Discipline Accountability & integrity

When do medication errors usually occur?

- When there is a lack of knowledge -Attitudinal problem -Complexity of health care delivery -Simply because one is human

Before you whistleblow what should you take into consideration?

-Determine legal duty -Determine ethical duty -Be prepared to defend yourself -Be aware of the risks

Give examples of wrongdoings in the workplace that you would whistleblow

-environmental hazards -staffing inadequacies -illegal, incompetent or unethical conduct of health care providers

What are 4 features of integrity?

1) Moral autonomy 2) Fidelity to promise 3)Steadfastness 4) Wholeness

Nursing professionals obligations extend to multiple obligations and ethical dilemmas can develop when these obligations conflict. List 4 obligations

1. Clients/families 2. The institution in which one practices 3. Other health care professionals 4. The community

What are 2 types of whistleblowing?

1. External 2. Internal

List 4 ethical issues as a result of medication error

1. Harm to clients 2. Whether to disclose the error 3. Diminished trust 4. Quality of client care compromised

When should you feel obligated whistleblow?

1. Potential or actual harm to the patient 2. believe that it will significantly influence the probability of change\

What are 3 things you need to know when you have the MORAL right to blow the whistle?

1. Serious harm to clients, employees to other members of the public 2. Should report problems to superiors ( ie. charge nurse) 3. If superiors do nothing- whistleblower should have reported up through the hierarchy without having reached satisfactory explanation

What is fidelity to promise?

Being true to one's morals; acting consistently with what we profess

What was developed in the nursing profession to address professional integrity and publicized the values and principles for which nurses are accountable?

Code of Ethics

What is wholeness?

Consistency and continuity of values and principles in one's actions

What is whistleblowing?

Exposing a serious wrongdoing (negligence, abuse, danger) that exists in the workplace

What is external whistleblowing?

External -Reporting to direct source (person)

What is the protection for persons in care act?

HCP's have a duty to protect clients from abuse and maintain a reasonable level of safety for them - if anyone w/ reason to believe that the client is being, or likely to be abused - must report

What is moral distress?

Knowing what is the right thing to do but being unable to do it ( gap between how nurses KNOW they should act and how they are EXPECTED to act)

What is integrity?

MORAL MAKE-UP of an individual. An uncompromising adherence to a code of moral, artistic or other values - sincerity, honestly, candor; avoidance of deception, expediency, artificality or shallowness of any kind

According to the CNA code of ethics for moral objections: is a nurse ethically obligated to provide requested care when complience would involve a violation of his or her moral beliefs?

No, a nurse is not ethically obligated, however "nurse who encounter such situations are morally obligated to seek to arrange conditions, so that the care of clients is not jeoprodized"

According to the CNA code of ethics, what is being accountable?

Nurses are accountable for their actions and answerable to their practice

What is our ethical responsibility in whistleblowing?

Nurses have an ethical responsibility to safeguard the patient and the public by reporting incompetent, unethical or illegal action of colleagues

What is internal whistleblowing

Report to people within the organization (Charge nurse)

What are some cons to whistleblowing?

Sleeplessness, depression, isolation, "trouble-maker", harassment, loss of employment, anxiety, ridicule

What is professional integrity?

Stand up for the values of the profession

What are some pros to whistleblowing?

Stops the wrongdoing, promotes change, improves quality of care for patients, self- gratification

What is steadfastness?

Unwillingness to yield one's principles

If you don't report abuse or maintain safety what could happen?

You could be fined up to $2000 & referred to CRNM for investigation and possible disciplinary action

The College of Registered Nurses of Manitoba (CRNM) nursing standards of practice reflect what specific issue in nursing?

accountability

What is accountability?

being responsible for actions. Practice with HONESTY and INTEGRITY, practice in accordance with Code of ethics, safeguard the quality of nursing care

Give an example of when integrity and the nurse-institution conflicts

ex. - being assigned duties beyond one's professional scope

Give an example of when integrity and the nurse-client relationship conflicts

ex. -A client with cancer doesn't want their spouse to know -A client wants you to ignore the bottle of vodka in the bedside table

Give an example of when integrity and the nurse-community conflicts

ex. More independence and more room to use your own judgement. You might work with lesser skilled, make to maintain safe, quality care.

When integrity of the nurse-colleague conflict what is the nurses primary responsibility?

health, welfare and safety of the client

What is moral autonomy?

taking ownership of one's morals