Unit 2:

Nursing as
profession

prepared by:
Ms. Shiny George
Asst. Lecturer.
 Nursing definition:
• Virginia Henderson defined nursing in functional terms: "The
unique function of the nurse is to assist the individual, sick or
well, in the performance of those activities contributing to health
or its recovery (or to a peaceful death) that he would perform
unaided if he had the necessary strength, will or knowledge. And
to do this in such a way as to help him gain independence as
rapidly as possible."
BASIC NURSING PRINCIPLES :

SAFETY
THERAPEUTIC EFFECTIVENESS
COMFORT
USE OF RESOURSES
GOOD WORKMANSHIP
INDIVIDUALITY
 OBJECTIVES :

• Prepare nurses who will give expert bedside nursing care

• Provide integration of health and social aspects theory &

practice
• Provide an adequate ,sound scientific foundation to

understand the functioning of body & mind in health &

disease
•Prepare to work cooperatively, develop sense of

responsibility

•Provide opportunity to develop skills& personality

•Upgrade nursing as a profession

 Concept of nursing:
• The tasks of nursing are:
• (a) to promote health

• (b) to prevent disease

• (c) to help ill-person to healing (to assist healing)

• (d) to assist the dying patient to pass away with quietude, peace, and
dignity.(to ease suffering)

• (e) The client is a holistic human being, including suffering

person and healthy person.
 Concept of nursing
• 6) The working place is not only in the hospital, but also in family,
community and whole society.

• 7) Nursing is not only a science, but also an art.

• 8) The nursing science attaches importance to human being’s living

environment and the interrelation between human being and its
environment.

• 9) The nursing science is a gradually perfect and developing science.

Philosophy
• The study of the fundamental nature of knowledge,
reality, and existence, especially when considered as
an academic discipline.

• A theory or attitude that acts as a guiding principle

for behavior.
 Philosophy of nursing
• Nursing is viewed as both an art and a science, reflecting upon the concepts
of the nursing. Nursing is an applied discipline which expresses itself in
practice, and has its foundation rooted in scientific/empirical knowledge,
theory, and research. Nursing is also expressed as a caring, therapeutic and
teaching discipline.

• The goal of nursing is optimum client wellness, and the maximum level of
functioning. The nursing interventions are evidence-based and stem from their
core knowledge.The professional nurse must appreciate the role of
informatics.
 Philosophy of nursing
Philosophy of nursing includes beliefs and values with regard to man in
general & specifically man as the learner ,teacher, nurse, client and the
beliefs about health, illness, society, nursing & learning etc..
It includes...
Spiritual : Religion should serve as the primary integrating factor.
Moral : Nurse has to develop right conscience.
Intellectual : to provide a systematic development & training& for
fulfilment of nursing function.
 cont....
Emotional needs : nurse must be able to function as a mature,
self – dependent & responsible individual & must be able to relate
well to other people.
Physical : to promote harmonious development, physical needs
to preserve essentials of health.
Social : nursing is linked with social culture ,in which nursing
activities are carried out.
 FUNCTIONS OF A NURSE
• Caregiver

• The caregiver role has traditionally included those activities that

assist the client physically and psychologically while preserving
the client’s dignity. Caregiving encompasses the physical,
psychosocial, developmental, cultural and spiritual levels.
• Communicator

• Communication is an integral to all nursing roles. Nurses

communicate with the client, support persons, other health
professionals, and people in the community. In the role of
communicator, nurses identify client problems and then
communicate these verbally or in writing to other members of the
health team. The quality of a nurse’s communication is an
important factor in nursing care.
• Teacher :

• As a teacher, the nurse helps clients learn about their health

and the health care procedures they need to perform to
restore or maintain their health. The nurse assesses the
client’s learning needs and readiness to learn, sets specific
learning goals in conjunction with the client, enacts teaching
strategies and measures learning.
• Client advocate

• Client advocate acts to protect the client. In this role the

nurse may represent the client’s needs and wishes to
other health professionals, such as relaying the client’s
wishes for information to the physician. They also assist
clients in exercising their rights and help them speak up
for themselves.
• Counselor

• Counseling is a process of helping a client to

recognize and cope with stressful psychologic or
social problems, to developed improved interpersonal
relationships, and to promote personal growth. It
involves providing emotional, intellectual, and
psychologic support.
• Change agent

• The nurse acts as a change agent when assisting others,

that is, clients, to make modifications in their own
behavior. Nurses also often act to make changes in a
system such as clinical care, if it is not helping a client
return to health.

• Researcher ,rehabilitator,& critical thinker.

• Leader

• A leader influences others to work together to accomplish a

specific goal. The leader role can be employed at different
levels; individual client, family, groups of clients, colleagues,
or the community. Effective leadership is a learned process
requiring an understanding of the needs and goals that
motivate people, the knowledge to apply the leadership skills,
and the interpersonal skills to influence others.
• Manager

• The nurse manages the nursing care of individuals, families, and

communities. The nurse-manager also delegates nursing
activities to ancillary workers and other nurses, and supervises
and evaluates their performance.
• Case manager

• Nurse case managers work with the multidisciplinary health

care team to measure the effectiveness of the case management
plan and to monitor outcomes.
 Qualities of a nurse :
• Caring nature:

• Nurses deal with the sick and injured and their families on a daily basis, and
must be able to show thatthey truly care about the situation.

• Empathic attitude

• Nurses must be able to put themselves in their patients’ shoes to provide

the quality care needed.

• Detail oriented

• Nurses must remember to make entries on patients’ charts and to bring

• Emotionally stable
• Nurses feel the joy of seeing a new baby born as well as the pain of
losing a long-term patient. Emotional stability is crucial to deal with
the wide range of emotions nurses must endure.

• Adaptable
• People are unpredictable at the best of times, but become even more
so under stress, so a nurse’s typical workday will require flexibility
and adaptability.
• Hardworking :Nursing is a never ending job. It is unusual for a
hospital or medical center to be overstaffed, which of course means
more workload on each nurse in the unit.

• Quick thinker :

• When a nurse notices something is not right with a patient, they

must be able to make decisions quickly and put their plans into
action instantly, because a fraction of a second can mean the
difference between life and death.
• Physical endurance
• Nurses are on their feet all day, sometimes 12 or more hours
at a time, and are often required to assist patients with
activities that require physical strength.

• Good judgment
• A nurse must be able to look at a patient’s current state and
accurately assess what is needed, especially during
emergencies.
• Good communication skills
• Nurses must communicate with other nurses, doctors,
patients, and patients’ families clearly.

• Responsible
• Good nurses know how to perform all of their responsibilities with
the utmost accuracy and detail. They play a major role in assessing
and treating patients’ , and when dealing with the health of
another human being, so nurses must responsibly carry out their
duties at all times.
• N – Nobility, Knowledge
• U – Usefulness, Understanding
• R - Righteousness, Responsibility
• S – Simplicity, Sympathy
• E – Efficiency , Equanimity
• Profession – is a calling that requires
special knowledge, skill and
preparation.

• An occupation with ethical components , that is

devoted to the promotion of human & social
welfare.
A profession is “ an occupation or
calling requiring advanced training
and experience in some specific or
specialized body of knowledge
which provides service to society in
that special field.”
• Criteria of Profession:
• To provide a needed service to the society.
• To advance knowledge in its field.

• To protect its members and make it possible to practice effectively.

Bixler and bixler criteria for profession:

• A profession is a form of employment especially one that is respected

in society as honourable and is possible only for an educated person
and after training in some special branch of knowledge.
•It has its own body of knowledge based on social & scientific principles.
•The members of this profession utilise this knowledge to identify & solve
problem
•Has a service aim as well as academic & theoretical aim.
•Constantly enlarges its body of knowledge through research inorder to
improve its services.
•It determines the qualifications necessary for those who enter into practice.
•It has a code of ethics
 Contd....
•Functions autonomously in the formation of professional policy
& in control of professional activities.
•It provides a freedom of action ,oppertunity for continous
professional growth & economic security.
•A profession recognises its responsibilities to develop
educational programmes in cooperation with institutions in order
to develop skills &to learn method of services
• Characteristics of a Profession:
• A basic profession requires an extended education of its
members, as well as a basic liberal foundation.
• A profession has a theoretical body of specialised
knowledge leading to defined skills, abilities and
norms.
• A profession provides a specific service.
• Members of a profession have autonomy in
decision-making and practice.
• The profession has a code of ethics for practice.
• Authority to control its work.
Contd.....
•Service to the society
•Extensive period of formal training
•Self – regulation
•Credentialing system to certify competence
•Legal reinforcement of professional standards
•Ethical practice
•Creation of a collegial subculture
Nursing as a profession:

• NURSING >is a disciplined involved in the delivery of

health care to the society.
• >is a helping profession
• >is service-oriented to maintain health and well-
being of people.
• >is an art and a science.

• NURSE – originated from a Latin word NUTRIX, to

nourish.
• Characteristics of Nursing:
• Nursing is caring.
• Nursing involves close personal contact with the recipient of care.
• Nursing is concerned with services that take humans into account
as physiological, psychological, and sociological organisms.
• Nursing is committed to promoting individual, family, community,
and national health goals in its best manner possible.
• Nursing is committed to personalized services for all persons
without regard to color, creed, social or economic status.
• Nursing is committed to involvement in ethical, legal, and political
issues in the delivery of health care.
ELEMENTS :

1. Accountability : service involves intellectual activities

,individual responsibilities
2. Autonomy : practitioners are relatively independent &
control their own policies & activities
3. Altruism : practitioners are motivated by service & consider
their work as an important component of their lives
4. Association :there is an organisation that encourages &
supports high standards of practice
Categories of nursing personnel
• Staff nurse
• Senior staff nurse
• Nursing superintendent grade II
• Nursing superintendent grade I
• Nursing tutor/clinical instructor
• Principal, school of nursing
• Lecturer, college of nursing
Categories of nursing personnel
• Assistant professor, college of nursing
• Professor, college of nursing
• Principal, college of nursing
• Senior assistant director of nursing
• Public health nurse- district family welfare bureau
 VALUES

Freely chosen
Values underlie all moral dilemmas. though, not all values are moral
values (people values about work, family, religion, politics, money and
relationships.
IMPORTANT: Values influence decisions and actions, such as nurses’
ethical decision making.
Beliefs or attitudes about the worth of a person, object, idea, or action.
 Values and ethics
Values and ethics are inherent in all nursing acts.
A value is a strong personal belief; an ideal that a person
strives to uphold.
Your values reflect cultural and social influences,
relationships and personal needs. Vary among people and
develop and change over time.
 DEFINITION

Values are enduring beliefs or attitudes about the

worth of a person, idea or actions.
They are important because they influence decisions
and actions, including nurses ethical decision making.
 COMPONENTS
A value set is the small group of values held by an individual.
A value system is an organization of values in which each set of values are ranked along a
continuum from most important to least important.
value system are basic to a way of life, give direction to life & form the basis of
behaviour
ELEMENTS

BELIEFS:
Interpretations or conclusions that people accept a truth.
They are based more on faith than fact & may or may not be true.
ATTITUDE:
mental positions or feelings towards a person ,object or
idea.
oAn attitude lasts overtime ,where as a belief may last only briefly.
 VALUES
BELIEFS ATTITUDES

 FAITH than FACT.  THINKING and BEHAVIORAL aspects.

 Last only briefly.  Continuous overtime.

 Judged as correct or incorrect. Judged as bad or good, positive

or negative.
 TYPES
1. Societal values :
Values that are derived from society & the individual subgroups
These values are heavily influenced by a person’s socio cultural envt; i.e. By societal
traditions; by cultural, ethnic & religious groups; & by family & peer groups.
2. Personal values:
People internalize some or all of the societal values & perceive them as personal
values.
Personal values are needed to have a sense of individuality.
3. Professional values:
Acquired during socialization into a profession.
 Professional values..

They provide the foundation for nursing practice &

guide the nurses interaction with pts; colleagues &
public.
Nurses professional values are acquired from code of
ethics, experiences, teachers & peers.
ESSENTIAL NSG PROFESSIONAL VALUES

Altruism
Autonomy
Human dignity
Integrity
Social justice
Altruism: Its a concern for the welfare & well being of
others. In professional practice altruism is reflected by the
nurse’s concern for the welfare of pts, other nurses & other
health care practitioners.
Autonomy: Its the right to self determination. Professional practice reflects autonomy
when the nurse respects pts rights to make decisions about their health care.
Human dignity: Its the respect for the inherent worth & uniqueness of individuals &
populations. In professional practice, human dignity is reflected when the nurse values
& respects all pts & colleagues.
 Integrity: Its acting in accordance with an appropriate code of ethics & accepted stds
of practice. Integrity is reflected in professional practice when the nurse is honest &
provides care based on an ethical frame work that is accepted within the profession.
Social justice: Its upholding moral, legal & humanistic principles. This value is
reflected in professional practice when the nurse works to assure equal treatment
under the law & equal access to quality health care.
 Essential Nursing Values and Behaviors

VALUES Professional Behaviors

Altruism • Understands cultures, beliefs, and perspectives of others.
Nurse’s concern for the welfare of patients, • Advocates for patients.
other nurses, and other health care providers. • Take risks on behalf of patients and colleagues.

Autonomy • Plans care in partnership with patients

Nurses respects patient’s right to make decisions about
their health care.
Human Dignity •Provides culturally competent and sensitive care.
Nurses values and respects the inherent worth • Protects patient’s privacy.
and uniqueness of all patients and colleagues. •Designs care with sensitivity to individual patient needs.
•Provides honest information to patients and the public.
Integrity •Document care honestly and accurately.
Nurses acts honestly and provides care based on an ethical •Seeks to remedy errors made by self or others.
framework. •Demonstrates accountability of own actions
•Supports fairness and nondiscrimination in the delivery of care.
Social Justice
Nurse upholds moral, legal, and humanistic principles by
ensuring equal treatment under the law and equal access to
quality health care.
 Development of values/ value transmission

•An individual is not born with values, rather values are formed during a lifetime from
information gathered from the envt, family & culture.
•As children observe the actions of others, they quickly learn what has high & low
value for them.
Common modes of value transmission:

Modelling
Moralizing
Laissez- faire
Rewarding & punishing
Responsible choice
Modelling

Through modelling, children learn what is of high or

low value by observing parents, peers & significant
others. Thus it leads to socially acceptable or
unacceptable behaviour.
Moralizing

In this mode of value transmission, children

are taught a complete value system by
parents or an institution that allows little
opportunity for them to weigh different
values.
 Laissez-faire

In this approach, children are left to explore values on their

own & to develop a personal value system. In this no one set
of values is presented as best for all. This approach often
involves little or no guidance & can lead to confusion &
conflict.
 Rewarding & punishing

Children are rewarded for demonstrating values held

by parents & punished for demonstrating
unacceptable values.
Responsible choice

In this mode, the caregivers encourage

children to explore competing values and to
weigh their consequences. Support &
guidance are offered as children develop a
personal value system.
Value clarification
Process by which people come to understand their own values & value system.
Process of discovery & allows a person to discover through feelings & analysis of
behaviour
What choices to make ?
When alternatives are presented...
Identify whether or not these choices are rationally made...
 FROM?
VALUES TRANSMISSION VALUES CLARIFICATION

 Acquired through Observation and Experience.
 Affected by Socio-Cultural environment
(societal conditions, family and peers)
PERSONAL VALUES
 A process by which people identify, examine, and develop their own
individual values.
 It promotes personal growth (promotes awareness, empathy, and
insight)
 It is an important step for nurses to take in dealing with
ethical problems.

 Nurses should keep in mind the influences  No One set of values is right for everyone.
of Values on health.
 People can retain or change the freely chosen values

 CLARIFYING THE NURSES’ VALUES

PROFESSIONAL VALUES
 CLARIFYING CLIENT VALUES
 FROM?
Professional Values Clarifying Nurse’s Values

 Acquired during experience from code of ethics,

nursing, teachers, and peers.  Nurses and nursing students

 5 VALUES ESSENTIAL FOR

need to examine the values
PROFESSIONAL NURSE: they hold about life, death,



ALTRUISM
AUTONOMY
health and illness.
 HUMAN DIGNITY
 INTEGRITY
 SOCIAL JUSTICE
Theory of Values Clarification (Raths, Harmin, and Simon, 1978)

Valuing Process
•Beliefs are freely chosen.
•Without outside pressure
Choosing Cognitive •After reflecting and considering consequences
or alternatives

•Chosen beliefs are cherished or prized

Prizing Affective

•Chosen beliefs are affirmed to others, incorporated

into one’s behavior and repeated consistently in
Acting Behavior one’s life.
 Clarifying Client Values

 Is an intervention used by the nurse s when clients experiences

unclear values that are harmful to their health.

Behavior Example
Ignoring a health professional’s A child client’s parent who values the
advice
Inconsistent communication behavior A n elderly who says she don’t want anymore to use cane when walking, but
won’t cooperate during her therapy.

Numerous admissions to a health A hypertensive client repeatedly seeks help for headache but does not take
the prescribed maintenance medicine.
agency for the same problem

Confusion about which course A pregnant woman who values her job to meet financial obligations, but also
needs to have complete bed rest for a safe labor and delivery.
of action to take
 Clarifying Client Values

Process How?

List Alternatives Ask: “Are you considering other alternative courses of actions?”
“Tell me about them”

Examine possible Ask: “What do you think you will gain from doing that?”
consequences of choices

Choose freely Ask: “Did you have any say in that decision?”

Feel good about the choice Ask: “How do you feel about that decision?” “Some peoplefeel
good after a decision is made; others feel bad. How do youfeel?”

Affirm the choice Ask: “What will you say to family or friends about this?”

Act on the choice Ask: “Will it be difficult to tell your wife about this?” (it
determines the client’s preparedness to act in his decision)

Act with a pattern Ask: “How many times have you done that before?” or “Would
you act that way again?”
Code of
ethics
 DEFINITION :
•Ethics refers to the moral code of nursing & is based on obligation to
service & respect for human life
Melanie & Evelyn
•A code of ethics is a set of ethical principles that are accepted by all
members of a profession.
Potter & Perry
Code of ethics is a guideline for performance & standards & personal
responsibilities.
 A code of ethics is a set of ethical principle that

A.) is shared by members of a group

B.) reflects their moral judgements over time

C. ) serves as a std for their professional actions

PURPOSES :
 Standards FOR THE BEHAVIOURS OF NURSE&
PROVIDE GENERAL GUIDELINES FOR NURSING
ACTION
 Helps TO DISTINGUISH BETWEEN RIGHT&
WRONG
 Enables A CORRECT DECISION
 Protect THE RIGHTS OF INDIVIDUAL
 USES :
Acknowledge the rightful place of individual in health care delivery
system
Constitutes towards empowerment of individual to become responsible
for their health & wellbeing
Contributes to quality care
Identifies obligations in practice, research & relationship
Inform the individual, family, community & others professionals about
expectation of nurse
 FUNCTIONS :
To inform the public about the minimum stds of the
profession
To provide a sign of the profession’s commitment to the
public it serves
To outline the major ethical considerations of the profession
To provide general guidelines for professional behaviour
To guide the profession in self regulations
 RESPECT & AUTONOMY
BENEFICENCE

JUSTICE

VERACITY(truth telling)
 FIDELITY

 CONFIDENTIALITY
ETHICAL ISSUES:

Practitioner –Assisted Suicide (PAS)

Refusal to treat
Genetic research
Right to refuse treatment

Do not resuscitate (DNR) orders

 Nursing Codes of Ethics
 Purposes:
 Inform the public about the minimum standards of the profession
and help them understand professional nursing conduct.

 Provide a sign of the profession’s commitment to the public it

serves.
 Outline the major ethical considerations of the profession.
 Provide standards for professional behaviors.
 Remind nurses of special responsibility they assume when
caring for the sick.
ETHICAL DILEMMA
Occurs when there is conflict between two
or more ethical principles.
No correct decision exists.

Nurse must choose b/w two alternatives that

are equally unsatisfactory.
Occurs as a result of difference in beliefs.

Ethical reasoning
 INTERNATIONAL CODE OF NURSING ETHICS
 THE ICN CODE OF ETHICS FOR NURSES

 An international code of ethics for nurses was first adopted by the

International Council of Nurses (ICN) in 1953. It has been revised and
reaffirmed at various times since, most recently with this review and
revision completed in 2005.

 PREAMBLE

 Nurses have four fundamental responsibilities: to promote health, to

prevent illness, to restore health and to alleviate suffering. The need for
nursing is universal.
 Inherent in nursing is respect for human rights, including cultural
rights, the right to life and choice, to dignity and to be treated with
respect. Nursing care is respectful of and unrestricted by
considerations of age, colour, creed, culture, disability or illness,
gender, sexual orientation, nationality, politics, race or social status.
 Nurses render health services to the individual, the family and the
community and co-ordinate their services with those of related
groups.
The ICN Code of Ethics for Nurses has four principal elements that
outline the standards of ethical conduct.
1. NURSES AND PEOPLE
•The nurse’s primary professional responsibility is to people requiring
nursing care.
•In providing care, the nurse promotes an environment in which the
human rights, values, customs and spiritual beliefs of the individual,
family and community are respected.
•The nurse ensures that the individual receives sufficient information on which
to base consent for care and related treatment.
•The nurse holds in confidence personal information and uses judgement in
sharing this information.
•The nurse shares with society the responsibility for initiating and supporting
action to meet the health and social needs of the public, in particular those of
vulnerable populations.
•The nurse also shares responsibility to sustain and protect the natural
environment from depletion, pollution, degradation and destruction
 2. NURSES AND PRACTICE
•The nurse carries personal responsibility and accountability for
nursing practice, and for maintaining competence by continual
learning.

•The nurse maintains a standard of personal health such that the

ability to provide care is not compromised.
•The nurse uses judgement regarding individual competence
when accepting and delegating responsibility.
•The nurse at all times maintains standards of personal
conduct which reflect well on the profession and enhance
public confidence.
•The nurse, in providing care, ensures that use of technology
and scientific advances are compatible with the safety, dignity
and rights of people
 3. NURSES AND THE PROFESSION
•The nurse assumes the major role in determining and
implementing acceptable standards of clinical nursing practice,
management, research and education.

•The nurse is active in developing a core of research- based

professional knowledge.

•The nurse, acting through the professional organisation, participates

in creating and maintaining safe, equitable social and economic
working conditions in nursing
 4. NURSES AND CO-WORKERS

The nurse sustains a co-operative relationship with

co-workers in nursing and other fields.
The nurse takes appropriate action to safeguard
individuals, families and communities when their
health is endangered by a co- worker or any other
person.
5. NURSES AND SOCIETY
 Participate and share responsibility with other citizens
&other health professionals.
 Recognize and perform the duties of citizenship
 Aware of laws and regulations which affect the
practice of medicine and nursing.
 INC CODE OFPROFESSIONALCONDUCT FOR NURSESIN
INDIA
1. Professional Responsibility and accountability
1.Appreciates sense of self-worth and nurtures it.
2.Maintains standards of personal conduct reflecting credit upon the profession.
3.Carries out responsibilities within the framework of the professional
boundaries.
4.Is accountable for maintaining practice standards set by Indian Nursing
Council
5.Is accountable for own decisions and actions
6.Is compassionate
7.Is responsible for continuous improvement of current practices
8.Provides adequate information to individuals that allows them informed choices
9. Practices healthful behavior
2. Nursing Practice

1.Provides care in accordance with set standards of practice

2.Treats all individuals and families with human dignity in providing physical,
psychological, emotional, social and spiritual aspects of care

3.Respects individual and families in the context of traditional and

cultural practices and discouraging harmful practices
4. Presents realistic picture truthfully in all situations for facilitating autonomous
decision-making by individuals and families
4.Promotes participation of individuals and significant others in the care
5.Ensures safe practice
6.Consults, coordinates, collaborates and follows up
appropriately when individuals’ care needs exceed the nurse’s
competence
3. Communication and Interpersonal Relationships
1.Establishes and maintains effective interpersonal relationship with individuals,
families and communities
2.Upholds the dignity of team members and maintains effective interpersonal
relationship with them
3.Appreciates and nurtures professional role of team members
4.Cooperates with other health professionals to meet the needs of the individuals,
families and communities
4. Valuing Human Being
1.Takes appropriate action to protect individuals from
harmful unethical practice
2.Consider relevant facts while taking conscience decisions in
the best interest of individuals
3.Encourage and support individuals in their right to speak for
themselves on issues affecting their health and welfare
4.Respects and supports choices made by individuals
5. Management
1. Ensures appropriate allocation and utilization of available resources

2. Participates in supervision and education of students and other formal care providers

3. Uses judgment in relation to individual competence while accepting and delegating

responsibility

4. Facilitates conducive work culture in order to achieve institutional objectives

Communicates effectively following appropriate channels of communication

5. Participates in performance appraisal

6. Participates in evaluation of nursing services

7. Participates in policy decisions, following the principle of equity and accessibility of services

8. Works with individuals to identify their needs and sensitizes policy makers and funding agencies
for resource allocation
6. Professional Advancement

1. Ensures the protection of the human rights while pursuing the advancement of knowledge

2. Contributes to the development

3. Participates in determining and implementing quality care

4. Takes responsibility for updating own knowledge and competencies

5. Contributes to the core of professional knowledge by conducting and

participating in research
 LEGAL CONSIDERATIONS
 1st nursing law : Nursing registration- 1903
 Indian nursing council act: enacted in 1947

 Amended in 1957

LEGALIMPLICATIONS: (civil disputes)

 Torts: Torts are when others interfere in individuals' privacy

 Assault: Assault occurs when a person puts another person in fear of

a harmful or offensive contact
 Battery: It is an intentional touching of another's body without the
other's consent
 Negligence: it is described as lack of proper care and attention
carelessness.
 Malpractice: Failure to meet the standards of acceptable care which
results in harm to another person.

 Fraud: It results from a deliberate deception intended to produce

unlawful gains.

 False imprisonment: It occurs when a client is not allowed to leave a health

care facility when there is no legal justification to detain the client or when
restraining devices are used without an appropriate clinical need.

 Invasion of privacy: It includes violating confidentiality intruding on private

client or family matters, and sharing client information with unauthorized

persons.
p
 Legal documents: it comprised:
a)Advance directive: Written document recognized by law that provides
directions concerning the provision of care when a person is unable to
make his or her own treatment choices.
b)Do not resuscitate orders: Written order by a physician when a client has
indicated a desire to be allowed to die if the client stops breathing or the
client's heart stops beating.
c)Informed consent: It is clients' approval [or that of the clients' legal
representative to have his or her body touched by a specific individual.
 NURSING LIABILITIES AND PREVENTIVE MEASURES
o All nursing observations should be noted carefully, describing
accurately

 Patients complaints should be recorded as accurately and

specifically

 Nurse must report through proper channels

 Authorities must be informed regarding any kind of equipment, materials or

supplies, which for any reasons less than safe for use in the patient's care

 Insurance protection
 LEGAL RESPONSIBILITY
 Registration

Licensing is a mandatory procedure for practice of nursing.

Registration aims at protecting patients by providing qualified
nurses. The nurse is responsible to obtain registration in the
respective State Nursing Registration Council

 Legal Liability/Act Of Negligence

License of a nurse can be suspended or cancelled for any act of

negligence or mal practice, following a specified procedure.

 Medico — Legal case (M.L.C.)

A medico legal case is a patient who is admitted to the hospital with some unnatural
pathology and has tobe taken care of in concurrence with the police and/or court
 Correct identity

A nurse/midwife is responsible to make sure that all babies born in

hospital are correctly labeled at birth and handed over to right parent.
 Unknown/unconscious patients must be labeled as soon as their
identity is known.
 Patients who have to undergo surgery should be appropriately
identified and labeled.
 Site of operation to be correctly marked particularly where
symmetrical sides or organs are there:
 Operation theatre (O.T.): scrub nurse has to see all the instruments/
swabs are returned. She has to say OKAY' before closure by the surgeon
 . Left Against Medical Advice (L.A.M.A.)
 Inform medical officer in charge. Signatures of both
patients and witness to be taken as per institutional policy.
 Patient's Property

Inform patient on admission that hospital does not take

responsibility of his belongings. If patient is unconscious/ or otherwise required
then a list of items must be made, counter checked by two staff nurses and kept
under safe custody.
 Dying Declaration

Doctor or nurse should not involve themselves in dying

declaration, in case where police records the dying declaration. Dying declaration is
to be recorded by the magistrate. But if condition of patient becomes serious then
medical officer can record it along with two nurses it witness. Dying Declaration
can be recorded by the nursing staff with two nurses aswitness when medical
officer is not present. Then the declaration has to be sent immediately in a sealed
cover to the magistrate.
 Wills
For this, doctor has to be present there, he can recode if
requested.
 Examination of rape case
Female attendant/female nurse must be present during the
examination.
 Artificial human insemination
 Written consent should be obtained from both donor and
recipient.
 Donor and recipient must have the same blood group. Donor
and recipient's identity should be kept confidential. .
 All related documents should be kept confidential & safe.
•Poison case
•Do not give either verbal or written opinion.
•Do not allow to take photos unless special permission is
granted by appropriate authority.
• Do not give any information to public or press.
• Preserve all evidence of poisoning.
•Collect and preserve all excreta, vomits and aspirates, seal
them immediately and send to forensic laboratory at the
earliest.
.Consumer Protection Act(l986)
Consumer protection act was passed by parliament in 1986
RIGHTS OFPATIENT:
Nurses role to prevent complications
1. Review nursing practice periodically. Update knowledge and improve skill by attending short term
courses, in- service education and continuing education programmes.

2. Should have complete knowledge of all rules and regulations of hospital and know their
descriptions

{duties and responsibilities).

3. Follow nursing practice standards/protocols.

4. Be a keen observer.

5. Written instructions must have rules and code of practice laid down to ensure the safety and
well being of patients and nurses.
6. All hospitals must have rules, a code of practice laid down to
ensure the safety and well being of patients and nurses.

7. Maintain records and reports of the unit properly.

8. Follow 6 Rights - right patient, right drug, right time and right
route with right technique and right of the patient lo know
about his/her disease condition.

9. Check the treatment order and use

professional judgment before implementing.

10. Do not exceed the limits of nursing

procedure laid down by statutory bodies.
Nursing
• The nursing science is an independent applying
science that synthesizes natural and social science.
• Nursing is a profession that helps human being and
serves for health of human being
• Nursing can assist individual to meet the basic needs
of human being and enforce the ability of self-care.
Nature and scope of nursing practice
• Nurses contribute to health care within a multidisciplinary
team. They are individually accountable for their actions and
practise within a statutory regulatory framework established
to protect the public and assure the quality of nursing
services.
• The role of the nurse is constantly changing and developing.
This means that nurses may add new functions to their work.
When deciding to do so, nurses must be sure that patients
will benefit and that they are competent for the new role.
Nature and scope of nursing practice
• Nursing is a service which:
• Helps individuals, families and communities to achieve and
maintain good health
• Supports, assists and cares for people during illness or
when their health is threatened
• Enhances people's ability to cope with the effects of illness
and disability
• Ensures, as far as possible, that death is dignified and free
from pain.
Nature and scope of nursing practice
• Nursing achieves these goals by applying knowledge and skills gained
through education and training, updated and tested by research. It is
the combination of professional knowledge and skills, with the desire
to care for others, which provides the base of nursing. Nursing practice
includes:
• Assessing people's health, their health problems and the resources they
have to cope with them; deciding what nursing help is needed and
referring them to other sources of expertise when necessary
• Planning, giving and evaluating programmes of skilled nursing care
Nature and scope of nursing practice
• Teaching individuals, families and communities about healthy lifestyles.
This involves helping them gain the knowledge and skills to control
their own health
• Teaching and enabling people to attain, maintain or recover their
independence
• Acting as the patient’s advocate and communicating the patient’s needs
to others
• Co-ordinating care where other health care workers are involved
• Maintaining an environment conducive to health or recovery.
Nature and scope of nursing practice
• Nursing is concerned, in particular, with:
• Situations in which people’s ability to maintain the normal activities
of life, such as breathing, feeding, elimination, mobility, rest, sleep
and personal cleanliness may be impaired
• Alleviating pain and discomfort
• Assessing physical and emotional responses to illness, trauma,
treatment and disability. These responses may include anxiety, loss,
loneliness and bereavement.
• Managing disordered intellectual responses, learning difficulties and
mental illness.
CODE OF ETHICS
American Nurses Association
1. The nurse provides services with respect for human dignity and the uniqueness of
the client unrestricted by considerations of social or economic status, personal
attributes, or the nature of health problems.
2. The nurse safeguards the client’s right to privacy by judiciously protecting
information of a confidential nature.
3. The nurse acts to safeguard the client and the public when health care and safety are
affected by the incompetent, unethical, or illegal practice of any person.
4. The nurse assumes responsibility and accountability for individual nursing
judgments and actions.
5. The nurse maintains competence in nursing.
CODE OF ETHICS
American Nurses Association
6. The nurse exercises informed judgment and uses individual competence and
qualifications as criteria in seeking consultation, accepting responsibilities, and
delegating nursing activities to others.
7. The nurse participates in activities that contribute to the ongoing development of the
profession’s body of knowledge.
8. The nurse participates in the profession’s efforts to implement and improve
standards of nursing.
9. The nurse participates in the profession’s efforts to establish and maintain conditions
of employment conducive to high-quality nursing care.
10. The nurse participates in the profession’s effort to protect the public from
misinformation and misrepresentation and to maintain the integrity of nursing.
11. The nurse collaborates with members of the health professions and other citizens in
promoting community and national efforts to meet the health needs of the public.
TRENDS IN NURSING

•Basic nursing education in community colleges and

universities.
•A growing variety of employment settings.
•Growing emphasis on the aspects of nursing that
characterize it as a profession.
•Increasing political influence of nursing.
•Nursing influences on health care policy and practice.
Thank you … 