Week 8 & 9

Question 1

CNA: Nursing values and ethical responsibilities:

Answer 1

• providing safe, compassionate, competent care
• promoting health and well-being
• promoting and respecting informed decision making
• honouring dignity
• maintaining privacy and confidentiality
• being accountable
• promoting justice

Question 2

What is the purpose of the CNA?

Answer 2

• serves as a foundation for nurses’ ethical practice.
• provides guidance for ethical relationships.
• used in conjunction w professional standards, laws and regulations that guide practice
• protect the public and provide practice reference for RN’s in line w The registered nurses act.

Question 3

CRNS standards and competencies:

Answer 3

• Professional responsibility and accountability
• knowledge based practice
• ethical practice
• service to the public
• self regulation

Question 4

CNA emphasizes four major components:

Answer 4

1. nurses and the client
2. nurses and practice
3. nurses and the profession
4. nurses and global health

Question 5

Bioethics:

Answer 5

• Bioethics investigates, critiques, and informs healthcare professionals in navigating ethical dilemmas.
• dilemmas may result from competing expectations, values, or duties.

1. Autonomy: right to self-determination – basis for informed consent; focus on client’s needs, opinions, and preferences for care; right to be involved in decisions to the extent they are able
2. Beneficence/Nonmaleficence: actions should “do good”; actions should “do no harm” benefit vs harm
3. Justice: being fair and impartial - who receives resources?; being truthful

Question 6

Concepts of ethical nursing practice: self disclosure

Answer 6

• Self disclosure must be in the best interest of the client; it is not about meeting the nurses’ needs

Question 7

Nurse-client professional boundary:

Answer 7

• Invisible structure which protects rights, privacy, and functional integrity of the nurse-client relationship
• Aim: a professional helping therapeutic relationship; not a personal unprofessional relationship
• The nurse (not the patient) is responsible for setting the boundary

Question 8

critical thinking characteristics:

Answer 8

• Attitude: Develops an analytical thinking ability; maintains an inquisitive mind set;
  open-minded & flexible thinking process
• Thought process: Reflective; combines existing knowledge & standards with new information; creative thinking; Recognizes when information is missing and seeks new information
  discards irrelevant information;
• Skills: Organized and methodical reasoning
  Diligently seeks new information
  revises actions based on new input
  evaluates solutions & outcomes

Question 9

Barriers to thinking critically and reasoning ethically:

Answer 9

• Attitudes and habits : my way is better”; cognitive barriers such as stereotypes
• Cognitive dissonance: mental discomfort you feel when there is a discrepancy between what you believe and new information - conflict
• personal values vs. professional values: personal values become a part of self-concept
  education helps us acquire a professional value system. be careful our personal values do not obstruct care for a client who holds differing values

Question 10

Ethical problem:

Question 11

Ethical Dilemma:

Answer 11

• inadequate staffing, end of life issues, inappropriate resource allocation.

Question 12

Ethical distress:

Question 13

Moral Courage:

Question 14

Using the ethical decisional models:

Answer 14

1. Obtain information: involve all the people implicated in the ethical situation including clients, family, care givers/health providers
2. Establish if an ethical committee exists
3. Identify conflicted ethical values in each case
4. Apply existing organizational processes to react to an ethical situation

Question 15

Oberle and Raffin Ethical model:

Answer 15

1. Assess the ethics of the situation
2. Reflect on and review potential actions
3. Select an ethical action
4. Engage in ethical action
5. Reflection and review ethical action

Question 16

Interpersonal Conflict:

Answer 16

An expressed struggle between at least two interdependent people who perceive incompatible goals, scarce resources, or interference in the achievement of their goals.

Question 17

Conflict:

Answer 17

Disagreement arising from differing values, needs, attitudes resulting in frustration in achieving goals. Result is stress or tension

Question 18

conflict triggers:

Answer 18

• Criticism
• Feeling Entitled (you give this but i dont give anything back).
• Perceived Lack of Fairness
• More Perceived Costs Than Rewards
• Different Perspectives – The Big Six (power and decision making, social issues, personal flaws, distrust, intimacy in relationships, distance in relationships)
• Stress and Lack of Rest
• Dialectical tension (wanting connection but wanting to be alone)

Question 19

Conflict process:

Answer 19

source, beginning, middle, end, aftermath

Question 20

Pseudo-conflict:

Answer 20

Conflict triggered by a lack of understanding and miscommunication.

Question 21

Simple conflict:

Answer 21

Conflict that stems from different ideas, definitions, perceptions, or goals.

Question 22

Ego conflict:

Answer 22

Conflict that is based on personal issues; conflicting partners attack on another’s self-esteem.

Question 23

interpersonal power:

Answer 23

degree to which a person can control/influence another (people use power to achieve their aim in conflict).

Question 24

Compliance Gaining:

Answer 24

action/communication one person takes to get the conflict partner to comply with one’s own goal (persuasion)

Question 25

Conflict management styles:

Answer 25

Avoidance
Accommodation
Competition
Compromise
Collaboration

Question 26

destructive conflict

Answer 26

• Each person has a win-lose attitude
• Damages the relationship
• lack of willingness to compromise and see others perspectives.

Question 27

Constructive conflict:

Answer 27

• Builds new insight
• Establishes a new pattern
• Strengthen the relationship

Question 28

Other-orientation and conflict management:

Answer 28

Stop: Stop making your arguments and concentrate on your partner’s points.

Look: Monitor emotions by observing nonverbal cues.

Listen: Concentrate on details, main points, and tone, and what the other person is saying.

Imagine: Imagine how you would feel in the other person’s place.

Question: Question for more information.

Paraphrase: Paraphrase to confirm understanding.

Question 29

Conflict management skills:

Answer 29

1. manage your emotions
2. manage information
3. manage goals
4. manage the problem

Question 30

interprofessional conflict:

Answer 30

role ambiguity
real and perceived power hierarchy
differing goals
differing values, styles, personality traits

Question 31

Incivility:

Answer 31

• Discourteous speech or behavior in violation of expected norms, with intent to harm
• Derogatory comments, dismissive points of view, not sharing information, not responding to communication, rude verbal and nonverbal behavior
• Nursing: violation of Code of ethics and CRNS competencies

Question 32

Reactions to hurtful words:

Answer 32

-Active verbal response (reactive statement)
-Acquiescent response (cry, apologize)
-Invulnerable response (ignore, silent, laugh)

Question 33

LOW LINE

Answer 33

listen, offer, wait, look, incline, nod, express

Question 34

Manage your own anger:

Answer 34

Reframe self-talk – look at situation as misunderstanding, accidental, clumsiness
Listen non-defensively – reframe criticism as a problem or challenge
Self-awareness – Am I engaging in incivility?
Deliberately calm yourself – breath, count, time out
Don’t revisit past injustices
Work on one issue at a time