Flashcards
Ethical Decisions
Flashcards do conjunto (25)
- 1Why is an ethical framework necessary?Nurses encounter ethical conflicts, uncertainty and distress daily in their practice
This is a guide to assist nurses in their daily practice
To make decisions about ethical situations nurses must understand their own personal values - 2What does the CNO say is the practice standard for ethics?Promoting the values of client well-being
Respecting client choice
Assuring privacy and confidentiality
Respecting quality of life
Maintaining commitments
Respecting Truthfulness
Ensuring fairness in the use of resources - 3Who is the Canadian Council for Practical Nursing Regulators?Canadian council for practical nurse regulators (CCPNR) is a federation of provincial and territorial members who are identified in legislation, and responsible for the safety of the public through the regulation of Licensed Practical Nurses (LPNs)
- 4What is the CCPNR Code of Ethics for Licensed Practical Nurses?Code articulates the ethical values and responsibilities of the Licensed Practical Nurses to which they are accountable
Code serves to guide LPNs ethical reflections and decision making across all areas of practice
Inform the public about the ethical values and responsibilities of the LPN profession and convey the profession's commitment to society
Use the code in conjunction with professional standards and competencies, workplace policies, and legal requirements that guide practice and behaviour - 5What are the 5 Ethical Principles as described by the CCPNR?Principle 1: Responsibility to the public
Principle 2: Responsibility to clients
Principle 3: Responsibility to the profession
Principle 4: Responsibility to colleagues
Principle 5: Responsibility to self - 6How do you know if you have made the right decision?In most circumstances, impossible to attain “perfection”, where everyone is perfectly content with the decision
To justify his/her decision and actions, a nurse must attain at least a level of certainty – use a systematic process
Decisions must be relevant to patient situation
“To do the right thing, at the right time, for the right reason and in the right proportion” - 7How do nurses enhance ethical practice?Although a nurses' input is important in making an ethical decision, there are also several other people/groups that are involved as well. This can be the family, friends, spouse, government, lawyers, community groups.
Skills required to enhance an ethical practise? Collaboration, Communication & Compromise. - 8How can you overcome constraints to ethical practise?Awareness of your values
Code of ethics
Respect values and opinions of others
Participate in ethics rounds
Serve on institutional ethics committees
Read!! Make sure you are knowledgeable of current literature on ethics
What are the legal requirements that are interspersed with ethical dilemmas - 9What do we have in our ethical decision making "toolkit"?Ethical analysis concepts
Ethical theories
Ethical principles
Relevant codes of ethics
Legal considerations
Decision making model
CCPNR - Guidelines for ethical decision making
CNO - Ethical Decision Making Framework
Michael McDonald - An Ethical Decision-Making Process
LEARN: Enhancing Ethical Practice - 10Steps to Ethical Decision Making1. Describe the issue
2. Gather Information
3. Clarify the issue (the personal, professional values, ethical principles & laws involved)
4. Identify options
5. Consider policy
6. Decide on actions
7. Implement decisions
8. Assess outcome - 11LEARN: An approach to ethical decision makingListen to others
Explain your perceptions
Acknowledge and discuss differences
Recommend alternatives
Negotiate agreement - 12An Ethical Decision Making OverviewMany models and guidelines but all involve the same process:
1. Descriptive analysis (fact finding):
Clinical condition
Who can give consent?
Quality of life now and expected
Context: laws, standards, policies
2. Conceptual analysis: think through problem using ethical theory, principles
Deontology: What is/are the duties?
Utilitarianism: In this case, what end will produce the most utility, well-being or least suffering?
Consider ethical principles: respecting autonomy, beneficence, non-maleficence, truth-telling, integrity, confidentiality
3. Normative analysis: decision based on descriptive and conceptual analysis - 13What is an ethical/moral dilemma?When there is no clear right choice, and all actions will have good and bad outcomes, we have an ethical dilemma
Most ethical course of action is unclear
Strong moral reasons needed to support several positions
Decision must be made based on the most right or the least wrong choice of action
An individual knows the ethically correct action to take but is unable to take the action because of internal or external barriers
Personal/professional values are being challenged
Each instance of moral distress leaves behind “moral residue”- what do you think this means?
If a situation re-occurs, then the moral residue increases - 14How can we overcome ethical dilemmas?Ethical principles and legal responsibilities to think, discuss and make decisions
Sometimes these principles conflict
Ethical decision making model
Self-reflect - 15What is a Reflective Practice?Method of making sense of situations and learning from experiences
Reflection in action- thinking process in in the midst of a situation
Reflection on action- thinking about the situation after the fact- how could things be improved
Experiencing the situation: What? | How did the situation begin? | What did you observe? | How did it end?
Reflective after the fact: So what? | Did you learn something new? | Was anything a surprise? | Are you happy with the outcome? | Are others? How do you know?
Applying, Changing or keeping for future: Now what? | What did you learn to take away? | Would you do the same thing in the future? | Why/Why not? - 16What happens when we are constantly challenged ethically?First:
MORAL INTEGRITY-
REFERS TO THE QUALITY OF ONE’S CHARACTER
INTEGRATION OF HONESTY AND TRUTHFULLNESS
MORAL DILEMMA -
SITUATIONS INVOLVING CONFLICTING ETHICAL BELIEFS
WHAT SHOULD I/WE DO?? - 17Challenges to moral distressIncreased autonomy
Workload
Changing technology- EMRs
End of life situations- what can change the degree of conflict within this issue?
Quality vs quantity
Access to resources (financial limitations)
New infections and communicable diseases threatening the global community
Biological/genetic technologies
A “business” approach to healthcare, privatization
communication - 18What happens when there is moral/ethical distress?Conflict
Illness
Anxiety
Frustration
Anger
Guilt
Emotional distress
Dissatisfaction
Burnout
Physical ailments- GI, insomnia, headaches, nightmares - 19What is burnout?occurs as a result of chronic stress – “a syndrome of emotional exhaustion, depersonalization of others, and perceptions of reduced personal accomplishment resulting from intense involvement with people in a care giving environment”
It is defined as emotional, mental, and physical exhaustion caused by excessive and prolonged stress
to put that into perspective, nearly 4 out of 10 nurses will drive to work dreading their shift
Nearly 4 out of 10 nurses will experience an extreme lack of empathy while taking care of their patients - 20Stats of a 2017 study done by Kronos on 257 nurses in US hospitals98 percent of hospital nurses reported their work is mentally and physically demanding
85 percent of the surveyed group said their jobs make them fatigued overall
63 percent of the nurses noted that their work has resulted in nurse burnout
44 percent reported being worried that their tiredness will cause their patient care to suffer
41 percent of the surveyed group have considered changing hospitals in the past year (2017) due to burnout - 21Why do nurses burnout?Long shifts
Service to others- putting others first
High stress environments
Employer demands
Coping with sickness and death
Dealing with families- is this a bad thing?
Personality- what do I mean?
Numerous, sometimes conflicting, responsibilities
Teamwork- #1 cause of stress in the US!!!! - 22Signs of burnoutPersonal level: Constantly sick and tired | Feel underappreciated | Dread going to work | Going through the motions | Becoming insensitive to/ disengaged from your patients | Leaving the profession
Institutional level: Issues with retention | Increased sick days | Poor communication | Decreased teamwork | Team conflict - 23How does burnout impact how we deliver care?Inadequate standards of patient care
safety
Poor patient engagement
Intolerance to change
Financial
Toxic environment - 24What are the 4 A's to address moral distress?Ask – What am I feeling? Why am I uncomfortable?
Affirm – This is real and I am going to take care of myself
Assess – Figure out the source of the distress and start to become ready to act
Act – Do something! Tell someone, get support. Don’t stop until the problem is resolved. - 25AdvocacyEthical dilemmas sometimes require advocacy
Acting in the client’s best interest
Expresses or defends the cause of another
Proactive
Speaks up
Some kind of difficulty or conflict exists that necessitates the need for advocacy
What limits nurses from being advocates?
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- CNO PNR300 (Week 1 ) FlashCards sobre Ethical Decisions , criado por Chris Ramgulam em 05-02-2019.
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- Chris Ramgulam
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