Specific Core Nursing Content # 11: Ethical and Legal Principles

Clinical Learning Outcomes

  • Clarify personal values concerning working with patients experiencing psychiatric disorders.
  • 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.
  • 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.
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.
  • ED psychotic patient. Process of obtaining involuntary admission.

Assessment Strategies

Test Bank - Sample question: 

Which patient meets criteria for involuntary commitment for mental health treatment?  (Answer: C)

A. Woman who has been non-adherent with antipsychotic medication.
B. Man who has continues to use and sell illegal drugs.
C. Woman who threatens to kill herself.
D. Man who has taken out multiple fraudulent loans.

  • 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.
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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