Copyright © 2008 Delmar Learning. All rights reserved. Unit 4 Ethical and Legal Issues Affecting the Nursing Assistant

Copyright © 2008 Delmar Learning. All rights reserved.

Unit 4

Ethical and Legal Issues

Affecting the Nursing Assistant


Objectives

• Spell and define terms.• Discuss ethical and legal situations in

health care.• Describe the legal and ethical

responsibilities of the nursing assistant concerning patient information.


Objectives

• Describe tactful ways to refuse a tip offered by a patient.

• Describe the legal responsibilities of a nursing assistant.


Objectives

• Describe how to protect the patient’s right to privacy.

• Define sexual harassment and give examples of activities that may be perceived as being sexually harassing.


Ethical Standards

• Ethical standards– Guides to moral behavior

• People who provide health care– Voluntarily agree to live up to these

standards


Ethical Standards

• When these rules are not followed:– Nursing assistant fails to live up to the

promise to give safe, correct care and to do no harm


Legal Standards

• Legal standards are guides to lawful behavior

• When laws are not obeyed:– Nursing assistant may be prosecuted and

found liable for injury or damage

• Legal guilt can result in the payment of fines or imprisonment


Ethics Questions

• At no other time in history have questions of medical ethics been under such scrutiny


Ethics Questions

• Questions health care providers ask:– When is life gone from a person on life

support systems?– How much lifesaving effort should be given

in situations of terminal illness?


Ethics Questions

• When does human life actually begin?• How much assistance should be given

to the conception process?• Should the body organs of a brain-dead

person be harvested for transplants for the living?

• Does an unborn baby have rights?


Ethics Questions

• Is assisting a patient before or after an abortion right or wrong?

• Is euthanasia ever justified?• Should animals be used in research of

potential value to human life?


Ethics Questions

• Should food and water be withheld to speed death when a patient has expressed the desire to have this action performed?


Ethics Questions

• Who makes decisions about removing life support systems when there is no direct expression of the patient’s wishes or there is conflict within the family?


Ethics Questions

• How will a choice be made when two or more people could benefit from an organ transplant but only one organ is available?


Ethics Questions

• How should the limited money available be spent when many serious disease conditions need to be researched?

• Who has the final authority over whether a woman will carry a pregnancy to term?


Ethics Questions

• Should marijuana be used for medicinal purposes?


Respect for Life

• One of the most basic rules of ethics is that life is precious.


Respect for the Individual

• Respect for each patient as a unique individual is another ethical principle

• Uniqueness is shown by differences in:– Age– Race– Religion– Gender


Respect for the Individual

• Uniqueness is shown by differences in:– Sexual preference– Culture– Attitudes– Background– Response to illness


The Golden Rule

• Do unto others as you would have them do unto you– Implies your intent to provide proper care


The Golden Rule

• Your good intentions are effective only when you act on them

• To provide proper care:– You also have the ethical responsibility to

maintain competence in your practice


Platinum Rule

• Treat others the way they want to be treated

• Platinum Rule– Shifts focus from treating everyone alike to

providing highly individualized care


Platinum Rule

• Find out what patients want– Give it to them, as much as possible, and

in keeping with their plans of care

• Use both principles to guide your practice


Patient Information

• Discuss patient information only in appropriate places

• Discuss patient information only with the proper people


Patient Information

• Refer patient requests for information about laboratory results, the patient’s condition, or course of the illness to the nurse or physician.


Patient Information

• Let the nurse or physician relay information about a patient’s death.

• Follow the ethical code to ensure respect of a patient’s personal religious beliefs.


Legal Issues

• Laws are passed by governments and are to be obeyed by citizens.

• Anyone who fails to obey a law may be liable for fines or imprisonment.


Legal Issues

• You need not fear breaking laws if you are careful to:– Stay within your scope of practice– Not overstep your authority– Do only those things you have been taught

• Within the scope of your training


Legal Issues

• You need not fear breaking laws if you are careful to:– Carry out procedures carefully and as you

were taught– Keep your skills and knowledge up to date


Legal Issues

• You need not fear breaking laws if you are careful to:– Request guidance from the proper person

before you take action in a questionable situation


Legal Issues

• You need not fear breaking laws if you are careful to:– Always keep the safety and well-being of

the patient a priority – Make sure you thoroughly understand the

instructions for the care you are to give


Legal Issues

• You need not fear breaking laws if you are careful to:– Perform your job according to facility policy– Stay within OBRA guidelines


Legal Issues

• You need not fear breaking laws if you are careful to:– Maintain in-service requirements of OBRA– Do no harm to the patient– Respect the patient’s belongings


Negligence

• Nursing assistants – Are educated care providers and are

expected to perform in certain ways


Negligence

• You would be guilty of negligence if you injured a patient by:– Not performing your work as taught– Not carrying out your job in a conscientious

manner


Negligence

• Negligence may be accidental or deliberate

• It may be the result of an action or omission – Failure to act

• In either situation, the patient is not given the expected level of care


False Imprisonment

• Restraining a person’s movement or actions without proper authorization constitutes unlawful or false imprisonment.


Assault and Battery

• Assault– Intentionally attempting to touch the body

of a person or even threatening to do so

• Battery– Touching a person without that person’s

permission


Abuse

• Abuse– Any act or failure to act that is non-

accidental and causes or could cause harm or death to a patient

• Verbal abuse– May be directed toward a patient or

expressed about a patient


Abuse

• Sexual abuse – Use of physical means or verbal threats to

force a patient to perform sexual acts.


Abuse

• Physical abuse – Does actual physical harm to a patient

• Psychological abuse– Involves making a patient fearful of you

• Such as threatening not to respond when he or she calls


Abuse

• Involuntary seclusion – Involves separating a patient from other

patients against the patient’s will

• Misappropriation of property – Involves taking or using the patient’s

belongings without permission


Abuse by Others

• If you suspect a person in your care is being abused by others– Discuss this matter with your supervisor

• You are not responsible for determining whether abuse has occurred


When Your Patience Is Stressed

• If you feel like your own tolerance level is being tested– You need to find ways to safeguard the

patient and release your stress


Neglect

• Failure to provide the services or care necessary to avoid physical harm, mental anguish, or mental illness.


Invasion of Privacy

• Patients have a right to have their person and personal affairs kept confidential.


Sexual Harassment

• Physical, verbal, or nonverbal actions or advances that are unwelcome by the other person.


Sexual Harassment

• This may be in the form of sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature.


Sexual Harassment

• Sexual harassment is illegal


Sexual Harassment

• Your facility will have policies and procedures listing actions to take and penalties if harassment occurs.


Sexual Harassment

• Upon being informed that an incident of sexual harassment has occurred:– Hospital is responsible for investigating the

situation

• During investigation:– Facility must protect the victim from further

harassment

Documents

Copyright © 2008 Delmar Learning. All rights reserved. Unit 4 Ethical and Legal Issues Affecting the Nursing Assistant