Transcript Lecture 6

Contemporary Psychiatric-Mental
Health Nursing
Third Edition
CHAPTER
12
Ethics, Clients’
Rights, and Legal
and Forensic
Issues
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
1. Describe the rights of the client in a psychiatric
setting.
2. Discuss the legal and ethical issues related to
seclusion and restraint.
3. Describe the components of malpractice.
4. Identify pertinent ethical issues in the practice of
psychiatric nursing.
5. Discuss the meaning of standard of care.
6. Describe the most common types of torts in the
mental health setting
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
Bioethics
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Autonomy
Beneficence
Fidelity
Justice
Nonmaleficence
Veracity
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
Ethical Guidelines
• Standards for Psychiatric-Mental Health
nursing practice published by ANA
• ANA Code of Ethics
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
Ethical Dilemmas
• The potential stigma of psychiatric
diagnostic labels
• Psychiatry’s right to control individual
freedom
• The justification for involuntary
treatment
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
Ethical Dilemmas (cont'd)
• The use of restrictive treatment
interventions
• The client’s right to suicide
• The client’s right to privacy
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
Stigma Associated
with Diagnostic Labels
• Stereotypes
• Need for diagnostic labels
• Nurse’s moral stance
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
Mental Health Statutes
and Regulations
• Rules and regulations are set by state
governments
• Vary considerably
• Nurses must know the law of the state
in which they practice
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
Voluntary Admission
• Informed consent
• Client retains all rights
• Client has a right to demand and obtain
release
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
Involuntary Commitment
• Hospitalization against one’s will
• Criteria:
– Dangerous to self or others
– Unable to provide for basic needs
– Mentally ill
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
Psychiatric Forensic Nursing
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Who is the client?
Mindset of nurse
Focus of the nurse-client relationship
Location
Primary purpose of relationship
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
Correctional Mental
Health Nursing
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Who is the client?
Mindset of nurse
Focus of the nurse-client relationship
Location
Primary purpose of relationship
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
Psychiatric–Mental
Health Nursing Care
• Rights
• Dignity
• Autonomy
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
Psychiatric Advance Directive
• Modeled after advance directives for
end-of-life care
• Allows competent persons to document
their preferences regarding mental
health treatment
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
Box 12-3
Determining Negligence
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
Box 12-4
Common Sources of Liability in Psychiatric–Mental Health Services
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff
Client Advocacy
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Poorly funded services
Stigma
Isolation
Denial of rights
Contemporary Psychiatric-Mental Health Nursing, Third Edition
Carol Ren Kneisl • Eileen Trigoboff