Show:
History & Current Events
What does CARNA Say??
Legal Issues
Ethics
Clinical Application
100
In 1993 the Supreme Court of Canada confirmed this human right. WHAT IS __________________________???
What is the right to refuse treatment. BONUS: What ethical principle does this directly relate to???
100
This principle of ethics is described as "the duty to benefit others," and encompasses assisting others, contributing to their welfare and acting in their best interest. WHAT IS __________________???
What is Beneficence. BONUS: Provide an example of when you have used this ethical principle in clinical or everyday life.
100
Health care providers need to consider what when determining a minor's capacity to consent. WHAT IS __________________________???
What is: "A)age; B)intelligence; C) education; D)previous experience; E) whether the child can understand the nature and consequence of the proposed. BONUS: Name the 4 elements of valid consent.
100
TRUE OR FALSE: the Canadian Code of Ethics is considered the gold standard for nursing worldwide. WHAT IS ___________???
What is "True." BONUS: Name the 7 core responsibilities that nurses are expected to uphold in their nursing practice.
100
ALL PLAY!!!!!!! A police officer approaches you on the ward, asks you to identify yourself and then requests information about a current patient. What should you do next and why??? Discuss in your team.
ANSWER: Identify yourself to the police officer. Do not give any information. Call CNPS for legal advice.
200
This non-for-profit society was established "by nurses for nurses" in 1988 in response to increasing costs of commercial professional liability insurance. WHAT IS _____________________???
What is the CNPS (Canadian Nurses Protective Society).
200
"External conditions" is one of the steps from this well known model related to ethics. WHAT IS ___________________________???
What is the "model of ethical questioning." BONUS: explain the importance of this step and what are the 3 other steps???
200
___________________ is a constitutional right (Canadian Charter sections 7 and 8) and is related to the “person” - the right to be free from intrusion and the right to share what/how information is distributed. In contrast, ___________________ is subject to disclosures of health information about the person and ensuring only authorized members can access it. WHAT IS _____________ and ____________???
What is "Privacy" and "Confidentiality."
200
For health care professionals ethical issues may be experienced in these 3 ways. WHAT IS _______________________???
What is "ethical violations," "ethical dilemmas," and "ethical distress." BONUS: differentiate between them!
200
ALL PLAY!!!!!!! On the night shift on a surgery unit, you are busy checking through charts and processing med orders all night. Even so, you quietly and conscientiously check your patients every hour while they sleep, including 25 year old Mr. Gibson who is due to be discharged from a routine appendectomy. You note his pulse and respirations, and check his IV pump and dressing. To save time, however, you leave all of the charting for 0600. Today when you enter Mr. Gibson’s room at 0500 you find him in cardiac arrest. You call a code and your patient is revived and transferred to the ICU. When things quiet down again you remember you must complete your charting. What are the possible legal ramifications of the current state of Mr. Gibson’s chart??? Discuss in your team.
ANSWER: You have no legal proof that you provided any nursing care to Mr. Gibson that night.
300
The latest version of this document was published in 2008. It serves as the foundation for nurse's ethical practice and is intended for nurses in all contexts of nursing practice and at all levels of decision making. WHAT IS __________________ ????
What is the "CNA Code of Ethics." BONUS: What timeline of events preceded this current publication?
300
This concept accepts that both clients and professionals are individuals with beliefs and values that may differ. It also accepts that individuals act on their own behalf. It involves partners who are sensitive to the particulars of the situation with respect and attention to notions of choice, tact and emotion. WHAT IS ____________________???
What is "relational ethics."
300
In 2006, a patient sued after being treated with multiple IM injections of Demerol. The patient claimed the injections caused weakness in his right leg, causing him to fall and injure his back. Informed consent had been provided only the very first time the injection was administered. Are separate written consents needed? WHAT IS ___________________???
What is "no." The court ruled that informed consent had been provided and that separate written consents were not required for each injection.
300
This is the most specific form of advanced directive. It addresses CPR, level of medical intervention, and administration of fluids/nutrition. It is portable from one facility to another BUT must be written by a physician in each setting. WHAT IS ___________________???
What is a "DNR order (Do not resuscitate)." BONUS: You are a nurse working in emergency. What potential ethical problem do you see???
300
ALL PLAY!!!!!!!! Upon admission to the obstetrical ward, Maggie indicates that she does not desire an epidural anesthesia or any pharmacological pain relief of any kind. Her labor is progressing normally. Whenever the nurse or physician enters her room they ask her if she would like anything for the pain. “Are you ready for an epidural now?” they ask. When she refuses they quickly listen to the FHR and leave the room again. Is the nursing care Maggie is receiving ethical or legal??? Qualify your answer in light of ethical and legal principles. Discuss in your team.
ANSWER: No, to both ethical and legal. Consider the shared ethical and legal principles of autonomy and beneficence.
400
In what year did the Supreme Court of Canada endorse women's rights to self-determination and "pro-choice" in relation to abortion. WHAT IS ___________???
What is "1988."
400
As a nurse it is important that we respect our client’s choices in regards to autonomy. Name the ways in which we do this. WHAT IS __________________________???
What is: "A) Respect client’s choice in treatment; B) respect their need to make informed choices about matters of life and death; C) respect the right to refuse treatment; D) respect the right to privacy; E) respect the right to truth-telling; F) respect the right to confidentiality; G) provide the client with accurate and honest information."
400
ALL PLAY!!!!!!! In a 1994 case, the plaintiff suffered an injury as a result of an influenza shot given by the defendant, a community health nurse. How do you think the court ruled??? And what is the legal differentiation between error and negligence in nursing practice??? Discuss in your team.
ANSWER: •The court found that the Public Health Act protected the community health nurse from liability for any act done or omitted in good faith in performing the services, as negligence was not itself a lack of good faith. •Negligence is treatment falling below the standard of care that a reasonable and prudent nurse would follow in particular health care circumstances. Errors involve a lack in judgment (simple human error), “an unintended mishap” by a nurse that does/doesn’t result in an injury.
400
ALL PLAY!!!!! Watch the video clip. As a team decide what ethical issues are presented in this clip. What ethical principles are being utilized?? If you were the nurse caring for these two patients what strategies could you utilize to address these issues??
Discussion!
400
ALL PLAY!!!!!!!! George is an 86 year old man who suffered a hemorrhagic stroke four weeks ago. He is currently unresponsive and left no advance directives. You speak with his son on Monday evening and he describes his father as an active, athletic man who strongly valued his independence. “He would not want to live like this!” the son asserts. A family meeting was set for Wednesday with the primary physician and nursing manager. On your next shift on Friday you are surprised to read George’s care plan and find he is receiving nutrition via naso-gastric tube, antibiotics for a chest infection, and three antihypertensive medications via IV. You also note that the physician has not issued a DNR order. What is your first step in addressing the ethical issues in this situation??? Discuss in your team.
ANSWER: Clarify your own values and those of the patient’s family.
500
ALL PLAY!!!!!! Refer to the Alberta RN Summer 2014 magazine hearing tribunal for member 81,179. Decide in your team how this lawsuit could have been avoided. What ethical responsibilities do nurses have to the profession at large in relation to standard of patient care particularly when poor/unsafe nursing practices are identified such as this???
Discussion.
500
As a health care professional, you will be able to encourage ethical outcomes in in clinical practice. Name the ways in which you are able to do this. WHAT IS ________________________???
What is A) Maintaining commitment to client choice; B)raising awareness of ethical issues in client care and research; C) obtaining necessary consultation on ethical concerns; D) becoming involved in the development of policy on ethical issues; E) advocating for safe and competent nursing care within Alberta communities; F)encouraging and facilitating cooperation and collaboration between professionals and between agencies to effect improvements within health care; G) participating in the development of practice standards; H) issues statement and position papers on professional issues; I) working with colleagues to identify crucial ethical issues for the profession (implementing evidence based practice, shaping the direction of health-care reform); J) linking of resource allocation decisions to client outcomes; K) providing constructive influence in ethical decision-making that arises at all levels (system wide, within institutions and provider groups, within individual nursing practice).
500
The following are elements of what??? 1) a legal document. 2) a clear, accurate, and contemporaneous record 3) contains objective, chronological, and frequent information. 4) Mistakes are corrected by crossing a line through the error, your initials, followed by the correct information. WHAT IS _______________??? WHAT IS ________________???
What is "proper nursing documentation."
500
This is the goal behind teaching ethics to students and health care providers. WHAT IS _______________???
What is: A) to stimulate moral imagination; B) to recognize ethical issues; C) elicit a sense of moral obligation; D) develop analytical skills; E) tolerate and reduce disagreements and ambiguity. BONUS: In you clinical experience have you had the opportunity to discuss ethical issues with you tutor and/or was the discussion of ethical dilemmas encouraged?
500
ALL PLAY!!!!!!!! On the medical unit where you work, the computer MAR lists the supply dosage in large font and the prescribed dosage in small font. Occasionally the prescribed dosage ends up on the next screen and can be missed. Three times you almost gave the supply dosage to a patient who was prescribed half that amount. Finally, at the end of one particularly busy shift, you make a medication error by giving the patient twice the dose of a sleep aid than what they were prescribed. What must happen next besides the patient getting an extra good sleep? What are your ethical responsibilities to your co-workers, patients and the profession at large??? What should you have done a long time ago??? Discuss in your team.
ANSWER: You should have reported your near misses and advocated for the MAR to be reorganized. Now, you must monitor and ensure the safety of your patient, report your medication error and advocate for changes to prevent similar errors in the future.