Unit2 nursing as a profession .
- 1. Unit 2: Nursing as profession prepared by: Ms. Shiny George Asst. Lecturer.
- 2. Nursing definition: • Virginia Henderson defined nursing in functional terms: "The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible."
- 3. BASIC NURSING PRINCIPLES : SAFETY THERAPEUTIC EFFECTIVENESS COMFORT USE OF RESOURSES GOOD WORKMANSHIP INDIVIDUALITY
- 4. OBJECTIVES : • Prepare nurses who will give expert bedside nursing care • Provide integration of health and social aspects theory & practice • Provide an adequate ,sound scientific foundation to understand the functioning of body & mind in health & disease
- 5. •Prepare to work cooperatively, develop sense of responsibility •Provide opportunity to develop skills& personality •Upgrade nursing as a profession
- 6. Concept of nursing: • The tasks of nursing are: • (a) to promote health • (b) to prevent disease • (c) to help ill-person to healing (to assist healing) • (d) to assist the dying patient to pass away with quietude, peace, and dignity.(to ease suffering) • (e) The client is a holistic human being, including suffering person and healthy person.
- 7. Concept of nursing • 6) The working place is not only in the hospital, but also in family, community and whole society. • 7) Nursing is not only a science, but also an art. • 8) The nursing science attaches importance to human being’s living environment and the interrelation between human being and its environment. • 9) The nursing science is a gradually perfect and developing science.
- 8. Philosophy •The study of the fundamental nature of knowledge, reality, and existence, especially when considered as an academic discipline. •A theory or attitude that acts as a guiding principle for behavior.
- 9. Philosophy of nursing • Nursing is viewed as both an art and a science, reflecting upon the concepts of the nursing. Nursing is an applied discipline which expresses itself in practice, and has its foundation rooted in scientific/empirical knowledge, theory, and research. Nursing is also expressed as a caring, therapeutic and teaching discipline. • The goal of nursing is optimum client wellness, and the maximum level of functioning. The nursing interventions are evidence-based and stem from their core knowledge.The professional nurse must appreciate the role of informatics.
- 10. Philosophy of nursing Philosophy of nursing includes beliefs and values with regard to man in general & specifically man as the learner ,teacher, nurse, client and the beliefs about health, illness, society, nursing & learning etc.. It includes... Spiritual : Religion should serve as the primary integrating factor. Moral : Nurse has to develop right conscience. Intellectual : to provide a systematic development & training& for fulfilment of nursing function.
- 11. cont.... Emotional needs : nurse must be able to function as a mature, self – dependent & responsible individual & must be able to relate well to other people. Physical : to promote harmonious development, physical needs to preserve essentials of health. Social : nursing is linked with social culture ,in which nursing activities are carried out.
- 12. FUNCTIONS OF A NURSE • Caregiver • The caregiver role has traditionally included those activities that assist the client physically and psychologically while preserving the client’s dignity. Caregiving encompasses the physical, psychosocial, developmental, cultural and spiritual levels.
- 13. • Communicator • Communication is an integral to all nursing roles. Nurses communicate with the client, support persons, other health professionals, and people in the community. In the role of communicator, nurses identify client problems and then communicate these verbally or in writing to other members of the health team. The quality of a nurse’s communication is an important factor in nursing care.
- 14. • Teacher : • As a teacher, the nurse helps clients learn about their health and the health care procedures they need to perform to restore or maintain their health. The nurse assesses the client’s learning needs and readiness to learn, sets specific learning goals in conjunction with the client, enacts teaching strategies and measures learning.
- 15. • Client advocate • Client advocate acts to protect the client. In this role the nurse may represent the client’s needs and wishes to other health professionals, such as relaying the client’s wishes for information to the physician. They also assist clients in exercising their rights and help them speak up for themselves.
- 16. • Counselor • Counseling is a process of helping a client to recognize and cope with stressful psychologic or social problems, to developed improved interpersonal relationships, and to promote personal growth. It involves providing emotional, intellectual, and psychologic support.
- 17. •Change agent •The nurse acts as a change agent when assisting others, that is, clients, to make modifications in their own behavior. Nurses also often act to make changes in a system such as clinical care, if it is not helping a client return to health. •Researcher ,rehabilitator,& critical thinker.
- 18. • Leader • A leader influences others to work together to accomplish a specific goal. The leader role can be employed at different levels; individual client, family, groups of clients, colleagues, or the community. Effective leadership is a learned process requiring an understanding of the needs and goals that motivate people, the knowledge to apply the leadership skills, and the interpersonal skills to influence others.
- 19. • Manager • The nurse manages the nursing care of individuals, families, and communities. The nurse-manager also delegates nursing activities to ancillary workers and other nurses, and supervises and evaluates their performance. • Case manager • Nurse case managers work with the multidisciplinary health care team to measure the effectiveness of the case management plan and to monitor outcomes.
- 20. Qualities of a nurse : • Caring nature: • Nurses deal with the sick and injured and their families on a daily basis, and must be able to show thatthey truly care about the situation. • Empathic attitude • Nurses must be able to put themselves in their patients’ shoes to provide the quality care needed. • Detail oriented • Nurses must remember to make entries on patients’ charts and to bring
- 21. • Emotionally stable • Nurses feel the joy of seeing a new baby born as well as the pain of losing a long-term patient. Emotional stability is crucial to deal with the wide range of emotions nurses must endure. • Adaptable • People are unpredictable at the best of times, but become even more so under stress, so a nurse’s typical workday will require flexibility and adaptability.
- 22. •Hardworking :Nursing is a never ending job. It is unusual for a hospital or medical center to be overstaffed, which of course means more workload on each nurse in the unit. •Quick thinker : • When a nurse notices something is not right with a patient, they must be able to make decisions quickly and put their plans into action instantly, because a fraction of a second can mean the difference between life and death.
- 23. •Physical endurance • Nurses are on their feet all day, sometimes 12 or more hours at a time, and are often required to assist patients with activities that require physical strength. •Good judgment • A nurse must be able to look at a patient’s current state and accurately assess what is needed, especially during emergencies.
- 24. • Good communication skills • Nurses must communicate with other nurses, doctors, patients, and patients’ families clearly. • Responsible • Good nurses know how to perform all of their responsibilities with the utmost accuracy and detail. They play a major role in assessing and treating patients’ , and when dealing with the health of another human being, so nurses must responsibly carry out their duties at all times.
- 26. • N – Nobility, Knowledge • U – Usefulness, Understanding • R - Righteousness, Responsibility • S – Simplicity, Sympathy • E – Efficiency , Equanimity
- 27. •Profession – is a calling that requires special knowledge, skill and preparation. •An occupation with ethical components , that is devoted to the promotion of human & social welfare.
- 28. A profession is “ an occupation or calling requiring advanced training and experience in some specific or specialized body of knowledge which provides service to society in that special field.”
- 29. •Criteria of Profession: • Toprovide a needed service to the society. • Toadvance knowledge in its field. • Toprotect its members and make it possible to practice effectively. Bixler and bixler criteria for profession: • A profession is a form of employment especially one that is respected in society as honourable and is possible only for an educated person and after training in some special branch of knowledge.
- 30. •It has its own body of knowledge based on social & scientific principles. •The members of this profession utilise this knowledge to identify & solve problem •Has a service aim as well as academic & theoretical aim. •Constantly enlarges its body of knowledge through research inorder to improve its services. •It determines the qualifications necessary for those who enter into practice. •It has a code of ethics
- 31. Contd.... •Functions autonomously in the formation of professional policy & in control of professional activities. •It provides a freedom of action ,oppertunity for continous professional growth & economic security. •A profession recognises its responsibilities to develop educational programmes in cooperation with institutions in order to develop skills &to learn method of services
- 32. •Characteristics of a Profession: • A basic profession requires an extended education of its members, as well as a basic liberal foundation. • A profession has a theoretical body of specialised knowledge leading to defined skills, abilities and norms. • A profession provides a specific service. • Members of a profession have autonomy in decision-making and practice. • The profession has a code of ethics for practice. • Authority to control its work.
- 33. Contd..... •Service to the society •Extensive period of formal training •Self – regulation •Credentialing system to certify competence •Legal reinforcement of professional standards •Ethical practice •Creation of a collegial subculture
- 34. Nursing as a profession: • NURSING >is a disciplined involved in the delivery of health care to the society. • >is a helping profession • >is service-oriented to maintain health and well- being of people. • >is an art and a science. • NURSE – originated from a Latin word NUTRIX, to nourish.
- 35. • Characteristics of Nursing: • Nursing is caring. • Nursing involves close personal contact with the recipient of care. • Nursing is concerned with services that take humans into account as physiological, psychological, and sociological organisms. • Nursing is committed to promoting individual, family, community, and national health goals in its best manner possible. • Nursing is committed to personalized services for all persons without regard to color, creed, social or economic status. • Nursing is committed to involvement in ethical, legal, and political issues in the delivery of health care.
- 36. ELEMENTS : 1. Accountability : service involves intellectual activities ,individual responsibilities 2. Autonomy : practitioners are relatively independent & control their own policies & activities 3. Altruism : practitioners are motivated by service & consider their work as an important component of their lives 4. Association :there is an organisation that encourages & supports high standards of practice
- 37. Categories of nursing personnel • Staff nurse • Senior staff nurse • Nursing superintendent grade II • Nursing superintendent grade I • Nursing tutor/clinical instructor • Principal, school of nursing • Lecturer, college of nursing
- 38. Categories of nursing personnel • Assistant professor, college of nursing • Professor, college of nursing • Principal, college of nursing • Senior assistant director of nursing • Public health nurse- district family welfare bureau
- 40. VALUES Freely chosen Values underlie all moral dilemmas. though, not all values are moral values (people values about work, family, religion, politics, money and relationships. IMPORTANT: Values influence decisions and actions, such as nurses’ ethical decision making. Beliefs or attitudes about the worth of a person, object, idea, or action.
- 41. Values and ethics Values and ethics are inherent in all nursing acts. A value is a strong personal belief; an ideal that a person strives to uphold. Your values reflect cultural and social influences, relationships and personal needs. Vary among people and develop and change over time.
- 42. DEFINITION Values are enduring beliefs or attitudes about the worth of a person, idea or actions. They are important because they influence decisions and actions, including nurses ethical decision making.
- 43. COMPONENTS A value set is the small group of values held by an individual. A value system is an organization of values in which each set of values are ranked along a continuum from most important to least important. value system are basic to a way of life, give direction to life & form the basis of behaviour
- 45. ELEMENTS BELIEFS: Interpretations or conclusions that people accept a truth. They are based more on faith than fact & may or may not be true. ATTITUDE: mental positions or feelings towards a person ,object or idea. oAn attitude lasts overtime ,where as a belief may last only briefly.
- 46. VALUES BELIEFS ATTITUDES FAITH than FACT. Last only briefly. Judged as correct or incorrect. THINKING and BEHAVIORAL aspects. Continuous overtime. Judged as bad or good, positive or negative.
- 47. TYPES 1. Societal values : Values that are derived from society & the individual subgroups These values are heavily influenced by a person’s socio cultural envt; i.e. By societal traditions; by cultural, ethnic & religious groups; & by family & peer groups. 2. Personal values: People internalize some or all of the societal values & perceive them as personal values. Personal values are needed to have a sense of individuality. 3. Professional values: Acquired during socialization into a profession.
- 48. Professional values.. They provide the foundation for nursing practice & guide the nurses interaction with pts; colleagues & public. Nurses professional values are acquired from code of ethics, experiences, teachers & peers.
- 49. ESSENTIAL NSG PROFESSIONAL VALUES Altruism Autonomy Human dignity Integrity Social justice
- 50. Altruism: Its a concern for the welfare & well being of others. In professional practice altruism is reflected by the nurse’s concern for the welfare of pts, other nurses & other health care practitioners.
- 51. Autonomy: Its the right to self determination. Professional practice reflects autonomy when the nurse respects pts rights to make decisions about their health care. Human dignity: Its the respect for the inherent worth & uniqueness of individuals & populations. In professional practice, human dignity is reflected when the nurse values & respects all pts & colleagues. Integrity: Its acting in accordance with an appropriate code of ethics & accepted stds of practice. Integrity is reflected in professional practice when the nurse is honest & provides care based on an ethical frame work that is accepted within the profession. Social justice: Its upholding moral, legal & humanistic principles. This value is reflected in professional practice when the nurse works to assure equal treatment under the law & equal access to quality health care.
- 52. Essential Nursing Values and Behaviors Professional Behaviors •Understands cultures, beliefs, and perspectives of others. •Advocates for patients. •Take risks on behalf of patients and colleagues. •Plans care in partnership with patients VALUES Altruism Nurse’s concern for the welfare of patients, other nurses, and other health care providers. Autonomy Nurses respects patient’s right to make decisions about their health care. Human Dignity Nurses values and respects the inherentworth and uniqueness of all patients and colleagues. Integrity Nurses acts honestly and provides care based on an ethical framework. Social Justice Nurse upholds moral, legal, and humanistic principles by ensuring equal treatment under the law and equal access to quality health care. •Provides culturally competent and sensitive care. •Protects patient’s privacy. •Designs care with sensitivity to individual patient needs. •Provides honest information to patients and the public. •Document care honestly and accurately. •Seeks to remedy errors made by self orothers. •Demonstrates accountability of own actions •Supports fairness and nondiscrimination in the delivery of care.
- 53. Development of values/ value transmission •An individual is not born with values, rather values are formed during a lifetime from information gathered from the envt, family & culture. •As children observe the actions of others, they quickly learn what has high & low value for them.
- 54. Common modes of value transmission: Modelling Moralizing Laissez- faire Rewarding & punishing Responsible choice
- 55. Modelling Through modelling, children learn what is of high or low value by observing parents, peers & significant others. Thus it leads to socially acceptable or unacceptable behaviour.
- 56. Moralizing In this mode of value transmission, children are taught a complete value system by parents or an institution that allows little opportunity for them to weigh different values.
- 57. Laissez-faire In this approach, children are left to explore values on their own & to develop a personal value system. In this no one set of values is presented as best for all. This approach often involves little or no guidance & can lead to confusion & conflict.
- 58. Rewarding & punishing Children are rewarded for demonstrating values held by parents & punished for demonstrating unacceptable values.
- 59. Responsible choice In this mode, the caregivers encourage children to explore competing values and to weigh their consequences. Support & guidance are offered as children develop a personal value system.
- 60. Value clarification Process by which people come to understand their own values & value system. Process of discovery & allows a person to discover through feelings & analysis of behaviour What choices to make ? When alternatives are presented... Identify whether or not these choices are rationally made...
- 61. VALUES CLARIFICATIONVALUES TRANSMISSION Acquired through Observation and Experience. Affected by Socio-Cultural environment (societal conditions, family and peers) PERSONAL VALUES Nurses should keep in mind the influences of Values on health. PROFESSIONAL VALUES A process by which people identify, examine, and develop their own individual values. It promotes personal growth (promotes awareness, empathy, and insight) It is an important step for nurses to take in dealing with ethical problems. No One set of values is right for everyone. People can retain or change the freely chosen values CLARIFYING THE NURSES’ VALUES CLARIFYING CLIENT VALUES FROM?
- 62. Professional Values Acquired during experience from code of ethics, nursing, teachers, and peers. 5 VALUES ESSENTIAL FOR PROFESSIONAL NURSE: ALTRUISM AUTONOMY HUMAN DIGNITY INTEGRITY SOCIAL JUSTICE Clarifying Nurse’s Values Nurses and nursing students need to examine the values they hold about life, death, health and illness. FROM?
- 63. Theory of Values Clarification (Raths, Harmin, and Simon, 1978) Valuing Process Choosing Cognitive •Beliefs are freely chosen. •Without outside pressure •After reflecting and considering consequences or alternatives Prizing Affective •Chosen beliefs are cherished or prized Acting Behavior •Chosen beliefs are affirmed to others, incorporated into one’s behavior and repeated consistently in one’s life.
- 64. Clarifying Client Values Is an intervention used by the nurse s when clients experiences unclear values that are harmful to their health. Behavior Example Ignoring a health professional’s advice A child client’s parent who values the Inconsistent communication behavior A n elderly who says she don’t want anymore to use cane when walking, but won’t cooperate during her therapy. Numerous admissions to a health agency for the same problem A hypertensive client repeatedly seeks help for headache but does not take the prescribed maintenance medicine. Confusion about which course of action to take A pregnant woman who values her job to meet financial obligations, but also needs to have complete bed rest fora safe labor and delivery.
- 65. Clarifying Client Values Process How? List Alternatives Ask: “Are you considering other alternative courses of actions?” “Tell me about them” Examine possible consequences of choices Ask: “What do you think you will gain from doingthat?” Choose freely Ask: “Did you have any say in thatdecision?” Feel good about the choice Ask: “How do you feel about that decision?” “Some peoplefeel good after a decision is made; others feel bad. How do youfeel?” Affirm the choice Ask: “What will you say to family or friends aboutthis?” Act on the choice Ask: “Will it be difficult to tell your wife about this?” (it determines the client’s preparedness to act in his decision) Act with a pattern Ask: “How many times have you done that before?” or“Would you act that way again?”
- 66. Code of ethics
- 67. DEFINITION : •Ethics refers to the moral code of nursing & is based on obligation to service & respect for human life Melanie & Evelyn •A code of ethics is a set of ethical principles that are accepted by all members of a profession. Potter & Perry Code of ethics is a guideline for performance & standards & personal responsibilities.
- 68. A code of ethics is a set of ethical principle that A.) is shared by members of a group B.) reflects their moral judgements over time C.) serves as a std for their professional actions
- 69. PURPOSES: Standards FOR THE BEHAVIOURS OF NURSE& PROVIDE GENERAL GUIDELINES FOR NURSING ACTION Helps TO DISTINGUISH BETWEEN RIGHT& WRONG Enables A CORRECT DECISION Protect THE RIGHTS OF INDIVIDUAL
- 70. USES : Acknowledge the rightful place of individual in health care delivery system Constitutes towards empowerment of individual to become responsible for their health & wellbeing Contributes to quality care Identifies obligations in practice, research & relationship Inform the individual, family, community & others professionals about expectation of nurse
- 71. FUNCTIONS : To inform the public about the minimum stds of the profession To provide a sign of the profession’s commitment to the public it serves To outline the major ethical considerations of the profession To provide general guidelines for professional behaviour To guide the profession in self regulations
- 76. ETHICAL ISSUES: Practitioner –Assisted Suicide (PAS) Refusal to treat Genetic research
- 77. Right to refuse treatment Do not resuscitate (DNR) orders
- 78. Nursing Codes of Ethics Purposes: Inform the public about the minimum standards of the profession and help them understand professional nursing conduct. Provide a sign of the profession’s commitment to the public it serves. Outline the major ethical considerations of the profession. Provide standards for professional behaviors. Remind nurses of special responsibility they assume when caring for the sick.
- 79. ETHICAL DILEMMA Occurs when there is conflict between two or more ethical principles. No correct decision exists. Nurse must choose b/w two alternatives that are equally unsatisfactory. Occurs as a result of difference in beliefs. Ethical reasoning
- 80. INTERNATIONAL CODE OF NURSING ETHICS THEICN CODE OF ETHICS FORNURSES An international code of ethics for nurses was first adopted by the International Council of Nurses (ICN) in 1953. It has been revised and reaffirmed at various times since, most recently with this review and revision completed in 2005. PREAMBLE Nurses have four fundamental responsibilities: to promote health, to prevent illness, to restore health and to alleviate suffering. The need for nursing is universal.
- 81. Inherent in nursing is respect for human rights, including cultural rights, the right to life and choice, to dignity and to be treated with respect. Nursing care is respectful of and unrestricted by considerations of age, colour, creed, culture, disability or illness, gender, sexual orientation, nationality, politics, race or social status. Nurses render health services to the individual, the family and the community and co-ordinate their services with those of related groups.
- 82. The ICN Code of Ethics for Nurses has four principal elements that outline the standards of ethical conduct. 1. NURSES AND PEOPLE •The nurse’s primary professional responsibility is to people requiring nursing care. •In providing care, the nurse promotes an environment in which the human rights, values, customs and spiritual beliefs of the individual, family and community are respected.
- 83. •The nurse ensures that the individual receives sufficient information on which to base consent for care and related treatment. •The nurse holds in confidence personal information and uses judgement in sharing this information. •The nurse shares with society the responsibility for initiating and supporting action to meet the health and social needs of the public, in particular those of vulnerable populations. •The nurse also shares responsibility to sustain and protect the natural environment from depletion, pollution, degradation anddestruction
- 84. 2.NURSES AND PRACTICE •The nurse carries personal responsibility and accountability for nursing practice, and for maintaining competence by continual learning. •The nurse maintains a standard of personal health such that the ability to provide care is not compromised. •The nurse uses judgement regarding individual competence when accepting and delegating responsibility.
- 85. •The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance public confidence. •The nurse, in providing care, ensures that use of technology and scientific advances are compatible with the safety, dignity and rights of people
- 86. 3. NURSES AND THE PROFESSION •The nurse assumes the major role in determining and implementing acceptable standards of clinical nursing practice, management, research and education. •The nurse is active in developing a core of research- based professional knowledge. •The nurse, acting through the professional organisation, participates in creating and maintaining safe, equitable social and economic working conditions in nursing
- 87. 4. NURSES AND CO-WORKERS The nurse sustains a co-operative relationship with co-workers in nursing and other fields. The nurse takes appropriate action to safeguard individuals, families and communities when their health is endangered by a co-worker or any other person.
- 88. 5. NURSES AND SOCIETY Participate and share responsibilitywith other citizens &other health professionals. Recognize and perform the dutiesof citizenship Aware of laws and regulations which affect the practice of medicine and nursing.
- 89. INCCODEOFPROFESSIONALCONDUCTFORNURSESIN INDIA 1. Professional Responsibility and accountability 1.Appreciates sense of self-worth and nurtures it. 2.Maintains standards of personal conduct reflecting credit upon the profession. 3.Carries out responsibilities within the framework of the professional boundaries. 4.Is accountable for maintaining practice standards set by Indian Nursing Council 5.Is accountable for own decisions and actions 6.Is compassionate 7.Is responsible for continuous improvement of current practices
- 90. 8.Provides adequate information to individuals that allows them informed choices 9. Practices healthful behavior 2. Nursing Practice 1.Provides care in accordance with set standards of practice 2.Treats all individuals and families with human dignity in providing physical, psychological, emotional, social and spiritual aspects of care 3.Respects individual and families in the context of traditional and cultural practices and discouraging harmful practices 4. Presents realistic picture truthfully in all situations for facilitating autonomous decision-making by individuals and families
- 91. 4.Promotes participation of individuals and significant others in the care 5.Ensures safe practice 6.Consults, coordinates, collaborates and follows up appropriately when individuals’ care needs exceed the nurse’s competence 3. Communication and Interpersonal Relationships 1.Establishes and maintains effective interpersonal relationship with individuals, families and communities 2.Upholds the dignity of team members and maintains effective interpersonal relationship with them 3.Appreciates and nurtures professional role of team members 4.Cooperates with other health professionals to meet the needs of the individuals, families and communities
- 92. 4.Valuing Human Being 1.Takes appropriate action to protect individuals from harmful unethical practice 2.Consider relevant facts while taking conscience decisions in the best interest of individuals 3.Encourage and support individuals in their right to speak for themselves on issues affecting their health and welfare 4.Respects and supports choices made by individuals
- 93. 5. Management 1. Ensures appropriate allocation and utilization of available resources 2. Participates in supervision and education of students and other formal care providers 3. Uses judgment in relation to individual competence while accepting and delegating responsibility 4. Facilitates conducive work culture in order to achieve institutional objectives Communicates effectively following appropriate channels of communication 5. Participates in performance appraisal 6. Participates in evaluation of nursing services
- 94. 7. Participates in policy decisions, following the principle of equity and accessibility of services 8. Works with individuals to identify their needs and sensitizes policy makers and funding agencies for resource allocation 6. Professional Advancement 1. Ensures the protection of the human rights while pursuing the advancement of knowledge 2. Contributes to the development 3. Participates in determining and implementing quality care 4. Takes responsibility for updating own knowledge and competencies 5.Contributes to the core of professional knowledge by conducting and participating in research
- 95. LEGAL CONSIDERATIONS 1st nursing law :Nursing registration- 1903 Indian nursing council act: enacted in 1947 Amended in 1957 LEGALIMPLICATIONS:(civildisputes) Torts: Torts are when others interfere in individuals' privacy Assault: Assault occurs when a person puts another person in fear of a harmful or offensivecontact Battery: It is an intentional touching of another's body without the other's consent Negligence: it is described as lack of proper care and attention carelessness.
- 96. Malpractice: Failure to meet the standards of acceptable care which results in harm toanother person. Fraud: It results from a deliberate deception intended to produce unlawful gains. False imprisonment: It occurs when a client is not allowed to leave a health care facility when there is no legal justification to detain the client or when restraining devices are used without an appropriate clinical need. Invasion of privacy: It includes violating confidentiality intruding on private client or family matters, and sharing client information with unauthorized ppersons.
- 97. Legal documents: it comprised: a)Advance directive: Written document recognized by law that provides directions concerning the provision of care when a person is unable to make his or her own treatment choices. b)Do not resuscitate orders: Written order by a physician when a client has indicated a desireto be allowed to die if the client stops breathing or the client's heart stops beating. c)Informed consent: It is clients' approval [or that of the clients' legal representative to have his or her body touched by a specificindividual.
- 98. NURSING LIABILITIES AND PREVENTIVE MEASURES o All nursing observations should be noted carefully, describing accurately Patients complaints should be recorded as accurately and specifically Nurse must report through proper channels Authorities must be informed regarding any kind of equipment, materials or supplies, which for any reasons less than safe for use in the patient's care Insurance protection
- 99. LEGAL RESPONSIBILITY Registration Licensing is a mandatory procedure for practice of nursing. Registration aims at protecting patients by providing qualified nurses. The nurse is responsible to obtain registration in the respective State Nursing Registration Council LegalLiability/Act Of Negligence License of a nurse can be suspended or cancelled for any act of negligence or mal practice, following a specified procedure. Medico — Legalcase (M.L.C.) Amedico legal case is a patient who is admitted to the hospital with some unnatural pathology and has tobe taken care of in concurrence with the police and/or court
- 100. Correct identity A nurse/midwife is responsible to make sure that all babies born in hospital are correctly labeled at birth and handed over to right parent. Unknown/unconscious patients must be labeled as soon as their identity is known. Patients who have to undergo surgery should be appropriately identified and labeled. Site of operation to be correctly marked particularly where symmetrical sides or organs are there: Operation theatre (O.T.): scrub nurse has to see all the instruments/ swabs are returned. She has to say OKAY' before closure by the surgeon
- 101. . LeftAgainst MedicalAdvice(L.A.M.A.) Inform medical officer in charge. Signatures ofboth patients and witness to be taken as per institutionalpolicy. Patient's Property Inform patient on admission that hospital does not take responsibility of his belongings. If patient is unconscious/ or otherwise required then a list of items must be made, counter checked by two staff nurses and kept under safecustody. Dying Declaration Doctor or nurse should not involve themselves indying declaration, in case where police records the dying declaration. Dying declaration is to be recorded by the magistrate. But if condition of patient becomes serious then medical officer can record it along with two nurses it witness. Dying Declaration can be recorded by the nursing staff with two nurses aswitness when medical officer is not present. Then the declaration hasto be sent immediately in a sealed cover to themagistrate.
- 102. Wills For this, doctor has to be present there, he can recode if requested. Examination of rape case Female attendant/female nurse must be present during the examination. Artificial human insemination Written consent should be obtained from both donor and recipient. Donor and recipient must have the same blood group. Donor and recipient's identity should be kept confidential. . All related documents should be kept confidential & safe.
- 103. •Poison case •Do not give either verbal or written opinion. •Do not allow to take photos unless special permission is granted by appropriate authority. • Do not give any information to public or press. • Preserve all evidence of poisoning. •Collect and preserve all excreta, vomits and aspirates, seal them immediately and send to forensic laboratory at the earliest. .Consumer Protection Act(l986) Consumer protection act was passed by parliament in 1986 RIGHTSOFPATIENT:
- 104. Nurses role to prevent complications 1. Review nursing practice periodically. Update knowledge and improve skill by attending short term courses, in- service education and continuing education programmes. 2. Should have complete knowledge of all rules and regulations of hospital and know their descriptions {duties and responsibilities). 3. Follow nursing practice standards/protocols. 4. Be a keen observer. 5. Written instructions must have rules and code of practice laid down to ensure the safety and well being of patients and nurses.
- 105. 6. All hospitals must have rules, a code of practice laid down to ensure the safety and well being of patients and nurses. 7. Maintain records and reports of the unit properly. 8. Follow 6 Rights - right patient, right drug, right time and right route with right technique and right of the patient lo know about his/her disease condition. 9. Check the treatment order and use professional judgment before implementing. 10. Do not exceed the limits of nursing procedure laid down by statutory bodies.
- 106. Nursing • The nursing science is an independent applying science that synthesizes natural and social science. • Nursing is a profession that helps human being and serves for health of human being • Nursing can assist individual to meet the basic needs of human being and enforce the ability of self-care.
- 107. Nature and scope of nursing practice • Nurses contribute to health care within a multidisciplinary team. They are individually accountable for their actions and practise within a statutory regulatory framework established to protect the public and assure the quality of nursing services. • The role of the nurse is constantly changing and developing. This means that nurses may add new functions to their work. When deciding to do so, nurses must be sure that patients will benefit and that they are competent for the new role.
- 108. Nature and scope of nursing practice • Nursing is a service which: • Helps individuals, families and communities to achieve and maintain good health • Supports, assists and cares for people during illness or when their health is threatened • Enhances people's ability to cope with the effects of illness and disability • Ensures, as far as possible, that death is dignified and free from pain.
- 109. Nature and scope of nursing practice • Nursing achieves these goals by applying knowledge and skills gained through education and training, updated and tested by research. It is the combination of professional knowledge and skills, with the desire to care for others, which provides the base of nursing. Nursing practice includes: • Assessing people's health, their health problems and the resources they have to cope with them; deciding what nursing help is needed and referring them to other sources of expertise when necessary • Planning, giving and evaluating programmes of skilled nursing care
- 110. Nature and scope of nursing practice • Teaching individuals, families and communities about healthy lifestyles. This involves helping them gain the knowledge and skills to control their own health • Teaching and enabling people to attain, maintain or recover their independence • Acting as the patient’s advocate and communicating the patient’s needs to others • Co-ordinating care where other health care workers are involved • Maintaining an environment conducive to health or recovery.
- 111. Nature and scope of nursing practice • Nursing is concerned, in particular, with: • Situations in which people’s ability to maintain the normal activities of life, such as breathing, feeding, elimination, mobility, rest, sleep and personal cleanliness may be impaired • Alleviating pain and discomfort • Assessing physical and emotional responses to illness, trauma, treatment and disability. These responses may include anxiety, loss, loneliness and bereavement. • Managing disordered intellectual responses, learning difficulties and mental illness.
- 112. CODE OF ETHICS American Nurses Association 1. The nurse provides services with respect for human dignity and the uniqueness of the client unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems. 2. The nurse safeguards the client’s right to privacy by judiciously protecting information of a confidential nature. 3. The nurse acts to safeguard the client and the public when health care and safety are affected by the incompetent, unethical, or illegal practice of any person. 4. The nurse assumes responsibility and accountability for individual nursing judgments and actions. 5. The nurse maintains competence in nursing.
- 113. CODE OF ETHICS American Nurses Association 6. The nurse exercises informed judgment and uses individual competence and qualifications as criteria in seeking consultation, accepting responsibilities, and delegating nursing activities to others. 7. The nurse participates in activities that contribute to the ongoing development of the profession’s body of knowledge. 8. The nurse participates in the profession’s efforts to implement and improve standards of nursing. 9. The nurse participates in the profession’s efforts to establish and maintain conditions of employment conducive to high-quality nursing care. 10. The nurse participates in the profession’s effort to protect the public from misinformation and misrepresentation and to maintain the integrity of nursing. 11. The nurse collaborates with members of the health professions and other citizens in promoting community and national efforts to meet the health needs of the public.
- 114. TRENDS IN NURSING •Basic nursing education in community colleges and universities. •A growing variety of employment settings. •Growing emphasis on the aspects of nursing that characterize it as a profession. •Increasing political influence of nursing. •Nursing influences on health care policy and practice.
- 115. Thank you …