Law and Ethics1 Assessment Item 1 1.A) Code of conduct is a dynamic tool for health care service. Code provides ethical principles, responsibilities and duties to the nursing occupation1.It is often updated to imitate changes in the structure of nursing, without make any changes in foundational values of nursing. It serves the non-negotiable standard of ethics in profession and expresses the understanding of commitments. B) Treating unfair to a person in compare to another or one group of people to the other is known as discrimination. It is harmful in any way for the society and for the values of the nursing occupation. Discrimination in nursing is found basically in race, religion, gender and disability2.It disturbs the human rights, self-esteem and unique qualities of an individual or all. C) Dignity is associated with the collaboration among the conditions and proficiencies. In reference to nursing it is important to consider dignity as palliative care. In the form of personal attribute, it can value the individual, unless a person can feel low andvulnerable. Valuation of the ethics, maintaining self-respect and self-esteem are the essential attributes of dignity in nursing profession3. D) Duty of care includes a professional, legal and ethical duty in the profession of nursing. It is an action, basically includes the care of a patient as a part of clinical role of nurses. The standard of care in nursing is higher than non-medical organisation4. Any kind of negligence in care of a patient can bring danger to a life of that person and it can arise legal issues.
Law and Ethics2 Nurses should ensure about their ethics, as there are many guidelines and codes in their profession. E) Informed consent is a task, assigned to the nurses, to obtain the written consent for the treatment of the patient5.It includes the information of risks and benefits of a treatment and also autonomy of the patient. It can affect by the treatment, understanding ability and condition of the patient. It should be cooperative among patient, nurse and the physician. F) Protection of health information is the trustful relationship between the nursing profession and the patients6.If the privacy and confidentiality of health information of a patient reveal then it can have serious reputational consequences. It can affect the economic and professional impression of the patients and providers. In maintaining the security of the information, some major challenges are faced, like retrieval technologies, recording and the hasty progress of communication. G) One of the basic rights of human is the right to safety and health. A workplace should be safe and healthy in the nursing profession. If the working environment of the nurses will be safe, then they can work more effectively7. The productivity of the organisation depends on the safety and health environment. Unhealthy workplace affectsthe quality and quantity of the work. 2.) Policies and procedures play a vital role in defining the functionality of an organisation. These create discipline in the workplace and promote the cooperative environment8. Policies and procedures must be specified in an organization so that the work can be performed
Law and Ethics3 smoothly and properly. These are the ideals, which should be complied by the managers and the workers at the workplace. It maintains the sincerity among the workers. It will help to increase the productivity and growth of the organization. The compliance of policy helps to achieve the goal of the organization. 3.) Evaluation of work practices and routines creates awareness of the responsibilities of an individual towards the organisation. One can evaluate the work practices with the awareness of work schedules, timelines and expected performance of the work. Guidelines related to operations and organisation with systems and safeguards can also help in evaluating the work practices. Compliance requirements include the management investigation, regular development, risks related to assessment, standards of compliance, oversight, testing, monitoring and management issues9. 4.) Two risks of non-compliance are that it can bring legal impact and reputational impact. In legal impact, an organisation can face some legal action like product seizers, charges, imprisoning or penalties. In reputational impact, social media or news press can damage the reputation of the organisation by spreading the bad things about it. It can lose the trust of customers. Two types of penalties for non-compliance are prosecution and disciplinary action. In prosecution, there will be a fine of maximum $13,345, and in disciplinary action, fines can be extended to the licence cancellation10. 5.) Amendment, consultation and implementation are the leading review points of the protocols, policies and procedures, which can improve them11.
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Law and Ethics4 i)In the review of the amendment, changes are identified, if they are required to maintain or remove from the policies. ii)Consultation increases the effectiveness of the policy and also ensure that if proper monitoring is occurred or not. It is necessary to determine the need, goal and purpose of the policies before implementing them. iii)After the amendment and consultancy of the policies in an organisation, it is important to apply them properly on all employees and manager or supervisor. 6.) Ten rights of residents that receive services are: Freedom from mistreating, negligence and manipulation. Procedure of using responsive complaint easily. Privacy right. Communication right. Living environment of comfort with respect and dignity. Property and money safeguard. Right of choices and independent decisions. Treatment and care with non-discrimination. Safety in entry, transfer and release. Organisation and activities participation of choices12. 7.) Ethical work is the main key to success for any organisation. A care worker must stick to the following ethical principles: Justice- A care worker should be fair to all, those who need it. Nurses must be taking care of the patients in the manner of equality.
Law and Ethics5 Beneficence- Doing right and good care of the patient is termed as beneficence. Nonmaleficence- It is an act of caring and it means not giving any harm or not doing anything evil to anyone. Accountability- Responsibilities accepted for actions and care, by the nurses comes in accountability. Nurses should accept the result of all professional or personal significances of the actions. Fidelity- The act of keeping promises of someone termed as fidelity. A care worker should be faithful and loyal to the responsibilities and promises of providing safety and good quality of care13. 8.) Policies and procedures empower employees and management. With clear and accurate policies, employees can do best in the work place. It is important to communicate while documenting the policies, it can help the people to understand them clearly. Once the procedures are clear to the workers, they can work freely and will do their work creatively within the parameters. There will be no need to check their work or asking them for the work constantly after that. They can give their best to the organisation after understanding the policies clearly. 9.) Ten signs of abuse are: Ignorance, elimination and loneliness. Unnecessary criticism. Blaming and take the credits of someone. Make someone feel useless. Delivering wrong information about someone14.
Law and Ethics6 Intentionally delaying progress or success of someone. Encouraging or creating backstabbing and conflict between the employees. Enforcing impossible targets. Challenge the work of an employee without significant reasons. Changing guidelines of task or responsibilities of an employee with no reasons. One should take some important steps if found someone being abused at the workplace. An employee can note the details, including names of presented co-workers, date, time and the place. By saving evidence one can prove the abuse. By reviewing work policies, a person can use the documents, evidence and with the help of co-workers, present them to the concerned authority and report the employee who is abusing. 10.) Mandatory reporting is very important in maintaining ethics and the practices for the health of a patient and in other services. Breaching of legal practices and ethics have very serious results for a person who gets the services from the organisation, for the profession of workers and also for the employing agency15.It can damage or break the trust beyond repair. It can limit the options and opportunities, which a person needs in the receiving services. One should approach the concerned persons like police officers, teachers working at school, doctors, nurses and care professionals if found a situation of breaching legal practices and ethics. 11.) Compliance means to obey the legal laws of the company or an organisation to manage the service qualities. It comes with some major responsibilities towards the workplace and can save from the legal and criminal charges16.Policies and procedures should be a complaint from the workers in any organisation, as both are a very essential part of the workplace.
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Law and Ethics7 Procedures and policies both are work as a roadmap for the betterment of an organisation and build a positive image and trust of the customer. It grows the productivity of the working place and satisfaction of consumers. 12.) There are some useful opportunities which can maintain and provide knowledge about the issues related to ethics and about legal requirements. A developed code can make a strategic priority from an ethical performance. Ethical values must be followed by the senior management in leadership then employees will themselves follow it automatically. By measuring the efficiency of ethics, one can ensure the needs and best practices for the ethical programme. 13.) Four privacy principles to protect the information of a client are: Personal information of a patient is only accessed by individuals on request. It should not be handed to anyone and should only use when necessary. Personal information must have updated and clear policy which can be used to manage the information as required. Personal information must be correct and one should be aware of the accurate, complete, relevant and leading details of the information17. One should only collect the required information and should delete it if not necessary for the activity of the purpose of taking it.
Law and Ethics8 Assessment Item 2 Advanced Care Plan or Advance Care Directive What is the advance care directive? The advance plan is an authorised document made for the future medical treatment of an adult person. It specifies the actions which should be practising for the care of illness if people will not be able to make a decision. It is legally pursuing in some countries. It is an important move in planning for the care in future. It has replaced the medical and existing powers, like guardianship and preventive directions. This is not only for old age. People of any age can take this plan. Even if someone is not sick in the present time, they can take an important step and can plan for the future to get care according to their medical need18. If someone, unfortunately, lost the ability to speak or communication, in future, the doctors or family members can decide for the medical care of the person. Sometimes it is difficult to take a decision for the medical care of someone, that time this directive can help to reduce the burden of family members, friends or doctors. This care helps in the learning about different decisions and letting know the family members of the person who is going to take it, about the provided healthcare facilities. An advance care plan allows a person to write the preferences, choices, instructions and wishes for the future treatment or end of life healthcare19.The patients or people who are not ill at the present time can write the preferred things in the directive like with whom they will like to stay, what kind of treatment they want when there will be no recovery signs. There are two kinds of directive available: For taking the decisions on the behalf of a person, it also provides substitute decision- makers, if someone not able to take one. One can permit or refuse medical treatment in the instructional directive. In values directive there are preferences for the health treatment are
Law and Ethics9 given and one can take decisions accordingly. Decision-making capacity is important for taking a care plan. a)Instructional directive: It is important to know about the healthcare treatment, if a person wants it in the future, to complete the instructional plan or directive. It is a statement of decision for healthcare treatment of a person. It is affected by the consent or refusal of the treatment. It can be used when a person has not a decision-making capacity for the treatment. Health practitioners must find out first if someone made the advance care plan with instructions then have to start treatment20. b)Values directives: Value directive includes the preferences and values for the treatment. A person should think, talk and record the preferences and values so it can help in the process of treatment later21. It is used whena person is not able to take a decision for the treatment. A health practitioner will ask for the decision-maker to make a decision on behalf of that person. Decision-makers only take the decisions when they reasonably believe that a person would take the same decision. They must have considered values directive and the preferences expressed by the person, if applicable. Information contained in the document: Advance care plan or directive is used to collect an array of information that can be useful in the treatment and care of a seriously injured and ill persons who are not able to make critical decisions regarding their health22.The document also includes the details of other persons who are appointed as decision-maker. They can take medical treatment decisions on behalf of the medical treatment of the patient. Like, who should take care of the patient and what medication he would not prefer to take in the case of life-threatening illness or injury is also
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Law and Ethics10 included in it. This document also includes some critical questions that people can choose to answer like, if in case of memory loss, paralysis, unable to communicate with others, and cannot take care by self then they can either mark life survivor as bearable, unbearable, or unsure. Besides, in the case of unsure, the appointed guardian will make a decision regarding what can be the best medical treatment for a person. Moreover, in the case of life-threatening diseases when it’s sure that a person will die then one can choose to be taken care at home, hospital, other location, or let the guardian take a decision. Also, in this section, a person can define the important cases that appointed caretakers should check before proceeding for the next step. A person can choose to write or can refuse to fill the different or individual sections of the directive or health care document. In the document of the advance care plan, there are mainly five sections that are briefly explained below. Section 1)It comprises of personal, and caretaker or guardian details. Here, one should mention the detailed information like, name, date of birth, address, guardian name, contact number, and relationship with the person whose name given in the document as a caretaker. One can legally appoint two enduring guardians or can refuse too23.In this section, if the people are not comfortable with any option in the document, they can leave it blank and can choose the only options they want to fill. Section 2)It consists of personal values that cover up important things, issues that worry, spiritual, religious, and personal care that one would like to take while undergoing treatment. Information of values can cover all medical needs of a patient. Information about the important things and likes or dislikes can also help the decision-maker to decide by the choice of a patient24.A patient can describe the personal values about death in this part of the document. A patient can choose, if wants to stay with family or stay in the hospital in the
Law and Ethics11 last time of its life. A patient can fill the options of this section by the choice and can refuse to fill it. Section 3)Directions of medical care are included in this section. This section is applicable when a person is not able to communicate about health care decisions. Patients can choose if they want any kind of medication treatment, in the condition of dying or in a condition of not expecting any recovery25.A person can choose if they want any CPR or other kind of treatment in the situation of dying or can also refuse to take these kinds of care treatment. Section 4)This section gives an opportunity to the person to help the other patient and requested to donate any body organ or tissue in case of death. A person can choose to donate any tissue or body organ for transplantation if there are no signs of recovery or a person is going to die after doing all efforts of treatment26. A person can also discuss with the family members andfriends about it for aware them to the decision. Section 5)Authorization of the document is very important in advance care and by filling this section the patients can give authority to the hospital and caretaker to follow the terms given by them in the previous sections27. This is a kind of agreement in which the patients agree with the treatment for health care which will giveto them in the future, in non-communicable conditions. This directive also gives the right to the patients, to fill the sections they want. There are options given in this document where a person can choose to refuse to fill the options if not comfortable with the conditions of health treatment. Legal and ethical implications an advance care directive may have: In modern time, patients with the help of advanced technology of medical are living longer. It is very important to inform and educate the patients about the rights of their medical care or treatment. It is mandatory in many hospitals to give knowledge of advance care planning to
Law and Ethics12 the patients with their admission for current medical care, to explore the options of treatment28.All patients do not need Advance care and it is not for all nurses too. If the health care professionals find that the care for a patient in advance directive, is impossible then there is no legal implication to force them to participate in the medical treatment. This is the ethical and moral decision for the nurse or the health care professional. There should be a responsibility to transfer an appropriate nurse on time, who can take care of the patient concerning the care directive. Some conflicts can be rise during advance care as in some families the family members have their own ethical and moral values and their name might not in the document of the close person as a guardian or a decision-maker. A nurse or a care professional bound in the duty of protecting the rights of the patient29. It includes the concerning decisions of the treatment for critical medical care or withdrawal of it. An advance directive is a document which is written by an adult and it is legally bound in a health care facility which the patient wants. It is the legal right of a patient to make a decision about its medical care and it is not dependable on the beliefs of nurses. Nurses make the health care easy and play a role of communicator between doctors and the person who need a health care. Nurses make the patients comfortable so they able to share all health regarding issues easily with the doctors. It can help in good care of the patients on their terms. An educational path can help the nurses to became a type of nurse a patient hope for. It is mandatory for all hospitals that every nurse who is working there, must be licensed. A nurse should know about the history and background of the health issues facing by the patient. Assessment and actions have to be done after understand the issue of a patient and nurse should have to support the person during the recovery. Health care practitioner should plan a communication to the person who is in charge. Nurses should keep the record that who have undertaking the responsibilities and risks of every person who is in care30. When any risk has
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Law and Ethics13 been identified, nurses should need to communicate to the risk management and have to follow the strategies. ‘Quality of life’ is one of the biggest reasons of the disagreement among the family members, in the document of the directive, as it is a question of competency and it needs witness or consistency of decision taken through the patient. A nurse for critical care must know the policies and procedures which can be followed or applied in such situations of conflicts, to resolve them. Many hospitals have their policies and procedures for resolving these kinds of conflicts. In many cases of advance care, there always a judge to make a decision with an inquiry through the official illustrated facility of the health care, in case the conflict does not resolve with any appropriate steps31. This is the major responsibility of any health care practitioner to ensure that the decisions of a patient are supported by the management of the hospital, at the admission time of care directive. Nursing is a very splendid and important chore in a hospital for both, the patient and the organisation. Nurses play a vital role in a treatment of a person, and work dynamically for different patient in a day. Documentation of patient covers various issues in system management. A nurse has a duty to identify the patients with correct information given by them like name, sex, age, address and other personal details32. Nurses or care taker should ask about the situation and current clinical status of the patient like if the illness is improving or stable. Observation of a patient is including the findings of that person in particular state.
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