00:01
Let's take a minute
to consider the fact
that it's not just the
codes in the hospital.
00:07
It's just not our scope of
action and our scope of nursing
that we have to
be responsible to.
00:15
We have to be responsible
to federal and state laws.
00:20
Our patients have rights.
00:22
Psychiatric patients
have special rights.
00:26
They have patient rights,
that are going to protect them.
00:31
They have the right
of self-determination.
00:33
Just because we might think something
is good for them does not mean
that they must do what
we tell them to do.
00:41
They have self-determined behavior.
00:44
If they want to
refuse some treatment,
they have the right to refuse.
00:50
If they want to refuse a medication,
they have the right to refuse.
00:57
If we want to do a
specific kind of therapy
or something else with them,
we must get informed consent
even more about that.
01:11
It's not just legal.
01:13
It's ethical.
01:16
And when we think of ethics,
we're thinking about moral issues
of what is right and what is wrong.
01:24
And there are rules, regulations,
and laws to make sure that as caregivers,
we are providing care that is
not only legal but ethical.
01:39
Meaning, there's a level of autonomy
that our patient has over his or her life
over their person,
over their future,
that we are going to act
in their best interest.
01:54
We are going to act
with beneficence.
01:57
We are going to do no harm.
02:01
We are going to do good.
02:04
And we are going to be just.
02:07
We are going to be just.
02:09
We are not going to say this
person has no insurance.
02:12
Therefore, I'm going to make sure
that this person doesn't get onto
that nice floor
that has flowers.
02:20
And I'm going to make sure this
person goes to a different hospital
because there's no insurance,
or perhaps they don't have legal status.
02:29
Justice means every patient
is treated the same bias,
that we are not passing
a judgment on someone
because of their race, religion,
income, social standing.
02:46
And veracity.
02:47
We're going to tell the truth.
02:49
We're going to make sure that what we
are telling our clients and our patients
is the truth that we are going to
stay on the right side of ethics.
03:02
Anything a patient says
to us as a professional
is considered privileged
communication.
03:11
In certain situations, that privileged
communication between you and the patient
takes a second seat.
03:21
And that means if
there's a duty to warn.
03:26
If a person tells you that they're
going to leave the hospital
and they're going home to kill
their husband who has been abusive.
03:35
You have a duty to warn.
03:38
You have to make sure that that
person before they are ever discharged
is reevaluated and that
someone warns the person
who is going to be
the victim of a crime.
03:55
If it is a child or an elderly person
who is telling you, if a child says,
"Yes, my cousin touched me
inappropriately and had sex with me."
And that child is
only six years old.
04:15
You want to protect that child, that
child needs protection from that adult.
04:20
And by bringing that to the
adult who has molested the child
or to someone who
has hurt a child.
04:31
You might actually be increasing that
child's likelihood of being further hurt.
04:38
And so, in that we have
a duty to warn the law.
04:43
We have to protect that child.
04:46
At that point,
we call in our social worker.
04:49
We make sure the social worker
comes in and does a full evaluation.
04:55
Same thing, if it's an elderly
person who is being abused,
either in a home or in an
extended care facility.
05:04
As soon as you see
any kind of bruises,
anything that might tell you that
this child or this older person
is in need of an
evaluation for abuse,
you call in the
specialty team for abuse.
05:23
We must be able to get informed
consent if a person is going to go
for electroconvulsive
therapy, for example, ECT.
05:33
They must sign consent for that
because it is an invasive procedure.
05:40
When we are going to have
to use restraints on someone
or we are going to have to
put someone in seclusion,
it's very important to know
both your hospital policy
as well as your state policy.
05:56
Because in different places,
there are different policies and laws.
06:02
And you want to make sure that
whatever the restraints are
that you're using
that they meet code.
06:08
You want to make sure that
that person is being evaluated
on the timeframe that
is required by law
and that the seclusion is being
done in a way that is safe.
06:21
Remember, safe,
this is all about safety.
06:24
You want to keep that patient
safe while in restraints,
also, while in seclusion.