Specific Core Nursing Content # 11: Ethical and Legal Principles


Clinical Learning Outcomes

  • Clarify personal values concerning working with patients experiencing psychiatric disorders.
  • Demonstrate ethical professional boundaries.
  • Apply ethical principles to treatment dilemmas.
  • Advocate for patients and families with legal and ethical concerns.
  • Develop plan of care to address ethical and/or legal concerns that promote individual integrity.


Teaching Strategies


Classroom Teaching Strategies
  • Review concepts of ethical principles. (Autonomy, Justice, Non-Maleficence, etc.)
    See: http://samples.ibpub.com/9781449665357/Chaper2.pdf
  • Discuss patient rights specific to psychiatric patients.
  • Discuss laws related to involuntary holds/commitment.
  • Review Psychiatric Advanced Directives available at http://www.nrc-pad.org/
  • Debate- Two teams discuss resolution of ethical dilemma applying different theories.
  • Have students debate pro and then con of same issue using discussion board postings.
  • Ethical Issues: The Patient's Capacity to Make Medical Decisions
    Review and discuss
    http://www.psychiatrictimes.com/special-reports/ethical-issues-patients-capacity-make-medical-decisions
    • Discuss client perception of this event.
    • Ability to communicate a choice
    • Ability to understand information necessary for the specific decision at hand
    • Ability to appreciate the implications and significance of the provided information or the choice being made
    • Ability to reason by weighing and comparing options as well as consequences of the potential decision
    • Provides case study
Clinical Teaching Strategies
  • Post-conference discussion of how patient rights are being upheld (or not).
  • Attend court hearing for Temporary Detention Order or Involuntary Commitment.
    • Discuss client perception of this event.
Role Play
  • “How would you respond if a patient said (or did)…….?” Maintaining professional boundaries.
Simulation
  • ED psychotic patient. Process of obtaining involuntary admission.
  • Consider state laws


Assessment Strategies


Assignment

  • Assign pairs of students to make a short video portraying how a nurse responds to a patient (played by a student) to protect the patient’s rights and to violate a patient’s rights. Show all videos to the class and discuss.

Nurses' Guide to Professional Boundaries:


 
Clinical Skills Checklist
  • Maintains professional boundaries with patients and staff. (Standard 7. Ethics, Standard 14. Professional Practice Evaluation)
  • Able to identify components of ethical dilemma and possible resolutions. (Standard 7: Ethics & Standard 2: Diagnosis)
  • Identifies type of admission of each primary patient and correct implications for nursing actions. (Standard 7: Ethics & Standard 10: Quality of Practice)
  • Clarify personal values concerning working with patients experiencing psychiatric disorders. (Standard 7: Ethics & Standard 14: Professional Practice Evaluation)
  • Correctly define and give example of Duty to Warn, Duty to Protect, Duty to Report. (Standard 7: Ethics)
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