42 terms

Nursing Theory and Ethics

Nursing theory- Definition-
- Composed of a group of concepts that describe a pattern of reality, explains a process and is based on facts.
Nursing theory- Purpose-
- Provides a focus for nsg care activities, guides nurses by providing a knowledge base , organizes concepts, provides guidelines for practice, identifies nsg care goals that are holistic, promotes health and prevents illness.
Inductive Reasoning-
- builds from multiple ideas to conclude about one general idea.
Deductive Reasoning-
- examines a general idea and considers other actions or ideas.
- describes objectives, properties and events and the relationships among them.
Conceptual Framework/Model-
- a group of concepts that follow an understandable pattern.
Paplau 1952
-Interpersonal relationships model- proper development of a pt.'s personality is important to improve their personal and community living.
Henderson 1955
- definition of nursing- believed autonomous nursing led to self help concepts.
Leininger 1978
-cultural care diversity and universality theory- believed caring is the central theme and foundation for transcultural nsg, improving human conditions and the life process.
Orem 1971
- self-care theory- self care is essential for sustaining health or for recovering from illness or injury.
Roger 1970
- science of unitary human beings- nsg should focus on mobilizing inner resources, the patient is central to the discipline of nsg.
Roy 1974
- adaptation model- nsg is required when the pt. demonstrates poor adaptive responses.
Watson 1979
- human caring theory- promotion of holistic healing and human caring.
King 1971
- goals attainment theory- the nurse and pt. mutually set goals and agree on ways to reach goals.
Neuman 1979
- systems model- less stress can lead to less medical conditions.
Values clarification-
- process which one comes to understand their own values; a belief about the worth of something that guides one's behavior.
Personal values-
- a belief that individualizes a person.
Professional values and characteristics-
- behavior that shows concern for the well being of others ( accountability, altruism, autonomy, human dignity, loyalty)
Codes of Ethics-
- set in place to protect a pt. from incompetent, unethical and illegal practices. (ANA Code of Ethics for Nurses, The ICN Code of Ethics for Nurses 2006)
Consumer rights-
-informed consents, advance directives, autonomy/right to self determination, HIPAA,
Nurses' responsibilities-
-identify professional practice limitations, serve as pt. advocate, maintain professional competenece, inform, supervise and evaluate subordinates.
Teleological/utilitarian theories-
- Jeremy Bentham 1748-1832- An act is right if the outcome is good or does the greatest good for the people involved. example: a deformed baby is allowed to die to not be a burden on society
Deontological theories-
-Immanuel Kant 1724-1804- actions should be based on moral duty to fellow man ( universal, unconditional, imperitive) example: an abused/raped girl does not get an abortion
Egoism theory-
-Davis and Aroskar- a decision is right because the doer desires it and is comfortable with it.
Act Deontology-
- agents own moral values are involved.
Rule Deontology-
rules for judging morally are involved, usually a command of God.
Theory of obligation-
- Frankena- justice as fairness with the greatest benefit given to the least advantaged. "Veil of Ignorance"
Ideal observer theory-
- Firth- disinterested, dispassionate and consistent viewpoint of all information considered of the future consequence.
-to tell the truth and not mislead or deceive intentionally.
- an obligation to be faithful to the agreement/ committment made ( concept of accountability)
- olbligation to do good and not harm to others.
- prohibition of intentional harm.
Fairness, treat like cases similarly.
- lying.
- respecting pt.'s personal information and not sharing it with others (diagnosis, medications, treatments...)
-acting on behalf of a pt. without their consent to secure good or prevent harm.
Ethical dilemma-
- occurs when one must choose between two unfavorable alternatives.
Process of ethical decision making-
-Identify and Clarify problems, Gather data, Identify options, Make decisions, Evaluate outcomes.
Beginning of Life Ethical Issues-
-abortion( should be legal/illegal?) surrogacy(what if gestational mother is unwilling to give up child?), in vitro fertilization(what should be done with left over fertilized eggs?)
Sustaining Quality of Life Ethical Issues-
- organ donation/transplantation(who deserves it?) genetic screening(abort a genetically impaired fetus?) eugenics(unwillingly sterilize the "socially inadequate" to accomplish "human perfectibility"?) stem cell research( use the leftover fetus or cells from abortions)
End of Life ethical issues-
-euthanasia(illegal in every state) asisted suicide, DNR, withdrawal of nutrition and hydration, right to die(legally recognizes client's right to refuse treatment)
- illegal- Negative euthanasia- "no codes" "DNR" Positive euthanasia - Prescription drugs result in death.