hi guys it's me Professor D and welcome back to my YouTube channel on this video I'm going to be going over fundamentals but to be more specific I'll be covering legal and ethical issues now before we get started as always I'm going to ask you to please support me and support this channel by liking this video subscribing to this channel if you haven't done so already and press that red notification button so you'll be notified every time a new video is released please do not forget I'm now offering Next Generation NCLEX uh prep now it's a two-hour course where if you follow me for any amount of time you know I go over the meat and potatoes I go over the type of questions you should expect to see um how to answer those questions even if you don't know what the answers are how to be able to think critically through those answers and I'm going to go over lots of questions for you we'll do lots of practice so you can book for that review on my website nexusnursinginstitute.com also I've got plenty of audio lessons available um depending on what you're looking for if you're in the nursing program and you need to really really really do well on your next exam be sure to check that out I've got lots of audio lessons again my website is nexusnursinginstitute.com without further Ado guys let's get started legal and ethical issues the right to make one's own personal decisions even if it might not be in their own best interest is known as beneficence Fidelity autonomy or Justice if you guys weren't able to make it into the kahoot on the live you guys can just put your answers in good most of you guys got it correct it's autonomy it's the right to make decisions for yourself even if it may not be the best decision for yourself so for an example for as an example you have a patient that desperately needs blood their um H H is just down to the ground you got to give them blood immediately and they're refusing their their Jehovah's Witness they don't want any blood and you explain to them if you don't get this blood transfusion you may possibly die and they say to you I'd rather die well guess what they have that right to make that decision for themselves that's autonomy not but beneficence that's doing good for your patient Fidelity that's keeping promises so for example if you tell your patient I'll be back in five minutes make sure you come back in five minutes even if it's just to tell them it's gonna be another 10 minutes another 10 minutes but still come back keep your promises and Justice that is treating everyone fairly treating everyone the same you encourage your patient to ambulate after surgery this is an example of which principle is it Fidelity Justice veracity or benefits benefits oh God I do no I can't speak beneficence very good it's beneficent so let's talk about the wrong answers first and I'm going to get into the right answer so uh you know Fidelity is keeping your promises justices treating everyone fairly veracity is telling the truth right beneficence that's doing something good for your patient so for example this is a perfect example you're ambulating your patient after surgery how you encourage your patient to ambulate after surgery how is that good for the patient well we know after patient has surgery does it matter what kind of surgery that patient had if they had surgery we're always going to be concerned about three things we're going to be concerned about Hemorrhage that patient bleeding out we're going to be concerned about that patient developing a clot that clot moving turning into embolism going to their lungs and getting a PE right and the third thing we're going to be concerned about is infection we don't want that patient to get something like pneumonia so you want the patient to walk around walk around it's going to improve circulation so they don't develop a DVT it's going to help you know with them with the breathing we want to get them moving around we don't want them to develop infections such as pneumonia so that's something good so you're encouraging that patient to ambulate after surgery is doing good for them so that's beneficence failing to keep your patients safe from harm is an example of what assault battery negligence or malpractice yep most of you guys got it right it is negligence so negligence is when you fail to do something that you've been trained to do you should have done right now let's look at the wrong answer choices assault assault is a threat you don't even have to touch your patient just the threat of harming them or touching them against their will that threat is assault battery is when you follow through with the threat you know lots of times people use assault and battery interchangeably but they're not the same thing assault is a threat battery is um is actually following through with that threat now what's malpractice just like I told you negligence is failing to do something that you've been trained to do malpractice is doing something that you've been trained not to do you should have known better but you did it anyway that is the difference between negligence and malpractice those are not the same things you miscalculate a drug dosage and cause harm to the patient this may result in a charge of what false imprisonment breach of confidentiality assault or malpractice you guys are doing great on the live wonderful malpractice you did something that you were trained not to do remember when you were taking dosage calc and pharmacology right you should have known better very good so false imprisonment let's talk about false imprisonment so you're you're in the day room and your patient gets rowdy you need to get that patient away from the other patients you want to keep your patients safe what's the best thing to do well you can walk them to an open garden and talk to them get them to calm down that doesn't work you can bring them into a room with the door open but you're still in a room secluded from everybody else you can try to talk to them right you close that door you time to bed guess what you're doing that's false imprisonment you cannot um you can't put your patient in I can't think guys on the live what's what's the word I'm looking for when you tie your patient up you can't put them in what what's it called again everyone's quiet on my life now thank you restraints yes you can't um excuse me the only time if you have to put your patient in Restraint and that means you've tried non-invasive measures and it didn't work and they were going to be a heart to themselves or others you have to get in order to cover you for that so you if you have to put your patient restraints guess what you have to get an order cover you and that um the health care provider has to see that patient within 24 hours okay otherwise that's false imprisonment uh breach of confidentiality um example is violating patients HIPAA right um giving personal health information to any party that is not caring for that patient that does not need access to that information that breach of confidentiality and are are already explained to you guys what assault was the threat of touching someone against um their will you overhear another nurse tell the patient that if she refuses her PO meds she'll be forced to give the meds I am this is an example of what assault battery negligence or malpractice thank you Michelle foreign the threat so you're trying to give your patient their medication by mouth and they're refusing when you tell them if you don't take this medication by mouth I'll be forced to give you an IM injection says who unless this patient has been deemed legally incompetent to make decisions for themselves they have the right to refuse medications remember what that's called autonomy right so the threat of giving them that medication that's assault and if you follow through and give them that I am injection against their will that's battery you suspect a co-worker to be high on an unknown substance what should be the nurse's immediate action tell the co-worker to stop or they'll be reported contact the authorities report the concerns to the nursing supervisor or report the observations in an incident report foreign that's right report it to the nursing supervisor so here's the thing whenever you have a problem with a co-worker as long as it has nothing to do with patient care it has nothing to do with patient safety the rule of thumb you always go to that co-worker first so if you feel like that co-worker always has an attitude they always have something to say to you as long as it has nothing to do with patient care patient safety you're going to go to them first and try to resolve the issue if you're unable to resolve the issue after going to them directly and that's when you go over up the chain of command however if patient care patient safety is involved you bypass that co-worker and you go directly to your nursing supervisor so absolutely that is the correct answer now let's go over the wrong choices tell the co-worker to stop or they'll be reported uh-uh patient safety's involved you don't even say anything that that co-worker you go directly to your nursing supervisor and you die you uh report this contact the authorities no you have to go up the chain of command how are you going to bypass your supervisor and call 911 one no you go to your um Superior look at this report observations in an incident report incident reports are interesting let's talk about this this is very important for you guys to know the incident report guys is for the facility it does not go into the patient's medical chart as a matter of fact as a nurse you're not even allowed to mention the existence of an incident report being filed the incident report is strictly for the facility to make sure that um they can Implement policies and measures so whatever it is to happen doesn't happen again so for example if a patient falls you have to fill out an incident report you you know you call the Family you let the family know that they fail you write that in the incident report but that incident report does not go in the patient's medical chart number one and number two you're not even allowed to document in their medical chart that an incident report was created okay the incident report is strictly for um the facility itself it does not go into the patient's medical chart select all that applies which activities may be delegated to an unlicensed assistive personnel and when I say unlicensed assistive Personnel someone such as a CNA or a PCT what activities can be delegated to them select all that applies medication administration Vital Signs taking vital signs for stable patients suctioning patients ambulating patients performing Wound Care on patients or performing ADL such as bathing or dressing patients which ones can you delegate to an unlicensed assistive personnel okay let's go over the correct answers first they can take Vital Signs absolutely but look at this vital signs for stable patients if your patient is acutely ill guess what you the RN you got to be the ones going in there to do the vital signs because while you're taking those vitals you're going to be assessing your patient frequently as well okay so vital signs for stable patients ambulating absolutely but let's talk about this ambulating stable patients let's say this is a patient who um just had a stroke they've got left side deficits and this is the first time that they're being ambulated after the stroke guess what you cannot delegate that to the UAP even though that's within their scoping practice to ambulate because this patient's not yet stable you the RN have to do the first ambulation because while you're walking with that patient you're going to be looking at them and you're going to be like you know what this patient doesn't look too stable I'm going to call the health care provider and ask for a physical therapy consult right by the way only you the RN can call the healthcare provider to ask for console such as physical therapy occupational therapy speech therapy now we know in real life LPNs do it all the time but I'm talking about testing purposes for testing purposes only you the RN can do that so if that patient's not stable the first time they're ambulating you the RN need to walk with that patient so that you can assess them and make those requests to the health care provider as ordered or as needed ADLs bathing dressing feeding absolutely the unlicensed assistive Personnel can do it unless that patient is unstable and let me give you an example same thing patient just had a stroke this is the first time that they're eating after the stroke guess what you can't delegate that to a UAP you the RN you have to keep that patient because while you're feeding that patient you have to assess that patient and look how they swallow if they look like they're choking or they're having a hard time swallowing you have to place a call to the healthcare provider and say Hey you know I was feeding the patient I think he or she may have a hard time swallowing can we get a speech evaluation because with the speech evaluation they do what a swallow study right so it this and this is where critical thinking comes in guys it's not black and white you have to look at the context of the entire situation before you make the decision of what's appropriate and what's not now definitely under no circumstance answers would it be appropriate to delegate this to um uaps they can't give medications they can't suction patients and they cannot perform wound care they can't do dressing changes select all that applies before delegating a task you the nurse must consider what select all that applies before you can delegate delegate a task what do you have to consider predictability of outcome the potential for harm the complexity of care the speed of the task the cost of the task the race of the patient so before you can delegate a task what do you have to consider select all that applies okay you have to you have to consider the predictability of outcome why well the only types of patients for example that you can delegate to the LPN right the only type of patients you can delegate to them are going to be your most stable patient the patient that um you most likely can predict the outcome so for example if you have a patient that is low Acuity they're only in there for you know hypertension they've been on these Medicaid hypertensive medications for a while you can give that to the LPN right because their outcome is pretty much predictable they give them the antihypertensive medication we expect that blood pressure to drop so predictability of outcome absolutely that must be considered if the patient is in acute state that we don't know where they're going to go we don't know what's going on with them you can't delegate that to um a PN you have to keep that patient because they're unstable the potential for harm that absolutely must be considered and um not only the care but the medication right so if you have a patient that they have to get uh plastic medication that if it infiltrates it will basically cause necrosis to the surrounding tissues you can't delegate that to a piano you the RN you have to keep that patient because that medication is so harmful um and so you have to do much much closer um assessments on that patient you can't give it to the PN complexity of care that also you have to be consider when you're delegating to the Practical Nurse you want to give them the patient that has the most routine going on the most routine medication the most routine um wound care you don't want to give them the type of patient where their care is very complex you would have to keep that type of patient now let's look at the wrong answer choices which you guys did such a great job with choosing the wrong answer choices by the way good job of not choosing the wrong answers I should say the speed of task no let me tell you something testing world we don't unless it's emergency situation like we're running we're rushing the patient to the or something like that we don't care about time in the real world we care about time because time is money but in the testing World unless it's an emergent situation we're not concerned about time we're not concerned about finances we're not concerned about staff we're not concerned about resources right what can somebody we're concerned about that stuff in real life but for testing purposes we have all the time in the world to do what we have to do for a patient unless it's an emergency situation we have the resources we have the staff we have the equipment so we don't care about the speed of the task we sure don't care about the cost of the task and we really don't care about the race of the two people chose race really no we don't care about the race of the patient which of the following tasks may be delegated to the unlicensed assistive personnel making changes to the care plan teaching the patient about a new medication changing a soil dressing making the patient's bed which one can you delegate to the unlicensed assistive personnel all right making the patients bad remember they're not licensed they're not a nurse you see this making changes to the care plan even the Practical Nurse can't do that only the RN the RN can create the care plan the RN can make changes to the care plan they can update the care plan the PN follows the care plan and remember guys please don't come at me in the comment section I'm trying to help you I'm not your enemy here I'm not putting down pns I'm trying to help you pass your test so for testing purposes because we know the real world and testing world is completely different okay for testing purposes only the RN can create and make changes to the care plan the PN cannot teaching the patient about a new medication only the RN can do that now the PN can come behind the RN after the RN has done that initial teaching and say Hey you know I know you learned about this medication but you know just to remind just to remind you after you take this anti-hypertensive don't get up too quick you might your blood pressure might drop make sure you dangle make sure you move position slowly changing a soil dressing the RN can do that the PN can do that the unlicensed assistive Personnel cannot so out of all of these choices making the bed that is what you can delegate to them a new admission from the pack you should be delegated to and pack you guys as a post anesthesia um Care Unit so a new a new admission from the pack you should be delegated to who the RN the PN the UAP or the medical secretary you guys are awesome that's right the RN any new patient and I don't care where they're coming from I don't care if they're coming off from off the street if they're coming from the or if they're coming from the ER if they're coming from the pacu if they are new to you they're unstable until you've assessed them and deemed otherwise so the RN you the RN is going to keep that patient very good which of the following tasks should be delegated to the PN the practical nurse creating a care plan assessing a new injury teaching on medication administration or administering a routine medication which one can you delegate to the PN awesome that's right administering a routine medication this medication's routine patients got it before we have an expected outcome a predictable outcome they can't create a care plan assessing a new injury no the RN assesses that new injury then after the RN's done the initial assessment then the PN you know if the PN is going to do wound care whatever of course the piano is going to be assessing that patient but that initial um assessment comes from who the RN teaching on medication nope it's going to be who the RN now the PN will come after the nurse and they can remind the patient about the teaching but that is the RN's responsibility but giving a routine medication yes that can be delegated to the PN all right last question select all that applies which of the following are essential steps of the of the admission process select all that applies orienting the patient to the staff to the staff roles and the patient's room planning for discharge teaching the patient that advanced directives are required for admission documenting the patient's wishes about organ donation developing a rapport with the patient or Professor D I have no clue what are essential steps of the admission process okay so orienting the patient to the staff the staff roles and the patient's room absolutely that's part of the admission process planning for discharge app let me tell you something the minute that your patient is admitted that is the minute you start planning for discharge discharge planning starts at admission very good documenting the patient's wishes about organ donation absolutely you want to document that because you don't know what's going to happen during this day developing a rapport for the patient you absolutely want to develop a report because guess what you're going to have more assessments coming up and you want that patient to be comfortable with you to ask questions and also Express themselves if there are any concerns that the patient has now let's look at the wrong answer Choice teaching the patient that advanced directives are required for admission no they're not they're encouraged but they're not required for admission and one person chose I have no clue okay you guys did a wonderful job okay guys thank you so much for watching please in the comment section let me know what you thought about this video let me know what you'd like to see me cover next and in what format do you want it in you know q a format the one that I do on Sundays 1 pm Eastern Standard time or do you want to in a kahoot format do you want an electro format let me know in the comment section also don't forget you can go to my website Nexus nursing Institute to book your review today thank you for watching and you guys will catch me on the next video