In your peer response to two (2) students in Group B, discuss the relationship between the Scope and Standards of Practice and issues related to accountability and liability within nursing practice. How are accountability and liability related? How do the Scope and Standards help protect patients and nurses from unsafe care? How does deviating from the Scope and Standards affect a nurse’s potential liability for patient outcomes?
“Nursing ethics is a system of principles concerning the actions of the nurse in his or her relationships with patients, patients’ family members, other health care providers, policymakers, and society as a whole” (Cherry & Jacob, 2016, p. 163). A Code of Ethics for nurses was established by the American Nurses Association as “a guide for carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession” (NUR 400, Module 5, Lecture Script, 2018). Nurses must follow this set of duties and ethical obligations when providing care, and they can utilize the code as guide when faced with ethical challenges at the societal, organizational, and clinical levels (Epstein & Turner, 2015).
Provision 3 of the ANA Code of Ethics is “the nurse promotes, advocates for, and protects the rights, health, and safety of the patient” (Fowler, 2015). This provision includes the protection of patient information, whistleblowing, promoting a culture of safety, and processes that address questionable practice (Fowler, 2015). Nurses must protect patient’s right to privacy and confidentiality, therefore “the nurse advocates for an environment that provides for sufficient physical privacy, including privacy for discussions of a personal nature and policies and practices that protect the confidentiality of information” (American Nurses Association, [ANA], 2015). Only information that is pertinent to patient treatment and welfare should be disclosed with health care team members and those designated by the patient (ANA, 2015). However, confidentiality guidelines may be modified, if needed, to protect the patient, other innocent parties, or in cases of state mandated reporting (ANA, 2015).
Patients have the right to choose whether to be involved in research studies or not. Nurses must assure that patient rights are protected during research activities, and that all available information has been provided to the patient (Fowler, 2015). Regarding a culture of safety, nurses are required to report errors and near misses. “Given that errors will occur, there must be processes and guidelines for prompt reporting and remedying, and for disclosure to the patient, whether the error is one’s own or that of a co-worker” (Fowler, 2015, p. 51). Questionable practice includes incompetent, unethical, illegal, or impaired practice (Fowler, 2015). If a nurse is witness to this type of practice, they have an obligation to protect the patient, and they must take appropriate action to rectify the situation (Fowler, 2015).
Provision 3 states nurses are advocates, and as such, must ensure that the health, safety, and rights of the patients are protected (Fowler, 2015). Additionally, nurse can not ignore impaired care provided by others, that could jeopardize patient safety (Fowler, 2015). Lastly, any observance of unethical or unsafe care by any health care professions requires immediate reporting (Fowler, 2015).
I apply this provision in my practice, and it is evident in the care that is provided by other members of the healthcare team, when we perform a time out prior to beginning a procedure. “The Time-Out is a deliberate pause in activity involving clear communication and verbal confirmation. All members of the surgical team participate in the Time-Out process. It is just one element of Universal Protocol, designed to ensure that the appropriate steps are taken prior to operations and other invasive procedures” (Penn Medicine, 2011). By performing a time out, we ensure we have the correct patient, procedure, and site. In doing so, we are advocating for the safety of the patient, ensuring their rights are being preserved, and holding all team members accountable for providing safe and ethical care.
A personal example is when a critical patient needed a central line inserted in the Emergency Department. Understanding the severity of the case, I knew things would move fast and time was crucial. However, during the time out, I noticed the resident looked fatigued (on the end of a 12 hour shift) and was clumsy when assembling his equipment. Feeling the safety of the patient was at risk, I immediately stopped the time out, and reported my findings to the charge RN and attending physician. The attending physician completed the procedure, and thankfully, the patient did well, and the resident said thank you for calling him out.
The Code of Ethics for Nurses with Interpretive Statements (The Code) was developed as a guide for carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession. To provide easy access to The Code, not only for ANA members but for all nurses and the public. The American Nurses Association (ANA) Center for Ethics and Human Rights was established to help nurses navigate ethical and value conflicts, and life and death decisions, many of which are common to everyday practice. The Center develops policy designed to address issues in ethics and human rights at the state, national, and international levels. Through its highly visible information, activities, and programs, the Center promotes the ethical competence and human rights sensitivity of nurses in all practice settings and demonstrates ANA’s abiding commitment to human rights.
Provision 3 of the ANA Code of Ethics is “the nurse promotes advocates for, and protects the rights, health, and safety of the patient”. Medical caretakers must ensure patient’s entitlement to security and classification, along these lines “the attendant promoters for a situation that accommodates adequate physical security, including protection for dialogs of an individual sort and arrangements and practices that ensure the privacy of data”. Provision 3 states medical caretakers are advocates, and all things considered, must guarantee that the wellbeing, security, and privileges of the patients are ensured. Furthermore, the medical attendant can’t overlook impeded care given by others, that could endanger understanding wellbeing. Ultimately, any recognition of untrustworthy or perilous care by any medicinal services callings requires quick announcing.
I apply this provision in my training, and it is apparent in the care that is given by different individuals from the social insurance group when we play out a timeout preceding starting a system. “The Time-Out is a consider stop in an action including clear correspondence and verbal affirmation. All individuals from the careful group take part in the Time-Out process. It is only one component of Widespread Convention, intended to guarantee that the suitable advances are taken before activities and other obtrusive strategies”. By playing out a timeout, we guarantee we have the right patient, system, and site. In doing as such, we are supporting for the security of the patient, guaranteeing their rights are being saved, and considering all colleagues responsible for giving protected and moral care.
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