1. Professional issues chapter 8 and code of ethics

2. Profession Is Nsg a profession, what the criteria to define profession, who decides

3. Professional status Profession exist for the purpose of meeting the needs of society Professional contract with society by promising to meet a set of identified needs better than any other group of people Society grants the profession a monopoly over these particular service

4. As a complex organized occupation preceded by long training program (Gruending)1985 these attributes lead to a monopoly that provide autonomy, public recognition, prestige, power and authority for the practitioner

5. Professional status of nursing Nurses and others have Debate the Professional status of nursing Flexner& Bixler evaluated nurse according to his criteria, he judged Nsg was not a profession Even physicians and judicial system recognized nursing as a profession.

6. Is nsg a profession According to Genevieve and Bixler seven main characteristics are 1-a body of specialized knowledge 2-use of the scientific method to enlarge the body of knowledge 3-education within institute of higher education

7. 4- applies its body of knowledge in practical service which are vital to human and social welfare 5- functions autonomously in the formulation of professional policy and in the control of professional activity.

8. 6- attracts individuals of intellectual and personal qualities who exalt service above personal gain 7- freedom of action,continues professional growth, and economic security.

9. Professional status for nursing Expertise Autonomy Accountability Authority Unity Ethical codes Competence testing licensure, credential the description of scope of nsg Establishment of standards

10. expertise Relate to the characteristics of having a high level of specialized skills and knowledge (gained through long years of study in academic setting) Is the primary distinguishing difference between professionals and non professionals

11. We gain experts :- Extensive educational requirements Intense guided practice Examination of licensure Certification Mandatory continuing education

12. We have knowledge base that is continually expanded through research. Our expertise is also advanced through graduate nursing education, specialty preparation, and certification process Purely claim expertise is not enough We need mechanism of accountability (must prove to society that we are faithful to the promise the profession makes)

13. society grants us authority to practice with a certain measure of autonomy Thus, the professional realms of expertise, accountability, autonomy, and authority are interrelated

14. autonomy Self governing Two level :- 1-autonomy of the profession *self regulation* 2-autonomy of the individual practitioner*self determination, responsibility, accountability, independence and willingness to take risks

15. people who consider to be professionals have the power and authority to control various aspects of their work (goals, choices, ----)

16. Since the profession of nursing is self regulating, it can be said to be autonomous ( board of nursing given nursing authority to practice Nsg act) No other group has the ability to do the work of nurses---legal restriction

17. Are you autonomous, even though you are required to follow physicians orders You can’t get to know the patients (too much work)

18. Lyon defines autonomous nsg practice as “ the diagnoses, and treatment of phenomena that nurse have self directed authority to treat”

19. Two different scopes of practice 1-medical scope requires physician authority to initiate treatment (order) 2-autonomus nursing scope require no authority (feverish pt)

20. Nurses might refuse to carry out physician’s order (incorrect) Protect pt from physician’s negligence and prevent court action against nurse,

21. Accountability Refers to being answerable to someone for something one has done Grounded in moral principles of fidelity, respect for dignity, worth, self determination of client

22. Nurse Accountability :-safe and autonomous practice Related to responsibility and answerability because Trust from society gained through expertise and (Autonomy) right given the profession to regulate practice Nurse is responsible and Accountable for all individual actions done/ judgment made and omission

23. Mechanisms of accountability -code of nsg ethics -standards of nsg practice Nurse practice act Nsg theory and practice derived from nsg research Education requirements for practice Advance certification Mechanisms for evaluation the effectiveness of performance for nurses

24. Codes of nursing ethics Is an explicit declaration of the primary goals and values of the profession that indicate the profession’s acceptance of the responsibility and trust with which it has been invested by society (ANA 1985)

25. Nurses make an implicit moral commitment to uphold the values and moral obligations expressed in their code Nurse should base their judgment upon consideration of consequences and universal moral principles of respect for persons, autonomy, beneficence, nonmaleficence, veracity, confidentiality, fidelity,and justice

26. E,g of professional code of ethics ANA code of ethics ICN international council of nurse code Canadian nurses association code of ethics

27. What does a code of ethics do Gives guidance for decision making about ethical matters by providing a set of values that are basic to nsg practice

28. What does code of ethics not do Provide rules of ethical or moral behaviors for every circumstances Offer guidance about which values should take priority or how they can be balanced in practice

29. Standards of nursing practice Are written documents outlining minimum expectation for safe nursing care Should reflect reasonable expectation for safe nsg care rather than optimal or ideal care

30. Standards may describe in detail specific acts performed by nurses or may outline the expected process of nursing care We use standards to guide and evaluate nsg care Courts look to standards of nsg practice for guidance when malpractice cases are deliberated

31. Basic types of standards of nsg practice Internal standards of nsg practice External standards of nsg practice

32. Internal standards of nsg practice Are those developed within the profession of nsg for the purpose of establishing the minimum level of nsg care They help to ensure that nurses are competent and safe to practice can be used as yardstick to measure the practice of individual nurse determine whether the actions of nurse accused of malpractice are consistent with reasonable minimum expectations

33. Nursing process is an example on internal standards of nsg practice They make nurses accountable for ensuring that each step of the process is followed in the delivery of nsg process

34. An example of internal standers is the American nurses association standers of nursing practice ANA publishes standards of care for nurses in advanced or specialty roles such as nurse practitioners, maternal child nurse, psychiatric nurses

35. standards of nsg practice (external) Consist of guides for nursing care that are developed by non nurses, the government, or institution These standards describe the specific expectation of agencies or groups that utilize the services of nurses

36. They serve the same function as internal guidance and evaluation eg document of nurse practice act of each state E,g formal policies and procedure for individual agencies

37. Nurse practice acts protect the public Define nsg practice Describes the boundaries of practice Establish standers for nurses Protect the domain of nsg

38. Nurse practice acts are considered a form of nsg standards Utilized by courts in determining the appropriateness of nsg action Violation can result in either civil or criminal action

39. Nursing theory and practice delivered by research Using the scientific method Past debate: is nsg body of knowledge or borrowed from other science Nsg research increase the unique body of nursing knowledge

40. The benefits of this process are: allow the nurse to response to the needs of society more knowledgeably and skillfully Validating nsg as a true profession

41. Authority Relates to the state of having legitimate power (legal) The authority to practice nsg is granted by government It acknowledges the professional's right and responsibilities E,g nurse practice act, specified entry to requirements into practice, scope and standards granted through : examination and licensure

42. Licensure benefits both public and professional. It protect public from unqualified and protect professional's job by establishing monopoly

43. unity one of defining characteristics of a profession is a sense of unity among members Ability of the nurse to organize for the purpose of fulfilling the profession’s promises and the relationships that nurses have with one another

44. Through unity, nurses can standardized the professional characteristics of competences, autonomy, authority, and accountability Professional associations

45. Main four elements of the ICN in nsg 1-nurses and people 2-nurses and practice 3-nurses and co-workers 4-nurses and profession

46. Nurses and people Primary responsibility is to people requiring nsg care In providing care, nurse promote an environment in which human rights, values, customs and spiritual bellies of family, individual and community are respected Sufficient information\ sharing responsibility

47. Nurse and practice Nurse carries personal responsibility and accountability for nsg practice Maintain competence by continual learning Maintain a standards of personal health Ensure the using of technology and scientific advance

48. Nurse and co-workers Sustain cooperative relationships with co workers in nsg and others Take appropriate action to maintain individual when care is endangered by co workers

49. Nurse and the profession Nurse play major role in determining and implementing desirable standards of nsg practice management and education Developing core of research based professional knowledge Participate in creating and maintain equitable social and economic working condition in nsg