1. edith cavell
-founder of the first nursing school in Belgium
2. aided soldiers escaping prison camps
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early twentieth century
,1. projected shortfall of 400,000 RNs expected by 2020
2. RN supply is growing faster than projected due to the surge in new nurses 23-26
yrs
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the nursing shortage
Typical issues across states:
1. Social Media Violations
2. Professional Boundary violations
3. Ethics Violations
4. Substance Use Violations
5. Abuse/Neglect Violations
6. Practice Errors
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The Disciplinary Process
1. Advance directives
2. Living will must be dated, signed, and witnessed. Don't sign any legal documents
3. DNR orders: clear communication needed with all people involved
-any questions about DNR-> get HCP
4. Document precisely what the patient's wishes are and the response of the family
5. Durable power of attorney
6. Informed consent mandated by federal statute
7. Lawsuits re: lack of informed consent
-HCP must provide nature of the therapy or procedure, expected benefits and
outcomes of therapy or procedure, potential risks of the therapy or procedure,
alternative therapies to the procedure and their risks and benefits, & risks of not
, having the procedure
8. Text's example: pt. signed consent for wound debridement but surgeon wanted to
perform an amputation
-What should the circulating nurse do in this case? should not give dr instruments to
do amputation-> notify manager right away
9. Hospitals that receive federal funds must provide a mechanism to assist with those
patients who do not speak English
10. Right to refuse a diagnostic test, treatment or care
-Case: Stamford Hospital v. Vega A patient who refused a blood transfusion due to
Jehovah's Witness beliefs
-Physician may elect to obtain a court order in life and death circumstances
11. Leaving AMA
-Nurse must immediately notify health care provider, inform patient of dangers of
leaving i.e. aggravate current condition, affect future care, result in permanent
physical injury, potential complications.
-If person is elderly and impaired, the nurse must notify the family member
Inform patient that some insurance companies may _refuse____ to _pay for hospital stay
if go out AMA (against medical advice)____
12.Physical restraints:
-Form of imprisonment
-Goal is to use the least restrictive restraint when all other strategies to ensure patient
safety are exhausted.
-Careful documentation is necessary
-Orders for restraints must be timed and dated and, renewed with physician exam
- If restraints used, how often are the assessments done? at least every 4 hrs
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The Law and Patient's Rights
1. Follow the nursing process!
2. Administer medications safely
3. Monitor the patient's status and report any changes
4. Communicate effectively
5. Delegate responsibly
6. Document in an accurate, timely manner
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