Legal aspects
- Four ethical principles and values that are integral to the professional nurse's practice.
Autonomy
- Respect for the individual's choice, regarding his own body and treatment
- Freedom of choice
- Self-determination and privacy
- Patients are more empowered today and are viewed as collaborators in health decisions.
Beneficence
- The word beneficence means -the state or quality of being kind, charitable and beneficial.
- To do good
- Commitment to beneficence helps to guide difficult decision where in it benefits the clients well being or dignity
Non maleficence
- Meaning: "First, do no harm"
- In healthcare ethics it is important to remember that ethical practice involves not only the will to do good, but also equal commitment to do no harm
- Emphasizes the need for medical competence, attention to care and safety, and a capacity to evaluate risk to the patient
Justice
- "giving to each that, which is his due'
- Ensure fair allocation of resources such as nursing care for all clients; determine the order in which client should be treated.
- Every patient has equal access to the standard of care
Responsibility
- Reliability and dependability.
- Includes to perform action well and thoughtfully.
Advocacy
- Promote what is best for the patient.
- Ensure that the patient's needs are met.
- Protect the patient's rights.
Legal aspects
- Respect for Autonomy: As a standard in ethics, autonomy represents an agreement to respect another's right to determine a course of action.
- Accountability: Ability to answer for one's own action
- Confidentiality: It refers to the right and privileges of clients for protection of privacy without diminishing access to quality care
INFORMED CONSENT
- Informed consent relates to the patient's right to accept or reject treatment by a nurse or any other health care provider and is a right of all legally competent adults or emancipated minors.
Psychological consideration
- Patient and family needs to be considered
- Social worker and nursing staff have important role in support and counsrling.
- Provide support to patient and family during initial crisis phase
- Counsel and teach
- Assess the patient's coping mechanisms from past history and current behavior.
- Provide opportunities for the patient to express thoughts, feelings, fears, and anxieties regarding injury.
- Explore with the patient alternative mechanisms for coping with the burn injury and its consequences
Enhancing Coping
Assure the patient of the normality of responses and the effect that time and healing will likely have on current concerns.
Interpret patient behavior to concerned family members and significant others.
Respect current coping mechanisms and discourage them only when an appropriate alternative can be provided.
Support family and friends' communications and visits if this is noted to help the patient.
Assess need for mental health consultation.
Offer antianxiety medications
Arrange for the patient to talk with other patients who have had a similar injury and are progressing satisfactorily.
Encourage participation in a burn survivor's group, other local support group.
Preserving Positive Body Image
- Gather data on the patient's pre bum self-image and lifestyle.
- When ready, encourage the patient to express concerns regarding changes in self-image or lifestyle that may result from burn injury.
- Be honest, but positive, in responding to the patient and family.
- Positively reinforce appropriate, effective coping mechanisms.
- Arrange for the patient to see face (if burned) with appropriate supportive personnel before being placed/transferred to a room with access to a mirror.
- Refer to psychological services as needed. Consider other areas of the patient's traumatic experience that may require intervention as well.
Medicolegal Assessment of Burns
- The principal medicolegal issue in the assessment of an injury resulting from heat usually is how the injury was caused and particularly was the injury caused as a result of a deliberate act or by accident.
- It is important to take the individual injury in the context of all the information available about the patient.
COMMENTS