Ethics
What are bio-ethics and name them
Bioethics is the study of ethical, social, and legal issues
Autonomy, Beneficence, Non-Maleficence & Justice
Personal Health Information Protection Act (PHIPA) , 2004
Balances a person’s right to privacy and organizations that provide health care?
Ways nurses obtain authorization to perform a controlled act?
Orders & Delegation
Two types of Orders:
Direct Order: client-specific regarding an activity. It may be written or verbal (verbal only in emergency situations or when prescriber cannot document)
Directive: an order for an activity or series of activities that may be implemented for a number of clients when specific conditions are met and specific circumstances exist. A directive is always written by a regulated health professional who has the legislated authority to order the activity
What are the 5 components of CNO's nurse-client therapeutic relationship
Trust
Respect
Professional intimacy
Empathy
Power
What is a definition of palliative care
Palliative care aims to relieve or reduce the symptoms of a disease
This type of ethical framework focuses on relationships
Relational Ethics
Substitute Decisions Act (SDA), 1992
Deals with decisions around property and decisions about personal care for the incapable person
What is delegation
Delegation occurs when a regulated health professional (delegator), who is legally authorized and competent to perform a controlled act, temporarily grants their authority to perform that act to another individual (delegatee).
Delegation by nurses– a nurse that is authorized to perform controlled acts can delegate to certain individuals
Delegation to nurses - Nurses can receive delegation for controlled acts that they are not authorized to perform
Facilitation, empathy, SOLER, paraphrasing...are examples of:
What is therapeutic communication
If a nurse has been found guilty of professional misconduct or incompetence by the Discipline Committee of CNO what are some potential penalities (name at least 2)
Revoking a nurse’s Certificate of Registration
Suspending a nurse’s Certificate of Registration
Imposing specified terms on a nurse’s practice
Appearing before the Discipline Panel to be reprimanded
Paying a fine
Paying the costs or reimbursing the College for funding therapy and counselling for victims if professional misconduct included sexual abuse
This type of ethical framework focuses on the greatest good for the greatest number of people
Utilitarian Ethics
Intentional Tort
A willful act that violates another person's rights (ie assault, invasion of privacy etc)
Torts can be intentional or unintentional (accidental)
Name the key concepts required to meet the standards of CNO scope of practice
Authority: Nurses must know their legislated scope of practice, including controlled acts, and authorizing mechanisms
Context : Nurses must determine if their practice environment or setting supports the performance of an activity and has the available resources to support safe client care
Competence: Nurses must ensure they have the individual knowledge, skill and judgment to perform an activity
Sharing secrets with the client, selective reporting of client’s behaviour (negative or positive)..are examples of
Crossing nursing boundaries
What are the 6P's of social media use according to International Nurse Regulators Collaborative (2016) document
Professional - Act professionally at all times
Positive - Keep posts positive
Patient/Person-free - Keep posts patient or person free
Protect yourself - Protect your professionalism, your reputation and yourself
Privacy - Keep your personal and professional life separate; respect privacy of others
Pause before you post — Consider implications; avoid posting in haste or anger
When two or more ethical values apply to a situation but these values support diverging courses of action
Ethical Dilemma
Bill 168
Bill 168 became law on June 15, 2010.
This new legislation is an addition to the Occupational Health and Safety Act. The changes strengthen protections for workers from workplace violence and workplace harassment.
Bill 168 requires employers to have policies and programs in place to deal with workplace violence, workplace harassment and domestic violence that may occur in the workplace. -- under Bill 168, which calls on employers to address domestic violence when it spills over into the workplace.
Must be voluntary, specific to treatment/care/procedure & person must be capable
Consent
Nurses protect the client from harm by ensuring that abuse is prevented or stopped and reported.
Name the forms of abuse
There are five forms of abuse:
financial, verbal and emotional, physical, sexual & neglect
Can a nurse sign a patient's request for MAID on their behalf
Yes, a nurse can sign a request for medical assistance in dying on the patient’s behalf if the nurse meets the legal requirement to do so.
The law requires the patient to make a written request for medical assistance in dying. The request must be signed and dated by the patient after they have been informed by a physician or NP that they have a grievous and irremediable medical condition. If the patient is unable to sign and date the request, another individual may do so in the patient’s presence and under the patient’s express direction.
The person who signs on the patient’s behalf must:
What is this and where is this found:
Nurses provide safe and competent care
CNO Code of Conduct (2024) Principles*:
1. Nurses respect clients’ dignity.
2. Nurses provide inclusive and culturally safe care by practicing cultural humility
3. Nurses provide safe and competent care
4. Nurses work respectfully with the health care team to best meet clients’ needs.
5.Nurses act with integrity in clients’ best interest.
6.Nurses maintain public confidence in the nursing profession
Health Care Consent Act (HCCA), 1996
Explicit Rules about when consent is required, who can give consent and when consent is required from SDA
According to HCCA:
1.Consent is required for any treatment except treatment provided in certain emergency situation
2.Consent to admission to a care facility (required by law) except in a crisis situation.
3.Consent to personal assistance Services (CNO includes this as a nurse’s accountability requirement)
If a nurse assigns a task to a UCP. What are they accountable for
•assessing the client’s condition, the environment and any associated risks involved with the activity or procedure
•ensuring the UCP has the competence to perform the task
•supervising &/or teaching the UCP,
•and following up with the UCP once the task is performed.
If a client is on a form 1 what other form must be given to the client and what is the form about
Form 42 must always be given to a client if there are on a form 1--informs them of reason for form 1 and their rights
Note: Form 1 - is a mental health assessment hold for 72hrs (not treatment)
Who can nurses accept direct orders from
physician, midwife, dentist, chiropodist or NP