Legal and Ethical Conduct
As emphasized in this week’s media presentation, all nurses need to be familiar with the laws and regulations that govern their practice: their state’s Nurse Practice Act, ANA’s Nursing: Scope and Standards of Practice, specialty group standards of practice, etc. In addition, basic ethical principles guide nurses’ decision-making process every day. ANA’s Code of Ethics and ANA’s Social Policy Statement are two important documents that outline nurses’ ethical responsibilities to their patients, themselves, and their profession. This said, there is a dilemma: The laws are not always compatible with the ethical positions nurses sometimes take. This week’s Discussion focuses on such a dilemma. Legal and Ethical Conduct
To prepare:
Review this week’s Learning Resources, focusing on the information in the media presentation about the relationship between the law and ethics.
Consider the ethical responsibility of nurses in ensuring patient autonomy, beneficence, non-malfeasance, and justice.
Read the following scenario:
Lena is a community health care nurse who works exclusively with HIV-positive and AIDS patients. As a part of her job, she evaluates new cases and reviews confidential information about these patients. In the course of one of these reviews, Lena learns that her sister’s boyfriend has tested HIV positive. Lena would like to protect her sister from harm and begins to consider how her sister can find out about her boyfriend’s health status.
Consult at least two resources to help you establish Lena’s legal and ethical position. These resources might include your state’s Nurse Practice Act, the ANA’s Code of Ethics, ANA’s Nursing: Scope and Standards of Practice, and internal or external standards of care. Legal and Ethical Conduct
Consider what action you would take if you were Lena and why.
Determine whether the law and the ANA’s standards support or conflict with that action.
Post a description of the actions you would take in this situation, and why. Justify these actions by referencing appropriate laws, ethical standards, and professional guidelines.
Required Readings
Milstead, J. A. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones and Bartlett Publishers.
Chapter 4, “Government Response: Regulation” (pp. 56-81)
This chapter explains the major concepts of the regulation of health professionals, with emphasis on advanced practice nurses (APN) and the process of licensure and credentialing.
ANA’s Foundation of Nursing Package – (Access this resource from the Walden Library databases through your NURS 6050 Course Readings List) Legal and Ethical Conduct
Guide to the Code of Ethics: Interpretation and Application
This guide details the history, purpose and theory, application, and case studies of this must-have Code of Ethics.
Nursing Social Policy Statement
The Nursing Social Policy Statement provides an understanding of the social framework and obligations of the nursing profession.
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Nursing: Scope & Standards of Practice
This book contains several national standards of practice that can be used to inform the decision-making process, development, implementation, and evaluation of several functions and aspects of advanced practice nursing.
Nursing’s Social Policy Statement: The Essence of the Profession (ANA, 2010, p. 3) builds on previous work and provides the following contemporary definition of nursing: Legal and Ethical Conduct
Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.
This definition serves as the foundation for the following expanded description of the Scope of Nursing Practice and the Standards of Professional Nursing Practice.
Professional Nursing’s Scope and Standards of Practice
A professional nursing organization has a responsibility to its members and to the public it serves to develop the scope and standards of its profession’s practice. As the professional organization for all registered nurses, the American Nurses Association (ANA) has assumed the responsibility for developing the scope and standards that apply to the practice of all professional nurses and serve as a template for nursing specialty practice. Standards do, however, belong Legal and Ethical Conduct
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to the profession and, thus, require broad input into their development and revision. Nursing: Scope and Standards of Practice, Second Edition, describes a competent level of nursing practice and professional performance common to all registered nurses.
Description of the Scope of Nursing Practice
The scope of practice statement describes the “who,” “what,” “where,” “when,” “why,” and “how” of nursing practice. Each of these questions must be answered to provide a complete picture of the dynamic and complex practice of nursing and its evolving boundaries and membership. The profession of nursing has one scope of practice that encompasses the full range of nursing practice, pertinent to general and specialty practice. The depth and breadth in which individual registered nurses engage in the total scope of nursing practice are dependent on their education, experience, role, and the population served.
Development and Function of Nursing Standards
The Standards of Professional Nursing Practice are authoritative statements of the duties that all registered nurses, regardless of role, population, or specialty, are expected to perform competently. The standards published herein may serve as evidence of the standard of care, with the understanding that application of the standards depends on context. The standards are subject to change with the dynamics of the nursing profession, as new patterns of professional practice are developed and accepted by the nursing profession and the public. In addition, specific conditions and clinical circumstances may also affect the application of the standards at a given time, e.g., during a natural disaster. The standards are subject to formal, periodic review and revision. Legal and Ethical Conduct
The Function of Competencies in Standards
The competencies that accompany each standard may be evidence of compliance with the corresponding standard. The list of competencies is not exhaustive. Whether a particular standard or competency applies depends upon the circumstances. For example, a nurse providing treatment to an unconscious, critical patient who presented to the hospital by ambulance without family has a duty to collect comprehensive data pertinent to the patient’s health (Standard 1. Assessment). However, under the attendant circumstances, that nurse may not be expected to assess family dynamics and impact on the patient’s health and wellness (Assessment Competency). In the same circumstance, Standard 5B. Health Teaching and Health Promotion may not apply at all Legal and Ethical Conduct.
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