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Legal and Ethical Issues in Nursing: Explore legal aspects and their impact on ethical decision-making as nurses gain more responsibility.

Nursing advocacy: discuss advocacy as a pillar of nursing practice for patients, workplace, communities, legislative and political.

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1. Discuss legal aspects of nursing practice and the impact on ethical decision-making.

2. Identify important issues and resources related to nursing advocacy.

3. Reflect on nurse advocacy as a pillar of nursing practice for patients, workplace, communities, legislative and political..

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Introduction to Foundational Ethical Principles: Start with the basics of ethical principles and patient rights to set the foundation.

Ethical Decision-Making Models: Introduce decision-making frameworks as new nurses begin to encounter real-world scenarios.

ANA Code of ethics: Review the provisions & application to nursing practice.

Professional Boundaries: Early education on maintaining professional boundaries to establish a professional mindset from the beginning.

Overview of ethics services & resources: Facility based services. AACN, ANA, position statements.

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Advanced Ethical Scenarios: Present more complex ethical dilemmas and encourage critical thinking and discussion. Introduce and apply 4 box approach to ethical decision-making.

Review and Reflection: Encourage reflection on ethical experiences and lessons learned during the residency, reinforcing the importance of ethics in nursing practice.

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Learning Objectives

1. Analyze and discuss complex ethical scenarios using the 4-box approach.

2. Reflect on experiences and lessons learned related to clinical ethics during RN residency.

3. Summarize the importance of understanding ethical considerations in nursing practice.

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By the end of this session the resident will be able to:

1. Examine the 4 principles of biomedical ethics as a framework for ethical reflection.

2. Apply the ANA Code of Ethics for nurses to clinical practice.

3. Apply bioethics principles to a case study using the "clinician's approach" model.

4. Discuss the importance of establishing professional boundaries in nursing practice.

5. Identify clinical ethics resources at organizational & national levels.

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Slides include links to IUH system ethics resources & professional organization resources AACN, ANA etc.

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RN Residency Foundations in Clinical Ethics 2025

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Ethical reasoning model for use with case study in slides

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clinician's approach to clinical ethical reasoning

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2025 ANA Code of Ethics handout

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Moral Distress and Moral Agency- Introduce these concepts early. Provide personal & professional strategies for navigating moral distress and exercising moral agency.

ANA Bill of Rights: Review the bill & explore implications to nursing profession.

Cultural Humility and Ethics: Discuss cultural humility & reflect on personal bias to ensure respectful and ethical care for diverse patient populations.

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By the end of the session the resident will be able to:

1. Discuss moral distress in nursing practice.

•Identify sources of moral distress for nurses.

•Explore resources to address moral distress.

•Discuss strategies to increase moral agency.

2. Utilize moral distress map to reflect on personal experiences.

3. Reflect on ANA nurses bill of rights and implications to nursing practice.

4. Explore the meaning of cultural humility and reflect on personal bias to ensure respectful and ethical care to diverse patient populations.

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Interdisciplinary collaboration & communication: Emphasize the importance of teamwork and ethical collaboration with other healthcare professionals. Practice communication strategies for discussing ethical concerns as they arise in discussions.

Cultural humility- Practice recognizing one’s own bias, assumptions & reflect on the ethical implications for nursing practice as scenarios arise in discussions.

Foundational concepts- apply COE provisions, ethics principles & decision-making models to ongoing ethical discussions & concerns. Promote use of ethics services & resources.

Moral distress: Introduce the concept early on and provide ongoing support and strategies to manage it as nurses encounter challenging situations.

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The American Nurses Association (ANA) believes that advocacy is a pillar of nursing. Nurses instinctively advocate for their patients, in their workplaces, and in their communities; but legislative and political advocacy is no less important to advancing the profession and patient care.

ANA offers the information, tools, and resources that nurses need to become effective advocates. Through championing the nursing profession, nurses give a voice to the essential role that they play in advancing access to high-quality, affordable care. With energetic participation in advocacy, every nurse can help the profession to improve and move to higher levels.

Championing nurse interests

ANA also amplifies the voice of nurses, by advocating directly with decision-makers. We represent nurses on Capitol Hill; provide support for state nurse associations as they advance their own advocacy agendas; empower nurses to share their perspective and expertise with policymakers; and foster political engagement among nurses.
STATE Government AFFAIRS PROGRAM FEDERAL GOVERNMENT AFFAIRS

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The American Nurses Association (ANA) believes that advocacy is a pillar of nursing. Nurses instinctively advocate for their patients, in their workplaces, and in their communities; but legislative and political advocacy is no less important to advancing the profession and patient care. ANA offers the information, tools, and resources that nurses need to become effective advocates.

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RN Residency_ Moral Distress_Moral Agency 2025

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Moral distress mapping reflection exercise to use with case study in the slides.

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Moral Distress Map Worksheet_RN Residency

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MDT validated tool for measuring acute moral distress levels. Example of use as pre post in unit-based ethics conversations (UBECS). Permission for use from Dr. Lucia Wocial, co-author of the tool.

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UBEC Pre_Post Moral Distress Thermometer

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ANA Bill of rights handout

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Link to ANA ethics resources page includes code of ethics & helpful ethics related position statements that impact professional nursing practice.

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2025 Code of Ethics for Nurses Related Resources

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The revision of the Code was informed by a panel of nurses selected from various practice settings, geographic locations, and differing levels of expertise. After a revised code was drafted, it was posted for public comment to which over 6,300 responses were received from 3,000 individuals. The contributions of these individuals are gratefully acknowledged.

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Another version of the 4-box model to use with case study.

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The 4 box model for use with case studies

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10 RN case studies and concepts

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Schumann and Alfandre_The Four Topics Approach-1

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Patient Refusal of Nursing Care—An Ethical Dilemma for Bedside Nurses

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Handout describing ethics consultation and available resources specific to West.

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Ethics Services and Consultation Information Flyer

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Communication skills from learning library

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Communication skills from learning library

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No results found. Clear your search and try again.

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Nursing Forum - 2022 - Vogelstein - The prosecution of RaDonda Vaught  An ethical and legal mistake

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Harvard implicit association tests - humility

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Log in or register to find out your implicit associations about race, gender, sexual orientation, and other topics!

Or, continue as a guest by selecting from our available language/nation demonstration sites:

GO!

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Log in or register to find out your implicit associations about race, gender, sexual orientation, and other topics! Or, continue as a guest by selecting from our available language/nation demonstration sites: GO!

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recognizing addressing moral distress quick reference guide

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Report on speaking up and advocating

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Gallows humor article - when and where are important to determine boundaries

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Watson Gallows Humor Hastings Center Report 2011

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Case and activity for professional boundaries

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Communication and analysis process 2021-09-10

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Advocacy in Nursing: What Does a Nurse Advocate Do?

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Nurse advocates use their positions of trust to protect the rights, health, and safety of patients.

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AONL Advocacy provides important public policy information on issues relevant to nursing and health care. It informs nursing leaders on current developments in the federal arena and encourages them to take action on health and patient care issues, which impact their ability to provide safe, accessible and quality patient care services.

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AACN Policy and Advocacy Website

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Stay up to date on the latest nursing policy issues and advocacy efforts with AACN. Discover resources and tools at the local, state, and national levels.

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RN Grand Rounds I gave at Riley that hits hard on ethics resources at IUH

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Old bias assignment and rubric

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Hidden Bias Exercise and rubric 2021-08-15

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Cultural Diversity resource w education & exercises on humility, competence etc. 

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Cultural Diversity resource w education & exercises on humility, competence etc. 

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No matter who we are or where we come from, every person belongs to a culture. The impact of culture on a person’s health is profound because it affects many health beliefs, such as perceived causes of illness, ways to prevent illness, and acceptance of medical treatments. Culturally responsive care integrates these cultural beliefs into an individual’s health care. Culturally responsive care is intentional and promotes trust and rapport with patients. At its heart, culturally responsive care is patient-centered care. The American Nurses Association (ANA) states, “The art of nursing is demonstrated by unconditionally accepting the humanity of others, respecting their need for dignity and worth, while providing compassionate, comforting care.”[5]

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Ted talk on cultural humility

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Cultural Humility | Juliana Mosley, Ph.D. | TEDxWestChester