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Summary NSG 335 Exam 2 Study Guide

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NSG 335-Exam 2 Study Guide. *An essential study resource!!

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  • November 12, 2024
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Module 7 Legal and Ethical - Readings: Chapter 6 and 33

Nurse’s primary role

 Protection of patients rights
 Advocate for patient
 Patient is the primary commitment of the nurse
 Standards of care
 Code of ethics
 Professionalism
 Franciscan values

Vulnerable populations are:

 Persons with mental illness, aging population, homeless persons with mental
illness, incarcerated persons with mental illness
o Persons with mental illness are more vulnerable, may not be aware of
their rights, are in a dependent position and may be taken advantage of
o Protection of rights→ laws are put into place
 Vulnerable aging population
o Prone to neglect and abuse
o Advance directives are important
 Vulnerable Homeless Population
o 20-25% of homeless population suffer from mental illness
o Mental illness is the third largest cause of homelessness
 Vulnerable incarcerated population
o Problem- there is inadequate funds
o Prisoners are forced to stay in their cells
o limited access to therapy

Types of Admission

 Voluntary- patient signs self into hospital
o Patient must understand the need for treatment and be willing to
participate in recommended treatment
o Have the right to request and obtain release
o If patient is under 16, there must be a parent or guardian sign for that
patient
o Before being released, re-evaluation may need to occur
o If caregiver feels the patient needs to stay, involuntary commitment may
be initiated
 Involuntary- 72 hour hold, petition for court hearing
o Court ordered without patient’s consent
o Criteria includes:
 Mentally ill

,  Danger to self or others
 Gravely disabled
 In need of treatment
 Informal admission- least restrictive of all admissions
o No formal application
o Person does not pose a threat to self or to others
o patient -caregiver relationship is normal and patient may leave or stay
depending on their needs

Types of commitment

 Emergency commitment- temporary admission or emergency hospitalization
o Used for people who are so confused they cannot make decisions on their
own
o For people who are so ill they need emergency admission
o Primary purpose of this is for observation, diagnosis, and treatment of
those who pose danger to themselves or others
o Length of time to be held ranges from 24-96 hours
o Court hearing is held to determine next decision
 Assisted outpatient treatment- court ordered outpatient treatment
o Can be preventative measures allowing a court order before the onset of a
psychiatric crisis that would result in inpatient admission
o Patient must participate in treatment to receives disability benefits and
housing
o If they do not participate, inpatient hospitalization may be required

Types of Discharge

 Conditional release- requires outpatient treatment for a specified period of time to
determine if the patient follows the medical regimen, can meet basic needs, and
is able to reintegrate with the community
o An involuntarily admitted patient who is conditionally released may be
reinstitutionalized, although the commitment is still in effect without
recommencement of formal admission procedures
 Unconditional release- termination of a patient-institution relationship
o May be court ordered or administratively ordered by the institution’s
officials
 Release against medical advice- when there is a disagreement between the
mental health care providers and the patient as to whether continued
hospitalization is necessary
o In cases where treatment seems beneficial but there is no compelling
reason (danger to self or others) to seek an involuntary continuance of
stay, patients may be released against medical advice

Rights of the Mentally ill and nurse’s role

,  Mentally ill are prone to criminal behavior→ sometimes end up in prison
 If mentally ill are incarcerated they have a right to treatment

Definitions→ not listed on study guide but is on pp. under ethics and rights

 Moral behavior- conduct that results in serious critical thinking on how to treat
others based on ethical principles
 Values-important beliefs about what is desirable
 Rights- valid legally recognized claim or entitlement encompassing freedom from
government interference or discriminatory treatment and an entitlement to a
benefit of service
 Kantianism- what is motivation on what the action is based on
 Utilitarianism- whatever promotes happiness
 Christian ethics- focused on the way of love and life of Jesus
 Christ- love, forgiveness, honesty
 Natural law- decisions versus right and wrong are self evident and determined by
human nature
 Benefiance- duty to act to benefit or promote the good of others
o Nursing care follows the standards of care
o Provide safe milieu
o Respectful listening to the patient
o Doing what is best for patient, SAFETY
 autonomy - respecting the rights of others to make their own decisions
o Ask patient about goals
o Allow patient to participate in care
o Problem solving: ask patient what would work for them
 Justice- duty to distribute equally - resources or care regardless of personal
attributes of the person
o Just care to all patients
 Fidelity (nonmaleficence)- maintaining loyalty and commitment to the patient
doing no wrong to the patient
o Giving education
o Going above and beyond
 veracity - nurse’s duty to communicate truthfully
o Observing and relating facts
o Factual and thorough documentation
o Standing up for what is right

Ethical issues in mental health:

 Labeling
 Stigma
 boundaries

Confidentiality

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