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Nurses and Dignity

Nurses recognize and respect the intrinsic worth of each person


The CNA Code of Ethics recognizes what about dignity?

Relate to ALL people with respect

Support for: people, families, communities

Take into account unique values, customs, and spiritual beliefs AS WELL as social and economic circumstances

Intervene and report when others fail to respect the dignity of a person receiving care

Respect privacy and be discreet with care

Use care when considering use of restraints

Maintain appropriate and professional BOUNDARIES – do not abuse relationships for financial gain or enter into personal relationships

Work to relieve pain and suffering

Support a dignified and peaceful death

Treat each other, colleagues, and STUDENTS with respect


What make's consent informed and legal?

To be legally valid:
The client must have the legal and mental capacity to make a treatment decision.
The consent must be given voluntarily and without coercion.
The client must understand the risks and benefits of the procedure or treatment, the risks of not undergoing the procedure or treatment, and any available alternatives to the procedure or treatment.


What is required for informed consent?

• A brief, complete explanation of the procedure or treatment.

• Names and qualifications of people performing and assisting in the procedure.

• A description of any possible harm, including permanent damage or death, that may occur as a result of the procedure.

• An explanation of therapeutic alternatives to the proposed procedure/treatment, as well as the risks of doing nothing. Clients also need to be informed of their right to refuse the procedure/treatment without discontinuing other supportive care and of their right to withdraw their consent even after the procedure has begun.


What the CNA has to say about informed consent

The process of giving permission or making choices about care. It is based on both a legal doctrine and an ethical principle of respect for an individual’s right to sufficient information to make decisions about care, treatment and involvement in research. In the code, the term informed decision-making is primarily used to emphasize the choice involved.


How consent is obtained?

A signed form is required for all routine treatment, hazardous procedures, and some other treatments.

Provisions must be made for disabled patients, those with literacy challenges and those for whom English is not the first language.


The Code of Ethics says about Informed Consent

Nurses, to the extent possible, provide persons in their care with the information they need to make informed decisions related to their health and well-being. They also work to ensure that health information is given to individuals, families, groups, populations and communities in their care in an open, accurate and transparent manner

Nurses respect the wishes of capable persons to decline to receive information about their health condition

Nurses recognize that capable persons may place a different weight on individualism and may choose to defer to family or community values in decision-making.

Nurses ensure that nursing care is provided with the person’s informed consent

Nurses are sensitive to the inherent power differentials between care providers and those receiving care. They do not misuse that power to influence decision-making.

Nurses advocate for persons in their care if they believe that the health of those persons is being compromised by factors beyond their control, including the decision-making of others.

When family members disagree with the decisions made by a person with health-care needs, nurses assist families in gaining an understanding of the person’s decisions


Labonte (1993)

Created a multidimensional conceptualization of health (not just an ideal state of well-being):

Feeling vitalized and full of energy
Having satisfying social relationships
Having a feeling of control over life
Being able to do things you enjoy
Having a sense of purpose
Feeling connected to community


Levels of Disease Prevention





Historical approaches to health in Canada





What is Health Promotion?

Health promotion is “directed toward increasing the level of well-being and self-actualization” (Pender et al., 2006)

Ottawa Charter views health promotion as the overarching concept, defined as “the process of enabling people to increase control over, and improve, their health”

Health promotion represents a comprehensive social and political process, it not only embraces actions directed at strengthening the skills and capabilities of individuals, but also action directed towards changing social, environmental and economic conditions so as to alleviate their impact on public and individual health. Health promotion is the process of enabling people to increase control over the determinants of health and thereby improve their health. Participation is essential to sustain health promotion action.”


The Ottawa Charter

Strengthen community action

Develop personal skills

Build healthy public policy

Create a supportive environment




Reorient health services


Health Promotion Principles

•Health promotion addresses health issues in context.
•Health promotion supports a holistic approach.
•Health promotion requires a long-term perspective.
•Health promotion is multi-sectoral.
•Health promotion draws on knowledge from social, economic, political, environmental, medical, and nursing sciences, as well as from first-hand experiences.


Health Promotion Strategies (Ottawa Charter)

Build healthy public policy
Create supportive environments
Strengthen community action
Develop personal skills
Reorient health care


Nurses role in health promotion

Nurses work with people to enable them to attain their highest possible level of health and well-being (CNA, 2008). This can be done by:
Information dissemination
Health risk appraisal
Lifestyle and behavior change programs
Environmental control programs


Population Health Model

Population health is an approach to health that aims to improve the health of the entire population and to reduce health inequities among population groups.

In order to reach these objectives, it looks at and acts upon the broad range of factors and conditions that have a strong influence on our health


Levels of Health Care

Level 1: Health Promotion
Level 2: Disease and Injury Prevention
Level 3: Diagnosis and Treatment
Level 4: Rehabilitation
Level 5: Supportive Care


Level 1: Health Promotion

*a level of health care
Wellness services
Antismoking education
Promotion of self-esteem in children and adolescents
Advocacy for health public policy


Level 2: disease and injury prevention

*a level of health care
Prevention services/strategies
Clinical (screening, immunizing)
Behavioural (lifestyle change, support groups)
Environmental (societal pressure for a healthy environment)


Level 3: Diagnosis and Treatment

*a level of health care
Primary care (first contact with health care system)
Secondary care (provision of specialized medical service)
Tertiary care (specialized and highly technical care)


Level 4: Rehabilitation

*a level of health care
Required after physical/mental illness, injury, or addiction
Services include:
Occupational and speech therapy
Social services


Level 5: Supportive Care

*a level of health care
Clients with chronic illness, progressive illness, or disability
Long-term care and assisted-living facilities, adult day care centres, home care
Also includes respite care and palliative care


Primary Disease Prevention

Seeks to prevent the onset of disease by risk reduction


Secondary Disease Prevention

Procedures that detect or treat the pre-clinical pathological changes and thereby control disease prevention


Tertiary Prevention

Soften the impact of disease on patients function, quality of life, and longevity