Bioethics in Nursing Practice Set 2 (Questions)

BIOETHICS IN NURSING PRACTICE SET 2 (Questions) Prepared By Ro!!ie "ia!res# RN $% Nurse Sa&ant'a Sa&ant'a 'as 'as aidenta aidentay y *i+en one one apsue apsue o, Ni,edipine Ni,edipine (Adaat) $- &* instead o, . &*% Sa&ant'a doesn/t see any ad+erse reation on t'e patient e+en 0it' t'e ar*er dose% 1'at is t'e &ost appropriate ation s'oud Sa&ant'a tae3 a% Not'in* Not'in* is 0ron* 0ron* so s'e s'e s'oud s'oud attend attend to 'er ot'er ot'er patients% patients% !% Ao&pis Ao&pis' ' a o&pete o&pete inident inident report% report% % 4ou&ent 4ou&ent t'at t'at s'e 'as *i+en *i+en a apsue apsue o, Ni,edi Ni,edipine pine (Adaat (Adaat)) . &*% d% Ca Ca t'e 'ospit 'ospita/ a/s s a0yer a0yer%% 2% Pa Patient tient G%Q% G%Q% is a !an e5euti e5euti+e +e 0'o under0ent under0ent sur*ery sur*ery t'at a6ete a6eted d 'is se5ua dri+e% 4urin* t'e assess&ent inter+ie0# 'e e5presses t'is onern to Nurse "eo 0'o is assi*ned ,or 'is are% In pannin* ,or 'is are# t'e &ost appropriate nursin* inter+ention 0oud !e a% Su**est re,err re,erra a to se5 ounse ounseor or or appropria appropriate te pro,essio pro,essiona% na% !% Pro+ide Pro+ide support support ,or ,or t'e spouse spouse or si*ni7a si*ni7ant nt ot'er% ot'er% % Enoura*e Enoura*e t'e patient patient to as as 8uestions 8uestions a!out persona persona se5uai se5uaity ty%% d% Pro+ide Pro+ide ti&e ti&e ,or pri+a pri+ay# y# t'e patient patient needs needs to e5a&in e5a&ine e 'is t'ou*'ts% 9% Re Re!ea !ea is is dia*nosed dia*nosed HI:; and s'e s'e is not in,or&ed in,or&ed yet% yet% 1'en Nurse Nurse   n a*positi+e3> 1'i' o, t'e ,oo0in* is t'e appropriate t'in* ,or Nurse Gisee to do3 d o3 a% 4eny no0ed*e no0ed*e a!out a!out t'e patien patient/s t/s onditio ondition n and do not *i+e t'e patient any ,urt'er in,or&ation% !% ?ae ?ae t'e patient/s patient/s 'art 'art a+aia!e a+aia!e to to 'er !eause !eause a,ter a,ter a# s'e s'e is entited to see it% % 4isus 4isuss s t'e situat situation ion 0it' 0it' t'e p'ysi p'ysiia ian% n% d% Gi+e a detai detaied ed e5panat e5panation ion on t'e t'e disease disease o, t'e patie patient% nt% T'e patient needs to no0% no0% @% Nurse Quino Quino ares ares ,or a patient patient 0'o 'as aute aute &yeo*enous &yeo*enous eu eue&ia e&ia (A?") 0it' poor pro*nosis% S'e 'as !een on7ned ,or o+er a 8uarter o, a year% year% No0# 'er ondition is deterioratin* tre&endousy% tre&endousy% Unti one day# s'e aready &eets t'e !raindeat' riteria% 1'i' nursin* inter+ention is t'e &ost appropriate at t'is ti&e3 a% Approa' Approa' t'e patie patient/s nt/s ,a&iy ,a&iy ,or ,or possi!e possi!e or*an or*an donation% donation% !% ?ae ?ae t'e deision deision to to 0it'dra0 0it'dra0 t'e t'e i,e i,e support% support% % Seda Sedate te t'e t'e i ien ent% t% d% Ta to t'e sta6 sta6 a!out a!out t'eir t'eir ,eein*s% ,eein*s% .% 4urin* 'is 'is un' !rea# !rea# Nurse Nurse Nat'an Nat'an o+er'eard o+er'eard a *roup *roup o, residents residents passin* !y t'at a poitiian 0as rus'ed in t'e e&er*eny roo& ast ni*'t due to e5tensi+e ana aeration% Ha+in* 'eard t'is# Nurse

Nat'an spread t'e ne0s to 'is ,riends in t'e nurses/ station% 1'at et'ia prinipe 0as +ioated !y Nurse Nat'an3 a% Bene7 ene7 ene ene !% Co Con7 n7de dent ntia iai ity ty % In,o In,or& r&ed ed Con Conse sent nt d% ,or ot'ers/ sa,ety% % Nurse &ain* &ain* sure sure t'at t'e patient/s patient/s 'art 'art is seured seured at at t'e ra ra in t'e nurses/ station d% Pro+idin Pro+idin* * t'e patient patient a opy o, 'ospita 'ospita poiies poiies and proedu proedures res t'at address patient on7dentiaity at ea' unit% a% !% % d%

$#2#9 $#2#@ $#9#@ A A o, o, t'e t'e a!o+ a!o+e% e%

% Nurse Een Een t'ins t'at t'at Nurse Peter Peter 'as !een !een drinin* drinin* ao'o ao'o !e,ore !e,ore t'eir s'i,t% S'e s&es ao'o on Gi!ert/s !reat' ! reat' and notes surred spee'% 1'at is t'e !est ourse o, ation Nurse Een s'oud tae3 a% Ca t'e t'e poie poie and 'a+e 'a+e Nurse Nurse Peter Peter detained detained !eause !eause 'e endan*ers t'e i+es o, t'e patients% !% Co+er up up ,or Nurse Nurse Peter Peter !eause !eause t'e pro,ess pro,ession ion depends depends on oyaty ,ro& oea*ues% % I&&ediatey I&&ediatey noti,y noti,y t'e t'e nursin* nursin* super+i super+isor sor%% d% Te Nurse Peter Peter t'at t'at 'e 'as one ast ast 'ane# 'ane# !ut i, 'e drins drins !e,ore anot'er s'i,t# 'e 0i !e reported% $-%Nurse ?art'a is 'andin* a @- yearod patient 0'o re,uses a proedure to !e done !eause o, rei*ious reasons% 1'i' o, t'e ,oo0in* is t'e &ost appropriate ation to tae3 a% I*nore I*nore t'e !e'a+io !e'a+iorr and ontinue ontinue 0it' t'e t'e proedur proedure% e% !% Con+ine Con+ine t'e patient patient t'at t'e t'e proedure proedure is is ,or 'er o0n o0n *ood% % Note t'at t'at t'e t'e patient patient re,uses re,uses and and in,or& in,or& t'e attendin* attendin* p'ysiian% d% Put restra restraints ints on t'e t'e patient patient !eause !eause t'e proedu proedure re 'as to !e done% $$%A patient is rus'ed in t'e e&er*eny roo& unonsious and is !eedin* pro,usey% pro,usey% T'e attendin* p'ysiian deides in !e'a, o, t'e patient ,or 'e !eie+es t'at 'e no0s 0'at is !est ,or t'e patient% 1'i' o, t'e ,oo0in* is t'is !eie,3 a% Pater aterna nai is& s& !% Brot Brot'e 'err'ood 'ood % Ca Ca&a &ara rade deri rie e d% Intr Intrus usio ion n ,or ,or t'e t'e Good Good $2%1'en a patient tes you t'at 'e is pannin* to 'urt 'i&se, and ased you to eep it as a seret# 0'at is t'e &ost appropriate response3 a% =Jou =Jou 'a+e &y 0ord 0ord sir# I 0i eep eep it%> it%> !% =Jou =Jou are pannin* pannin* to 'urt yourse, yourse,3 3 Can I te t'at t'at to your dotor3> % =No% =No% I an/t an/t pro&ise% pro&ise% I 'a+e 'a+e to in,or& in,or& your your dotor dotor%> %> d% =Jou =Jou see& !ot'ered% !ot'ered% Jou Jou &ay 'a+e to tae tae a rest%> $9%Nurse C'esea 0ors as a sta6 nurse in t'e Ne0!orn Unit% 1'ene+er s'e arries t'e !a!ies ,or ,eedin*# s'e 'andes t'e& 0it' ut&ost are in order to pre+ent 'ar&in* t'e !a!ies% 1'i' o, t'e ,oo0in* prinipes is o!ser+ed !y C'esea3 a% Auto utono&y !% Bene7 ene7 ene ene % Non Non&a &ae e7 7en ene e d% Hu&a Hu&an n 4i*n 4i*nit ity y $@%4r% $@%4r% Derrero Derrero ordered Nurse Say S ay to *i+e a pae!o &ediation to a patient o&painin* o, sto&a' pain% 1'i' o, t'e ,oo0in* prinipes is !ein* +ioated3 a% Bene7 ene7 ene ene !% Non& Non&a ae7 e7e en ne e

% 4o 4ou! u!e e E6e E6ett d% :era eraity ity $.%Nurse 0e3> !% =T'ere =T'ere are &any &any peope peope 0antin* 0antin* your donor/s donor/s i+er i+er%> %> % =4o you 0ant 0ant to see your your dau*'ter dau*'ter on 'er 'er 0eddin* 0eddin* day3> day3> d% MT'e 'id 'id in your your 0o&! is is a *i,t *i,t to your your ,a&iy ,a&iy%> $F%Nurse "uy attends to ey 0'o is a +iti& o, *an* rape t0o days a*o% Her &ot'er 'ad no idea unti s'e notied 'er dau*'ter/s uneasiness and srea&in* at ni*'t% T'e &ot'er 0ants so&et'in* to !e done to 'er dau*'ter t'at oud pre+ent oneption% Nurse "uy no0s t'at !y doin* 0'at is re8uested# it oud eit'er pre+ent oneption or it oud indue a!ortion i, t'ere is aready a union !et0een e** e and sper& sp er& e% T'is senario is a diret in+o+e&ent o, t'is et'ia prinipe a% :era eraity ity !%
&ediation# ?r% ?r% Ii*o is 0it' 'is 'aris&ati partners and sin*in* son*s o, praise% 1'i' o, t'e ,oo0in* s'oud Nurse S'eia do3 a% "ea+e "ea+e t'e roo& roo& and ao0 ao0 t'e t'e patient patient to 7nis' 7nis' 'is rituas rituas and and Lust in,or& t'e operatin* roo& !% Interrupt Interrupt and in,or in,or& & t'e patient patient t'at t'at t'e s'edue s'edue o, o, sur*ery sur*ery s'oud !e strity ,oo0ed% % Re Report port t'e 'aris& 'aris&ati ati partners partners to t'e super+iso super+isorr so t'at t'ey t'ey 0i !e ased to ea+e% d% Stay in t'e t'e roo& roo& unti t'e ritua ritua is done done and t'en t'en i&&ediatey i&&ediatey *i+e t'e preoperati+e &ediation% 2$%Nurse ?ya entered to*et'er 0it' 4r% 4r% "arena in t'e ne0y ad&itted patient/s roo&% 4r% 4r% "arena in,or&s t'e patient o, 'er ondition# 'er treat&ent protoo and t'e possi!e aternati+e treat&ents and possi!e pro*nosis% T'is proper disosure o, in,or&ation to t'e patient de&onstrates 0'i' o, t'e ,oo0in*3 a% Tota otait ity y !% Auto utono&y % 4o 4ou! u!e e E6e E6ett d% Co Con7 n7de dent ntia iai ity ty 22%In ases o, e&er*eny# 0'i' o, t'e ,oo0in* pro,essionas an &ae a deision ,or t'e patient in ase t'e patient is unonsious and is in i,e anddeat' situation3 a% Nurse !% Atte Attendi ndin* n* P'ys P'ysi iia ian n % C'apain d% Hosp Hospit ita a/s /s a0y a0yer er 29%1'i' o, t'e ,oo0in* patients are apa!e o, *i+in* an in,or&ed onsent $% ?arrie ?arried d e&an e&anipa ipated ted &inor &inor 2% Bind ind adut dut 9% A &ani &anidep depre ressi ssi+e +e pati patient ent @% 2. yea yearr od od &ute &ute pati patient ent a% $#2#9 !% $#2#@ % $ ony d% None None o, t'e t'e a!o a!o+e +e%% 2@%Nurse Rupert no0s t'at an in,or&ed onsent is i&portant !eause it protets !ot' t'e patient and t'e 'ospita ,or potentia a0suit% 1'i' o, t'e ,oo0in* are e5eptions to in,or&ed onsent3 $% Co&pusory Co&pusory trea treat&ent t&ent is is &andated &andated !y a ourt order order 2% I, patient patient rein8uis'e rein8uis'es s t'e ri*'t to onsent onsent 9% E&er E&er*e *en ny y ase ases s @% T'e patie patient nt is an e&an e&anip ipate ated d &inor &inor a% !% % d%

$ and 9 $#2#9 2#9#@ $#9#@

2.%T'e ,oo0in* senarios s'o0 t'e appiation o, t'e prinipe o, Lustie e5ept one% 1'i' one is it3 a% Propery Propery disosi disosin* n* o, in,or&atio in,or&ation n re*ardin* re*ardin* t'e proedure proedure and &aintainin* anony&ity o, resear' su!Lets on a!ortion !% Pro+idin Pro+idin* * aessi!e aessi!e 8uaity 8uaity 'eat' are are ser+ie ser+ie ,or a patients patients % ?ae ?ae a+aia!e a+aia!e t'e t'e 'eat' 'eat' resoure resoures s aordin* aordin* to t'e needs needs re*ardess o, soia status d% None None o, o, t'e t'e a!o a!o+e +e 2%4r% 2%4r% a&ora ordered a &ediation to !e *i+en intra&usuary on t'e ri*'t detoid o, ?rs% Noaso% Nurse Ro0ena no0s t'at ?rs% Noaso is post ri*'t ?R?% 1'i' o, t'e ,oo0in* s'oud Nurse Ro0ena do3 a% Doo0 Doo0 t'e t'e order order% It is not ontra ontraindia indiated% ted% !% Gi+e t'e &ediation &ediation on t'e t'e e,t e,t detoid% detoid% % Gi+e t'e t'e &ediatio &ediation n on t'e e,t e,t detoid detoid and and dou&ent dou&ent it on t'e t'e patient/s 'art% d% In,or& In,or& 4r% 4r% a&ora a&ora t'at ?rs% ?rs% Noaso Noaso is is post ri*'t ri*'t ?R? and ari,y t'e order% 2% A patient is s'edued ,or open redution interna 75ation o, t'e ri*'t ar&% He 'as to si*n an in,or&ed !e,ore proeedin* 0it' t'e operation%  T'e ,oo0in* state&ents are are true re*ardin* in,or&ed onsent e5ept e5ept $% A,ter A,ter si*nin* si*nin* t'e in,or&ed in,or&ed onsent# onsent# t'e patient patient an an not turn !a !a 2% T'e 0i,e 0i,e an onsent onsent ,or ,or t'e patient patient 0'o is in t'e !at'roo&% !at'roo&% 9% T'e aternat aternati+es i+es s'oud s'oud !e e5paine e5pained d 0e to t'e patient patient and and 'is 0i,e @% I, t'e patient patient re,uses re,uses to to *i+e onsent onsent## t'e attendin attendin* * p'ysiian p'ysiian s'oud persuade 'i& to pus' t'rou*' 0it' it% a% $#2#9 !% $#9#@ % $#2#@ d% 2#9#@ 2F%Nurse "esie 0ors in t'e sur*ia 0in* o, a !i* tertiary 'ospita% E+ery ti&e ea' o, 'er assi*ned patients is !rou*'t ,or sur*ery# s'e is ased to 0itness an in,or&ed onsent ,or sur*ery% sur*ery% "esie no0s t'at 0'at s'e is 0itnessin* is t'at t'e a% Patient atient si*n si*ns s t'e ons onsent ent ,or ,or& & !% In,or In,or&ed &ed ons onsent ent too too pae% pae% % Da&iy a&iy onsent onsented ed to t'e pro proedur edure% e% d% Pa Patient tient 0as 0as ,uy ,uy in,or&e in,or&ed d a!out a!out t'e proedur proedure e 2%Nurse Ba!y 0ors on t'e pediatri unit and is *i+in* &ediations at $--- a&% S'e enters t'e roo& o, a patient# as t'e patient !y na&e# 'es t'e na&e !and ,or auray and ad&inisters an ora +ita&in% A,ter A,ter t'e patient s0ao0s t'e t' e pi# t'e &ot'er states t'at t' at anot'er nurse 'as aso *i+en 'er t'is sa&e pi an 'our a*o% Nurse Ba!y 'es t'e &ediation reord and 7nds t'at anot'er nurse 'as si*ned o6 on t'e dru* entry% entry% T'e &ost appropriate ation !y t'e nurse is to to a% Su!&it an an inident inident report report desri!i desri!in* n* t'e iru& iru&stan stanes es o, t'e &ediation error%

!% Report Report t'e 7rst 7rst nurse to t'e nurse nurse &ana*er &ana*er ,or not not in,or&in* in,or&in* t'e t'e &ediation nurse t'at a dru* 'ad !een *i+en% % Noti,y Noti,y t'e t'e patient/ patient/s s p'ysiian p'ysiian and as as ,or ,or ad+ie% ad+ie% d% 4o not'in*# not'in*# !eause !eause t'e patient patient 0as not 'ar&e 'ar&ed d !y t'e seond seond +ita&in% 9-%Nurse# T'e &ost appropriate repy o, 1iia& 0oud !e a% =I a& respons responsi!e i!e ,or ,or t'e 'eat' 'eat' o, ot'er ot'er peope peope as 0e 0e so I/& I/& sorry !ut I an/t eep your seret%>

!%

=No pro!e&# pro!e&# you an an te &e% &e% Our ode ode o, et'is et'is pre+ents pre+ents &e &e ,ro& tein* anyone%> % =I 0i 0i not te te anyone anyone 0'o does does not need need to no0% no0% But i, it it is i&portant to your 'eat' or to so&eone ese/s 'eat'# I &ay 'a+e to te anot'er person% = d% =1'y not% not% Jou Jou an te te &e anyt'in*# anyt'in*# you no0 no0%> 9.%Heen Ta&ayo# Ta&ayo# RN reei+ed 'er eduation ,ro& a at'oi nursin* s'oo% S'e no0s t'at a nurse is &oray opposed to a!ortion at any ti&e durin* pre*nany% pre*nany% 1'i' state&ent !est desri!es t'e nurse/s responsi!iity reated to t'is !eie,3 a% S'e &ay deine deine to partiipa partiipate te in a!ortion a!ortions# s# !ut &ust are are ,or ,or 0o&en a,ter t'e proedure% !% S'e &ust &ae &ae t'is t'is position position no0n no0n !e,ore !e,ore !ein* !ein* e&poyed e&poyed at at an a*eny t'at pro+ides a!ortions% % S'e &ust &ust pro+ide pro+ide t'e t'e sa&e are are ,or 0o&en 0o&en under*oi under*oin* n* a!ortion a!ortion proedures as ,or any ot'er 0o&an% d% S'e annot annot aept aept e&poy&ent e&poy&ent in any a*eny a*eny t'at t'at &ay pro+ide pro+ide a!ortion ser+ies% 9%Nurse ?aou is one o, t'e nurses ,or t'e ni*'t s'i,t in t'e e&er*eny roo&% S'e e+auates se+era patients 0'o 'a+e ' a+e o&e into t'e e&er*eny depart&ent% 1'i' o, t'e ,oo0in* patients s'oud ?aou *i+e 'i*'est priority3 a% An edery edery 0o&an 0o&an 0'o is o&pa o&painin* inin* o, o, a oss o, o, appetite appetite and ,ati*ue ,or t'e past 0ee% !% A &ot'er &ot'er 0it' 'er @yea @yearrod son 0'o 'as 'as !een o&pa o&painin* inin* o, nausea and 'as +o&ited one sine  in t'e e+enin*% % A ,oot!a ,oot!a payer# payer# i&pin* i&pin* and o&paini o&painin* n* o, pain pain and s0ein* s0ein* on 'is ri*'t ane% d% A @- yearod yearod &an# diap'or diap'oreti eti and o&pai o&painin* nin* o, se+ere se+ere 'est 'est pain radiatin* to 'is La0% 9%A nurse no0s t'at in ti&es o, e&er*eny and disaster# in order to pre+ent &ass 'ysteria and ,renKy# t'e nurse s'oud are 7rst ,or t'ose 0'o s'o0 si*ns o, a% Eup' Eup'o oria !% Pani % 4e 4epr pres essi sion on d% Addi ddittion ion 9F%1'en arin* ,or patients eit'er ,or or*an donation or reeption# 0'at s'oud !e inuded in nurses/ response 0'en t'e patient ass ,or ,atua in,or&ation a!out !eo&in* an or*an donor3 a% T'ere T'ere are so&e so&e ontraindia ontraindiations tions ,or ,or !ein* an or*an or*an donor% donor% !% A donor donor an !e o, any a*e% a*e% % Da&iy &e&!ers &ust aso aso *i+e *i+e t'eir t'eir onsent onsent%% d% :er!a er!a onsen onsentt 0oud 0oud !e enou* enou*'% '% 9%Nurse
,oo0in* is t'e !est reason to inude in ude ,a+orite or uturay re8uired ,ood in t'e diets o, patients ,ro& utures ot'er t'an t'e do&inant one3 a% So t'at t'at patient patient 0i 0i not not !e easiy easiy a*itated%% a*itated%% !% In order order to &ae &ae t'e patient patient ,ee t'e t'e aeptane aeptane o, o, 'is rei*ious rei*ious or utura !eie,s % In order order to *et *et t'e t'e oopera ooperation tion o, t'e t'e patient patient d% So t'at t'at &anutritio &anutrition n 0i 0i !e pre+e pre+ented nted @-%Jou @-%Jou are arin* ,or Hindu patient 0it' a se+ere nerotiKin* uer o, t'e o0er ri*'t e*% He re,uses to under*o sur*ery !eause o, rei*ious !eie,s re*ardin* reinarnation% reinarnation% T'e p'ysiian 0i s'edue s'ed ue a !eo0 nee a&putation o, t'e ri*'t e*% 1'i' o, t'e ,oo0in* is t'e &ost appropriate nursin* inter+ention3 a% ?eet 0it' t'e ,a&i ,a&iy y and disuss disuss t'e issue% !% Enoura*e Enoura*e t'e patient patient to to 'a+e t'e t'e sur*ery sur*ery !eause !eause it is ,or ,or 'is o0n *ood% % In,or& In,or& t'e patient patient o, t'e ot'er ot'er options options a+aia!e% a+aia!e% d% 4isuss 4isuss t'e rei*ious rei*ious !eie, !eie,s s and onerns onerns o, t'e patient patient 0it' 0it' t'e p'ysiian% @$%Nurse 1'at is Nurse 4ennis/ !est ! est response3 a% =1oud =1oud you ie ie to ta ta to your &inister &inister a!out a!out t'e si*ni7a si*ni7ane ne o, deat'3> !% =I no0 you you are are tired tired o, 7*'tin* 7*'tin* t'is iness iness## !ut deat' deat' 0i o&e o&e in due ti&e%> % =1oud =1oud you you ie ie to ta ta to a psy'oo psy'oo*ist *ist a!out a!out your t'ou*'ts t'ou*'ts and ,eein*s3> d% =1oud =1oud you you ie ie to &eet 0it' your your ,a&iy ,a&iy and your p'ysi p'ysiian ian a!out t'is &atter3> @9%Nurse
ea+e a*ainst &edia ad+ie and re,uses to si*n t'e paper0or% 1'i' o, t'e ,oo0in* ations is t'e ne5t n e5t t'in* ss%> !% =Hod =Hod on ,or ,or a &o&ent# &o&ent# I/ I/ *et t'e na&e na&e and teep'on teep'one e nu&!er o, 'er p'ysiian%> % =I/ =I/ Lust Lust te te 'er to a a you%> you%> d% =I/& sorry sorry I an an not on7r& on7r& 0'et'er 0'et'er your your e&poyee e&poyee is a patient patient 'ere%> @F%Nurse
a% Tae &easur &easures es to pre+ent pre+ent t'e patient patient ,ro& ,ro& ea+in* ea+in* !% Noti, Noti,y y t'e p'ysi p'ysiia ian n o, t'e pati patient% ent% % Re8uest e8uest t'e pati patient ent to si*n si*n a 4A?A 4A?A ,or ,or&% &% d% Ca t'e seurit seurity y to 'ep detain detain t'e patient patient @%Nurse p3> !% =4o =4o you 'a+e ,re8uent ,re8uent episod episodes es o, 'eada'e3> 'eada'e3> % =4o =4o you e+er e+er e5peri e5perien ene e 'est 'est pain3> pain3> d% =4o =4o you 'a+e any diu diuty ty in !reat'in*3 !reat'in*3> > .2%Nurse "eda is assi*ned to a patient 0'o is reenty dia*nosed 0it' ooreta ooreta aner% T'e p'ysiian/s treat&ent protoo ,or t'e patient is !o0e resetion and $2 yes o, 'e&ot'erapy% 'e&ot'erapy% T'e patient p atient ass Nurse "eda i, s'e oud try so&e o&pe&entary t'erapies% 1'i' o, t'e ,oo0in* is t'e appropriate response o, Nurse "eda3 a% =T'ere =T'ere are &any &any di6erent di6erent ,or&s ,or&s o, o&pe&ent o&pe&entary ary t'erapies% t'erapies% "et/s ta a!out t'ese t'erapies%> !% MI a& sorry !ut !ut no# !eause !eause it 0i 0i intera interatt 0it' t'e t'e 'e&ot'erapy%> % =I 0oud 0oud try anyt'in anyt'in* * t'at I oud i, I 'ad 'ad aner aner%> %> d% =Jou =Jou need to as your p'ysiia p'ysiian n a!out a!out it%> .9%A nurse in t'e station 'ears a patient ain* out ,or 'ep% 1'en t'e nurse arri+es# s'e sa0 t'at t'e patient in yin* on t'e oor% oor% S'e 'eped t'e patient *et up and 0ent !a to !ed% 1'i' o, t'e ,oo0in* entries s'oud !e 0ritten in t'e inident report3 a% T'e patien patientt sid sid ,ro ,ro& & t'e t'e !ed !ed !% T'e patient patient i&!ed i&!ed t'e t'e raised raised side rais rais and ,e ,e on 'er 'er !utt%

% T'e patie patient nt 0as ,oun ,ound d yin* yin* on t'e t'e oor oor% d% T'e patient patient seep0a seep0aed ed and and sipped sipped in 'is !eddin*s !eddin*s do0n do0n to t'e oor% .@%1'en a nurse 0rites e*i!y and o&petey into t'e patient/s 'art# s'e o!ser+es 0'i' o, t'e ,oo0in* et'ia prinipes3 a% Pri+ay !% :era eraity ity % In,o In,or& r&ed ed Con Conse sent nt d% Auto utono&y ..%1'en a nurse taes !ene7ent ations in t'e per,or&ane o, any nursin* proedure and pro+ides t'e needed e&otiona support o, t'e patient# 'e up'ods 0'i' o, t'e ,oo0in*3 a% Pri+ay !% Auto utono&y % Non Non&a &ae e7 7en ene e d% Bene7 ene7 ene ene .%Prudene is +ery i&portant durin* &ediation ad&inistration to a+oid or essen errors 0'i' resuts to un,a+ora!e reations o, t'e &ediation% "a o, prudene in dru* ad&inistration +ioates 0'i' o, t'e ,oo0in* ideas3 a% =I 0i 0i !e ,ait',u ,ait',u to t'e patient patient/s /s are%> are%> !% =I 0i 0i a+oid a+oid anyt'i anyt'in* n* 'ar&,u 'ar&,u to to t'e patient%> patient%> % =I 0i 0i a+oi a+oid d doin* doin* *ood *ood to t'e t'e patie patient% nt%> > d% =I 0i 0i !e 'one 'onest st in &y &y patien patientt are are%> %> .%As Nurse Grae reports to t'e nursin* super+isor t'at Nurse ?oy 'as !een drinin* ao'o !e,ore t'eir s'i,t# s'e appies 0'i' o, t'e ,oo0in* prinipes3 a% Auto utono&y !% In,o In,or& r&ed ed Co Cons nsent ent % Non Non&a &ae e7 7en ene e d% Co Con7 n7de dent ntia iai ity ty .F%As t'e nurse ,ae et'ia die&&as# t'e prinipe o, non&ae7ene s'oud !e re&e&!ered ,or it &eans a% 4o *ood !% Be trut trut', ',u u % Be di disr sree eett d% 4o no 'ar 'ar& .%1'i' o, t'e ,oo0in* pro,essionas 'as t'e ri*'t to a t'e deat' o, a potentia or*an donor3 a% T'e T'e 'os 'ospit pita a a0ye a0yerr !% Atte Attendi ndin* n* P'ys P'ysi iia ian n % ?edi ?edi o oe*a e*a d% Transpa ranspant nt Sur*eo Sur*eon n -%T'e ,oo0in* are t'e 8uaities 8 uaities o, a ,uy &ature and responsi!e onsiene% 1'i' one is not3 a% Caous !% Cear % Certain

d% Dree $%1'i' o, t'e ,oo0in* s'oud !e onsidered !y t'e nurse in 'is et'ia pratie3 $% O0n +a +aues 2% :aue aues s o, o, ot' ot'er ers s 9% Nurs Nursin in* * Code Code o, o, Et'i Et'is s @% I&port I&portan ane e o, o, Dre Dreedo edo& & a% $#2#9 !% 2#9#@ % $#9#@ d% A A o, o, t'e t'e a!o+ a!o+e e 2%T'e !asis ,or Hu&an 4i*nity is su&&ariKed in t'e Hoy Sriptures and is no0n as a% Nati Nati+i +ity ty o, o, t'e t'e "or "ord d !% Sa+ Sa+at atio ion n His Histo tory ry % Di* Di*'t 't to E*yp E*yptt d% Ge Gene nesi sis s eno enount unter er 9%1'i' o, t'e ,oo0in* is not a ondition t'at appies ,or t'e Prinipe o,   Totaity3  Totaity3 a% T'at t'e t'e da&a*e da&a*e !ein* a+oided a+oided to t'e t'e 0'oe !e proporti proportiona ona to t'at 0'i' is aused !y t'e &utiation o, t'e part% !% T'at t'e part part potentia potentiay y in+o+es in+o+es t'e patient patient into &edia &edia riss in t'e ,uture % T'at t'ere t'ere is no ot'er ot'er 0ay 0ay t'an tain* tain* t'e indiat indiated ed ation ation a*ainst it o, o!tainin* t'e desired *ood resut% d% T'at su' su' or*an or*an or part# !y !y its deterior deterioratio ation n in ,untion# ,untion# &ay &ay ause da&a*e to t'e 0'oe or*anis& or at east pose a serious t'reat to it% @%I, t'e sur*ery did not pus' t'rou*' as stated in t'e onsent# 0'i' o, t'e ,oo0in* s'oud !e done3 a% Re Report port t'e sur*eon sur*eon to t'e t'e 'ospita 'ospita e*a e*a ounse ounse !% Use t'e sa&e sa&e onsent onsent ,or&% ,or&% It asts asts unti unti t'e proedu proedure re is done% done% % O!tain O!tain anot anot'er 'er ons onsent ent ,or ,or anot' anot'er er day day d% Put a ine ine aross aross t'e t'e date and and ti&e o, o, t'e si*ned si*ned onsent onsent o, t'e t'e postponed sur*ery# ri*'t t'e ne0 date and ti&e and a5 your si*nature .%1'en a patient does not intend to eat ,ood or tae &ediations# a +ioation is o&&itted a*ainst 0'i' et'ia prinipe3 a% Bene7 ene7 ene ene !% 4o 4ou! u!e e E6e E6e t % Ste0ar Ste0ards' ds'ip ip and Creat Creati+i i+ity ty d% Auto utono&y %Nurse Gina re,rains ,ro& disussin* t'e in,or&ation re*ardin* 'er patient 0it' AI4S 0it' t'ose 0'o are not direty in+o+ed 0it' t'e patient/s are% 1'i' o, t'e ,oo0in* prinipes is appied !y Nurse Gina3 a% Bene7 ene7 ene ene !% Tota otait ity y

% Non Non&a &ae e7 7en ene e d% In,o In,or& r&ed ed Co Cons nsent ent %Nurse Pau is arin* ,or a patient 0'o is ,or ad&ission due to aute &yoardia in,artion% in,artion% T'e patient ardenty re,uses to !e ad&itted and 0is'es to !e trans,erred to t'e 'arity di+ision o, t'e sa&e 'ospita% In &ain* t'e ri*'t response# Nurse Pau s'oud utiiKe 0'i' o, t'e ,oo0in* prinipes3 a% Pri+ay !% Auto utono&y % Bene7 ne7ene d% Ste0ar Ste0ards' ds'ip ip and and Cre Creati ati+it +ity y F%Nurse 1esey is arin* ,or a patient in isoation in t'e psy'iatri p sy'iatri unit o, a 'ospita% 4urin* t'e +ita si*ns tain*# t'e patient re,uses to !e tou'ed% Nurse 1esey s'outs at t'e patient and tes 'er t'at s'e 0i !e restrained i, s'e does not ooperate% 1'i' o, t'e ,oo0in* an Nurse 1esey !e 'ar*ed 0it'3 a% Ne* e*i*en i*en e !% ?ap ?apra rat ti ie e % Assaut d% Battery %A person ,ro& t'e p'ar&ay 0as au*'t !ro0sin* o+er t'e 'arts o, so&e patients% T'e &ost appropriate nursin* ation 0oud !e a% I*nore I*nore it !eause !eause p'ar&ai p'ar&aists sts are are part o, t'e t'e 'eat' 'eat' tea&% !% In,or& In,or& t'e seurity seurity oe oe o, t'e t'e inident inident%% % Na* at t'e p'ar&ais p'ar&aistt !eause !eause readin* readin* patients patients 'art 'art is unet'ia% d% Te t'e p'ar&ai p'ar&aist st t'at 0'at 'e is doin* is inappro inappropriat priate e !eause ony t'ose persons in diret in+o+e&ent to t'e patient are are aut'oriKed to read t'e 'arts% -%In a 7rst ass 'ospita in ?aati# nurses ,ro& A,ria A,ria 0ere ao0ed to pratie due to reiproity% A *roup o, nurses 0ere 0 ere 'a+in* t'eir o6ee !rea 0'en one o, t'e& opened t'e issue t'at !as s'oudn/t !e ao0ed to 0or 'ere !eause t'ey do not 'a+e &u' no0ed*e and sis as t'ey do% Hearin* t'at# 0'at s'oud !e t'e proper response3 a. “I think ethnic ethnicity ity has nothin nothing g to do with a person’ person’s s performan performance ce of quality health care.”  b. “Hahaha, “Hahaha, you are are so right. right. They should should study study more here here in our country.”  c. “Hey, “Hey, don’t be be that mean. mean. Those Those creatur creatures es might might hear you. you. Haha.”  d. “hut “hut up! They are are better becaus because e "frica "frica is home to thousan thousands ds of diseases.”  $%Nurse A!ra'a& no0s t'at t'e uti&ate destiny o, 'u&an !ein*s is a% 1ord ord Pea eae e !% Interna Interna and E5tern E5terna a Tran8uiity ran8uiity % "i+in* "i+in* in in peae peae and 'ar&o 'ar&ony ny 0it' 0it' t'e soie soiety ty d% Reunitin eunitin* * 0it' 0it' t'e t'e Cre Creato atorr

2%T'e ,oo0in* situations e5'i!it ino'erene 0it' t'e Prinipe o, Ste0ards'ip and Creati+ity !ut one% 1'i' one is it3 a% Panned Panned a&put a&putati ation on o, a dia!et dia!eti i ,oot ,oot !% A ee!rity ee!rity under*oin* under*oin* a!ortio a!ortion n to preser+e preser+e 'er i&a*e i&a*e % Burnin* Burnin* do0n t'e t'e ,orest ,orest to 'asten su!di+ision su!di+ision de+eop de+eop&ent &ent d% S&u**in* S&u**in* stray do* &eat &eat ,or ap'rodi ap'rodisia sia deia deiay y% 9%1'en deain* d eain* 0it' an e&er*eny ase 0'ere t'ere are no reati+es present# 0'o 0i deide ,or t'e patient3 a% Nurse Nurse in' in'ar ar*e *e o, t'e pati patient ent !% Hospit Hospita/ a/s s "e*a "e*a Couns Counse e % Atte Attendi ndin* n* P'ys P'ysi iia ian n d% Anyo Anyone ne o&p o&pet eten entt enou* enou*' ' @%1'i' o, t'e ,oo0in* para&eters &aes a 0ritten onsent +aid and e*a3 a% T'e pati patient ent is in in t'e e*a e*a a*e% a*e% !% T'e patient patient is did did not tae tae any any ao'o ao'o and ie*a ie*a dru*s dru*s % T'e patient patient/s /s onsent onsent s'oud s'oud not !e a8uire a8uired d 0it' duress duress and oerion d% A A o, o, t'e t'e a!o+ a!o+e% e% .%T'e 0ritten onsent ,or in+asi+e proedures ie sur*eries is *ood ,or 'o0 &any days3 a% $ day !% 2 days % . days d% It depen depends ds on t'e t'e ir iru&st u&stan anes% es% %A $@year od teena*er 'as under*one e&er*eny appendeto&y% appendeto&y% Her nurse# Toni# Toni# 0'o auratey and puntuay dou&ents 'er are on 'is 'art# e5'i!its 0'i' o, t'e ,oo0in*3 a% Prude udene ne !% :era eraity ity % Co Con7 n7de dent ntia iai ity ty d% Ge Gene nerrosi osity %A dyin* yearod &ae re8uests to !e sedated so t'at 'e 0on/t ,ee t'e pain a o+er 'is !ody% !ody% Nurse Genda no0s t'at 0'ene+er sedati+es are *i+en# t'e patient/s ondition deteriorates ,urt'er t'us s'ortens 'is i,e% 1'i' et'ia prinipe prin ipe responds to t'is situation3 a% Non Non&a &ae e7 7en ene e !% Bene7 ene7 ene ene % Tota otaiity d% 4o 4ou! u!e e E6e E6e t F%1'en Nurse Bar!ara in,or&s 'er super+isor t'at s'e sa0 Nurse Prine tain* estasy ri*'t !e,ore t'eir s'i,t# s'e e5'i!its 0'i' o, t'e ,oo0in*3 a% Tota otait ity y !% Auto utono&y % Non Non&a &ae e7 7en ene e d% Se5ua Se5uaity ity A0arene 0areness ss %1'i' o, t'e ,oo0in* situations s'o0s pro&otion o, *ood to patients3

$% 2% 9% @%

Ad&in Ad&inist isteri erin* n* ana*e ana*esi sis s Pro+idin Pro+idin* * 'oisti 'oisti are are to t'e patient patient Ao0in* Ao0in* t'e patient patient to to read read *reetin* *reetin* ards ards ,ro& ,ro& ,riends ,riends Gi+in* Gi+in* &ediation &ediation 'ours 'ours earier earier t'an t'e t'e s'edue s'edue to sa+e sa+e ti&e%

a% $#2#9 !% $#2#@ % $#9#@ d% A A o, o, t'e t'e a!o a!o+e +e%% F-%Nurse Cynt'ia 0as ased to oat in t'e pediatri intensi+e are unit (PICU) !eause t'e unit is understa6ed% Nurse Cynt'ia is not ,a&iiar 0it' t'e settin* and proedures done in t'e PICU% 1'i' o, t'e ,oo0in* is t'e &ost appropriate ation o, Nurse Cynt'ia3 a% Be asserti+e asserti+e and and report report to t'e PICU PICU and per,or per,or& & t'eir usua usua tass ,or patient are is *enera in a types o, units% !% Courteousy Courteousy re,use re,use t'e assi*n&ent assi*n&ent to to t'e unit % "oo "oo ,or t'e t'e Nursin* Nursin* Super+isor Super+isor and and su!&it su!&it an inident inident report report d% Re Report port to t'e PICU PICU and in,or in,or& & t'e 'ar*e 'ar*e nurse o, o, t'e proedures s'e an sa,ey per,or&% F

%$