Ethics in Nursing Practice

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By: Sathish Rajamani M. Sc (N)

Lecturer,BKIN - Daudhar


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INTRODUCTION

Health care delivery system has undergonenotable changes during the last few decades

1. Increased client participation2. Shorter hospital stays

3. Restructuring services (outpatientclinics, short-stay units, long-term care

and in home-care)


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Changes Contributed to the

development of new clinicalenvironment and expanded practice.

Nurses today frequently encounterdifficult situations involving decisionsabout the best course of action.

Nurses are obligated to provide ethicaland legal client care that demonstratesrespect for others.


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Code - A code may be defined asconventionalized set of rules or expectationsdevised for a specific purpose.

Ethics-Word ethics is derived from the wordEthos.

It is a Greek word and meaning of this wordis customs, character or conduct.

Ethics is the branch of philosophy thatexamines the difference between right and

wrong.


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A specific set of professional behaviors andvalues the professional interpreter mustknow and must abide by, includingconfidentiality, accuracy, privacy, integrity.


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An ethical code is adopted by an

organization in an attempt to assistthose in the organization called upon tomake a decision (usually most, if not

all) understand the difference between'right' and 'wrong' and to apply thisunderstanding to their decision.

The ethical code therefore generallyimplies documents at three levels:


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A code of ethics often focuses on social

issues. It may set out general principlesabout an organization's beliefs onmatters such as mission, quality,

privacy or the environment. It maydelineate proper procedures todetermine whether a violation of the

code of ethics has occurred and, if so,what remedies should be imposed.


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The code of ethics links to and gives riseto a code of conduct for employees.

1. Employee Ethics2. Professional Ethics
http://en.wikipedia.org/wiki/Business_ethicshttp://en.wikipedia.org/wiki/Code_of_conducthttp://en.wikipedia.org/wiki/Code_of_conducthttp://en.wikipedia.org/wiki/Code_of_conducthttp://en.wikipedia.org/wiki/Code_of_conducthttp://en.wikipedia.org/wiki/Code_of_conducthttp://en.wikipedia.org/wiki/Code_of_conducthttp://en.wikipedia.org/wiki/Business_ethicshttp://en.wikipedia.org/wiki/Business_ethicshttp://en.wikipedia.org/wiki/Business_ethicshttp://en.wikipedia.org/wiki/Business_ethicshttp://en.wikipedia.org/wiki/Business_ethics


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EMPLOYEE ETHICS

A code of conduct is a document designed toinfluence the behavior of employees.

They set out the procedures to be used in specific

ethical situations. The effectiveness of such codes of ethics depends

on the extent to which management supports themwith sanctions and rewards.

Violations of a code of conduct may subject theviolator to the organization's remedies which canunder particular circumstances result in the

termination of employment.
http://en.wikipedia.org/wiki/Code_of_conducthttp://en.wikipedia.org/wiki/Code_of_conducthttp://en.wikipedia.org/wiki/Code_of_conducthttp://en.wikipedia.org/wiki/Code_of_conducthttp://en.wikipedia.org/wiki/Code_of_conducthttp://en.wikipedia.org/wiki/Code_of_conduct


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PROFESSIONAL ETHICS

A code of practice is adopted by a professionor by a governmental or non-governmentalorganization to regulate that profession.

A code of practice may be styled as a code ofprofessional responsibility, which will discussdifficult issues, difficult decisions that will often

need to be made, and provide a clear accountof what behavior is considered "ethical" or"correct" or "right" in the circumstances.
http://en.wikipedia.org/wiki/Professional_responsibilityhttp://en.wikipedia.org/wiki/Professional_responsibilityhttp://en.wikipedia.org/wiki/Professional_responsibilityhttp://en.wikipedia.org/wiki/Professional_responsibilityhttp://en.wikipedia.org/wiki/Professional_responsibilityhttp://en.wikipedia.org/wiki/Professional_responsibilityhttp://en.wikipedia.org/wiki/Professional_responsibilityhttp://en.wikipedia.org/wiki/Professional_responsibilityhttp://en.wikipedia.org/wiki/Professional_responsibilityhttp://en.wikipedia.org/wiki/Professional_responsibilityhttp://en.wikipedia.org/wiki/Professional_responsibilityhttp://en.wikipedia.org/wiki/Professional_responsibilityhttp://en.wikipedia.org/wiki/Professional_responsibilityhttp://en.wikipedia.org/wiki/Professional_responsibilityhttp://en.wikipedia.org/wiki/Professional_responsibility


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Ethics gives the professionals various guidelinesthat how should they behave with each other,with the public and with governments.

These are guideline which the professionalshould follow when they are dealing with theirclients o

Ethics also tell the public that what they canexpect from a professional and tells theprofessionals that what the public expects fromthem.


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Nursing ethics refers to ethical issues that

occur in nursing practiceNursing is a great profession, giving a

healing touch to patients along with taking

care of their diseases and maintaining theirhealth.

Strict following of the codes in some

countries leads to credibility of thatprofession and esteem of that professionrises automatically.


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In India the Indian Nursing Council (INC) has

laid down code of ethics and professionalconduct.


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Assurance: A promise that you will definitelydo something.

Health: A state of dynamic balance of anindividuals ability to perform personallyvalued roles and responsibilities, to deal andcope with physical, biological, psychological

and social stresses and challengesthroughout the life while continuing tomaintain a sense of well-being.


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Nurse: Nurse is a person who has completedprescribed course in Nursing from aninstitution recognized by Indian Nursing

Council and registered herself/himself underthe State Nursing council as Nurse andmidwife.

Nursing: Nursing is a professional servicefor enabling a person to maintain andsustain health and wellbeing.


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Performance criteria: Selected behaviorswhich illustrate how the standard isachieved.

Practice standards: Set of Activities expectedfrom professional group of workers.

Personal etiquettes: Being polite & soft

spoken, honest, sincere, cheerful, dignified,affectionate, compassionate and courteous.


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Professional etiquettes: Being attentive listener,keen observer, objective, non-judgmental,empathetic, confident, assertive, disciplined,

prompt and efficient. Professional body or Regulatory body: Indian

Nursing Council / State Nursing Council is statutorybody which regulates the Nursing Education and

practice in India.

Professional Worker: A person who confirms to alevel of practice that is expert and ethical after

completing an authorized educational programme.


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Provider: Same as nurse

Quality Nursing Practice: Quality of nursingpractice is achieved when organizations

processes and activities are designed andimplemented to meet the needs andexpectations of the receiver on a competent,

consistent and continuous basis. Quality Assurance in Nursing: Quality

Assurance is a program for formal guaranteefor provision of quality nursing care against setstandards.


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Rationale: Reasoning for the standards.

Receiver: Receiver(s) refer to thoseindividual persons/ families/ groups/communities who are in need of assistancefrom Nurse to maintain and sustain theirhealth and well-being.

Standards: Level of performance requiredfor obtaining a specified desired outcome.


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Vulnerable: vulnerable persons are those whoare disadvantaged due to physical, emotionaland social and economic reasons e.g.,

Mentally and physically challenged person.

Emotionally traumatized persons.

Women, children, marginalized groups.

Well Being:It is an active state of a person withmaximum potential by maintaining balanceand is at peace with inner and outer world.


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The code of professional conduct for nursesis critical for building professionalism andaccountability.

Ethical considerations are vital in any areadealing with human beings because theyrepresent values, rights and relationships.

. The nurse must have professionalcompetence, responsibility andaccountability with moral obligations.


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Nurse is obliged to provide serviceseven if it is in conflict with her/hispersonal beliefs and values.


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To inform both the nurse and the society ofthe minimum standard for professionalconduct.

It provides regulatory bodies a basis fordecisions regarding standards ofprofessional conduct.

Protect the rights of individuals, families andcommunity and also the rights of the Nurse.


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Acknowledges the rightful place of Individuals inhealth care delivery system.

Contributes towards empowerment of

individuals to become responsible for theirhealth and well-being.

Contributes to quality care.

Identifies obligations in practice, research andrelationships.

Informs the individuals, families, community andother professionals about expectations of anurse.


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Provides care for individuals withoutconsideration of caste, creed, religion,culture, ethnicity, gender, socio-

economic and political status, personalattributes, or any other grounds


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Individualizes the care consideringthe care considering the beliefs, valuesand cultural sensitivities.


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Appreciates the place of theindividual in family and community andfacilitates participation of significant

others in the care.


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1.4 Develops and promotes trustfulrelationship with individual(s).

1.5 Recognizes uniqueness of response of

individuals to interventions and adaptsaccordingly.


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Appreciates the place of theindividual in family and community andfacilitates participation of significant

others in the care.


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The nurse respects the rights ofindividuals as partner in care and helps

in making informed choices

Appreciates individuals right tomake decisions about their care andtherefore gives adequate and accurate

information for enabling them to makeinformed choices.


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The nurse respects the rights of individualsas partner in care and helps in making

informed choices

Respects the decisions made by individual(s) regarding their care.

Protects public from misinformation and

misinterpretations.

Advocates special provisions to protectvulnerable individuals/groups.


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Respects the individuals right to privacyof their personal information.

Maintains confidentiality of privileged

information except in life threateningsituations and uses discretion in sharinginformation.


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Nursing care must be provided only byregistered nurse.

Nurse strives to maintain quality nursingcare and upholds the standards of care.

Nurse values continuing education,initiates and utilizes all opportunities for selfdevelopment.


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Adheres to code of ethics and code ofprofessional conduct for nurses in Indiadeveloped by Indian Nursing council.

Familiarizes with relevant laws andpractices in accordance with the law of thestate.


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Demonstrates personal etiquettes inall dealings.

Demonstrates professional attributesin all dealings.


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1. Professional Responsibility andaccountability

Appreciates sense of self-worth andnurtures it.

Maintains standards of personal conductreflecting credit upon the profession.

Carries out responsibilities within theframework of the professional boundaries.


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Is accountable for maintaining practicestandards set by Indian Nursing Council

Is accountable for own decisions andactions

Is compassionate

Is responsible for continuous improvement

of current practices


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1.8 Provides adequate information toindividuals that allows them informed

choices

1.9Practices healthful behavior


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2. Nursing Practice

2.1 Provides care in accordance with setstandards of practice

2.2 Treats all individuals and families withhuman dignity in providing physical,psychological, emotional, social and spiritualaspects of care

2.3 Respects individual and families in thecontext of traditional and cultural practices

and discouraging harmful practices


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2. Nursing Practice

2.4 Presents realistic picture truthfully in allsituations for facilitating autonomousdecision-making by individuals and families

2.5Promotes participation of individuals andsignificant others in the care

2.6Ensures safe practice

2.7 Consults, coordinates, collaborates and followsup appropriately when individuals care needs

exceed the nurses competence.


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3. Communication and InterpersonalRelationships

Establishes and maintains effective interpersonal

relationship with individuals, families and communitiesUpholds the dignity of team members and maintains

effective interpersonal relationship with them

Appreciates and nurtures professional role of team

membersCooperates with other health professionals to meet the

needs of the individuals, families and communities


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4. Valuing Human Being Takes appropriate action to protect individuals

from harmful unethical practice

Consider relevant facts while taking consciencedecisions in the best interest of individuals

Encourage and support individuals in their right

to speak for themselves on issues affecting theirhealth and welfare

Respects and supports choices made byindividuals


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5. ManagementEnsures appropriate allocation and utilization of

available resources

Participates in supervision and education ofstudents and other formal care providers

Uses judgment in relation to individual

competence while accepting and delegatingresponsibility

Facilitates conducive work culture in order toachieve institutional objectives


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5. ManagementCommunicates effectively following appropriate

channels of communication

Participates in performance appraisal

Participates in evaluation of nursing services

Participates in policy decisions, following the

principle of equity and accessibility of servicesWorks with individuals to identify their needs

and sensitizes policy makers and funding agenciesfor resource allocation


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6. Professional AdvancementEnsures the protection of the human rights while

pursuing the advancement of knowledge

Contributes to the development

Participates in determining and implementingquality care

Takes responsibility for updating ownknowledge and competencies

Contributes to the core of professionalknowledge by conducting and participating inresearch


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Ethics in Nursing Practice

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