The Ethics of nursing
Ethics is principles and values believed by nursing profession in executing its duty related to patient, society, with profession organization and also college, and also arrangement of practice in treatment of it. (Berger & Williams, 1999), to profession or nursing , ethics is represent as reference in executing practice, do not aside from psychiatric mental health nursing. Become action and decision nurse of psychiatry to client differentiated by what is called with manner ethics ( way of matching with ethics). Decision making according to ethics is effort to take a decision of mistake situation without clear guideline. If nurse have known how its values and implementation it in its framework according to code of ethic, will be able to develop two quality, it is the quality of given treatment upbringing and will get satisfaction of given service.
Ethics is study of philosophical beliefs about what is considered right or wrong a society. The term bioethics is used in relation to ethical dilemmas surrounding client care. Bioethics in psychiatric mental health nursing is the application of ethical principles within the scope of the psychiatric nursing practice setting.
The house of delegates of the American nurses Association approved these nine provisions of the new code of ethics for nurses at its June 30, 2001 meeting in Washington , DC
- the nurses, in all professional relationship, practices with compassion and respect for the inherent dignity, worth, and uniqueness af every individual, unrestricted by considerations or social or economic status, personal attributes or the nature of health problems
- the nurse`s primary is commitment is to the patient, whether an individual, family, group, or community .
- the nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient
- the nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurses`s obligation to provide optimum patient care
- the nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth.
- the nurse participates in establishing, maintaining, and improving health care environments and conditions of employment conducive to the provision of quality health care and consistent with the values of profession trough individual and collective action
- the participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development
- the nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs
- the profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the proffesion and its practice, and for shaping social policy
Professional nursing practice is not determined by simply following patient`s rights. Rather. It is interplay between the rights of patient. The Legal Role of the Nurse and concern for quality psychiatric care. There are three roles that the psychiatric nurse moves in and out of while completing professional and personal responsibilities : provider of service, employee or contractor or service and private citizen. These roles are stimultaneous , and each carries certain right and responsibilities.
Because the primary function of mental health nursing is relating with people, it is important to review the way in which nursing “care” occurs. Richards has examined the concept of “caring for“ versus ”caring about”. When a person cares for another, the implications is that the other is like a child and is incapable of self-care; he or she is dependent and cannot make any contributions to his or her own well-being. Caring about, on the other hand, demonstrates respect for the other as a full human being. Although a client may be temporarily incapacitated (to a greater or lesser degree), the nurse should continually relate to him or her in manner that promote self-acceptance, ability to care for self, and ultimate restoration of health.
It can be helpful to review one`s own philosophy of client care to determine which approach described above does not contribute to the ultimate well-being or potential autonomy of client
The Code of Nursing practice noted earlier describes the ethical relationship that ideally exists between a nurse and a mental health client. These ethical codes, although clearly stated, can sometimes create internal conflicts in the nurse. Because nursing practice deals whit all aspect of human existence, it cannot consist of circumstances that fit within perfect guidelines. In actual practice, it is possible to be caught between a personal belief and a professional ethic or law that causes strong disagreement and consternation. If this occurs and the dilemma seems unresolvable, it can be helpful to seek the counsel of someone in the profession who is knowledgeable the issues involved.
Physically or mentally ill individuals are in a dependent position when hospitalized. Accordingly, the legal systems in various states have instituted laws designed to safeguard their well-being. Laws regarding mentally ill people differ from state, so it is important that nurse obtain specific information about the statutes affecting their delivery of care during orientations programs in their respective institutions or agencies
Laws are developed by a society as an outcome of personal and professional values and ethics. A single instance of violation of another`s well-being does not usually result in a law designed to forbid its recurrence. Instead, repetition of similar types of violations causes people to respond with indignations and call for a law to control and punish its continued occurrence.
Right to treatment
All people who are hospitalized for mental illness have the right to treatment.
Right to Treatment :
- a treatment plan that is continuously reviewed by a qualified mental health professional and modified, if necessary
- a mental examination and review of a client`s care plan every 90 days by qualified mental health professional other than the professional responsible for supervising and implementing the plan
- a statement of client problems and needs
- a statement of the least restrictive treatment conditions necessary
- intermediate and long-range goals and a timetable for implementing them
- a statement or rationale for plan
- a description of proposed staff involvement
- criteria for release to a less restrictive environment and discharge
- notation of therapeutic tasks to be performed by the client
Confidentiality
The client in the mental health setting has many rights to safeguard his or her well-being. These include the right to confidentiality. Confidentiality requires that the nurse`s knowledge of all aspect of client`s conditions belong, in essence, to the client. The nurse cannot reveal this information publicly without the client informed consent. Obviously, the nurse`s documentation of information revealed in the nurse-client relationship falls within this guideline.
In the client-nurse relationship, the client share sensitive or potentially damaging information with the nurse. It is important that the nurse be aware of the specific guidelines regarding documentation or verbal reporting of this information developed by the institutions in which he or she working.
Guidelines can vary among different institutions. If should be necessary to change any charted material, the following recommendations should be closely followed:
- the record should never be erased
- a line should be drawn through the erroneous material in the chart and the corrected version substituted
- the correction should be date and initialed
- a chart should never be altered after material has been subpoenaed in a lawsuit. This may be considered tampering with evidence and could result in a serious penalty
Because the nurse is a member of a treatment team, such information should be shared verbally with the director of the team, whose clinical judgment forms the basis of the decisions about whether and how this information should be shared with the team.
Informed Consent and Competency
Consent is a person`s agreement to an act that will affect his or her body or to disclosure of information about himself or herself. There are four general types consent. Informed consent is the agreement by a competent person who has been give the information necessary to weigh the advantages and disadvantages of the treatment that is being proposed to hem or her.
In addition regarding treatment, another type of informed consent refers to the release of information about a client`s out-patient treatment or hospitalizations. Because such information can be potentially damaging to a client, he or she the right to know exactly what information will be given and why it is needed.
Competency is a person`s mental status that renders him or her capable of sound decision making and management of his or her own life circumstances. The concept of competency is subject to different legal definitions, depending on circumstances and the particular state in whice a person lives.
The decision to obtain a court decision on mental competency is usually made when family members or caregivers have serious concerns about a person`s judgment and ability to handle his and her own affairs. If sufficient data are presented to the judge, he or she can order that a guardian, conservator, or committee be appointed to make and implement decisions that will safeguard all aspect of client`s well-being.
Right to Refuse Treatment
Most of the rights of client have been established because of legal precedents that were determined when former caregivers for denial of their rights when they were hospitalized. Two of the most common treatment that have potentially negative side effects are electroshock treatment (EST) and all psychotropic medications.
in conclusion, the knowledge regarding ethics and legal issues in mental health nursing is expanding rapidly. As the issue of client right became more urgent, nurses began to review their own ethical responsibilities to client. One of the major reasons for the increase in knowledge of legal issues was consumer awareness that their needs were not being adequately met by the mental health care system. Lawsuits that mandated change in particular states often had effects beyond the boundaries of those states. Other states, in viewing the outcomes of these lawsuits, began to review and revise some of their own questionable practice
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