not be in the client's best interest
beneficence
the care that is in the best interest of a client
fidelity
keeping one's promise to the client about care that was offered
justice
fair treatment in matters related to physical and psychosocial care and use of resources
nonmaleficence
the nurse's obligation to avoid causing harm to the client
veracity
the nurse's duty to tell the truth
ethical dilemma
problems for which more than one choice can be made, and the choice is influenced by the values and beliefs of the decision makers.
a problem is an ethical dilemma if-
it cannot be solved solely by a review of scientific data, it involves a conflict between two moral imperatives, the answer will have profound effect on the situation/client