...Confidentiality in Nursing Introduction: This essay will give a brief definition regarding the principles of nursing practice, state why there are important to nursing practice. It will then explore confidentiality as a principle E of nursing practice, report why confidentiality is extremely important within nursing practice and will discuss the patient’s rights in relation to law. Relevant reference of published literature will be put forward in this essay to support the author statement. Main body: RCN (2010) states that the Principles of nursing practice “describe what everyone can expect from nursing practice, whether they are colleagues, patients, the families or carers of patients”. There are eight Principles of nursing practice such as; Principle A: “focuses on dignity, equality, diversity and humanity” Principle B: “focuses on ethical integrity, legal integrity, accountability and responsibility”. Principle C: “focuses on the safety of all people (patients, visitors and staff), the environment, organisational health and safety, management of risk, and clinical safety”. Principle D: “encompasses themes of advocacy, empowerment, patient-centred care, and patient involvement in their care”. Principle E: “focuses on communication, handling feedback, record keeping, reporting and monitoring”. Principle F: “focuses on evidence-based practice, technical skills, education, training and clinical reasoning”. Principle G: “encompasses themes of care...
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...Professional Boundaries in a Healthcare Setting Professional boundaries are the defining lines which separate the therapeutic behavior of a registered nurse from any behavior that could reduce the benefit of nursing care to clients, well intentioned or not (as cited in Fronek et al., 2009). Paavillainen & Astedt-Kurki (1997) state that each nurse "ensures that the nurse-client relationship is a therapeutic relationship" and "maintains appropriate boundaries in all interactions with clients at all times" (p. 138). Nurses must maintain their professional boundaries and be aware of events or situations that may threaten them. They should have limitations in their scope of practice. It is staying within their role by refraining from personal involvement with a patient. As nurses, they are limited by their duties and activities as defined by their job scope, so it is very important for them to understand their job description (Gutheil, 2008). The concept of professional boundaries is so important to psychiatric nursing because the health and well being of patients depends upon a collaborative effort between the nurse and the patient (Muskin & Epstein, 2009). It is the nurse’s professional responsibility to understand the dynamics of the therapeutic relationship, to establish the relationship, and to maintain the relationship within therapeutic boundaries. Nurses must understand the differences between a therapeutic relationship and a social or personal relationship (Paavillainen...
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...Using ‘Person Centred’ Communication Skills and Models to Help Clients Admitted for the First Time to a Mental Health Hospital Introduction Communication is one way of exchanging information and feelings from one person to another (Bach and Grant 2009). It is transmitted through verbal and non-verbal behaviour. Communication is an essential and fundamental aspect of nursing care (Timmins 2011). It is a major and important part of daily nursing practice in the nurse-client relationship (Sheldon et al. 2006). Communication in nursing is unique and it is different from communication between healthcare providers because nurses are at the start of the healthcare service as they spend more time with the client than other healthcare professionals (McCabe and Timmins 2006). Therefore, nurses have to pay more attention to improving their communication skills for better client care. In order to establish a positive relationship with the client, it is necessary to communicate effectively and subsequently improve the quality of nursing care (McCabe and Timmins 2006). Effective communication is key to a therapeutic relationship with the client. It is defined as a ''purposeful form of communication used in the helping relationship'' (Ruesch 1961 cited in Arnold and Boggs 2007, p18). It is developed by the nurse for the purpose of assessing, planning, implementing and evaluating client care (Arnold and Boggs 2007). The establishment of a nurse-client relationship was a key element...
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...for Nurses in Australia Developed under the auspices of Australian Nursing and Midwifery Council, Australian College of Nursing, Australian Nursing Federation Introduction This Code of Ethics for Nurses in Australia has been developed for the nursing profession in Australia. It is relevant to all nurses at all levels and areas of practice including those encompassing clinical, management,education and research 1 domains. This Code is framed by the principles and standards set forth in the United Nations’ Universal Declaration of Human Rights, International Covenant on Economic, Social and Cultural Rights and International Covenant on Civil and Political Rights; the World Health Organization’s Constitution and publication series entitled Health and Human Rights; and the United Nations Development Programme Human Development Report 2 2004: Cultural liberty in today’s diverse world. In considering this Code and its companion, the Code of Professional Conduct for Nurses in Australia, it should be borne in mind that they are designed for multiple audiences: nurses; nursing students; people requiring or receiving nursing care; the community generally; employers of nurses; nursing regulatory authorities; and consumer protection agencies. It is also noteworthy that the concepts of ‘ethics’ and ‘morality’ are substantially the same and have been used interchangeably throughout this Code. This Code outlines the nursing profession’s commitment to respect, promote, protect and uphold the...
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...of phoenix HCS 350 LITA TSAI June 19, 2014 My Reflections My Reflections from the Nursing Expertise Self –Report Scale (Garland, 1996, p. 197) indicates that I am a competent nurse at the moment on my unit as evidenced by my experience of 2 years as a registered nurse and “Typically, a nurse at the competent level has been in practice 2 to 3 years. This person can rely on a long-range of goals and plans to determine which aspects of a situation are important which can be ignored.’’(Berner & Berner, 1984)). My answers in the Self-Report scale from number 1,2,3,5,6, 7,14 and 15 reflects me as a competent nurse because I assist my patient first at all times, teach them about the management of their diseases and treatment , monitor frequently for safety since, identifying and managing of rapid changing situations, make right decisions about administering medication, giving therapeutic intervention at all times, monitoring and ensuring they have a quality health care services during their stay at the hospital by checking their vital signs and lab values for changes and use the information to make the best appropriate decision regarding their care.(Munjas,Barbara A, PhD., F.A.A.N., 1985). In conclusion, all information stands out important to me with my patient care at work. On number 9, I disagreed because that is not the best way to provide good nursing care. “Self-disclosure from the nurse needs to be limited. Telling a client your problems is not appropriate.”( Arnold&Boggs...
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...MODULE: PP0613 PROFESSIONAL BOUNDARIES BOUNDARIES BETWEEN NURSES AND PATIENT. As health care professionals, nurses strive to inspire confidence in their patients and their families, treat all patients and other health care providers professionally, and promote patients independence. Patients can expect a nurse to act in their best interests and to respect their dignity. This means that a nurse abstains from obtaining personal gain at the patient’s expense and refrains from inappropriate involvement in the patient’s personal relationships. "Boundaries are mutually understood, unspoken physical and emotional limits of the relationship between the patient and the nurse." (Farber, 1997) When these limits are altered, what is allowed in the relationship becomes ambiguous and possibly unethical. The health and well being of patients depends upon a collaborative effort between the nurse and the patient. Patients are extremely vulnerable to boundary violations because they trust us as their health care providers. They come to us in a time of need, presenting with physical, and often emotional, distress. Some patients demand continuous attention but are unaware of their insatiable neediness. (Muskin and Epstein, 2009) A nurse enters a therapeutic relationship with skills and knowledge that include a great deal of personal information about the individual in their care; and the authority to provide the care required by the individual. The community trusts that nurses...
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...Simply because nursing school and on-the-job training and orientation does not adequately prepare the nurse for delivering traumatic diagnostic and prognostic information that requires life-changing, delicate, and emotional discussions, I was honestly unaware that evidenced-based, best practices even existed. Nevertheless, I was cognizant of diverse models of communication, however, the ones I encountered appeared unrealistic and I have been unable to grasp how to incorporate them into my nursing practice. Regarding an enormous barrier on a high acuity, Medical Oncology Unit that stifles this delivery are, ASCOM phones and pagers. It is a rare occurrence that one or the other does not interrupt an opportunity of full disclosure concerning a patient’s new prognosis or diagnosis. With the tension of the unknown, this is distracting, embarrassing, and gives a sense as if that very patient, in that exact moment, isn’t the most important patient on the nurses or physicians assignment. Another barrier is the...
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...the Nightingale Pledge “I promise to do all in my power to maintain and elevate the standard of my profession, and hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling” (Gretter, 2012). The duty continues today, with hospital policies, state regulations, and federal law aimed at protecting patients’ confidentiality. Critical care providers are often privy to confidential information in the course of clinical practice. The dilemma may arise when confidential information is requested by family members or friends of the patient. Although at times it seems that regulations and laws are so stringent that any disclosure of health care information is forbidden, it may be necessary and appropriate to make disclosures, and the current regulations and laws support the professional judgment in communicating patients’ health information (Wielawski, 2009). Privacy is limited access to a person, the person’s body, conversations, bodily functions or objects immediately associated with the person. Because people have different beliefs and values about...
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...HIV Disclosure to Sexual Partners an Ethics Study Human immunodeficiency virus (HIV) is a prominent disease in the United States today. According to the Centers for Disease Control and Prevention, approximately fifty thousand Americans will be newly diagnosed with HIV this year alone (Basic Statistics, 2014). Although HIV can be transmitted in several ways the most common ways are via sexual transmission or intravenous drug use. Therefore there has always been a stigma attached to HIV – even for those who are in the health profession. A nurse who has been in this vocation for twenty years will probably be able to tell you of a nurse who refused to take care of an HIV patient. Nursing has come a long way since the 1980s, when HIV became known. However, there are still issues that a nurse may face today. One of these issues is when a newly diagnosed HIV patient has a significant other. Should a nurse, knowing the potential devastating consequences of HIV, tell a patient’s sexual partner about their HIV status? This paper will discuss, the legal, moral and ethical ramifications of HIV disclosure. It will weigh the pros and cons of a nurse revealing this information, and it will provide recommendations for nurses who encounter this issue during their practice. It is understandable that a nurse may feel perplexed about this ethical dilemma. Once someone is diagnosed with HIV, they will have the disease for the rest of their lives. Currently there is not a cure. Although...
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...LVN Texas Board of Nursing 333 Guadalupe, Ste. 3-460, Austin, TX 78701-3944 Phone: 512-305-7400 -- Web Site: www.bon.texas.gov For Office Use Only: Amount Date Rec’d Timely License Renewal Form This form may be used during the 60 days prior to the license expiration. Please refer to the enclosed General Instructions, checklist and statistical code sheet to assist in completing this form. Answer all questions, sign, date, and return both pages. Processing time is within ten (10) business days once all requirements are met. The Rules pertaining to the maintenance of your license and your eligibility to renew are located at 22 Texas Administrative Code (TAC) chapter 216 and §§213.27, 213.28, 213.29, 213.33, 217.6 and 217.7. Make your check or money order payable to the Texas Board of Nursing. Fees are non-refundable. The application and payment are valid for one year from the date of receipt in the Board’s office and all licensure requirements must be met within that timeframe. [ ] TIMELY LVN RENEWAL ONLY (prior to expiration date) Fee: $45.00 [ ] LVN RETIRED LICENSE Fee: $10.00 Must be requested prior to license expiring and meet requirements of 22 TAC §217.9 [ ] LVN INACTIVE STATUS No Fee Required Must be requested prior to license expiring and meet requirements of 22 TAC §217.9 Name(Last): Legal documentation is required for a name change (see 22 TAC §217.7) (First): Social Security Number: (City) (M): - LVN License Number: (Address) ...
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...Competence. This refers to a patient’s capacity for decision-making. One is considered competent when (a) one has made a decision (b) one has the capacity to justify one’s choice – competence here requires some process of deliberation, justification, and an articulation of why one has made this particular choice; (c) one does not only justify one’s choice but does so in a reasonable manner. 2. Disclosure. This refers to the content of what a patient is told or informed about during the consent negotiation. Then patient must be informed and must understand the information concerning medical treatment to be undertaken, so that a moral decision can be made. The disclosure of the information must be conducted in such a way that the patient understands the whole process and is aware of the possible outcomes of his or her normal choice. Should there be a language barrier between the physician and the patient; an interpreter might be consulted to communicate the pertinent information. 3. Comprehension. This refers to whether the information given has been understood. The disclosure of information is not enough: equally important is the comprehension of that information. If the patient does not understand what...
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...Patient Advocacy Advocacy is the heart and soul of nursing practice. We as nurses believe that we hold the patients’ safety and care in our hands, and we do. Many nurses give this advocate role a lot thought, considering looking out for our patients’ well-being is a big part of our daily job. Nurses are at the front lines of care, and we have a good handle on the issues and what the patients need more than other clinicians. Advocating is about standing up for the rights of your patients and firmly defending them even if you personally may not agree. Your personal feelings of preferences are put aside, since health care is about the patient and their needs, not us the caregivers. According to (Sylvan, 2013), Registered Nurses (RN) have a complex role in advocating for patients. The definition of advocacy varies according to who is providing the definition and the health care setting in which she acts. Many ethical, professional and personal issues are involved that require appropriate education, experience and judgment (Sylvan, 2013). Advocacy ranges from activities on behalf of patients, such as hand washing and proper identification before treatments, to arguing that an early discharge will harm her patient's recovery and etc…. Advocacy also means, if a nurse observes a practice or procedure she believes to be wrong, advocating for the patient demands means, she will speak out even if that practice was carried out by her superior. This is not always easy and may have a...
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...Introduction Report cards are referred to as public disclosure of the performance of health care providers (e.g., hospitals and physicians). This has been of increase since the early 1990s. In many states, these report cards rate providers on the performance of a particular procedure, most often reporting whether they had high, normal, or low risk adjusted mortality rates relative to the expected rates given the health characteristics of the patient population (Wang, J., et al., 2011). According to Mukamel, (2008) “Quality report cards have become a major component of initiatives to enhance the quality of the American health care system and in addition to numerous private and state report cards, the Centers for Medicare and Medicaid Services (CMS) now provides web-based reports on the quality of health maintenance organizations (HMOs), nursing homes, home health agencies, hospitals, and renal dialysis clinics.” Quality report card report also has helped health care agencies and their professionals to strive to provide the highest quality, safest, most efficient, and cost-effective care possible including a drastic reduction in medical errors. Health outcomes report cards are said to be one mechanism by which health care provider quality information is disseminated to the public. Health outcomes report cards usually provide information related to adverse health outcomes, such as mortality rates and complications rates, at the provider for a specific procedure or treatment...
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...When it comes to boundaries, it is imperative for counselors to set and know their boundaries with their clients. Boundary issues mostly refer to the therapist's self-disclosure, touch, exchange of gifts, bartering and fees, length and location of sessions and contact outside the office (Guthiel & Gabbard, 1993). In any professional relationship there is an inherent power imbalance. The therapist’s power arises from the client’s trust that the therapist has the expertise to help with his or her problems, and the client’s disclosure of personal information that would not normally be revealed. The fact that services cannot be provided unless clients are willing to cooperate, does not change the fundamental power imbalance (Gutheil, T. G., & Gabbard, G. 1998). Therefore, the therapist has a fiduciary duty to act in the best interest of the client, and is ultimately responsible for managing boundary issues and is therefore, accountable should violations occur (Gutheil, T. G., & Gabbard, G. 1998). Given the power imbalance that is inherent in the professional/client relationship, clients may find it difficult to negotiate boundaries or to recognize or defend themselves against boundary violations. As well, clients may be unaware of the need for professional boundaries and therefore, may at times even initiate behavior or make requests that could constitute boundary violations. According to Lazarus & Zur, “A boundary violation occurs when a therapist crosses the line of decency and...
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...Business Ethics in a Hospital Setting Darlene V Nickerson Columbia Southern University Abstract Business ethics in a hospital setting includes a review of many areas. Ethical considerations include the areas of patient care, nursing ethics, physician ethics, patient privacy, and medical billing practices. This paper will touch on ethical concerns for each of these topics. Keywords: hospitals, ethics, patient care, nursing, physicians Business Ethics in a Hospital Setting When beginning a discussion of business ethics in a hospital setting it is important to take a broad approach. Because a hospital is a business and also a treatment facility, the ethical concerns must be considered not only for areas such as billing and privacy but also for ethics related to the appropriate care of patients, nursing ethics, and physician ethics. The ethics of the treatment methods employed based on the patient’s condition must also be considered. Ethics and Patient Care I believe that when discussing the ethical implications of patient care it is helpful to review a real-world scenario. One highly publicized case involved Terri Schiavo and her husband’s fight to stop her tube feedings as there was no hope for her recovery (VandeKieft, 2005). One reason for the high visibility of this case in the media occurred because the patient's husband and the patient's family disagreed on the diagnosis (VandeKieft, 2005). Terri suffered a cardiac arrest due to severe hypokalemia (low potassium...
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