MEDICAL ETHICS AND LAW

Ethical Roles and Responsibilities of a

Health Care Worker

Quality health care workers show a commitment to certain values.

Each person determines how values are reflected in their day to day actions.

But the employer describes what values are important and how to reflect them while working. These values are found in the employee handbook or policy and procedure book.

Value Indicators

•Dignity•Service•Excellence•Fairness/Justice

Dignity• When you are honest, truthful,

trustworthy, sincere and respectful of others.

• Work to the best of your ability.

• Communicate through listening actively, being positive, showing understanding and respecting all people.

Service

¥ Responding to patients/clients and co-workers with an understanding of their unique needs.

¥ Show kindness and patience.

¥ Means making comments that are positive, courteous, and helpful.

Excellence※ Taking responsibility for

yourself, your team’s decisions, and the results.

※ Adapt to changing needs by learning new skills, knowledge, and behaviors that encourage continuous improvement.

※ Accepting and seeking feedback help you improve your performance excellence.

Fairness/Justice

∯ Treat all people with mutual respect and provide the same dignity, service and performance excellence regardless of the patient's race, beliefs, ethnic background, or financial resources.

∯ Use supplies and available resources effectively to provide appropriate care and a safe environment for everyone.

CODE OF ETHICS

-A CODE OF CONDUCT REPESENTING IDEAL BEHAVIOR FOR A GROUP OF PEOPLE. -ALL HEALTH CARE WORKER OBSERVE THE CODE OF ETHICS.

Dignity• KNOW YOUR LIMITATIONS

– Know what you are trained to do– Know what you are capable of

doing

• BE SINCERE– Always be honest/trustworthy

in performing your duties– Do NOT solicit gifts or

additional money– Expect your salary in return

for your work• BE WELL GROOMED

– Wear name badge– Never wear perfume/trigger

an allergic reaction

SERVICE

• BE A GOOD CITIZEN – Respond to the needs of others– Demonstrate concern for meeting

those needs

• BE CARING– Try to understand the unique needs of

others– Respond quickly and effectively to

problems that arise while you are working

Excellence• Be accountableBe accountable

– Seek out and use feedback from others to learn.

– Take responsibility for yourself and your team’s actions, decisions and results

• Be informedBe informed– Learn from your experiences– Seek growth and development

opportunities• Follow the rules and regulationsFollow the rules and regulations

– Read the policy manual & procedure manual

– Practice Standard Precautions and the Bloodborne Pathogen Rule

FAIRNESS/JUSTICE

• BE LOYALBE LOYAL– To patient/clients, co-workers, and

your employer.– Always project a positive attitude

toward the institution where you are employed

• RESPECT THE PRIVACY OF OTHERSRESPECT THE PRIVACY OF OTHERS– Always keep privileged

information about any personal or private matter confidential

RESPONSIBILITY OF AN EMPLOYEE

Employees are required to assume certain responsibilities. Which include; being dependable, honest, and well groomed; displaying a good attitude; and following the rules and regulations of the organization.

Dignity

• COMMUNICATE EFFECTIVELY– Express ideas, information, and

view points clearly.– Use active listening skills, and

seek to understand others.– Create and maintain positive

working relationships.– Understand and respect

differences in people. – Be supportive of others’ success

when they do well.

SERVICE

• HAVE A GOOD ATTITUDE– Be willing to help your co-workers– Be aware of your body language

and facial expressions, and reflect a positive outlook

– Be respectful by changing your behavior when it appears to irritate others

– Work effectively under pressure

Excellence

– Be dependableBe dependable• Be on time• Report in when you arrive• Report to the person taking

care of your assignment prior to leaving your area

• Do your job to the best of your ability

• Call your supervisor ahead of time on those few occasions when you are unable to be at work

FAIRNESS/JUSTICE

BE HONEST Never clock in or out for another person. Never take anything from the facility

that is not yours. Never say that you have completed a

task when you have not. Work with commitment and enthusiasm

to improve the care patients/clients receive.

Patient and/or Customer Satisfaction

€ …is an essential element in providing effective health care.

€ Demonstrating the values of service and excellence helps patients, their families and their friends feel satisfied with their care.

€ Satisfactions does not always mean that people get want they want, however. It does mean they receive the very best care available and that the care is given with respect and with a sincere attitude.

PATENT AND CUSTOMER SATISFACTION GUIDELINES

Patient or Customer Satisfaction

€ Each patient/client is fully informed about the service provided by being told:~what is needed~why it’s needed~who will provide the

service~when it will be

provided~how it will be provided

Communication Communication ObjectiveObjective

≠ Demonstrate open, honest and respectful communication.

≠ Present ideas, information, and viewpoints clearly, both verbally and in writing.

≠ Listen actively and seek to understand others.

≠ Anticipate and strive to understand the unique needs of the patient.

≠ Tailor each interaction to the specific needs of the person and/or situation.

≠ Seek growth and developmental opportunities for yourself and others.

≠ Adapt to changing needs by acquiring new skills, knowledge, and behaviors.

≠ Learn from your experiences.

Service ~ Excellence

¤ Welcome patients, family members, and visitors in a warm, friendly manner.

¤ Listen to and communicate with one another and the people you serve.

¤ Have respect for each person's privacy, comfort, and dignity.

¤ Use good elevator manners.¤ Provide a safe, clean environment.¤ Anticipate the wants and needs of

those served.¤ Strive to do your best.

BehaviorBehavior≥ Introduce yourself to the patient &

their family.≥ Address the patent by Mr., Mrs. or

Miss unless directed otherwise. ≥ Make eye contact and smile. ≥ Explain who you are and what you

do.≥ LISTEN.≥ Wear your name badge. ≥ Adhere to the dress code.≥ Listen attentively. Do NOT

interrupt.≥ Address the person’s needs and

take whatever action is necessary.

BehaviorBehavior£ Do NOT argue£ Try to eliminate distractions

when communicating with patients and families.

£ Make sure patients understand their treatment or procedures.

£ Encourage patients to ask questions.

£ Respect patients confidentiality in all settings.

£ Keep noise and conversation levels low.

£ Interview patients in private.£ Close curtains and doors during

exams.£ Remember to care for the whole

person-body, mind, and spirit.

BehaviorBehavior£ Use the elevator as an

opportunity to make a favorable impression. Be friendly.

£ Remember confidentiality-do not discuss patients, their care, or any business on elevators.

£ Be alert to unsafe conditions.£ Correct, warn and/or report

safety hazards for immediate repair.

£ Pick up and dispose of litter.£ Keep all areas neat, orderly,

and clutter-free.

BehaviorBehavior£ Be aware and sensitive to the

different cultures an religious beliefs of patients.

£ Communicate any anticipated delays.

£ Be prepared to address special needs, such as hearing impairments, language barriers and disabilities.

£ Focus on education, comfort, and privacy needs at all times.

£ Anticipate and provide appropriate comfort measures.

BehaviorBehavior£ Identify better ways to serve

patients and their families.£ Be a role model.£ Promoter cooperation and

teamwork.£ Take opportunities to improve

your skills.£ Seek out and constructively

use feedback from others.£ Show appreciation and thank

your co-workers.

The Team Concept

¬ Depends on every health care worker’s doing their part.

¬ Each member is an important part of the interdisciplinary team.

¬ Professional with different backgrounds, different education, and different interests all work together to provide appropriate quality care.

TEAM CONCEPT

The Team Concept

The registered nurse delegates duties to a team of licensed and unlicensed assistive personnel.

The RN determines what tasks the members of the interdisciplinary team are assigned.

The RN over sees health care workers from various departments and trains them to provide patient care and effectively delegates by using The 5 Rights of DelegationThe 5 Rights of Delegation.

THE 5 RIGHTS OF THE 5 RIGHTS OF DELEGATIONDELEGATION

The 5 Rights of DelegationThe 5 Rights of Delegation1. Right task ~ identifying an appropriate

caregiver-patient relationship

2. Right circumstances ~ verifying that the correct patient setting and resources are available.

3. Right person ~ Identifying who is trained and capable of doing the task.

4. Right direction/communication ~ providing a clear, short description of the task and clarifying limitations and the expected result.

5. Right Supervision ~ providing appropriate monitoring, assistance, and feedback.

NOTE:NOTE:It is the team It is the team effort of all effort of all health care health care

workers that workers that provides service provides service

to the to the patient/client.patient/client.

COMPLETE WORKSHEET 1 & 2

Legal Roles and Legal Roles and Responsibilities of a Health Responsibilities of a Health

Care WorkerCare Worker

→ Patient/clients have rights that represent moral and ethical issues which are legislated by both federal and state governments.

→ It is the health care worker’s responsibility to recognize the importance of treating patients/clients with dignity.

Legal Roles and Legal Roles and Responsibilities of a Health Responsibilities of a Health

Care WorkerCare Worker

→ A list of rights if meaningless unless the person working with the patient understands and follows them.

→ All health care workers must commit to giving the best possible care.

→ All health care workers are bound to provide care as it is stated in the Patient’s /Client’s Bill of Rights

Patient Bill of RightsPatient Bill of RightsFirst adopted by American Hospital Association

in 1973- revised in Oct. 1992

1. The patient has the right to considerate and respectful care.

2. The patient has the right to and is encouraged to obtain from physicians and other direct caregivers relevant, current and understandable information concerning diagnosis, treatment, and prognosis.

3. The patient has the right to make decisions about the plan of care prior to and during the course of treatment and to refuse a recommended treatment or plan of care to the extent permitted by law and hospital policy and to be informed of the medical consequences of this action.

Patient Bill of RightsPatient Bill of Rights

4. The patient has the right to have an advance directive concerning treatment or designating a surrogate decision maker with the expectation that the hospital will honor the intent of that directive to the extent permitted by law and hospital policy.

5. The patient has the right to every consideration of privacy.

6. The patient has the right to expect that all communications and records pertaining to their care will be treated as confidential by the hospital, except in cases such as suspected abuse and public health hazards when reporting is permitted or required by law. The patient has the right to expect that the hospital will emphasize the confidentiality of this information when it releases it to any other parties entitled to review information in these records.

Patient Bill of RightsPatient Bill of Rights

7. The patent has the right to review the records pertaining to their medical care and to have the information explained or interpreted as necessary, except when restricted by law.

8. The patient has the right to expect that, within its capacity and policies, a hospital will make reasonable response to the request of a patient for appropriate and medically indicated care and services.

9. The patient has the right to ask and be informed of the existence of business relationships among the hospital, educational institutions, other health care providers, or payers that may influence the patient’s treatment and care.

Patient Bill of RightsPatient Bill of Rights

10. The patient has the right to consent to or decline to participate in proposed research studies or human experimentation affecting care and treatment or requiring direct patient involvement, and to have those studies fully explained prior to consent.

11. The patient has the right to expect reasonable continuity of care when appropriate and to be informed by physicians and other caregivers of available and realistic patient care options when hospital care is no longer appropriate.

12. The patient has the right to be informed of hospital policies and practices that relate to patient care, treatment, and responsibilities.

Hospitals have many functions to Hospitals have many functions to perform, including the enhancement perform, including the enhancement

of health status, health promotion, of health status, health promotion, and the prevention & treatment of and the prevention & treatment of injury and disease; the immediate injury and disease; the immediate and ongoing care and rehabilitationand ongoing care and rehabilitationof patients: the education of health of patients: the education of health professionals, patients, and the professionals, patients, and the community; and research.community; and research.

All of these activities must be All of these activities must be conducted with an overriding conducted with an overriding concern for the values andconcern for the values anddignity of patients.dignity of patients.

® Patient Bill of Rights

Natural Death Guidelines

I.I. Living Will Living Will ~ provides a way for a person to express their desire for or against extraordinary measures that could prolong life. A LW takes effect while a person is still alive. Legal assistance may be necessary to ensure that it is interpreted in the way it was intended.

II.II. Health Care Power of Attorney Health Care Power of Attorney (HCPOA) ~ authorizes a person to make health care decisions for an individual if they are unable to do so. Can cover any health care decision; such as temporary unconsciousness or in case of diseases like Alzheimer’s that affect decision making.

III.III. Durable Power of Attorney for Health Care Durable Power of Attorney for Health Care (DPAHC) ~ the document is signed, dated, and witnessed paper, naming an authorized person to make medical decisions for the individual if they are unable to make them. It also includes instruction about treatment to avoid.

Ombudsman

is a social worker, nurse, or trained volunteer who makes certain that the patient/client is not abused and that the person’s rights are secure.

Licensure Licensure - governmental agency oversees the individual meeting the qualification for a particular occupation.

CertificationCertification - given for recognition. Guidelines must be met, equals licensure.

RegistrationRegistration – a list of individuals on a official record who meet the qualifications for an occupation.

Controls on Health Care Workers

Legal Terms and Boundaries

• Assault• Battery• Informed Consent• Crime• Libel• Slander• False Imprisonment• Felony• Invasion of privacy• Malpractice• Negligence

• Privileged communication• Reasonable care• Sexual harassment• A Will• Reportable incidents and

conditions

CONFIDENTIALITY

ConfidentialityConfidentiality It means secret. Health care workers are

obligated to protect and keep all patient/client information confidential.

A good rule is to discuss a patient/client only when the discussion affects their care in some way.

A medical facility, physician, or a health care worker can be fined, sued , or lose their gob for sharing any information about patients/clients with others, including family members.

POLICIES AND PROCEDURES

Policies and Procedures

Successful health care workers are familiar with their employer's policies and procedures. Each facility has a policy manual that explains their rules and regulations:

Holiday and vacation policy Insurance and sick leave benefits All other information concerning the

operation of that business

A procedure manual explains the step-by-step method of performing tasks, including:

How to take a temperature How to fill out forms How to package and wrap trays

Summary----

1. Boundaries2. Confidentiality3. Policies are guidelines4. Complete tasks

COMPLETE WORKSHEET 3 & 4

REVIEW FOR QUIZ