PROFESSIONAL

DEVELOPMENT

M I S S S H I WA N I S A H
LECTURER
 NURSING ETHICS
• Nursing ethics is the applied discipline that addresses
the moral features of nursing practice.

• It is a subset of health care ethics or bioethics.

• Three dimensions of nursing ethics interrelate as they

prescribe ethical norms, describe ethical aspects of
nursing, and generate ethical guidance.
 NURSING ETHICS
• Nurses are advocates for patients and must find a balance while
delivering patient care.

• There are four main principles of ethics:

• Autonomy,
• Beneficence,
• Justice, and
• Non-maleficence.

Each patient has the right to make their own decisions based on
their own beliefs and values
ETHICAL PRINCIPLES
CODE OF ETHICS FOR NURSES

There are provisions that contain an intrinsic relational:

NURSE TO PATIENT,

NURSE TO NURSE,

NURSE TO SELF,

NURSE TO OTHERS,

NURSE TO PROFESSION, AND

NURSE AND NURSING TO SOCIETY

 ETHICAL RESPONSIBILITIES OF A
NURSE
The nurse owes the same duties to self as to others,
including the responsibility to
• Promote health and safety,
• Preserve wholeness of character and integrity,
maintain competence,
• Continue personal and professional growth.
• Advocating for patient
• A nurse must also demonstrate care for self as well as
others.
 ESSENTIAL STEPS OF ETHICAL
PROBLEM SOLVING
• 1. DETERMINE whether there is an ethical issue or/and dilemma.

• 2. IDENTIFY the key values and principles involved.

• 3. RANK the values or ethical principles which - in ones

professional judgement - are most relevant to the issue or dilemma.

• 4. DEVELOP an action plan that is consistent with the ethical

priorities that have been determined as central to the dilemma.

• 5. IMPLEMENT your plan, utilizing the most appropriate

practice skills and competencies.
 TRENDS IN NURSING
• COVID-19 takes a toll. Nurses are feeling exhausted and
overwhelmed as wave after wave of COVID-19 patients
have.
• Focus on behavioral health.
• More nurses traveling.
• Nursing shortage.
• Nurse entrepreneurship.
• Public health and emergency preparedness.
• Nurse innovation.
• Technology growth.
 ICN CODE OF ETHICS
• 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 2012.
ICN CODE OF ETHICS
• The ICN Code of Ethics for Nurses is a
guide for action based on social values
and needs.
• It will have meaning only as a living
document if applied to the realities of
nursing and health care in a changing
society.
 ICN CODE OF ETHICS
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 a 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 coordinate their services with those of related groups.
 THE ICN CODE
• 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 accurate, sufficient
and timely information in a culturally appropriate manner on which
to base consent for care and related treatment.
 THE ICN CODE

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 ICN CODE

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 that supports evidence-
based practice.
• The nurse is active in developing and sustaining a
core of professional values.
 THE ICN CODE

4. Nurses and co-workers:

• The nurse sustains a collaborative and respectful
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.
• The nurse takes appropriate action to support and guide
co-workers to advance ethical conduct.
 LEGAL RIGHT

LAW:
• Law is the system of rules which a
particular country or community
recognizes as regulating the actions of
its members and which it may enforce
by the imposition of penalties.
 LEGAL RIGHT
• Public Laws: Public laws are laws intended for
general application, such as those that apply to the
nation as a whole or a class of individuals.

• Private laws are enacted for the benefit of a

particular individual or small group, such as claims
against the government or individual immigration or
naturalization matters
NEPAL NURSING COUNCIL(NNC)
• Nepal Nursing Council (NNC) is established under
Nepal Nursing Council Act 2052 (1996).
• It came into force on 2053-03-02(16June 1996).
• First amendment of the act was done on 2058/10/14
(17th January, 2002 A.D.)
• However, initially the office of council was located
within the premises of Ministry of Health at present it is
located in Bansbari, Kathmandu.
 FUNCTIONS
• Register the nurse through licensing examination and
manage the registration of qualified nursing
professionals
• Formulate policy required to operate the nursing and
midwifery profession smoothly and to provide better
care to the public.
• Inspect, monitor and recognition to nursing and
midwifery academic institutions and monitor the quality
of nursing and midwifery services for better nursing
care.
 FUNCTIONS
• Maintain the standardization in nursing and midwifery education
through evaluating and reviewing the nursing and midwifery
curriculum, the terms and conditions of admission and
examination systems.
• Formulate professional code of conduct of the nursing and
midwifery professionals and to take action against those
professionals who violate such code of conduct.
• Develop the scope of practice for nursing and midwifery
professionals to determine the work limit of nursing and
midwifery professionals.
• Publish the annual Journal of the Nepal Nursing Council.
 NURSING ASSOCIATION OF NEPAL
(NAN)
• Nursing Association of Nepal (NAN) is an only one professional
organisation of the nurses in Nepal. It is a non-political non-
sectoral organization not influenced by class and religion.
• It is determined to provide quality-nursing service to the people in
order to protect & promote the professional rights & interests of all
Nurses in the kingdom of Nepal.
• NAN was established in BS 2018 Magh 15 (1962 A.D ) with the
Regd. No. 8/018 and became a member of International Council of
Nurses (ICN) Geneva in 1969 A.D. In initial it was registered as
Trained Nurses Association of Nepal (TNAN).
 NURSING ASSOCIATION OF NEPAL
(NAN)
• By the 3rd ammendment of its constitution on 2048
B.S, the name of the association is changed and the
organization shall be called as "Nepal Nursing Sangh"
in Nepali and "Nursing Association of Nepal" in
English and abbreviated as NAN.
• The organization is run by executive board, which is
formed by nationwide election of secret ballot every 3
years.
 OBJECTIVES
• To Protect, promote and develop professional code
of conduct, right and interest of all nurses in the
country.

• To raise the health status of the people and undertake

various activity necessary to avail basic health
services throughout the country.
 MEDICO-LEGAL CASE (MLC)

• Medico-legal case (MLC) refers to a

case of injury or illness that indicates
investigation by law enforcement
agencies to establish and fix the
criminal responsibility for the case
according to the law of the country.
 MEDICO-LEGAL CASE (MLC)
• Labelling a case as MLC.
• RMO / Casualty medical officer / MO in charge of
MI Room / Duty Medical Officer (DMO) / MO In
charge ward who is attending to the case, may label a
case as a MLC.

• All cases of accidents, burns, assaults, alleged suicide

or homicide, poisoning, road traffic accident, rape,
drowning, etc shall be registered as medico legal cases
(MLC).
 ORGAN DONATION
• Organ donation is the process of surgically removing an
organ or tissue from one person (the organ donor) and placing
it into another person (the recipient).

• Transplantation is necessary because the recipient's organ has

failed or has been damaged by disease or injury.

• Organ donation is the process when a person allows an organ

of their own to be removed and transplanted to another
person, legally, either by consent while the donor is alive or
dead with the assent of the next of kin.
STEPS IN THE PROCESS

Steps in the process are as follows:

• Identification of the Potential Donor by the Hospital.
• Evaluation of Donor Eligibility.
• Authorization for Organ Recovery.
• Medical Maintenance of the Patient.
• Matching Organs to Potential Recipients.
• Offering Organs Regionally, Then Nationally.
• Placing Organs and Coordinating Recovery.
TYPES
DISPOSAL OF
DEAD BODY
 DEAD BODY CARE
• This area of nursing practice involves comforting and caring for
people of all ages who are dying. It includes helping clients live as
comfortably as possible until death and helping support person
cope with death.
• As soon as the patient is declared dead, screen the bed.
• Wash hand and wear gloves.
• Elevate head of bed 10-15 degree it preventing pooling of blood in
the face and subsequent discoloration.
• Position body in supine sleeping position.
• All the tubes should be removed.
• Close the eyes, clean body with plane H2O.
• Plug all opening with cotton swab.
 DEAD BODY CARE
• All valuable things should be handover and take signature.
• If death is due to communicable disease special care must be taken to prevent
spread of disease.
• If death is due to legal cause, should inform to legal authorities.
• Prepare and attach 2 mortuary tags.
• Cover the patient faces with sheet.
• Send the patient's chart to make death certificate to account section.
• Handover body to relative's after bill has paid.
• Assist for transporting body to the mortuary.
• Remove gloves, properly dispose and wash hands.
• Complete hospital task.
• Clean the bed.
• Record the time, date of body and send to mortuary.