MY PRELIM NOTES FOR PROFESSIONA ADJUSTMENT o Therapeutic use of self
o Executing health care techniques and procedures
PROFESSION o Essential primary health care An occupation or calling requiring advance training o Comfort measures Experience in some specific or specialized body of o Health teachings knowledge o Administration of written prescription for treatment Provides service to society in that special field o Therapies The term profession is honoric and should be carried o Oral with pride and honor o Topical o Parenteral medications NURSING o Internal examination during labour in the absence of An occupation requiring a unique body of knowledge antenatal bleeding and delivery and skills and which serves society o Suturing of perineal laceration Establish linkages with community resources PROFESSIONAL NURSE Coordination with the health team Completed a basic nursing education program Provide health education to individuals, families and Licensed in his/her country or state to practice communities professional nursing Teach, guide and supervise students in nursing education programs NURSING PRACTICE The nurse is required to maintain competence by continual Primary responsibility promotion of health and prevention of learning through continuing professional education illness Collaborate with other health care providers o Curative QUALIFICATIONS AND ABILITIES OF A PROFESSIONAL NURSE o Preventive Professional Preparation o Rehabilitative aspects of care o Have a license to practice o Restoration of health o Bachelor of science degree in nursing o Alleviation of suffering o Be physically and mentally fit o Towards a peaceful death Personal Qualities and Professional Proficiencies Provide nursing care through the utilization of the nursing o Interest and willingness to work and learn process o Warm personality and concern for people o Resourcefulness and creativity, well balanced Morals emotional condition o Capacity and ability to work cooperatively with others Specific ways of behaviour or of accomplishing ethical o Skill in decision making principles Greek work MORALIS DEFINITION OF LICENSE Social consensus about moral conduct for human beings and A legal document given by the government that permits a society person to offer to the public his or her skills and knowledge in Morality is what you believe is right and good a particular jurisdiction Health Care ethics CONTRACT Division of ethics that relates to human health Meeting of minds between two persons whereby one binds Realm of human values, morals, customs, personal beliefs and himself, with respect to other, to give something or to render faith some service Bioethics A promise or a set of promise which the law recognizes as a duty and when that duty is not performed the law provides a Specific domain of ethics that focuses on moral issues in the remedy field of health care Result of life and death dilemmas faced by health care NURSING ETHICS practitioners Ethics came from the Greek word ETHOS moral duty Systematic study of human behaviour in the field of life Standard to examine and understand moral life science and health care in the light of moral values and Guides of human conduct provided by ethical systems principles How people make judgement in regard to right or wrong TELEOLOGICAL APPROACH Critical reflection about morality and rational analysis about it JOHNSTON- examination of all ethical and bio-ethical issues Greek word TELOS or goal or end from the prospective of nursing theory and nursing ethics The right thing to do is the good thing to do VERCOE- the fields of nursing ethics be focused on the needs Act utilitarianism- good resides in the promotion of happiness and experiences of practicing nurses, the exploration of its or the greatest net increase of pleasure over pain meaning and that of ethical practice in terms of the If the act helps people, then it is a good act perception of these nurses If the act hurts people then it is a bad act Duties of beneficence-helping to better the condition of other beings FLETCHER’S GUIDELINES FOR MAKING ETHICAL DECISIONS Duties of self improvement- bearing ourselves with respect to 1. Consideration for people as human beings virtue or intelligence 2. Consideration of consequences Duties of nonmaleficence- avoiding or preventing injury to 3. Proportionate good to come from the choices others 4. Propriety of actual needs over ideal or potential needs VIRTUE ETHICS APPROACH 5. A desire to enlarge choices and reduce chance 6. A courageous acceptance of the consequence of the decision ARETIC, Greek word ARETE, heart of the person performing the act DEONTOLOGICAL APPROACH OR DUTY ORIENTED THEORY Traits and virtues of a good person, courage, temperance, Basic rightness or wrongness of an act depends on the wisdom, and justice intrinsic nature rather than upon the situation or its DIVINE COMMAND ETHICS consequences Greek word DEON meaning DUTY Supreme or divine that sets down rules to provide guidance to Immanuel Kant- rational human being with freedom and social moral decisions worth UNIVERSAL PRINCIPLES OF BIOMEDICAL ETHICS A person is morally good and admirable if his actions are done from a sense of duty and reason To determine right or wrong in regard to value issues Autonomy- W.D ROSS- PRIMA FACIE DUTIES- WHAT ONE SHOULD DO WHEN o Greek word AUTOS meaning self and nomos meaning OTHER RELEVANT FACTORS IN A SITUATION ARE NOT CONSIDERED governance Duties of fidelity- telling the truth, keeping promises o Self determination Duties of reparation- righting the wrong we have done to o Freedom to choose and implement one’s decision others o Informed consent Duties of gratitude- recognizing the service others have done o Allowing the patient to refuse treatment if he decides for us so Duties of justice- preventing distribution of pleasure or o The person making the decision must be deemed happiness that is not in keeping with the merit of people competent, intellectual capacity, legal age involved Veracity o Health care providers are bound to tell the truth Beneficence o Provide services that maintain respect for human o Promotes the doing acts of kindness and mercy that dignity directly benefit the patient LVING WILLS OR ADVANCE DIRECTIVE PATIENT’s BILL OF RIGHTS o Accept or refuse any treatment, service or procedure o Considerate and respectful care used to diagnose or treat physical or mental condition o Relevant, current and understandable information o Decision to provide or withhold life-sustaining o Make decisions regarding his care plan measures o Have advance directive (living will) o This living will is signed by the patient o Every consideration of his privacy o Witnessed by two other persons who is not designated o Confidentiality of communications and records as the person’s health care representative o Review his records concerning his medical care o Directive has force of law o Be informed of business relationship among the MORAL PRINCIPLES hospital educational institution o The golden rule o Consent or decline to participate experimental Do unto others what you would like others do research affecting his care unto you o Reasonable continuity of care when appropriate and o The two fold effect be informed of other care options May have bad and good effect o Be informed of hospital polices and practices Must be morally good NONMALEFICENCE- Good effect must be willed and the bad effect o To do no harm merely allowed o Not assisting in or performing abortion Good effect must not come from an evil action o Not to assist people to commit suicide Good effect must be greater than the bad effect o Be involved in mercy killing o The Principle of Totality JUSTICE The whole is greater than any of its parts o The right to demand to be treated justly, fairly and o Epikia equally Exception to the general rule NURSES’ BILL OF RIGHTS o One who acts through an agent is himself responsible o Registered nurses promote and restore health Ex. Nurse recommends patient to another clinic o Prevent illness for abortion but does not want to perform o Protect the people entrusted to their care o No one is obliged to betray himself/herself o Alleviate suffering No one can force any person to answer a o Commitment to a life of sacrifice and genuine question if such will incriminate him/her selflessness in carrying out their professional duties o The end does not justify the means Integrity and Objectivity Giving sleeping tablets to someone who has o Perform their responsibilities with the highest sense of chronic illness integrity o Defects of nature may be corrected Professional Competence Corrected by plastic surgery o Knowledge, technical skills, attitudes and experience o If one is willing to cooperate in the act, no injustice is Solidarity and teamwork done to him/her o Maintain and support one professional organization With patient’s consent Social and Civic Responsibility o A little more or less does not change the substance of o Shall always carry out their professional duties with an act due consideration of the broader interest of the public Stealing Global Competitiveness o The greatest good for the greatest number o Shall remain open to challenges of a more dynamic and Have more good effects for more people than a interconnected world smaller group Equality of All professions o No one is held to the impossible o Shall treat their colleagues with respect and strive to Do not promise impossible things be fair in their dealings with one another o The morality of cooperation Formal cooperation is an evil act and never AMENDED CODE OF ETHICS FOR NURSES allowed Section 3 Republic Act No. 877 known as the Philippine o Principle relating to the origin and destruction of life Nursing Law and Section 6 of P.D No. 223 the amended Code Thou shall not kill of Ethics of Nurses GOOD SAMARITAN LAW Article I o Preamble- health is a fundamental right of every A nurse who renders first aid or treatment at the scene of an individual emergency and who does so within the standard of care, Article II acting in good faith, is relieved of the consequences o Values, customs and spiritual beliefs held by individual CODE OF GOOD GOVERNANCE shall be represented o Consider the individuality and totality of patients when Service to others they administer care Article III o Source can be defined o Human life is inviolable o A right to enforce the same must be provided o Quality and excellence in the care of patients are the Controlling authority in our system is the government goals of the nursing practice Fundaments law of the government is the constitution o Accurate documentation of actions and outcomes of Principal sources of pronouncements delivered care is the hallmark of nursing accountability o Constitution Article IV o Statutes or legislations o The registered nurse is in solidarity with other o Executive branch members of the healthcare team in working for the o Case decision/judicial opinions patient’s best interest o Presidential decrees Article V o Letters of instructions o Preservation of life, respect for human rights and promotion of healthy environment RESONSIBILITY AND ACCOUNTABILITY FOR THE PRACTICE OF o Promotion in local, national, and international efforts PROFESSIONAL NURSING to meet health and social needs of the people Professional Negligence Article VI o Commission or omission of an act, pursuant to a duty o Maintenance of loyalty to the nursing profession and Existence of a duty on the part of the person preservation of its integrity are ideal charged to use due care under circumstances Article VII Failure to meet the standard of due care o The certification of registration of the registered nurse The foresee ability of harm resulting from shall either be revoked or suspended for violation of failure to meet the standard any provisions of this code. The fact that the breach of this standard DEFINITION AND MEANING OF LAW resulted in an injury to the plaintiff Article 19 of the civil code The sum total of rules and regulations by which society is o One shall act with justice, give every man his due, governed observe honest and good faith Man mad regulates social conduct in a formal and binding way Article 20 Rule of conduct pronounced by controlling authority and o Those who in the performance of their obligations which may be enforced through negligence causes any injury to another, are o Authority or right to declare that the rule exists liable for damages o Rule is pronounced or expressed Common acts of negligence o Burns resulting from hot water bags, heat lamps, Carelessness of professional personnel vaporizers, sitz bath LESNIK- negligent act committed in the course of professional o Objects left inside the patient’s body; sponges suction performance tips, loose dentures lodged in the patient’s trachea DOCTRINE OF FORCE MAJEURE o Falls of the elderly; confused, unconscious, sedated patients Irresistible force; unforeseen or inevitable o Falls of children whose bed rails were not pulled up No person shall be responsible for those events which cannot and locked be foreseen o Failure to observe and take appropriate action Floods fire, earthquakes o Failure to report observations to attending physicians o Failure to exercise the degree of diligence which the DOCTRINE OF RESPONDEAT SUPERIOR circumstances of the particular case demands Let the master answer for the acts of the subordinate o Mistaken identity- drug given to the wrong patient The liability is expanded to include the master as well as the o Wrong medicine, wrong concentration, wrong route, employee wrong dose o Defects in the equipment INCOMPETENCE o Errors due to family assistance Lack of ability, legal qualifications or fitness to discharge the o Administration of medicine without a doctors required duty prescritption CONSENT TO MEDICAL AND SURGICAL PROCEDURES THE DOCTRINE OF RES IPSA LOQUITUR Consent Injury was of such nature that it would not normally occur o Free and rational act that presupposes knowledge of unless there was negligent act teh thing to which consent is being given by a person Injury was caused by an agency within control of the who is legally capable to give consent defendant o Signed by the patient or authorized Plaintiff himself did not engage in any manner that would tend representative/legal guardian to bring about the injury o An authorization by a patient or a person authorized MALPRACTICE by law to give the consent on the patient’s behalf o Nurse secures the consent of the patient upon The idea of improper or unskilful care of a patient by a nurse admission Stepping beyond one’s authority with serious consequences Informed Consent o Established principle law that every human being of o There must be a third person who hears or read the adult years and sound mind has the right to determine comment before it can be considered defamation what shall be done with his own body o May choose whether to be treated or not CRIMES, MISDEMEANORS, AND FELONIES Proof of Consent o A written consent should be signed to show that the CRIME procedure is the one consented to and that the person An act committed or omitted in violation of the law understands the nature of the procedure Two elements o Criminal act TORTS o Evil/criminal intent A legal wrong, committed against a person or property Conspiracy to commit a crime Assault and Battery o Two or more persons agree to commit a felony o Imminent threat of harmful or offensive bodily contact Principals- who take a direct plan/part o Unjustifiable to tough another person or to threaten to Accomplices- cooperate in the do so execution Battery Accessories- having knowledge of the o An intentional, unconsented touching of another commission of the crime person Criminal Actions False Imprisonment of Illegal Detention o Acts or offenses against public welfare o Unjustifiable detention of a person without a legal Criminal negligence warrant within boundaries o Reckless imprudence- person does an act or Invasion of Right to Privacy and breach of confidentiality fails to do it voluntarily but without malice o Right to privacy is the right to be left alone o Simple imprudence- did not use precaution and o Right to be free from unwarranted publicity the damage was not immediate or the o Exposure to public view impending danger was not evident or manifest o Divulge information from patient’s chart to improper Criminal Intent sources or unauthorized person o States of mind of a person at the time the Defamation criminal act is committed that he/she knows o Character assassination that an act is not lawful and still decide to do it anyway o Slander-oral defamation o Libel-written words WILLS
A legal declaration of a person’s intentions upon death
Testamentary document takes effect after the death of its maker Decedent- person whose property is transmitted through the succession whether or not he left a will If he left a will he is called a testator Woman is testatrix Heir- called to succession either by the provision of a will or by operation of law A person who dies leaving a will is said t have died testate One who dies without will is said to have died intestate Validation of the will in a court is known as probate A will which is written, dated and signed by the testator is called holographic will An oral will is called nuncupative will or nuncupation- made during the person’s last illness, that it be done in the place in which he died, one or more witnesses to the will Testator must have the expressed intention of making a will Must be right of age Under 18 cannot make a will Required to have sound mind Think clearly ability at the time of its execution
NURSES OBLIGATIONS IN THE EXECUTION OF A WILL
The nurse should note the soundness of the patient’s mind
There was freedom from fraud or undue influence Make a notation on the patient’s chart of the apparent mental and physical condition of the patient at the time of making the will