chapter 21 Flashcards

(71 cards)

1
Q

which healthcare profession promotes advocacy

A

nursing

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2
Q

what must nurses learn to advocate

A

the system in which patient care occurs

- learn the reason for and patient’s expectations for the visit

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3
Q

when does the nursing assessment begin and end

A

begin at the first interaction with patient

continue through entire patient contacte period

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4
Q

where does the word advocacy come from

A

the Latin word advocate

meaning “to call to one’s aid”

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5
Q

what does it mean to advocate

A

come to his or her aid OR give voice to his or her concerns

  • protect patient privacy
  • ensure that patient has a voice in decision making
  • protect patient from unethical and illegal practice
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6
Q

where is advocacy mentioned in nursing

A

the ANA, Code of Ethics for Nurses with Interpretive Statements (2001)

CNA, Code of Ethics for Registered Nurses (2002)

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7
Q

Who was the earliest nurse ethicist

A

Myra Levine

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8
Q

what did Myra Levin do

A

describe every interaction between a nurse and patient as a MORAL INTERACTION

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9
Q

what can the nurse do for a patient

A

run interference

- educate patient and remove barriers so patient achieves desired goals

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10
Q

who is in control of a hc situation, why

A

the nurse

  • has information the patient does not have
  • knows what the patient has to do and where he/she has to go
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11
Q

what two traits do nurses use for moral interactions

A

respect and competency

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12
Q

who gets the final decision

A

the patient

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13
Q

what two types of goals are there in helathcare

A

goals created by hc provider AND patient

goals created by hc provider and not endorsed by patient

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14
Q

what can a nurse do between a hc doctor and patient

A

facilitate a conversation

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15
Q

how can the nurse conduct research regarding advocacy

A

library
internet
personal contacts

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16
Q

what does the nurses actions depend on (2)

A

standard of care

patients wishes and communicating with patient

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17
Q

how does the nurse advocate for a patient

A

providing patient with necessary information

facilitating decision making y talking with patient

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18
Q

what are the three parts of the therapeutic relationship between nurse and patient

A

allowing patient to

  • speculate
  • think out loud
  • use nurse as sounding board
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19
Q

what are some ways the nurse can advocate by avoiding preventable harms (at a minimum) (3)

A

maintaining competence in area of practice
using critical thinking skills
promoting health and safety of patients

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20
Q

what do individual acts of the nurse avoid

A

iatrogenic illness

- those caused by medical treatment or health care staff

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21
Q

what is advocacy of the patient based on (3)

A

autonomy
beneficence
non-maleficence

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22
Q

what do many patients, especially elder patients NOT do

A

question physician authority

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23
Q

describe nurse anchor

A
  • assigned to 73 yr old women with wound on foot
  • believes that patient needs pain medication before dressing changes
  • Dr.Carney tells patient he will hurry so that wound does not hurt very much, but does not give pain medication
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24
Q

what does advocacy require

A

analyze situation

decide what actions give patient a voice and advance his/her interests

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25
describe student nurse baker
- with 3 year old boy in playroom - med. student wants to perform examination on boy even though the playroom is considered a safe place and exam free zone
26
who coined the phrase doctor nurse game
stein
27
what is the doctor nurse game
describes deference on behalf of the nurse to the authority of the physician - the nurse makes it seem like the physician has arrived to the conclusion - nurses have a "fear" of physicians
28
What did savage, in 1995 say
that doctor nurse game is effective for patient advocacy
29
what is affected by the quality of nurse-physician relationships (2)
nurse job satisfaction | patient outcomes
30
what do new graduates believe causes anxiety
interacting with physicians
31
what is required for a nurse a physician on behalf of the patient
moral courage
32
why would the nurse NOT speak up
out of fear of the physician (verbal abuse) | out of concern for their relationship with the physician
33
what is one way a non-charge nurse can get the outcome they desire and believe is right
follow the chain of command in nursing structure
34
what four relationships impact patient care
relationships among | nurses, student nurses, physicians, medical students
35
what 3 factors result in complex issues in ehalthcare
hierarchy gender personalities
36
what is used as an excuse for the lack of civility in healthcare
the intensity of work
37
what 3 things should ensure effective communication and functional relationships
- respectful language - professional decorum - diplomacy
38
describe nursh ash
orthopedic resident is changing patients dressing when he contaminates sterile gloves nurse ash must inform the physician of the contamination and tell him to change his gloves
39
what are two reasons the physician did not change his gloves
did not notice | was anxious to complete the dressing
40
what are ethical issues embedded in (3)
clinical context where there are sociopolitical forces of - power - institutional culture - professional codes
41
how could issues in healthcare be described as
grey not black or white
42
what is an ethical uncertainty
question of whether a problem is an ethics problem | - usually when there are two unpleasant options
43
what did jameton, 1984 do (3)
describe ethical issues as uncertainty dilemma distress
44
how can nurses describe their feelings about a bad situation
articulate with "is not right" AND decide what is right
45
describe nurse hunt
home health care nurse - caring for Mr.Dash who had a stroke - realized that Mr.Dash has not been taking his antihypertensive and anticoagulant medications - Wants to inform the physician of his 230/150 blood pressure but Mr.Dash says no
46
describe nurse gorrell
caring for 82 yr old man with myocardial infarction and experiencing left heart failure - has DNR intern is running blood test for patient regardless of the DNR, bc the physician wants to know the potassium levels nurse gorrell believes this is unfair as it will cause the patient pain, discomfort, and extra money
47
what is a CQI commitee
continuous quality improvement committee - addresses palliative care for dying patients - both groups perspectives are listens to and mutually agreeable policy is enacted
48
what did Mallik and Rafferty, 2000, conclude in their bibliometric analysis of patient advocacy
nurses use advocacy to empower themselves
49
what did Foley, Minick, and Kee (2002) find
nurses learn advocacy in a haphazard manner dependent on situations - there are three methods of learning advocacy
50
what are the 3 ways nurses learn advocacy
1. identifying how the nurse learned to stand up for others,i n the past 2. watching how other nurses advocate 3. gaining confidence with experience, validation, and mentoring
51
what are the main roles of the ANA and CNA
advocate for health and welfare of citizens advocate for special patient populations advocate for advancement of nursing
52
what represents the professions expectations for ANA members
1991 ANA Code of Ethics for Nurses With Interpretative Statements
53
what does the 2001 ANA code discuss (2)
client patient interests | workplace issues
54
what is the goal of nursing
having a work environment that is conducive to optimal performance
55
what 2 things are critical to a nurses performances | and what 2 things must a nurse do?
staffing and worload determination priortize and delegate tasks
56
what two events does a nurse have to shift time and attention
- too many patients | - too many acutely ill patients
57
how can nurses adocate change
advocate for change - increase number of nurses - decrease patient census - refer acute patients to better staffed units
58
what group are nurses part of for advocacy
UAN, AFL-CIO United American Nurses merged with The American Federation of Labor and Congress of Industrial Organizations
59
what key issues affect patient health (3)
staffing workload delegation
60
what issues affect nurse safety and health
workplace violence sexual harassment avoidance of hazardous materials and situations
61
where does workplace violence occur
emergency department | psychiatric unit
62
what is a source of conflict between nurses and administrators
mandatory overtime | - usually in times of nursing shortages
63
what does fatigue lead to
errors | - that is why nurses should RESIST mandatory overtime
64
what is a conundrum in nurses
nurses will risk their lives to save their patients with overtime
65
what is an operative issue in healthcare
nurse judge whether they are capable of providing care during their shift during mandatory overtime, their judgement is unnecessary and they must remain on teh unit if they leave, they are accused of patient abandonment
66
what should each institution have
a definition on patient abandonment | - the nurses should have input into the transferring of care
67
what ethical principle is important for identifying unsafe situations
non maleficence
68
what are three important issues for discussion in nursing
educational preparation entry level for practice socialization
69
what are some workplace issues that should be addressed in facilities employing nurses
needle less intravenous systems latex allergy management work related disability benefits
70
what should be threeo focuses of advocacy for NURSES
on going education through in services formal education with tuition reimbursement paid release time to attend conferences
71
what did the ANA have 84 statements regarding in 2004
``` blood borne and airborne disease ethics and human rights social causes and health care drug and alcohol abuse nursing education, practice, research consumer advocacy and workplace advocacy use of unlicensed assistive personnel ```