lecture 6: legal + ethical issues, image of nursing

assurer la protection du public par et avec les infirmiers tout en veillant a l'amelioration de la santé des quebecois

Quebec law that governs professional system in Quebec

establish professional inspection committee

set up disciplinary process

draw up code of ethics

helps define the practice of nursing within the professional system

identifies obligations for OIIQ and nurses

The practice of nursing consists in assessing health, determining and carrying out the nursing care and treatment plan, providing nursing and medical care and treatment in order to maintain and restore the health of a person in interaction with his environment and prevent illness, and providing palliative care.

there is a whole list of activities "reserved" to nursing

professional code

nurses act

quebec charter rights + freedoms

civil code of quebec

act respecting health services and social services

organization and management of institutions regulation

youth protection act

more laws

every human being who's life is in peril has a right to assistance

every person has a right to non-disclosure of confidential information

no person may be made to undergo care of any nature, whether for examination, specimen taking, removal of tissue, Tx except with consent

consent to care required by state of health of a minor (<14) is given by person having parental authority

no person may be confined in a health or social services institution for a psychiatric assessment without consent or without authorization by law or the court

No person may be made to undergo care of any nature, whether for examination, specimen taking, treatment or any other intervention, except with his consent.

The record of a user is confidential and no person may have access to it except with the consent of the user or the person qualified to give consent on his behalf. Information contained in a user’s record may, however, be communicated without the user’s consent......

Force, isolation, mechanical means or chemicals may not be used to place a person under control in an installation maintained by an institution except to prevent the person from inflicting harm upon himself or others. The use of such means must be minimal and resorted to only exceptionally, and must be appropriate having regard to the person's physical and mental state.

Every institution shall keep an individual record for each beneficiary who obtains services from it

The consent of a beneficiary or his legal representative to anesthesia or surgery shall be supported by a written document signed by the beneficiary or his legal representative specifying that the beneficiary has obtained appropriate information particularly about possible risks or effects. The document must be countersigned by the attending physician or dentist and be preserved in the beneficiary’s record

Every professional who, by the very nature of his profession, provides care or any other form of assistance to children and who, in the practice of his profession, has reasonable grounds to believe that the security or development of a child is or may be considered to be in danger, must bring the situation to the attention of the director without delay. The same obligation is incumbent upon any employee of an institution, any teacher, any person working in a childcare establishment or any policeman who, in the performance of his duties, has reasonable grounds to believe that the security or development of a child is or may be considered to be in danger within the meaning of the said provisions. .....

pt have the right to make their own decision based on their own beliefs and values

healthcare workers have an obligation to refrain from maltreatment, minimize and prevent harm, intent of doing good

pt have a right to no harm

all pt have a right to be treated fair and equally

a keystone of the order's professional legislation

serves as a guide for nurses and imposes general and specific duties and obligations toward the public, clients and the profession, in order to protect the public and regulate unacceptable conduct within the profession

adhering to the ethics, rules and regulations that govern the profession

values

integrity

respect for the client

professional autonomy

professional competence

excellence in care

professional collaboration

humanity

refers to honesty and truthfulness - it transcends all dimensions of the practice of the profession and is the cornerstone of nurses' professional ethics

establishing and maintaining a relationship of trust, and recognizing the client's uniqueness, right to privacy and decision-making autonomy, as expressed in his or her right to make choices and to be informed

relates to nurses' ability to make objective and independent decisions in the client's interest, and to be accountable and responsible for them

refers to nurses' responsibility to maintain and update their knowledge and skills to take account of evidence-based data and best practices - also means nurses' ability to recognize and respect their limits in practising the profession

is the raison d'être of the nursing profession, and reflects the importance accorded to human life - ensure the well-being and security of clients of every age, at every stage, and is the ultimate goal of the nursing profession

reflects the importance of acting in partnership with other professionals and individuals involved, so as to ensure and optimize the quality and security of care and services for clients

means showing generosity, tolerance, solidarity in dealing with others - show empathy and recognize others' uniqueness

I: duties inherent to the practice of the profession

II: relationship between nurses and client

III: quality of care and services

IV: relations with persons with whom the nurse interacts in the practice of the profession

V: relations with the order

VI: determination and payment fees

VII: conditions and procedures for the exercise of the client's rights of access and correction of information contained in records established in respect of him or her

VIII: conditions, obligations and prohibitions relating to advertising

IX: professions, trades, industries, businesses, offices or duties incompatible with the dignity or practice of the profession

X: graphic symbol of the order

GENERAL PROVISIONS

1. nurse shall come to aid of anyone whose life is in peril,except in the event of danger to the nurse or a third party, or unless the nurse has another valid reason.

2. A nurse may not refuse to provide professional services to a person on the basis of race, colour, sex...

• However,may refer the client to another nurse.

INTEGRITY

12. A nurse shall report any incident or accident

13. A nurse shall not appropriate medications or other substances,

COMPETENCE

17. the nurse shall take into consideration the limits of her or his knowledge and skills.

18. A nurse shall practise his profession in accordance with accepted standards of practice and scientific principles. he shall update and develop his professional knowledge and skills.

RELATIONSHIP OF TRUST

28. A nurse shall seek to establish and maintain a relationship of trust

29. A nurse shall act respectfully toward the client

30. A nurse shall respect the pt's values and personal convictions.

PROVISIONS TO PRESERVE CONFIDENTIALITY

31. A nurse shall abide by the rules set forth in the Professional Code in regard to the obligation to preserve the secrecy of confidential info

31.2. he shall preserve the professional secrecy of each member of the couple or family.

36. A nurse shall not hold or participate in indiscreet conversations, including on social networks, concerning a pt

PROHIBITED BEHAVIOUR

37. NO physical, verbal or psychological abuse against the client.

38. a nurse may not establish a personal friendship or an intimate, amorous or sexual relationship with the client.

INFO AND CONSENT

40. A nurse shall provide his client with all the explanations necessary for the pt comprehension of the care

41. to obtain a free and enlightened consent, he shall:

(1) provide the client with all the info required for that purpose;

(2) ensure that the pt consent remains free and informed

(3) respect the pt right to revoke his consent at any time.

THERAPEUTIC PROCESS

42. a nurse shall take reasonable measures to ensure the safety of clients

44. A nurse shall not be negligent in the care and treatment provided to the client

perform the assessment required by the pt state of health;

intervene promptly when the pt state of health so requires;

ensure the clinical monitoring and follow-up required by the pt state of health;

take reasonable action to ensure continuity of care and treatment.

45. A nurse shall not be negligent when administering or adjusting medication or other substances. a nurse shall have sufficient knowledge of the medication

46. A nurse may not refuse to collaborate with health professionals engaged in providing care

reviews complaints

investigated by syndic

makes decisions/imposes sanctions

the legal responsibility of a professional to pay for damage, harm or loss that they cause while practicing their profession

nurses are covered against any fault or negligence by the professional liability insurance program (OIIQ - pay annual fees)

failure to take proper care in doing something, resulting in damage/injury

- unprofessional to post any info/photos/comments about pt or clinical institution

- students are not to become "friends" with their pt

- never discriminate (includes liking things)

- conduct yourself online like you would in public