Professional Responsibilities
the obligations that nurses have to their clients
In order to meet these pro. res. nurses must be knowledgeable in these areas:
Client Rights, Advocacy, Informed Consent, Advance Directives, Confidentiality & Information Security, Legal Practice, Disruptive Behavior, Ethical Practice
Client Rights
The legal guarantees that clients have with regard to their health care.
Clients Rights that require particular attention:
Informed consent, refusal of treatment, advance directives, confidentiality, and information security
Regardless of age, needs or setting, clients have the right to:
1. be informed about all aspects of care and take and active role in the decision making process
2. Accept, refuse, or request modification to the plan of care.
3.Receive care that is delivered by competent individuals who treat client with respect.
Refusal of treatment:
PSDA-Patient Self Determination Act stipulates that a client must be informed of their right to refuse or accept care. (Documentation is required if refused)
Client should also be informed of:
1. Possible complications that can occur w/out treatment.
2. Possibility of permanent physical or mental impairment or disability.
3. Possibility of other complications that could lead to death
Advocacy
Advocacy refers to nurses role in supporting clients by ensuring that they are properly informed, that their rights are respected and that they are receiving the proper level of care.
Should a nurse act as an advocate even though they disagree with their clients decision?
YES
Situations in which nurses may need to advocate for clients:
End of life decisions
Access to health care
Protection of client privacy
Informed consent
Substandard practice
Essential Components of Advocacy:
Skills:
Risk taking Self Confidence Assertiveness
Vision Articulate Communication
Essential Components of Advocacy 2:
Values:
Caring Autonomy Respect Empowerment
Informed Consent:
a legal process by which a client has given written permission for a procedure or treatment to be performed.
Nurses role in informed consent-
to witness the clients signature on the informed consent form & to ensure that consent has been appropriately obtained.
People authorized to grant consent for another person
Parent of a minor
Legal Guardian
Court specified representative
Spouse or closest available individual who has durable power of attorney
Emancipated minors
The nurse must verify that consent is informed and witness the consent form being signed.
If a person is unable to communicate due to a language barrier or hearing impairment what can you as a nurse do?
You can provide a trained medical interpreter so the client can be informed and then give consent
Advance Directives
The purpose of Adv Dir is to communicate a clients wishes regarding end of life care should the client become unable to do so
2 components of Adv Dir
Living Will
Durable Power of Attorney for health care
Living Will
A legal document that expresses the clients wishes regarding medical treatment in the event the client becomes incapacitated and is facing end of life issues. Legal in all states.
Durable power of attorney for health care
a legal document that designates a health care proxy, who is an individual authorized to make health care decisions for a client who is unable. This is an adjunct to a living will & may be more effective at ensuring the clients decisions are honored.
Providers orders
Unless a DNR or AND order is written, the nurse should initiate CPR when a client has no pulse or respirations
What can happen to a nurse who discloses client information to an unauthorized person?
The nurse can be held liable for invasion of privacy, defamation or slander
What was HIPPA enacted to protect?
The confidentiality of health care information & to give the client the right to control the release of information.
The Privacy Rule of HIPPA requires what?
That nurses protect all written and verbal communication about their clients.
Information Security Protocols:
Logging off from the computer before leaving the workstation.
Never sharing a user ID or password with anyone
Never leaving a clients chart or written PHI where others can access it
Shredding any printed or written client information used for reporting or
How to protect yourself regarding social media:
1.Become familiar with facility policies about its use
2.Avoid disclosing any client health information online. When you are speaking about a client on the phone, be careful not to be overheard.
3.Do not take or share photos or videos of a client
4.Rememb
By practicing nursing within the confines of the law nurses are able to do what?
1. Provide safe and competent care
2. Advocate for clients rights
3. Provide care that is within the nurses scope of practice.
4. Discern the responsibilities of nursing in relation to the responsibilities of of other members of the health care team.
5. P
Federal Laws that impact nursing practice
Health Insurance Portability and Accountability Act (HIPPA)
Americans with Disabilities Act (ADA)
Mental Health Parity Act (MHPA)
Patient Self Determination Act (PSDA)
Uniform Anatomical Gift Act and the National Organ Transplant Act
Unintentional Torts
Negligence
Malpractice
Quasi-intentional Torts
Breach of confidentiality
Defamation of character
Intentional Torts
Assault
Battery
False Imprisonment