Professional Ethics - Nurse Practice Acts

March 19, 2012

Ann Marie Peckham

Professional Ethics Paper

As nurses we are faced with ethical dilemmas every day. Nurses have a standard of practice by which they are bound to deliver quality care to patients. Every patient decides on the delivery of his or her care. A nurse's personal values, ethics, and morals play a role in the nurse-client relationship. This paper will be describing the relationship between legal and ethical issues, identify personal values with professional values, and also discuss ethical theories and principles. Legal issues have a specific law behind them, they carry a consequence if not obeyed; ex: Robbery. Ethical issues have no force of law; they affect society around us, and only have consequences for those involved; ex: a first trimester abortion, not illegal, but an unethical issue for the baby's father as he may not have agreed.

Nurse Practice Acts were originated to protect the public at large, define the practice of nursing, give guidance within the scope of practice, and set standards for the nursing profession. The nurse practice act is so influential that it affects all facets of nursing practice. The nurse practice act is the law. In 1955, the American Nurses Association (ANA) approved a model definition for nursing practice that has continued to change and broaden over the years.

Nurse practice acts govern how nurses can practice. In a hospital setting, a hospital normally has policies and procedures that each nurse or employee must follow. These policies can sometimes limit the nurse's scope of practice. The nurse can choose to practice nursing based on the nurse practice acts over the hospital's policy. The nurse practice act, when practiced by a nurse within that scope is the overriding factor of decisions. Policy and procedures should be updated frequently to prevent limiting a nurse in his or her scope of practice. Committee members should include; medical and nursing staff to ensure quality evidence-based care is chosen for patient care.

Complementary and alternative medicine, "also known as", CAM is gaining popularity in the United States. CAM involves therapeutic touch, biofeedback, guided imagery, acupuncture, and massage therapy. CAM is often used in illness rather than conventional medical therapies. These therapies are not in the nurse's scope of practice unless the nurse has had specific training in the area, and obtained a license. In addition, a patient must be fully informed and provide informed consent prior to initiating any CAM therapies. Ethical issues can arise with CAM. Patients are reluctant to reveal to the general practitioner they are using this therapy, or they may not understand the consequences of using both therapies simultaneously. Herbal medicines often interact with many prescription medications. Nurses must not make any judgment on the patient or how he or she may be participating in his or her health care. A nurse must make the patient understand the safety concern behind the use of herbal medications which are not regulated by the FDA. Documenting medication and herbal use in the patient's medical record is essential to patient safety.

Another ethical concern is a nurse's right to refuse care to a specific patient based upon religious beliefs. However, do nurses have the right to refuse to care for patients with HIV, drug resistant TB, SARS, and other infectious diseases? Common morality states that we have a duty to treat someone who is in need. If someone is drowning, you just throw them a life preserver. It is the correct thing to do. As nurses, we took an obligation to treat patients who are ill. It is our duty to take care of those patients no matter what the illness may be. The Code of Ethics for nurses (ANA 2001) mandates that nurses provide optimal patient care at all times.

Values guide anyone throughout the day, as you make a decision; it has a future consequence. Nurses are no different in that each of us are engrained with a value system that drive us personally as well as professionally. Values are important principles and standards that shape our lives.

Professional values are often found in the form of a mission statement. A mission statement is a clearly defined set of standards of principles that each employee must practice to keep the organization's mission statement true. Personal and professional values must be in balance at all times. Keeping a balance with both values, personal, and, professional; it helps to identify who you are as person. Once these values are out of balance, you begin to see unethical behavior and even illegal behavior.

Professional autonomy and authority are being challenged from different angles. Patient roles have changed; modern patients are empowered with more knowledge. Patients are entitled to know about their condition; with all the latest research just a few clicks away. Patients' views and expectations have changed accordingly; they want to be active participants in their health care. If professional values are not up-to-date with current practice in decision making, the result could lead to higher burnout rates, and feelings of inadequacy. The point is to create a value informed clinician who practices in a trustworthy role professionally for themselves and for the patient.

Ethical theory and principles are the basis of ethical analysis of case-by-case situations. These offer guidance to decision making. There are several types of ethical principles these include the following:

Beneficence: this theory is to do what is good

Least Harm: similar to beneficence, but deals with situations in which a provider must choose the route to do the least harm to the patient

Respect for Autonomy: this theory allows people to reign over themselves and make decisions that apply to their lives

Justice: this theory prescribes actions which are fair to those involved

Ethical theories also have several different levels and these include:

Deontology: states that people should adhere to their obligations and duties when analyzing an ethical dilemma. This theory will produce will produce very consistent decisions as they will be based upon one's set duties.

Utilitarianism: ethical theory based on the ability to predict the consequences of