NSG 326 AH IEthicsBasic TermsCod of Ethics for Professional NursingProfessional Nursing Code of EthicsValuesSlide 7How to Process an Ethical DilemmaBioethicsIssues in BioethicsSlide 11The Experience of Loss, Death, & GriefSlide 13Theories of Grief and MourningBowlby’s Attachment TheoryWorden’s Grief Tasks ModelTypes of GriefFactors Influencing Loss & Grief and CopingEnd-of-Life CareCare for the Grieving NursePrepared by Dr. K. EnnenNSG 326 AH IWeek #2Ethics & ValuesandLoss, Death, & Grief2EthicsIdeals of right & wrong behaviorCode of EthicsSee ANA website for Code of Ethics with Interpretive StatementsBioethicsIssues arise in health careEthical dilemma3Basic TermsAutonomyPerson’s independence, right to determine course of actionBeneficencePositive action to help others, urge to do goodNonmaleficenceDo no harm, potential for harm v. health promotionJusticeFairnessFidelityAgreement to keep promises4Cod of Ethics for Professional NursingCode of Ethics consists of 9 planks with interpretative statementsAccountabilityAnswer for one’s own actionResponsibilityReliability & dependabilityConfidentialityHIPPA (Health Insurance Portability & Accountability), protection of privacyVeracityConformity to truth5Professional Nursing Code of EthicsA set of guiding principles that all members of a profession acceptHelps professional groups settle questions about practice or behaviorIncludes responsibility, accountability, and confidentiality6ValuesValuePersonal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behaviorReflect cultural and social influencesVary among peopleDevelop & change over time Values clarification8How to Process an Ethical DilemmaStep 1: Ask if this is an ethical dilemma.Step 2: Gather all relevant information.Step 3: Clarify values.Step 4: Verbalize the problem.Step 5: Identify possible courses of action.Step 6: Negotiate a plan.Step 7: Evaluate the plan.9BioethicsGender biases, feminist ethicsEthic of CareSocial relevance v. moral contentQuality of lifeGenetic screeningFutile careAllocation of scarce resourcesMedical technologiesNursing workforce10Issues in BioethicsQuality of life:Central to discussions about futile care, cancer therapy, physician-assisted suicide, and DNRFutile care:Interventions unlikely to produce benefit for the clientAllocating scare resources:A key issue in discussions about access to careThe nursing shortage:Produces difficult working conditions and affects clients outcomes12The Experience of Loss, Death, & GriefLossNecessary, actual or perceived, maturational, situationalGriefEmotional response to a lossBereavement – grief & mourningTheoriesKubler-Ross’s Stages of DyingBowlby’s Phases of MourningWorden’s Four tasks of Mourning14Theories of Grief and MourningKübler-Ross’s Stages of DyingDenialAngerBargainingDepressionAcceptance15Bowlby’s Attachment TheoryNumbing:Protects the person from the full impact of lossYearning and seeking:Tearing, sobbing, and acute distressDisorganization and despair:Examines loss and expresses angerReorganization:Person begins to accept change, new role or skills16Worden’s Grief Tasks ModelTask I: Accept the reality of the lossTask II: Work through the pain of griefTask III: Adjust to the environment in which the deceased is missingTask IV: Emotionally relocate the deceased and move on with life17Types of GriefNormalAnticipatory“Letting go”Complicated Chronic, delayed, exaggerated, maskedDisenfranchised18Factors Influencing Loss & Grief and Coping Human developmentDifferent agesPsychosocial perspectivesSocioeconomic statusNature of the lossCulture & ethnicitySpiritual beliefsSurvivor risk factorsHope19End-of-Life CareAcute carePalliative careHospiceAssisted suicidePostmortem care20Care for the Grieving NurseNurses need to assess their own emotional well-being.Self-reflection is a part of critical thinking that assesses whether sadness is related to caring or unresolved personal experiences.Being a professional is knowing when to get away from the situation to care for
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