Professional Practice, Ethics, and Legal Aspects
Ethical Frameworks
Nurses apply autonomy (the patient's right to choose), beneficence (do good), nonmaleficence (avoid harm), justice (fair allocation), veracity (truthfulness), and fidelity (keep promises). Informed consent requires capacity, disclosure, comprehension, and voluntariness; the nurse's role is to verify understanding and witness, not to obtain consent or explain the procedure's risks in place of the provider.
Legal Concepts
Know negligence elements (duty, breach, causation, damages), malpractice, assault versus battery, false imprisonment, defamation, and invasion of privacy. Confidentiality is protected by law with limited exceptions such as mandated reporting of abuse, communicable disease reporting, and imminent threat to identifiable others. Follow the chain of command when a provider's order is unsafe; document the concern and the escalation.
Scope and Advocacy
Practice within state nurse practice acts, facility policy, and licensure level. Delegation requires the right task, circumstance, person, direction, and supervision - and never includes assessment, teaching, or evaluation. Advocacy means supporting the patient's expressed wishes, including advance directives and refusal of treatment.
Traps
Questions often present a patient refusing care and offer "persuade" or "override" as answers; competent refusal must be respected after ensuring understanding. Another trap is a nurse accepting a verbal order for a high-risk drug without read-back verification.
Rule of Thumb
When ethics and law conflict with convenience, follow the patient's autonomous, informed choice and escalate through the chain of command when safety is at stake.