value
belief about the worth of something, about what matters, acts as a standard to guide one's behavior
t/f
Moral values give individuals the ability to identify correct behaviors and the ABILITY to DISCERN RIGHT FROM WRONG
true
Modeling
Children learn what is of high or low value BY OBSERVING parents, peers, and significant others
Moralizing
TAUGHT a COMPLETE value SYSTEM by parents or an institution (church, school) that allows little opportunity for them to weigh different values
Laissez-faire
Children to explore values ON THEIR OWN (no single set of values is presented as best for all) and to develop a personal value system
Involves little or no guidance
May lead to confusion and conflict
Rewarding and punishing
Rewarded for demonstrating values held by parents
Punished for demonstrating unacceptable values
Responsible choice
Encourage children to EXPLORE competing values and to WEIGH their CONSEQUENCES
Support and guidance are offered as children develop a personal value system
A child is born with values and forms new values during a lifetime from information from the environment, family, and culture.
A. True
B. False
false
Rationale: A child is not born with values, but rather forms values during a lifetime from information from the environment, family, and culture.
we learn values
3 main actions of the valuing process
choosing
prizing (treasuring)
acting
choosing
choosing freely from alternatives after careful consideration of the consequences of each alternative
choosing examples
quitting smoking and working fewer hours
prizing (treasuring)
involves pride, happiness, and public affirmation
prizing examples
losing weight or running a marathon
acting
combining choice into one's behavior with consistency and regularity on the value
acting examples
joining a gym for the year and following a low-cholesterol diet faithfully
altruism
the CONCERN FOR the wellfare and WELL BEING of others
autonomy
right to self determination
human diginity
RESPECT for inherent WORTH and UNIQUENESS of individuals and populations
integrity
acting according to code of ethics and standards of practice
social justice
upholding moral, legal, and humanistic rights
The nurse includes the client in developing the plan of care
A nurse provides privacy for an older adult client.
A nurse plans individualized nursing care for her clients.
A nurse refuses to discuss a client with a curious friend.
examples of human dignity
A nurse researches the culture of a Muslim client when planning care.
example of altruism
Which value involves acting in accordance with an appropriate code of ethics and accepted standards of practice?
A. Altruism
B. Autonomy
C. Human dignity
D. Integrity
E. Social justice
Integrity
ethics
systematic STUDY of principles OF RIGHT AND WRONG conduct, virtue and vice, good and evil, as they relate to conduct and human flourishing
bioethics
encompasses a number of fields of lfie sciences
nursing ethics
formal study of ethical issues that arise in the practice of nursing; serves as an expression of nursing's own understanding of its commitment to society
analysis used by nurses to make ethical judgments
feminist ethics
critiques existing patterns of oppression and domination in society especially affecting women and the poor
Utilitarian action guiding theory
the rightness or wrongness of an action depends on the consequences of the action
deontologic
an action is right or wrong independent of its consequences
1) ideals and beliefs held by an individual or group; act as a standard to guide one's behavior. ideas held by an individual about what matters
2) moral principles and values that guide the behavior of honorable people.
3) a standard for right and wrong.
1) values
2) ethics
3) morals
4) bioethics
autonomy
respect rights of patients to make health care decisions
Nonmaleficence
avoid causing harm
Beneficence
benefit the patient
justice
give each his or her due and act fairly
fidelity
keep promises
veracity, accountability, privacy, confidentiality
...
care based approach to bioethics
centrality of the caring relationship
promotion of dignity and respect for patients as people
attention to the particulars of individual patients
cultivation of responsiveness to others
redefinition of fundamental moral skills to include virtues like kind
ethical conduct
practice based on professional standards of ethical conduct as well as professional valeus
how should nurses display ethical conduct?
cultivate the virtues of nursing
understand ethical theories that dictate and justify professional conduct
be familiar with codes of ethics for nurses and standards for professional nursing conduct
purposes of the code of ethics for nurses
It is a succinct statement of the ethical obligations and duties of every nurse.
It is the profession's nonnegotiable ethical standard.
It is an expression of nursing's own understanding of its commitment to society.
Study the standards under each element of the code.
Reflect on what each standard means to you.
Discuss the code with coworkers and others.
Use a specific example from experience to identify ethical dilemmas and standards of conduct in the code.
Work in g
ICN guidelines to achieve purposes of code of ethics
Uses Code of Ethics for Nurses with Interpretive Statements to guide practice
Delivers care in a manner that preserves and protects health care consumer autonomy, dignity, rights, values, and beliefs
Recognizes the centrality of the health care consumer a
measurement criteria for standard 7 ANA standards
Practice in a manner that fulfills obligations to society and to those who receive nursing care
Practice in environments that allow them to act in accordance with professional standards and legally authorized scopes of practice
Work in an environment that
7 Basic Tenets of Bill of Rights for RNs
ethical dilemma
two or more CLEAR moral principle apply but support MUTUALLY INCONSISTENT COURSES OF ACTION
difficult choice has to be made between two or more alternatives, especially equally undesirable ones.
ethical distress
occurs when the nurse KNOW the right thing to do but either PERSONAL or INSTITUTIONAL factors make it DIFFICULT to follow the correct course of action
A nurse who is dedicated to providing culturally competent care to her patients finds herself without the resources to communicate with a patient who speaks a different language. This problem may result in an ethical dilemma for the nurse.
A. True
B. Fals
false
rationale: personal factors - lack of knowledge in different language
institutional factors - may lack tools, interpreters necessary for nurse to communicate with patient
Four A's to rise above moral distress
Ask
Affirm
Assess
Act
using the nursing process to make ethical decision
A ssess the situation (gather data)
D iagnose (identify) the ethical problem
P lan - identify options, think ethical problems through, make a decision
I mplement your decision
E valuate your decision
ethical problems
...
o An alert older resident who lives in a long term care facility and who is now at high risk for falls refuses to call the nurse for assistance when getting out of bed
o The nurse must decide whether to obtain an order to restrain the patient
o Does this
paternalism
o A postoperative patient asks the student nurse, who is about to administer an intramuscular injection for pain, "is this your first shot?"
o It is the student's first injection
o Would the student's intent to decrease the patient's anxiety justify telli
deception
o A nursing student in your class shows you her recent facebook posting that includes a photo of a patient with a large sacral pressure ulcer
o She says that since the patient is lying face down, this is not an invasion of privacy
o What pt. info can you
privacy
o Asks a middle aged woman who is crying quietly "would you like to share what's troubling you?"
o The woman tells the nurse she has no idea how she will pay for this clinic visit because she entered the country illegally 2 months ago
o If the nurse belie
confidentiality
o A floor is understaffed
o You have a discharge pt with many questions, older patient close to death, women with cancer who has been vomiting all day and in severe pain
o You know you cannot meet everyone's needs well
o How do you distribute your nursing
allocation of scarce nursing resources
o Resident performing a spinal tap on adolescent who you know dislikes the resident
o After one failed attempt, adolescent tells resident to stop
o Resident asks you to administer an antianxiety med to the pt to enable the resident to get the spinal tap d
valid consent or refusal
o Infertile woman asks what you think about in vitro fertilization
o She tells you that she is desperate to produce a child
o Says "I've read about couples who end up with seven frozen embryos and I think that would kill me thinking I've got seven potenti
conflicts concerning new technologies
o Pediatric surgeon - not concentrating during surgery, making more mistakes than usual
o Rumors that surgeon struggling with cocaine abuse
o The parents are dissatisfied with progress of pt. and ask nurse for an opinion about the surgeon
o Should the nur
Unprofessional, incompetent, unethical, or illegal physician practice
o Pt. at risks with short staffing
o Nurses are talking about forming a union and going on stroke
o You are unsure whether striking is a morally legitimate option
o Efforts to get management to address the issues have repeatedly failed, contemplating goin
short staffing and whistle blowing
o Working in catholic hospital whose ethical and religious directives forbid abortion and abortion counseling
o Talking with a single woman who is expressing great ambivalence about continuing the pregnancy
o You personally believe that you ethical obliga
beginning of life issues
o Seriously advanced cancer pt.
o Pt. says she is unwilling to fight anymore and wants to die with some dignity while she is still in control
o She begs you to get her something that will "put me gently to sleep once and for all before my pain gets worse.
end of life issues
A nurse attempts to obtain an order for a feeding tube for an anorexic teenager who refuses to eat. What is the term for the ethical problem this nurse is experiencing?
A. Deception
B. Confidentiality
C. Allocation of scarce nursing resources
D. Advocacy
paternalism
functions of ethics committees
Education
Policy making
Case review
Consultation
Occasionally research
advocacy in nursing practice
Primary commitment to the PATIENT
Prioritization of GOOD OF INDIVIDUAL patient rather than society in general
Evaluation of competing claims of patient's autonomy and patient well-being
areas of concern for patient advocates
...
pt with terminal cancer tells his nurse that he wants to go home to die. Pts. Family tells the nurse that they cannot care for him at home. as an advocate, the nurse recognizes the rights of both the pt. and his family. Nurse then works to help find a sol
representing patient
o Advocacy is linked to the belief that making choices about health is a fundamental human right that promotes the individual's dignity and well being
o Nurses must realize that they do not make ethical decisions for their patients. Support decision makin
promoting self determination
o Every nurse who witnesses unsafe care has a duty to pts to report it
whistle blowing
o Continuing voice in the political arena on behalf of those least well served - homeless ppl, minorities, women, children
being politically active
.A nurse caring for patients in the intensive care unit develops values from experience to form a personal code of ethics. Which statements best describe a characteristic of the development of a personal value system? Select all that apply.
People are bor
Values act as standards to guide behavior.
Values are ranked on a continuum of importance.
Values influence beliefs about health and illness.
rationale: A value is a belief about the worth of something, about what matters, which acts as a standard to guid
Five-year-old Bobby has dietary modifications related to his diabetes. His parents want him to value good nutritional habits and they decide to deprive him of a favorite TV program when he becomes angry after they deny him foods not on his diet. This is a
Rewarding and punishing
A nurse who is working in a hospital setting after graduation from a local college uses value clarification to help understand the values that motivate patient behavior. Which examples denote "prizing" in the process of values clarification? Select all th
A patient shows off a new outfit that she is wearing after losing 20 pounds.
A patient proudly displays his certificate for completing a marathon.
rationale: Prizing something one values involves pride, happiness, and public affirmation, such as losing we
The American Association of Colleges of Nursing identified five values that epitomize the caring professional nurse. Which of these is best described as acting in accordance with an appropriate code of ethics and accepted standards of practice?
Altruism
A
Integrity
A professional nurse with a commitment to social justice is most apt to:
Provide honest information to patients and the public
Promote universal access to health care
Plan care in partnership with patients
Document care accurately and honestly
Promote universal access to health care
rationale: The American Association of Colleges of Nursing lists promoting universal access to health care as an example of social justice. Providing honest information and documenting care accurately and honestly a
When an older nurse complains to a younger nurse that nurses just aren't ethical anymore, which reply reflects the best understanding of moral development?
"Behaving ethically develops gradually from childhood; maybe my generation doesn't value this enoug
Behaving ethically develops gradually from childhood; maybe my generation doesn't value this enough to develop an ethical code.
A home health nurse who performs a careful safety assessment of the home of a frail elderly patient to prevent harm to the patient is acting in accordance with which of the principles of bioethics?
Autonomy
Beneficence
Justice
Fidelity
Nonmaleficence
Nonmaleficence
A professional nurse committed to the principle of autonomy would be careful to:
Provide the information and support a patient needed to make decisions to advance one's own interests
Treat each patient fairly, trying to give everyone his or her due
Keep a
Provide the information and support a patient needed to make decisions to advance one's own interests
Janie wants to call an ethics consult to clarify treatment goals for a patient no longer able to speak for himself. She believes his dying is being prolonged painfully. She is troubled when the patient's doctor tells her that she'll be fired if she raises
Ethical distress
rationale: Ethical distress results from knowing the right thing to do but finding it almost impossible to execute because of institutional or other constraints (in this case, fear of losing her job). Ethical uncertainty results from feel
A student nurse begins a clinical rotation in a long-term care facility and quickly realizes that certain residents have unmet needs. The student wants to advocate for these residents. Which statements reflect a correct understanding of advocacy? Select a
Advocacy is the protection and support of another's rights.
Patients with special advocacy needs include the very young and the elderly, those who are seriously ill, and those with disabilities.
Effective advocacy may entail becoming politically active.
r