Lecturer

Dr/ Fatma Mohamed Abdelhamid

 Objectives
 By the end of this lecture the students will be able to:
 Recognize the Principles and Ethical Responsibilities
of Licensed Practical Nurses (LPNs).
 Understand the purpose of the ethical practice
environments
 Explain how to achieve the ethical practice
environments
 Outlines
 The Principles and Ethical Responsibilities of
Licensed Practical Nurses (LPNs)
 1. Responsibility to the Public
 2. Responsibility to Clients
 3. Responsibility to the Profession
 4. Responsibility to Colleagues
 5. Responsibility to Oneself
 Ethical practice environments
The Principles and Ethical
Responsibilities of (LPNs)
 1. Responsibility to the Public
 2. Responsibility to Clients
 3. Responsibility to the Profession
 4. Responsibility to Colleagues
 5. Responsibility to Oneself
PRINCIPLE 1: Responsibility to the
Public
As self-regulating professionals, commit to provide safe, 
effective, and ethical care to members of the public.
 Maintain standards of practice, professional
competence, and conduct.
 Provide only those functions for which they are
qualified by education or experience.
 Demonstrate an understanding that community,
society, and the environment are important factors in the
health of individual clients.

 Respect the rights of all individuals regardless of their
diverse values, beliefs, and cultures.
 Provide care directed toward the health and well-
being of the person, family, and community.
 Collaborate 2 with clients, their families (to the
extent appropriate to the client’s right to confidentiality),
and health care colleagues to promote the health and well-
being of individuals, families, and the public.
PRINCIPLE 2: Responsibility to
Clients
 Provide safe and competent care for their clients.
 1. Respect the right and responsibility of clients to
be informed and make decisions about their health
care.
 Respect and support client choices.
 Assist and support client participation in making
decisions about their health and wellbeing.

 Respect and adhere to the jurisdictional legislation on capacity
assessment and substitute decision-making when the client is
 incapable of consent.
 Consider with other health care professionals and
substitute decision-makers the best interests of the client and
any previously known wishes or advanced directives that apply
in situations where the client is incapable of consent.
 2. Advocate for the client to receive fair and equitable access to
needed and reasonably available health services and resources.
 3. Respect and protect client privacy and hold in
confidence information disclosed except in certain
narrowly defined exceptions.
 Safeguard health and personal information by
collecting, storing, using, and disclosing it in compliance
with relevant legislation and employer policies.
 Report any situation where private or confidential
information is accessed or disclosed without appropriate
consent or legal authority, whether deliberately or through
error.
 Ensure that any discussion/communication (verbal,
written or electronic) is respectful and does not identify
the client unless appropriate.
 Maintain professional boundaries in the use of
electronic media.
 4. Act promptly and appropriately in response to harmful
conditions and situations, including disclosing safety
issues to appropriate authorities.
 5. Report to appropriate authorities and take other action
in a timely manner to ensure a client’s safety and quality
of care.
 6. Provide care to each client recognizing their
individuality and their right to choose.
 7. Develop trusting, therapeutic relationships, while
maintaining professional boundaries.
 8. Use evidence and judgement to guide nursing decisions.
 9. Identify and minimize risks to clients.
 10. Apply new knowledge, technology, and scientific
advances to promote safety, client satisfaction and well-
being.
PRINCIPLE 3: Responsibility to the
Profession
 Licensed Practical Nurses have a commitment to their
profession and foster the respect and trust of their
clients, health care colleagues and the public.
 Maintain the standards of the profession and
conduct themselves in a manner that upholds the
integrity of the profession.
 Participate in activities allowing the profession to
evolve to meet emerging healthcare needs.
 Practice in a manner that is consistent with the
responsibility of self-regulation.
 Promote workplace practices and policies that
facilitate professional practice in accordance with the
principles, standards, laws, and regulations under
which they are accountable.
PRINCIPLE 4: Responsibility to
Colleagues
 Develop and maintain positive, collaborative
relationships with nursing colleagues and other health
professionals.
 Take appropriate action to address the
unprofessional conduct of other members of the
interprofessional team.
 Collaborate with colleagues in a cooperative,
constructive, and respectful manner with the primary
goal of providing safe, competent, ethical, and
appropriate care to individuals, families, and
communities.
 Engage in opportunities to inform colleagues and
other health professionals about the LPN role and
capabilities.
 Acknowledge colleagues’ roles and their unique
contribution to the inter-professional team.
 Respect the expertise of colleagues and share own
expertise and knowledge.
PRINCIPLE 5: Responsibility to Self
 Recognize and function within their personal and
professional competence and value systems.
 Demonstrate honesty, integrity, and trustworthiness
in all interactions.
 Recognize their capabilities and limitations and
perform only the nursing functions that fall within their
scope of practice and for which they possess the required
knowledge, skills, and judgement.
 Accept responsibility for knowing and acting
consistently with the principles, practice standards, laws,
and regulations under which they are accountable.
 Inform the appropriate authority in the event of
becoming unable to practise safely, competently
and/or ethically.
 Engage in opportunities for career-long learning
to continuously develop the competencies required to
meet the ethical and regulatory requirements of the
profession.
 Maintain the required mental and physical
wellness to meet the responsibilities of their role.
Ethical Practice Environments
 1. To underscore the nurse’s commitment to create,
sustain, and continuously improve the ethical
workplace environment in all practice settings.
 2. To support nurses by offering tools and resources
with which they can fulfil that commitment.
Organizational leaders must take the following
actions:

 1. Provide ongoing education in ethics

concepts and ethical practice for nurses in all roles and
all settings.
 2. Strongly encourage use of the Code as an ethical
framework for nursing.
 3. Demonstrate zero tolerance of lateral violence for
nurse safety and well-being.
 4. Create safe spaces for discussing ethics issues
 Every nurse must learn about the existing
resources in their practice setting for resolving
situations involving ethical conflicts, learn how to use
them, and collaborate with colleagues at all levels to
institute approaches to such conflict resolution as
needed.
Approaches include:

 a. Establishment of an ethics consult service

 b. Creation of ethics committees
 c. Policy development, such as
 1. culture policies
 2. End-of-life treatment policies, including those that
minimize unwanted, or unnecessary medical treatment and
patient suffering
Definition of team:
A team is defined as two or more individuals who work 
together to achieve specified and shared goals, have task-
specific competencies and specialized work roles, use
shared resources, and communicate to coordinate and to
adapt to change
 Teamwork refers to the behaviors (e.g.,
communicating and sharing information, checking for
understanding), attitudes (e.g., belief in the collective
ability of the team and need for teamwork), and
cognitions (e.g., shared mental models) teams use to
communicate, coordinate, and collaborate their efforts
to achieve shared, collective goals
 An effective teamwork is essential for patient safety:
 An effective teamwork is essential for patient safety as
it minimizes adverse events caused by
miscommunication with others caring for the patient,
and misunderstandings of roles and responsibilities.
 teamwork processes within health care is important
because the quality of teamwork is associated with the
quality and safety of care delivery systems.
Health care teams: 
 Health care teams involve physicians, nurses, social
workers and other health care professionals — all of
whom play various clinical and administrative roles in
the care of a single patient at one or several sites of
care.
Characteristics of health care
teams:
 the team members need to share certain characteristics, which
include:
 Trust.
 Respect.
 Collaboration.
 Possess specialized knowledge and skills and often function
under high-workload conditions.
 Know their role and the roles of others in the team(s) and
interact with one another to achieve a common goal.
 Act as a collective unit, as a result of the interdependency of
the tasks performed by team members.
 Possess specialized and complementary knowledge and
skills.
Benefits of effective teamwork:
 a. Organizational benefits:
 - Reduced time and costs of hospitalization.
 - Reduction in unexpected admissions.
 - Services are better accessible to patients.
 b. Team benefits:
 - Improved coordination of care.
 - Efficient use of health-care services.
 - Enhanced communication and professional diversity.
 c. Patient benefits:
 - Enhanced satisfaction with care.
 - Acceptance of treatment.
 - Improved health outcomes and quality of care
Reduced medical errors.
 d. Benefits to team members:
 - Enhanced job satisfaction.
 - Greater role clarity.
 - Enhanced well-being.
Components of Successful Teamwork :
• Open communication
 • Clear direction
 • Clear and known roles and tasks for team
members
 • Respectful atmosphere
 • Shared responsibility for team success
 • Appropriate balance of member participation for
the task at hand
• Clear specifications regarding authority and
accountability
 • Clear and known decision making procedures
 • Regular and routine communication and
information sharing
 • Enabling environment, including access to
needed resources
 • Mechanism to evaluate outcomes and adjust
accordingly
Different types of teams can be
identified in health care systems:
 1. Core teams
 These are directly involved in caring for the patient.
 They usually consist of team leaders and members
who are direct-care providers such as nurses, dentists,
pharmacists, doctors, assistants…etc. They also include
case managers.
 2. Coordinating teams
 The group responsible for operational management,
coordinating functions and resource management for
core teams.
 3. Contingency teams
- Formed to deal with emergencies or specific
events (e.g. cardiac-arrest teams, disaster-response
teams,. etc).
 4. Ancillary teams/services
- The group supports services that facilitate patient
care such as cleaners or domestic staff.
 key relationships for the provision of humane and
healthcare:
 1. Nurse’s relationship with self.
 2. Relationships with team members.
 3. Relationships with patients and families.
Enhanced professional relationships and communication
skills influence patient care outcomes

 Inter-professional collaboration and open

communication can only strengthen and
improve the delivery of safe, consistent, and
efficient patient care. Healthy relationships
increase nurses’ ability to make care decisions
based on ethical principles.
Role of nurse as part of a
collaborative healthcare team:
 Nurses are positioned to lead and partner in teams
that provide services across the continuum of care
(hospitals, ambulatory care, public health, schools,
long-term care, and home health).
 Communication in teams is more than just efficient work. It
allows everyone on the team to be educated on any topic that
may affect their work. Moreover, it develops trust, the team
members,, and helps employees stay engaged in the workplace.
Collaboration between health care team:

 Collaboration between physicians, nurses, and other

health care professionals increases team members’
awareness of each others’ type of knowledge and skills,
leading to continued improvement in decision
making.
Nurse-physician collaboration can be defined as 
interactions between nurses and physicians that work
together to achieve shared problem-solving, decision-
making, communication and coordination.
Common Barriers to Inter-professional Communication and
Collaboration :

 Differences in requirements, regulations, and norms of

professional education
 Differences in accountability, payment, and
rewards
 Concerns regarding clinical responsibility
 Complexity of care
 Personal values and expectations
 Personality differences
 Culture and ethnicity
 Generational differences
 Gender
 Differences in language
 Differences in schedules and professional routines
 Varying levels of preparation, qualifications
Strategies for Effective Health
Communication
 Be Humble
 Ask Open-Ended Questions
 Speak in Plain Language
 Keep Communications Confidential
 Communicate Like a Leader in Healthcare
Settings
Thank You