Project #92041 - Professional Code of Conduct

Nurses confront with ethical issues throughout their career in a daily basis. Many of these ethical issues are legal and related to patient care. According to Silvestri, “ethics is the distention between what is right and wrong based on knowledge and not only on opinions”. There are different ethical principles and codes that determine the best client care; some of these ethical principals are autonomy, beneficence, non-maleficence, justice, fidelity, and veracity. Two organizations set the ethical codes of nursing, the American Nurses Association (ANA) and the International Council of Nurses (ICN). The purpose of this paper is to discuss some of the ethical principles and code of conduct in nursing such as, regulation of nursing practice, legal liability, and risk, client’s rights and informed consents, advance directive, and confidentiality, and finally reporting responsibilities.

Nursing practice is how professional nurses practice nursing. Nurses can only perform a task that is within their scope and must be familiarize with provisions of the nursing practice act in their state.  In practice, nurses have guidelines that help the client and the nurse to identify what to expect during the nursing care, “ the nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of task consistent with the nurse obligation to provide optimum client care” (Silvestri, 2011). Guidelines are there to determine whether the nurses have executed the duties in a conventional manner.  By not following the guidelines not only nurses can be in jeopardy, the facility is held liable too. Agencies have policies in addition to ANA and ICN that nurses must follow. Polices are not laws but the nurse can be also liable if they don’t behave as the employer expect. Disciplinary action can also come from the board of nursing in their state, where they can revoke, deny, or even suspend the nurse’s license if they find out unprofessional conduct, breach in confidentiality of patient’ s privacy, and physically or verbally abusing a patient. These are just few examples; many other actions from part of a nurse can lead to disciplinary actions (Silvestri, 2011). 

In nursing practice there are different legal risk areas. As professionals, nurses must protect the dignity of their patients. Touching somebody without the person consent can result in liability to the nurse (Silvestri, 2011). As previews mentioned, nurses are in the obligation to protect patients’ privacy from others; however, they must keep in mind they should not be disrupting in matters that only concern the patient and the family, unless, and this is just my opinion, the matter is strongly related to the patient care. In this case just educate the patient and try to always respect their right to self-determination. Other areas where that can put nurses in jeopardy is false imprisonments, such as retaining the patient in the hospital without a justification and restraint devices with no appropriate clinical needs (Silvestri, 2011). Nurses are liable if they neglect the person’s care. Some of the most common negligent acts I’ve seen in hospitals are medication errors and falls. Passing meds without scanning them before, documenting before the medication is given and pulling meds for several patients at the same time without the proper identification, are the most common cause of medication errors I’ve seen so far. Injuries result from falls is the second most common because they do not implement safety measurements to the client and the limited number of rounds.

Client’s right could be one of the most challengeable ethical dilemma nurses face in their career because they must respect the patient’s autonomy, even though sometimes decisions are unwise and irresponsible. The American Hospital Association issued Patient’s Bill of Right and all facilities are required to have a copy posted in an area visible to patients. This document emphasizes the client autonomy and the client’s right to be involved in their health care.  Patients in mental health care facilities also need to have a copy of this document. Patient mentally ill must be treated with dignity and respect, educate, treatment and refuse treatment, the right not to be subjective to restraints that are unnecessary and right for privacy and confidentiality. (Silvestri, 2011). Patients have in general the right to be given information about their diagnosis and care in an unambiguous manner that facilitates the patient to make decisions that is pertinent to their own person. (ANA, 2015).

Many different types of consent must be obtained from patients, blood transfusion, research, surgery, admission, immunization, and special consents. Consent is the client permission that allows healthcare professionals to touch and treat the patient.  Client must be aware of the risk and benefits of the procedure and what to expect before, during, and after any kind of procedure. The patient must be willing to sign the consent without pressure from medical staff or family. A patient that is medicated and sedated should not be signing consent. The standard of practice is that whoever is signing must be mentally alert and emotionally competent.  If the patient is a minor the consent must be obtained from the parent or legal guardian. (Silvestri, 2011)

Patient self-determination act indicates client desire to receive treatment in case they become mentally or physically impaired to make a decision regarding their healthcare. Nurses are required to ask patient about advance directive, document and contact HCP. Something also very important is patient’s privacy. Patients have the right to privacy and confidentiality. Disclosure of patient’s records to an unauthorized person or someone not involve directly in the patient’s care is illegal and unethical because is consider an invasion of the client’s privacy. The Health Insurance Portability and Accountability Act (HIPAA) protects personal health information and the client may file a complain if he or she believes her medical record was released to an unauthorized person or party. Medical records are confidential; nurses must protect medical records from all unauthorized readers. Whoever is uninvolved in the patient care must ask for client permission to access the files (Silvestri, 2011). Other violations and invasion to client’ privacy that are part of code of conduct is taking pictures of the client and using them for hospital advantages. Not providing privacy during procedure and not asking permission from the client when performing a procedure or treatment. Dialogue personal information in a room where this conversation can be overheard. The nurse must always protect the client confidentiality (Silvestri, 2011)

A part of professional code of conduct is reporting responsibility. Nurses are asked to report domestic violence, including suspected child abuse to the appropriate authorities. Sexual harassment, stab wounds, gunshots and homicides following the agency policies and procedure to handle the situation (Silvestri, 2011). Any suspected co-workers abusing chemicals and controlled substances should be reported because this can affect the client’s safety, which should always be the priority. According to the Drug Enforcement Administration, many healthcare professionals lose their families, house, and career to substance abuse. The nurse has the ethical responsibility to report any suspected misconduct to pertinent parties because patient future can be jeopardized if they don’t report their concerns.

 

In another words nurses are required to follow the guidelines of nursing practice act and facility protocols and policies when they are delivering nursing care to patients. An appropriate standard of care is necessary when delivering medical care, else the nurse will be in trouble if his/ her action harm the patient. Informed consent is that legal document that indicates the client’s approval to a procedure. The consent must be in explicit and transparent words; it must state the risk and the benefits of procedure or medical care. Nurses must protect the confidentiality by nurse practice act, standards of practice, laws, institutional protocols, and ethical principles. OSHA permits employees to report any working condition that do not meet the standard regulations (Silvestri, 2011). The US Department of Justice and DEA encourage co-workers to identify and report any drug seeking abuse and provide a guide that will help to recognize this problem.

Subject English
Due By (Pacific Time) 11/08/2015 10:46 am
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