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Updates to the new version of the Code of Ethics (3)

1) Stronger language which covers "preservation of integrity"
2) Navigating care for the dying patient -End of Life Care
3) Vigilance in the age of social media


In regards to Stronger language it has changed from: _____ express to ____ express

May express to Must express

When placed in circumstances that exceed moral limits...nurses MUST express to appropriate authority their conscientious objection. Previously stated "may express"


Example of Stronger Language)

If short staffing puts the nurse in jeopardy of providing unsafe care, the nurse should _______ ______ to providing care without more help.

Conscientiously object


What has changed with end of life care in regard to nurses role?

How do nurses feel in these situations?

Patients have the right to refuse treatment, and nurses SHOULD SUPPORT patients in that refusal, but MAY NOT PARTICIPATE IN ENDING OF LIFE.

Nurses often feel caught in the middle between patients, families, and physicians.


Bigger Picture

Nurses now have to
1) mandate to:
2) see beyond:
3) create:

1) mandate to work together nationally and globally to address social determinants of health, such as violence, poverty, homelessness, and abuse

2) see beyond the individual patient in the bed and look to outside factors that are causing the illness

3) Policy! Need for involvement in professional organization


What is an integral part of why nursing has been rated the top profession for honesty and ethical standards for the 13th consecutive year?

When was it updated last?

Our revised code of ethics



Why is the Code of Ethics important for nurses?

- Nurses make dozens of decisions about patient care every day.

- Making those decisions with *ethical considerations* in mind is increasingly challenging in the modern healthcare environment where technology and patient care are evolving at a rapid pace.


What are the 9 Provisions of the ANA Code of Ethics:

1) Affirming Health through Relationships of Dignity and Respect

2) The Patient as Nursing's Foundational Commitment

3) Advocacy Geography

4) The Expectations of Expertise

5) The Nurse as a Person of Dignity and Worth

6) The moral Milieu of Nursing Practice

7) Diverse contributions to the Profession

8) Collaboration to Reach the Greater ends

9) Social Justice: Reaching Out to a World in Need of Nursing


The Nine Provisions delineate the basis of our commitment and obligations to (3) while also assuring the:

Respect, Protect, and Advocate

Integrity of the Profession


What is the purpose of the Code of Ethics? (4)

1) The ANA guidelines to practice and decision making goals and obligations for practice for RN's in every role and setting

2) Will guide and support nurses as they face tough decisions from end of life care to involvement in social media

3) Succinct statement of the ethical values, obligations, duties, and professional ideals of nurses individually and collectively

4) Is the profession's non-negotiable ethical standard


Nurses obligations in regards to Vigilance in the age of Social Media:

To maintain patient confidentiality in work setting and off-duty in all venues, including social media, and other communication

Urged to maintain vigilance regarding postings, images, recordings or commentary


Accountability =

The state of being accountable, liable or answerable to oneself and others for one’s own choices. Decisions and actions as measured against a standard such as that established by the Code of Ethics.


Responsibility =

Can be shared- being responsible for yourself and others; state or fact of being responsible or accountable for something within one’s power, control or management. An obligation to perform required professional activities


Beneficence =

It often goes ____ what is required by _____?

The doing of good, compassion. The bioethical principle of benefiting others by preventing harm, removing harmful conditions, or affirmatively acting to benefit.

above, law






The ethical principal of doing no harm.
Core of medical oath and nursing ethics.
Should not be done through omission or commission.


What is Negligence?

A breach of professional duty that causes harm


Autonomy (____ ____) =

(Self Determination)

Independence or freedom as of the will or one’s action. Agreement to respect another’s right to self determine a course of action. Support of independent decision making of the PT.


In Autonomy, the patient is the decision maker as long as they have:

The decisional capacity (makes own decision without force, right to make choice about oneself), need for truthful disclosure and informed contest (decisional privacy right to make choice regarding oneself and own belief and has non directiveness of provider- info without threat or deception). Based on values, religion, and culture


Paternalism =

It is an application of ______

Belief about what is in the best interest of the patient, choosing to reveal or withhold patient information.

Paternalistic- act of limiting one’s power when its believed to be their best interest

An application of power over the patient.


What is this an example of?

The doctor denies or offers treatment bc he has a strong belief of what is best for the pt.



Justice =

What type of Justice do Nurses practice?

Equal and fair distribution of resources, time and effort on PT; based on analysis of benefits and burdens of decisions; Being right, righteousness, equitableness, moral rightness.

Distributive Justice


Fidelity =

Loyalty, fairness, truthfulness, advocacy, and dedication in relationships. Promise keeping, truth telling, and fulfilling commitments.


These are examples of examples of ?

"Following through on your actions"
"Not flaky"



Veracity =

Truth in speech or statement; truthfulness


Genetics =

Who is the father of this science?

The science of heredity

Mendel - who studied inheritance of pea plants


Genomics =

The science of the entire genome—“the totality of the chromosomes” (& the DNA therein) unique to a particular organism (or any cell within the organism).


Genes =

Functional and physical unit of heredity passed from parent to offspring. A specific set of instruction cells use to produce a specific protein.


Penetrance =

This is a _____ measurement.
Two Types are =

The proportion of individuals with a mutation who exhibit clinical symptoms of the disorder.


Complete and Incomplete Penetrance


Mutation =

A permanent change in the DNA. These are mistakes in the cells DNA which ultimately leads to changes in the proteins they make. Not always bad, could be good bad or indifferent.