nursing code of ethics

Nursing Code of Ethics

What Every Job Corps Nurse Needs to Know

Goal

• Provide an interactive training focusing on ethical and moral decision making using the Code of Ethics for Nurses and the Privacy Act.

Objectives

Participants will be able to:• State why nursing ethics are important.• Name three of the five Nursing Ethics

Provisions.• Discuss moral and ethical decision making

through the use of scenarios.

Why Nursing Ethics Are Important

• Having a code of ethics helps guide nurses through tricky situations and serves as a common reference point for everyone on the health care team.

• The primary goal of nursing ethics is to protect patients. Veering from the code of ethics can lead to a breakdown in team communication and physical consequences for a patient.

• A nurse in any setting must rely on and refer back to the nursing code of ethics throughout his or her career.

http://www.medi-smart.com/nursing-articles/nursing-questions/ethics

ANA Code of Ethics for Nurses

• The ANA of Ethics for Nurses consists of two components: provisions and interpretive statements

• There are nine provisions—each provision is composed of four interpretive statements to serve as examples

Source: American Nurses Association: http://nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/AboutTheCode.aspx

Provision #1• The nurse should practice compassion

and respect for each individual.

• Respect individual differences• Treat all ailments• Collaborate with other health staff• Provide accurate, complete, and easy

to understand information


Provision #2• The nurse’s primary commitment is to the

student.

• Care that reflects individual needs• Conflict resolution• Provide accurate information• Respect personal and professional

boundaries


Provision #3• The nurse maintains privacy and

confidentiality to protect the rights of the student.

• HIPAA/Privacy Act of 1974• Confidence and information sharing• Confidential environment• Safeguard information


Provision #4• The nurse recognizes and takes

appropriate action regarding any instances of incompetent, unethical, illegal, or impaired practice by any members of the health care team.

• Report questionable practices• Professional integrity/conflict resolution• Professional conduct• Personal responsibility


Provision #5• The nurse and other members of the

health staff must handle medications appropriately.

• Prevent medical errors• Follow procedure when handling

controlled substances• Maintain accurate drug and medical

records• Report suspicious behavior


Scenario 1• On Claudia’s entry urine she spilled glucose and the

physician ordered a fasting blood sugar. • Fasting blood sugar was 130 mg/dL. • Claudia met with Ms. Smith, one of the center nurses.

Ms. Smith tells Claudia that her blood sugar is only slightly elevated and she should watch what she eats, exercise and increase her water intake to flush her system and to follow up in 1 month.

• Claudia returned to wellness a week later complaining of feeling tired and thirsty all of the time. You pulled Claudia’s SHR, see the fasting blood sugar, and schedule Claudia to see the doctor for that afternoon.

• Claudia becomes upset with you; she says Ms. Smith told her she was okay she just needed to watch what she ate and exercise.

• This is not the first time this has happened and you are concerned about the information Ms. Smith is giving.

Questions for Scenario 1

• Which provision or provisions is this? • How do you explain to the student in a

professional manner that the information she received was not accurate?

• Will telling the student they were given misinformation jeopardize the reputation of the wellness center?

• Should you confront Ms. Smith and question her about the information she is giving?

• Should you bring this to the attention of your supervisor?

Scenario 2• One of the female counselors on your center seems

to have become very friendly with a 17-year-old male student. At first you thought it was nice that your new co-worker has such a good relationship with the students, but now you’re starting to wonder if the relationship is appropriate.

• On numerous occasions, you’ve witnessed this co-worker chatting with the male student in the halls, in the parking lot, and near the dormitories. In addition, the other day you thought that you saw the counselor hand him money; however, you are not certain.

• You don’t want to get your coworker in trouble and are not completely sure if there is anything going on; however, your intuition tells you something is not right.


• Which provision(s) is this?• How would you handle this situation? • Who would you talk to about it and why? • What would you say?

Scenario 3• During the same week, Jose J. Carrusco enters the JC

program and Joseph J. Carrusco transfers into your center.

• Jose’s entry lab results came back positive for Chlamydia and he has a positive drug screen. You call Jose’s classroom and ask that Jose come to wellness after lunch.

• In the mean time, Joseph comes to wellness to make an appointment to see the doctor for his upper respiratory symptoms.

• Wellness is busy and you see the last name Carrusco and give Joseph Jose’s lab results and medication.

• After lunch Jose comes to wellness to meet with the TEAP Specialist and get his lab results.

• It is at this time you realize what has occurred.


• What provision is this?• What do you do?• Who do you contact?• What errors occurred? • How do you handle the confidentiality

breach?• What do you do to avoid this situation in

the future?

Scenario 4• You work with only one other nurse at your center. • He reports that he has completed the controlled

medications count for the week. • You know that you should do the count with the other

nurse.• Your colleague calls in sick one day, which leaves you to

do open hours. You open the controlled medication cabinet to get out medication for a student and find the count is incorrect. After open hours you go back and realize there is a large quantity of controlled medication missing.

• There are only two keys to the controlled medication cabinet and you know that you have not taken any of the medications.

• You know that if you report it, you will be in trouble since you did not follow PRH requirements.

• You decide to wait and talk to the other nurse.


• What provision is this?• What should have happened? • What are you going to do now?• What could happen to you?• Who do you notify?

Scenario 5

• It is new input day and the wellness center waiting room is full of new students, you come back from a meeting to hear a loud argument outside of the TEAP office between the TEAP Specialist and the Center Standards Officer over a student who is in the TEAP Program. You see the student sitting in the TEAP Specialist’s office in tears.


• What Provision(s) is this?• What should you do first?• How should you handle this situation?• Has there been a breach of confidentiality?

Scenario 6

• Hillary is a 16-year-old female who has been on center for approximately 6 months when she comes to wellness for a pregnancy test.

• Hillary tells you that she was drinking at an off-center party 6 weeks ago with students, including Michael, a 21-year-old male student. Hillary does not remember much of the night except there was a lot of alcohol.

• The pregnancy test comes back positive. Hillary says she is not certain who is the father.

• A couple days later the Michael comes in wanting to know if Hillary is pregnant.


• What provision is this?• What should you do?• Is this statutory rape in your state?• Who should be notified?• Does this need to be reported and who

does the reporting?• Do you inform Michael?

Scenario 7• Michael is a good student; he is set to complete the

program in a week and he has a job lined up with Homeland Security.

• You really like Michael and are proud of his accomplishments since he has arrived on center. You are aware of the statutory rape/sexual conduct laws in your state and the reporting requirements.

• You go to your supervisor to report this information about Hillary and Michael and the fact that Hillary is a minor and pregnant.

• Your supervisor asks you to look the other way on this, since the center has now moved to the second page on the OMS 10 report and Michael will lose his placement with Homeland Security if he is charged with a misdemeanor or a felony.


• What provision is this?• What should you do?• Would you report this incident?

Scenario 8• Sharena is a Health Occupations Trade student waiting

to take her state test. • The HOT instructor calls you to see if Sharena can

come and make beds and assist you. • The phone rings and Sharena answers it. It is the

culinary instructor calling saying she is sending a student to wellness because she is complaining of severe abdominal pain.

• Sharena meets with the new students and obtains his height, weight and blood pressures, temperature and pulse.

• Sharena brings in the information after the new students leave and she sees an open SHR on the counter with lab results and a note to make an appointment for the student at the Health Department.


• What provision(s) is this?• Has confidentiality been compromised?• Do you think HIPAA privacy laws have

been violated?• What are appropriate activities for WBL

students in wellness?• What steps could you have taken to

protect students’ confidential information? • What provisions could be made to safe

guard student information?

Resources

• Policy and Requirements Handbook PRH Chapter 6:6.10-6.12

• American Nurse Association (ANA) Nursing Code of Ethics www.nursingworld.org

• Health Insurance Portability and Accountability Act 1996 (HIPAA)

• Job Corps Community Website – Health and Wellness Managers Desk Reference Guide

• http://www.medi-smart.com/nursing-articles/nursing-questions/ethics

http://www.nursingworld.com/

http://www.nursingworld.com/

nursing code of ethics

Documents

nursing ethics provisions

ana code of ethics

primary goal of nursing

american nurses association

nursesthe ana of ethics

interpretive statements

individual needs of

job corps nurse needs