Seminar Exam 1

ALL of Chapter 3 Outline

Types of leadership styles

Negligence

Unintentional failure of individual to perform an act that a reasonable person would or would not perform in similar circumstances; can be an act of omission or commission

Justice

Use of available resources fairly and reasonably

Tort

A civil wrong committed against another through actions of commission or omission. Enforced by civil court for monetary damages

The Integrated Ethical Problem-Solving Model

***FOCUS: What are the ethical principles and key values. Work through problem while considering autonomy. Did you keep in mind your ethical principles/did it work out? 1. State the problem. 2. Collect additional information and analyze the problem. 3. Develop alternatives and analyze and compare them. 4. Select the best alternative and justify your decision. 5. Develop strategies to successfully implement a chosen alternative and take action. 6. Evaluate the outcomes and prevent a similar occurrence.

Nursing Process: A Problem-Solving and Decision-Making Model

***FOCUS: identifying problems, solutions, and evaluating (feedback mechanism) ***WEAKNESS: not requiring clearly stated objectives (goals should be clearly stated in the planning phase of the process, but this step is frequently omitted or obscured) -Assess -Diagnose -Plan -Implement -Evaluate

TRADITIONAL Problem-Solving Process

***PROBLEM: Takes too long to do all of this & no objective/goal set 1. Identify the problem 2. Gather data to analyze the causes and consequences of the problem 3. Explore alternative solutions 4. Evaluate the alternatives 5. Select the appropriate solution 6. Implement the solution 7. Evaluate the results

Which of the following statements are true about statutes? Select all that apply

-Also called statutory law or legislative law, laws that are passed by the state of federal legislators and that must be signed by the president or governor. -Nurse practice acts are statutes.

Intentional Tort

-Assault -Battery -False imprisonment -Invasion of privacy -Defamation -Slander

False Imprisonment

-Client is denied discharge from a health care facility -Client is denied discharge after signing an against medical advice (AMA) document -Client is placed in restraints without appropriate medical need

Nonmaleficence

-Do no harm; act with empathy toward client and staff without resentment or malice -Violated by acts performed in bad faith or with ill will, or when making false accusations about client or employee

Beneficence

-Duty to help others by doing what is best for them; -Client advocacy for refusal of care

Common Responses to Change

-Early majority -Innovator -Early adopter

Characteristics of a Critical Thinker

-Insight -Intuition -Empathy -Willingness to take action

Classic Change Strategies

-Normative - reeducative -Rational empiracal -Power-coercive

Accountability

-Nurse is responsible for using reasonable care in practicing nursing -To remain competent, nurse needs to participate in lifelong learning programs

Autonomy

-Support of client's independence to make decisions and take action for themselves; -Overrides beneficence

Critical Thinking (Reflective Thinking)

-The mental process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and evaluating information to reach and answer or conclusion ***Requires reasoning and creatively analyzing a situation (initiation, insight, empathy) -Would need this for behavioral decision making, but not for prescriptive

Moral Distress

. Occurs when the individual knows the right thing to do but organizational constraints make it difficult to take the right course of action

MANAGERIAL Decision-Making Model

1. Determine the decision and the desired outcome (set objectives) 2. Research and identify options 3. Compare and contrast these options and their consequences 4. Make a decision 5. Implement an action plan 6. Evaluate results

Duty-based (deontological)

A duty to do something or refrain from doing something

Durable Power of Attorney

A legal document that gives someone (Health-care surrogate) authority to make health care decisions for you if you are disabled, incapacitated, or otherwise unable to make decisions.

Living Will

A legal document to is implemented only if person is terminal or irreversible condition develops. Regards type of care to provide and whether to use resuscitation measures.

Moral Uncertainty or Conflict

An individual is unsure which moral principle or values apply and may even include uncertainty as to what the moral problem is.

Moral Indifference

An individual questions why morality in practice is even necessary

Recognition-Primed Decision (RPD) Model for INTUITIVE Decision Making

Naturalistic Decision Making ***Blends intuition and analysis -Comes with experience, as a nurse -What we see happening at the bedside

Unintentional Tort

Negligence

Unintentional Tort

Careless acts or accidents that cause injury. Negligence and malpractice are examples.

Veracity

Communicate truthfully and accurately

Ethical Dilemmas

Described as being forced to choose between two or more undesirable alternatives

Malpractice Requirement Elements

Duty - relationship between nurse and client; Breach of Duty (failure to meet standard of care);Forseseeability of Harm; Causation- nurse conduct causes injury; Injury

Intuitionist (deontological)

Each case weighed on a case-by-case basis to determine relative goals, duties and rights

Rational and Administrative Decision Making

Economic Man ***OPTIMIZING (ideal solution - the perfect choice) - you have EVERYTHING you need to make the decisions -Makes decisions in a rational manner -Has *COMPLETE KNOWLEDGE* of a problem or situation -Considers all alternatives -Has systematic ordering of alternatives -Selects maximizing choice Administrative Man ***SATISFICING (decision is made but not necessarily ideal, but adequate) - making a satisfactory decision based on what you know -Knowledge is fragmented -It is impossible to accurately predict future consequences -Considers multiple alternatives but not all -Makes decisions that are good enough -Final choice is satisficing -MOST DECISIONS MADE HERE

Self-Determination Act

Federal law - requiring health care facilities to provide written information to adult clients about their rights to make health care decisions

Fidelity

Following through on what the nurse says will be done; carefully attending to the details of the client's care

Rights-based (deontological)

Individuals have basic inherent rights that should not be interfered with.

Assault

Intentional threat to cause harm or offensive unwanted contact

Battery

Intentional touching without consent

While the traditional problem solving process and nursing process can be used for solving ethical dilemmas, the MORAL decision making model is specific to ethical decisions? What do the letters stand for?

Massage the dilemma, outline the options, review the criteria and resolve, affirm position and act, and look back (evaluate the decision making)

Moral Outrage

Occurs when an individual witnesses the immoral act of another but feels powerless to stop it

Malpractice

Professional negligence involving misconduct or lack of skill in carrying out professional responsibilities

Utilitarian (teleological or consequentialist) Theory

Provide the greatest good to the greatest number of people. "Ends justify the means"

Invasion of Privacy

Release of information to an unauthorized person without the client's consent

Laws

Rules of conduct established and enforced by authority; reflect public policy; indicates what society views as good and bad, right and wrong behavior

Confidentiality

Safeguard the client's privacy

Nurse Practice Acts

State law; define "reasonable care" in each state; scope of nursing practice, roles, rules, educational requirements

Tarasoff Act

State laws, Duty to warn of threatened suicide or harm to others

Good Samaritan Laws

State laws, Limit the liability of professionals in emergency situations

Utility

The good of many outweighs the wants or needs of the individual

Intentional Tort

Willful acts that are intentional and cause injury. Direct violation of a person's legal rights, such as assault, battery, false imprisonment, and fraud.

Advanced Directives

Written instructions regarding end of life care. Three types: living will, do not resuscitate orders, and durable power of attorney