Unit 5-Ethical and Legal Issues

8/14/2019 Unit 5-Ethical and Legal Issues

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DHSR Approved Curriculum-Unit 5 1

Nurse Aide I Course

Unit 5


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Ethical and Legal

IssuesIntroductionAs a member of the health careteam, the nurse aide will frequently

be faced with ethical and legaldecisions that govern his or heractions.

A knowledge of ethical standards,residents rights and legal issues areimportant for the protection of nurseaides, employers, and residents.


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5.0 Define ethics.5.1 List at least six basic rules of

ethics for the nurse aide.


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Ethics

Discipline concerned with right orwrong conduct

Guides to moral behavior

Making choices or judgments


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Nurse Aide Ethical

Standards Show respect for each resident as anindividual

Understand the limits of rolePerform only acts for which

adequately prepared

Perform acts only within legal scopeof nurse aide


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Nurse Aide EthicalStandards(continued)

Carry out assignments to best ofability

Be loyal:

Maintain a positive attitude towardinstitution that employs you

Support co-workers

N Aid E hi l


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Be responsible citizen at all times

Respect others

Respect values that differ fromyours


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5.1.2 Identify the kind of informationthat should be kept confidential.


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Resident information should be kept

confidential

Discuss only in appropriate places

Discuss only with proper people

Refer questions from residentsabout their condition to supervisor

Nurse Aide Ethical

Standards(continued)


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Resident information should be kept

confidential (continued)

Refer questions about residents

death to supervisor

Respect personal religious beliefs

Nurse Aide Ethical

Standards(continued)

N Aid E hi l


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Respect privacy of others:

while dressing

while performing personal hygiene

during examination or treatment

during visits with clergy during visits with spouse orsignificant other



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Put residents needs ahead of yourown

Be sincere, honest and trustworthy inperformance of duties

caring and concerned

golden rule



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5.1.3 Explain why nurse aides shouldnot accept monetary tips for a

health care service.

N Aid Ethi l


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Do not accept monetary tips

Residents are paying for service

You are paid to provide service

Do not discriminate regardless ofrace, creed, color, age, financial

resources

Provide care based on need


N Aid Ethi l


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Do not accept monetary tips(continued)

Display tactful and courteous refusalof tips

Display continued desire to behelpful



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5.2 Demonstrate skills supporting ageappropriate behavior byencouraging the resident to makepersonal choices, and by providingand reinforcing other residentsdignity.


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Age Appropriate

Behavior Dependent elderly residentsare not children

If resident seen as a child If resident treated as a

child

Then resident behaves as

a child

A A i t


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Age AppropriateBehavior(continued)

Residents are treated as adults in

manner appropriate to persons age

Age-appropriate considerations:

Recreationalactivities

Social activities

Style of dress

Hair style andgrooming

A A i t


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Guidelines for Nurse Aide

Address resident in a dignified way Listen to what resident has to say

Converse with resident in an adult

manner Respect residents privacy

A A i t


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Guidelines for Nurse Aide (continued)

Dont ignore or humor resident

Explain what care you are going togive

Promote resident independence Treat resident as you would want to

be treated

A A i t


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Encourage resident to makechoices:

select clothing to wear

select books to read select television programs to

watch

A A i t


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Encourage resident to makechoices:

select food and nourishments

select activities of interest select friends

Age Appropriate


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Recognize value of past experience

Praise age appropriateaccomplishments

Encourage adult behavior


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5.3 List six legal responsibilities of anurse aide.


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Legal Issues

Authorized or based on law

Legislated by state and federal

government Liable if laws not obeyed

Fines

Imprisonment


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Legal Issues

(continued) No fear of breaking laws if nurse aide: performs only acts within scope of

nurse aide keeps skills and knowledge current

keeps residents safety and well-being in mind

understands directions for care


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Legal Issues

(continued) No fear of breaking laws if nurse aide:

follows facility policy

does no harm to residents or their

belongings

Laws designed to protect publicwelfare


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5.3.1 Give examples of malpracticeand negligence.

Legal Issues:


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Legal Issues:Civil Law Examples

Of Torts Malpractice

Giving care for which you are notallowed legally to do

Providing improper care

ega ssues:


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ega ssues:Civil Law Examples

Of Torts(continued) Malpractice

Example: nurse aide givingmedication

Example: nurse aide performingtreatment only allowed by licensednurses

ega ssues:


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Negligence Unintentional wrong

Failure to perform in reasonably

prudent manner


Of Torts(continued)

ega ssues:


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Negligence

Example: brakes on a wheelchair

not locked and resident falls

Example: defective equipment notreported and resident is harmed


Of Torts(continued)

ega ssues:


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Assault

Care or treatment without properconsent (intentional)

Threatening to injure a resident orco-worker


Of Torts(continued)

ega ssues:


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Assault

Example: rough treatment ofresidents during care

Example: performing procedure

resident has refused Example: threatening to restrain

resident


Of Torts(continued)

Legal Issues:


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Battery Unlawful touching of another person

without his or her consent


Of Torts(continued)

Legal Issues:


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Battery Example: nurse aide striking

resident

Example: does procedure residentrefuses


Of Torts(continued)

Legal Issues:


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Battery

Get informed consent

Written safest

Verbal Gesture


Of Torts(continued)

Legal Issues:


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Invasion of privacy

Unnecessary exposure ofindividual

Revealing personalinformation withoutconsent


Of Torts(continued)

ega ssues:


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Invasion of privacy

Example: giving news mediainformation without residentspermission

Example: giving information toinsurance company withoutpermission


Of Torts(continued)

ega ssues:


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False imprisonment

Restraining an individual

Restricting residents freedom


Of Torts(continued)

ega ssues:


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False imprisonment Example: use of physical restraints

without authorization or justification

Example: preventing resident fromleaving facility against residents will


Of Torts(continued)

Lega Issues:


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Defamation

False statements that cause aresident to be ridiculed or causedamage to their reputation

Example: slander spoken

Example: libel written

Lega Issues:Civil Law Examples

Of Torts(continued)


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5.3.2 Identify the responsibilities ofthe nurse aide when a resident

wishes to make a will.


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Wills

Legal document giving direction onhow resident wants propertydistributed after death

Refer requests to prepare will tosupervisor

Nurse aide may witness signing of

will Check facility policy

Discuss with supervisor


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5.4 Support the residents right tomake personal choices to

accommodate individual needs.


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Residents Rights

Basic Human Rights Protected by Constitution

Laws clarify these rights:

Right to be treated with respect

Right to live in dignity

Right to pursue a meaningful life

Right to be free of fear

R id t Ri ht


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Residents Rights

(continued) Basic Human Rights (continued) Behavior that infringes on these

rights:

addressing residents as children

using demeaning nicknames for

residents leaving door open during bath

threatening a resident with harm


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5.4.1 Describe the Residents Bill ofRights.


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The Residents Rights

Ethical and legal basis

Federal and state regulations

Posted in facility

Distributed on admission in manyfacilities

Residents Rights

(continued)

R id t Ri ht


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Residents have the right to:

Considerate and respectful care

Obtain complete current informationconcerning diagnosis, treatment andprognosis

Receive information necessary togive informed consent prior totreatments or procedures

Residents Rights

(continued)

R id t Ri ht


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Residents have the right to (continued):

Refuse treatment to extent

permitted under law Privacy of residents body, record,

care and personal affairs

Confidential treatment of all records Reasonable response to request forservice

Residents Rights

(continued)


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Examine bill and receive

explanation of charges

Be informed of any

facility rules and

regulations

Residents have the right to (continued):

Residents Rights

(continued)


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5.4.2 Demonstrate behavior whichmaintains residents rights.

Be av or T at


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Be av or T atMaintains

Residents Rights Address as Mr., Mrs., or Miss unless

asked to use a specific name

Never be rude or unkind Never withhold social

responsiveness

Never ignore residents

Make eye contact

Be av or T at


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Be av or T atMaintains

Residents Rights(continued)

Never be rude or unkind (continued)

Allow to complete sentences prior toleaving room

Dont shut or slam door to quietresident

Never threaten or intentionally hurt


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5.4.3 Give needed assistance in goingto and participating in resident

and family groups and activities.

Behavior That


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Help meet emotional/spiritual/socialneeds.

Encourage socialization (meal-time)

Assist to activities/meetings/church

Behavior ThatMaintains



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5.4.4 Maintain the residentsenvironment and care through

the appropriate nurse aide

behavior.

Behavior That


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Explain care you plan to give

Observe safety precautions

Obtain proper consent after

identifying resident



Behavior That


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Treat all residents equally

Promote positive attitudes

Report errors tosupervisor immediately




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5.4.5 Explain the purpose and valueof a Resident Council.

Resident Council :


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Resident Council :

advisory group Provides opportunity for discussion Recommendations may be made for:

Facility policies Decisions regarding activities

Exploration of concerns

Resolving grievances

Resident Council :


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Resident Council :advisory group

(continued) Gives residents a voice infacility operations

Members residents

facility staff members

(you) representatives from

community


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5.5 Administer care which maintainsthe residents free from abuse,mistreatment, neglect, diversion ofdrugs, fraud, or misappropriation

of property.

Mistreatment of the


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Mistreatment of theElderly

Federal and State DefinitionsAbuse means willful infliction of

injury, unreasonable confinement,

intimidation or punishment withresulting physical harm, pain or

mental anguish.

M streatment o t e


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M streatment o t eElderly

Federal and State Definitions(continued)Neglect means a failure to provide

goods and services necessary to avoidphysical harm, mental anguish or

mental illness.

s rea men o e


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Misappropriation of property means

deliberate misplacement, exploitation,or wrongful, temporary or permanent

use of a belonging or money without

consent.

s rea men o eElderly

Federal and State Definitions(continued)

Mistreatment of the


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Diversion of drugs means the

unauthorized taking or use of any drug.


Federal and State Definitions

(continued)


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Elderly

Federal and State Definitions(continued)Drug means any chemical compound

that may be used on or administered to

humans or animals as an aid in thediagnosis, treatment or prevention ofdisease or other condition or for the

relief of pain or suffering or to controlor improve any physiologicalpathologic condition.

M streatment o t e


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M streatment o t eElderly

Federal and State Definitions

(continued)Fraud means an intentional deception

or misrepresentation made by a personwith knowledge that deception couldresult in some unauthorized benefit tohimself or some other person. Itincludes any act that constitutes fraudunder applicable Federal or State Law.

Mistreatment of the


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Residents Right To Be FreeFrom Abuse Physical

Verbal Sexual

Mental

Corporal Punishment

Involuntary Seclusion

Mistreatment of the


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Signs of abuse Fractures

Bruises of face, upper arms,

upper thighs, abdomen

Fearfulness

Withdrawn, paranoidbehavior

streatment o t e


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streatment o t eElderly

Examples of Abuse Threatening resident

Frightening resident

Pinching, slapping, pushing,grabbing or kicking resident

Withholding food or fluids

Restraining resident against her/hiswill without apparent reason anddoctors order

Mistreatment of the


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Examples of Abuse(continued)

Leaving resident in soiled

linen or clothing

Yelling angrily at or

making fun of resident

Refusing to reposition orgive treatment

Not answering call signal

Mistreatment of the


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Examples of Abuse

(continued) Humiliating resident

Making disparaging,derogatory remarks

Sexual coercion

Sexual harassment

Verbal harassment


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Mistreatment of the


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Elderly Identification of residents at risk for

being abused

noisy individuals

wandering individuals

philandering individuals

socially/logistically isolatedindividuals


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5.5.1 Report any instances of abuse tothe appropriate facility/agency

staff.

R ti Ab


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Reporting Abuse

If observed, stop abuse and reportimmediately to supervisor

Cause for immediate dismissal of

perpetrator and posted on NA IRegistry if proven

Know state law

Not reporting abuse is

aiding and abetting


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5.6 Assist in resolving grievances.

Advocates


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Advocates

Plead cause of another Resolve grievances

Protect residents rights

Advocates


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Advocates

(continued) Advocates can be:You and your co-workers

Member of residents family/supportsystem

Residents guardian

Ombudsman

Advocates


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AdvocatesResidents Right to Voice

Grievances

Regarding services furnished

Regarding services not furnished With respect to behavior of others

Nurse aide must report grievances to

supervisor

Advocates


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AdvocatesFacility policy components for

resident grievance

Acknowledgment

Prompt attempt to resolve Resident kept apprised


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Grievance


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Procedures Grievance Procedures

Review federal grievance

procedures


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Residents Personal


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Possessions Protect personal items

These possessions may

be all they have Items may be impossible

to replace

Report observed thefts


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Documents

Unit 5-Ethical and Legal Issues