Chapter 10: Laws

• Advocacy


  Acting on behalf of others
• Health professions


  • Have a long history of acting for others
  • Have a lengthy history of ethical discussion and discernment about the extent and bounds of such action
• There is a consideration of the ethical difficulties and conflicts that develop when doing advocacy, as well as modern-day changes that have increased requests for advocacy as a key professional role
• Case advocacy


  Nurses speaking up for specific patients and their families to obtain the services they need and find solutions to issues unique to the case
• Case advocacy in nursing

  • It is a tradition in the profession and upholds ongoing professional values
  • It has experienced a significant transformation, progressively emerging to place a greater emphasis on client empowerment
  • Its original connotation of intervening on behalf of those who could not or would not help themselves has changed
  • Today's definition of patient advocacy encompasses a more complicated rage of actions that place the nurse in mediator and promoter roles
• Advocating for patients has been a longstanding practice among nurses
• Class advocacy


  • A political strategy wherein advocates work towards systemic change rather than focusing solely on individual cases
  • Aims to alter the underlying structures and systems that create opportunities and barriers for larger groups, organizations, or communities
  • Seeks to address root causes of social issues by targeting laws, institutional systems, policies, and resource distribution patterns
• The American Nurses Association (ANA) defines Nursing practice as "the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations."
• The ANA discusses the significance of advocacy in its Code of Ethics, specifically in Provision 3: "The nurse promotes, advocates for, and protects the rights and welfare of the patient, family, and the public."
• Nursing advocacy


  • It is built on the principles of upholding human dignity
  • It is built on the principles of patient equity
  • It is built on the principles of freedom from suffering
• Preserving human dignity


  • Nurses can guide patients through a complex system and facilitate communication with their doctors
  • Nurses should be mindful on how culture and ethnicity may influence a patient's experience
  • Nurses are in a unique position that enables them to combine all facets of patient care, ensuring that issues are addressed, standards are upheld, and successful results continue to be the aim
• Patient equality


  • The healthcare industry is continually evolving, both in terms of structure and use of new technology
  • Regulations governing the provision of care and health services are changing as a result of these changes
  • The ANA Code of Ethics mandates that nurses remain above the fray and represent patients "with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or nature of health problems"
• Freedom from suffering


  • Nursing is a job that people choose because they want to help others
  • A big part of this is the fundamental value of aiding in the prevention or management of suffering
  • This can be accomplished on a physical, emotional, or psychological level
  • As defenders of their well-being, nurses ought to be accessible to patients and their families
• Lobbying


  The deliberate attempt to influence political decisions through various forms of advocacy directed at policymakers on behalf of another person, organization or group
• Lobbyist


  • A person who influences and advocates certain views to lawmakers in the hope of influencing at the local, state, or federal level
  • They can stand for the concerns of nurses who do not have the opportunity or access to represent them personally to the government
  • They act as a bridge between the experiences of nurses in their daily practice and the policymakers who shape healthcare policy
  • They serve as intermediaries between nurses and policymakers, leveraging their expertise and influence to advocate for policies that align with ethical standards and support quality patient care
• Lobbying in nursing


  It involves the transfer of information, the art of persuasion, the contact and relationship building to push a policy maker for policies that benefit the nursing profession, communicating nurses' views on local, state, or national policy issues to the elected officials in a timely and effective manner, leads to a favorable change in the quality practice of the profession
• Healthcare lobbyists are employed by: Insurance groups, Drug companies, Specialty organizations, Public health groups, Others who have a stake in health care legislation
• Ethical dilemmas related to lobbying

  They tend to arise when various behaviors by lobbyists and lawmakers undermine the fairness and transparency of that process and do not contribute to the common good
• Lobbying vs. Advocacy


  • Lobbying always involves advocacy but advocacy does not necessarily involve lobbying
  • Lobbying involves attempts to influence specific legislation at the local, state, or federal level while advocacy is focused on educating about a specific issue
  • Lobbying makes up a small portion of the total amount of advocacy efforts by most nonprofits
• Ang Nars Party-list is a nonstop profit organization for ensuring and promoting the socio-economic political professional rights of nurses with the responsibility to provide safe quality nursing care to the Filipinos
• The Philippine Nurses Association has been an outlet for all Filipino nurses in addressing diverse concerns from their work places to the pressing matters affecting their rights as Filipino citizens
• The ICN Code of Ethics for Nurses is a statement of the ethical values, responsibilities and professional accountabilities of nurses and nursing students that defines and guides ethical nursing practice within the different roles nurses assume
• Purpose of the ICN Code of Ethics for Nurses


  • It is not a code of conduct but can serve as a framework for ethical nursing practice and decision-making to meet professional standards set by regulatory bodies
  • The values and obligations expressed in this Code apply to nurses in all settings, roles and domains of practice
• The ICN Code of Ethics for Nurses provides ethical guidance in relation to nurses' roles, duties, responsibilities, behaviors, professional judgement and relationships with patients, other people who are receiving nursing care or services, co-workers and allied professionals
• The ICN Code of Ethics for Nurses has four principal elements that provide a framework for ethical conduct: nurses and patients or other people requiring care or services, nurses and practice, nurses and the profession, and nurses and global health
• Nurses and patients or other people requiring care or services


  Nurses' primary professional responsibility is to people requiring nursing care and services now or in the future, whether individuals, families, communities or populations
• Nurses


  • Promote an environment in which the human rights, values, customs, religious and spiritual beliefs of the individual, families and communities are acknowledged and respected by everyone
  • Nurses' rights are included under human rights and should be upheld and protected
• Nurses


  • Ensure that the individual and family receive understandable, accurate, sufficient and timely information in a manner appropriate to the patient's culture, linguistic, cognitive and physical needs, and psychological state on which to base consent for care and related treatment
  • Hold in confidence personal information and respect the privacy, confidentiality and interests of patients in the lawful collection, use, access, transmission, storage and disclosure of personal information
  • Respect the privacy and confidentiality of colleagues and people requiring care and uphold the integrity of the nursing profession in person and in all media, including social media
• Nurses


  • Share with society the responsibility for initiating and supporting action to meet the health and social needs of all people
  • Advocate for equity and social justice in resource allocation, access to health care and other social and economic services
  • Demonstrate professional values such as respect, justice, responsiveness, caring, compassion, empathy, trustworthiness and integrity
  • Support and respect the dignity and universal rights of all people, including patients, colleagues and families
• Nurses


  • Facilitate a culture of safety in health care environments, recognizing and addressing threats to people and safe care in health practices, services and settings
  • Provide evidence-informed, person-centered care, recognizing and using the values and principles of primary health care and health promotion across the lifespan
  • Ensure that the use of technology and scientific advances are compatible with the safety, dignity and rights of people
  • In the case of artificial intelligence or devices, such as care robots or drones, ensure that care remains person-centered and that such devices support and do not replace human relationships
• Nurses, Nurse Leaders and Nurse Managers


  • Provide people focused, culturally appropriate, care that respects human rights and is sensitive to the values, customs and beliefs of people without prejudice or unjust discrimination
• Educators and Researchers


  • In curricula, include content on cultural norms, safety and competence, ethics, human rights, equity, human dignity, justice, disparities and solidarity as the basis for access to health care
  • Design studies to explore human rights issues
• National Nurses Associations


  • Develop position statements, standards of practice and guidelines that support human rights and ethical standards
• Nurses and practice


  • Nurses carry personal responsibility and accountability for ethical nursing practice, and for maintaining competence by engaging in continuous professional development and lifelong learning
  • Maintain fitness to practice so as not to compromise their ability to provide quality, safe care
  • Practice within the limits of their individual competence and regulated or authorized scope of practice and use professional judgement when accepting and delegating responsibility
• Nurses


  • Value their own dignity, well-being and health
  • Maintain standards of personal conduct at all times, reflecting well on the profession and enhancing its image and public confidence
  • Recognise and maintain personal relationship boundaries in their professional role
• Nurses


  • Share their knowledge and expertise and provide feedback, mentoring and supporting the professional development of student nurses, novice nurses, colleagues and other health care providers
  • Are patient advocates, and they maintain a practice culture that promotes ethical behaviour and open dialogue
  • May conscientiously object to participating in particular procedures or nursing or health-related research but must facilitate respectful and timely action to ensure that people receive care appropriate to their individual needs
  • Maintain a person's right to give and withdraw consent to access their personal, health and genetic information
  • Protect the use, privacy and confidentiality of genetic information and human genome technologies
  • Take appropriate actions to safeguard individuals, families, communities and populations when their health is endangered by a co-worker, any other person, policy, practice or misuse of technology
  • Are active participants in the promotion of patient safety, promote ethical conduct when errors or near misses occur, speak up when patient safety is threatened, advocate for transparency, and work with others to reduce the potential of errors
  • Are accountable for data integrity to support and facilitate ethical standards of care
• Nurses, Nurse Leaders and Nurse Managers

  • Pursue professional development through reading and study
  • Request and participate in continuing education to enhance knowledge and skills
• Educators and Researchers


  • Teach and facilitate learning the value and obligation of lifelong learning and competence to practice
  • Explore current concepts and innovative teaching methods for theory and practice
• National Nurses Associations


  • Develop a range of continuing education opportunities, through journals, media, conferences and distance education, that reflects advances in nursing theory and practice
• Nurses and the profession

  • Assume the major leadership role in determining and implementing evidence-informed, acceptable standards of clinical nursing practice, management, research and education
  • Are active in expanding research-based, current professional knowledge that supports evidence-informed practice
  • Are active in developing and sustaining a core of professional values
  • Through their professional organisations, participate in creating a positive and constructive practice environment where practice encompasses clinical care, education, research, management and leadership
  • Contribute to positive and ethical organisational environments and challenge unethical practices and settings
  • Collaborate with nursing colleagues, other (health) disciplines and relevant communities to engage in the ethical creation, conduct and dissemination of peer reviewed and ethically responsible research and practice development as they relate to patient care, nursing and health
  • Engage in the creation, dissemination and application of research that improves outcomes for individuals, families and communities
  • Prepare for and respond to emergencies, disasters, conflicts, epidemics, pandemics, social crises and conditions of scarce resources