Nursing administration

Nursing Administration
By
Mr. Anandh Sam Perera. S
Professor
PDMSNC

INTRODUCTION
• Nursing has been called the oldest of the arts and the youngest of the
professions.
• The term ‘Nurse’ evolve from the Latin word nutrix, which means to
nourish or to cherish.
• Today nursing emerged as a learned profession, that is both a science and
an art.
• It is a body of knowledge. Knowledge is an awareness or perception of
reality, which is acquired through learning or investigation.
• Science is defined as both a unified body of knowledge concerned with
specific subject matter, the skills and methodology necessary to provide
such knowledge.

• Nursing as an art is the application of knowledge and skill to bring
about desired results. It is an individual action.
• Nursing art is carried out by the nurse in an one-to-one
relationship with the patient and constitutes the nurse’s conscious
responses to a specific and patient’s immediate situation.

Profession
Profession is defined as "a vocation requiring advanced
training and usually involving mental rather than manual
work, as teaching,
engineering, especially
medicine, law“ –
Webster1989.

Profession: a type of occupation that meets certain criteria that raise
it to a level above that of an occupation. • Profession: is a calling that
requires special knowledge, skill and preparation. • An occupation
that requires advanced knowledge and skills and that it grows out of
society’s needs for special services.

Difference between Occupation
& Profession.
According to Webster:
– Occupation: is defined as what occupies or engages, one’s time,
business and employment.
– Profession: is defined as a vocation requiring advanced training and
usually involving mental rather than manual work, as teaching,
engineering, especially medicine, law etc.

CRITERIA OF PROFESSION
i. HIGH INTELLECTUAL LEVEL OF FUNCTIONING:
MODERN NURSES USE ASSESSMENT SKILL AND KNOWLEDGE, HAVE THE
ABILITY TO REASON AND MAKE ROUTINE JUDGMENT DEPENDING ON
PATIENT’S CONDITION. PROFESSIONAL NURSES FUNCTIONS AT A HIGH
INTELLECTUAL LEVEL.

II. HIGH LEVEL OF INDIVIDUAL RESPONSIBILITY AND ACCOUNTABILITY:
NURSES MUST BE ACCOUNTABLE AND DEMONSTRATE A HIGH LEVEL OF
INDIVIDUAL RESPONSIBILITY FOR THE CARE AND SERVICES THEY PROVIDE. THE
CONCEPT OF ACCOUNTABILITY HAS LEGAL, ETHICAL AND PROFESSIONAL
IMPLICATIONS THAT INCLUDE ACCEPTING RESPONSIBILITY FOR ACTION TAKEN
TO PROVIDE CLIENT CARE AS WELL AS ACCEPTING RESPONSIBILITY FOR THE
CONSEQUENCES OF ACTION THAT ARE NOT PERFORMED.

III. SPECIALIZED BODY OF KNOWLEDGE:
NURSING HAS DEVELOPED INTO AN IDENTIFIABLE SEPARATE DISCIPLINE, A
SPECIALIZED BODY OF KNOWLEDGE CALLED AS NURSING SCIENCE. IT WAS
COMPILED THROUGH THE RESEARCH EFFORT OF NURSES WITH ADVANCED
EDUCATIONAL DEGREES. ALTHOUGH THIS BODY OF SPECIALIZED KNOWLEDGE IS
RELATIVELY SMALL, IT FORMS A THEORETICAL BASIS FOR THE PRACTICE OF
NURSING TODAY. AS MORE NURSES OBTAIN ADVANCED DEGREES, CONDUCT
RESEARCH AND DEVELOP PHILOSOPHIES, AND THEORIES ABOUT NURSING, THIS
BODY OF KNOWLEDGE WILL INCREASE IN SCOPE.

IV : EVIDENCE BASED PRACTICE:
EVIDENCED BASED PRACTICE IS THE PRACTICE OF NURSING IN WHICH INTERVENTIONS
ARE BASED ON DATA OBTAINED FROM RESEARCH THAT DEMONSTRATE THAT, THE
FINDINGS ARE APPROPRIATE AND SUCCESSFUL. IT INVOLVES A SYSTEMATIC PROCESS OF
UNCOVERING, EVALUATING AND USING INFORMATION FROM RESEARCH AS THE BASIS
FOR MAKING DECISIONS ABOUT PROVIDING CLIENT CARE.

V: PUBLIC SERVICE AND ALTRUISTIC ACTIVITIES:
INDIVIDUAL IS THE FOCAL POINT OF ALL NURSING MODELS AND NURSING PRACTICE.
NURSING HAS BEEN VIEWED UNIVERSALLY AS BEING AN ALTRUISTIC PROFESSION
COMPOSED OF SELFLESS INDIVIDUALS WHO PLACE THE LIVES AND WELL BEING OF
THEIR CLIENTS ABOVE THEIR PERSONAL SAFETY. DEDICATED NURSES PROVIDE CARE
FOR VICTIMS OF DEADLY DISEASES WITH LITTLE REGARD FOR THEIR OWN WELFARE.

VI: WELL ORGANISED AND STRONG REPRESENTATION:
PROFESSIONAL ORGANIZATIONS REPRESENT THE MEMBERS OF THE PROFESSION AND
CONTROL THE QUALITY OF PROFESSIONAL PRACTICE. IN INDIA TNAI & SNAARE THE TWO
ORGANIZATIONS THAT REPRESENT NURSING IN TODAY’S HEALTH CARE SYSTEM. MANY DO
BELONG TO SPECIALTY ORGANIZATIONS THAT REPRESENT A SPECIFIC AREA OF PRACTICE.

VII. COMPETENCIES AND PROFESSIONAL LICENSE:
NURSES MUST PASS A NATIONAL LICENSURE EXAMINATION TO DEMONSTRATE THAT THEY ARE
QUALIFIED TO PRACTICE NURSING. ONLY AFTER PASSING THE EXAMINATION THE NURSES ARE
ALLOWED TO PRACTICE. THE GRANTING OF A NURSING LICENSE IS A LEGAL ACTIVITY
CONDUCTED BY THE INDIVIDUAL STATE UNDER THE REGULATIONS CONTAINED IN THE
STATE’S NURSING PRACTICE ACT.

VIII. PROFESSIONAL IDENTITY AND DEVELOPMENT:
UNTIL NURSES ARE FULLY COMMITTED TO THE PROFESSION OF NURSING,
IDENTIFY WITH IT AS A PROFESSION AND ARE DEDICATED TO ITS FUTURE
DEVELOPMENT, NURSING WILL PROBABLY NOT ACHIEVE PROFESSIONAL STATUS.

Ethics : Greek word - ethos’= character
Webster dictionary = The science of moral duty or ideal human character’

“A system of rules or principles that are used to guide
human behavior”
Guiding force in the development, implementation and
evaluation of nursing practice since the “Florence
Nightingale Era”.
What is Ethics

Why nursing code of ethics…
• Ethics includes values, codes, and principles that govern
decisions in nursing practice.
• Guide for action based on social values and needs.
• Provide means to professional standards
• Formal guidelines for the professional action
• Basis for Self regulation and relationship with others.
• Evaluating the merits, risks, and social concerns.
• Ethical principles are necessary to guide to the
professional development

• Help in assessing the complex situations
• Better decision making
• Enhances interaction between the health
professionals and with the community
• Provide well defined policy and procedure in resolving ethical
dilemma.
• Unethical practices will be minimized
• Reflect the good image of the nurses and the
organization they work.

• Provide a sign of the profession’s commitment to the public .
• Give a framework for the standards of conduct.
• Provide general guidelines for professional behavior.
• Helps to protect the rights of the individual, family and the
community
• Provide standard curriculum .

Who recommends the Code of Ethics for Nurses…
• The International Council For Nurses (ICN)
• American Nurses Association
• Canadian Nurses Association
• Trained Nurses Association Of India (TNAI)
• Indian Nursing Council.(INC)

The ICN- Code of Ethics for Nurses Preamble
Nurses have four fundamental responsibilities
• To promote health,
• To Prevent illness,
• To restore health and
• To alleviate suffering.

Other principles
• Paternalism
• Confidentiality
• Double Effect
• Respect for Persons
• Sanctity of Life
• Veracity
• Informed consent

Nursing …..
Universal.
Working for a noble cause.
Dealing with human life.
Respect for human rights, including cultural
rights.
Right to life.
Treating client with dignity.
Care to humanity.
Definition: “autos” = self, “nomos” = rule
– It is person’s independence and self reliance
– People should have control on their own lives
– Individual rights of self determination for
making decisions.
– Freedom of choice
– Informed consent. right to know procedure,
complications, other options.
– Nurse should respect client’s decision and
choices….
Autonomy

Nursing …..
Universal.
rights.
Right to life.
Beneficence
Duty to do good, goodness, kindness,
Positive actions to help others
Client interest is more important than
personal
Care should be beneficial to all
Treating client with dignity.
Care to humanity.

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
Commitment ……. Balance risk and benefits
Not to cause harm
Prevent harm
Remove harm
Non malfeasance

Maintain Confidentiality
Personal and medical
information of the client
will not disclosed to other
unless the the client gives
informed consent.
Share information
selectively
NURSING CONFIDENTIALITY

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
Confidentiality
• Share or discuss patient information
only if it is necessary .
• Never share patient’s identification
number or password with anyone.
• Follow the hospital’s or healthcare
provider’s policies.
• Log off your computer when you are not
by your workstation/ nurses station
• Be careful about computer records

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
Justice
• Providing nursing care equally
to all as per needs
• Fairness/ unbiased
• Giving equal treatment
• Equal distribution of benefits,
costs and even risk.
• Some time equality
distribution is not possible
during emergency , the
services are based on priority.

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
Respect
Call by name
Respect as an individual
Respect their opinion
Respect relatives
Especially respect the women
in labour/delivery room

– Establish a culture of privacy to ensure
that personal information of patients is
kept as private as possible
– Provide space
– Ensure that the patient’s body is
appropriate covered
– Informed consent
Respecting Privacy

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
Responsibility
 Remember you are taking
responsibility of human life
 Willing to take responsibilities
 Having to be answerable for the
action
 Be accountable
 Need to remain competent-
 Knowledge
 Attitude
 Practice
 Take those responsibility which are
in your job descriptions

 Be answerable to oneself and others for
one’s own actions.
 Nurses are accountable for judgments made
and actions taken in the course of nursing
practice.
 It is all about justifying actions, explaining
why something was (or was not) done
 Account for their actions is therefore to
establish whether they had good enough
reasons for acting in the way they did.
Accountability

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
Accountability

 Support for a cause
 As a nurse you support for the health
,safety, and rights of the clients.
 Follow institutional policy and procedure
 Report any unethical occurrence that
may cause harm to the clients
Advocacy

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
Veracity
“If you tell the truth , you don’t have to
remember anything”.
Truth is the basis for mutual trust between
clients and health professionals.
Provide all information truthfully

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
Double Effect
Some actions can be morally justified even
though consequences may be a mixture of good
and evil
• Must meet 4 criteria:
– The action itself is morally good or neutral
– The agent intends the good effect and not the evil
(the evil may be foreseen but not intended)
– There is no favorable balance of good over evil

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
• Duty to be faithful to
one’s commitments
• Faithfulness
• Keep promises
• Don’t make promises you
cant keep;
Fidelity

Nursing ….. Paternalism
To treat someone
paternalistically is to treat
the person in a way that
ignores or discounts his/her
wishes.
When one individual assumes
the right to make decisions
for another
• Limits freedom of choice
• Think about parents making
decisions for children

Sanctity of Life
law, religion,
• It depends in which context,
philosophy etc.
But in general terms, it's the belief that all life,
from the moment of conception is sacred and,
therefore has the right to live
• If life is the highest good, is it ethical to keep a
brain dead person alive?

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
COMPONENTSOF NURSING ETHICS

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
NURSES AND THE PEOPLE
• The nurse’s primary professional
responsibility is towards people
requiring nursing care.
• nurse promotes an environment in which
human rights, values, customs and
spiritual beliefs of the individual, family
and community are respected.

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
• The nurse shares with society the
and
responsibility for initiating
supporting
NURSES AND THE PEOPLE
• The nurse ensures that the individual
receives sufficient information
• The nurse holds in confidence personal
information and uses judgment in
sharing this information.

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
• Action to meet the health and social
needs of the public, in particular those
of vulnerable populations.
• The nurse also shares responsibility to
sustain and protect the natural
environment from depletion, pollution,
degradation And destruction.
• Provide health education
NURSES ANDTHE PEOPLE

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
Nurses and the practice
• Provide care as per set standards
• Maintains standards of personal
conduct
• Respect individual and family
• Enhance the competency
/knowledge and skill with
changing needs.

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
Nurses and Practice
• The nurse, in providing care, ensures
that use of technology and scientific
advances are compatible with the
safety, dignity and rights of people.
• Promote participation of individuals and
others in patient care

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
NURSES AND THE PROFESSION
• Develop professional knowledge
• Developing research based
professional knowledge.
• Work in the professional organization
• Developing equitable and social
working condition for nurses.

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
NURSES ANDCO-WORKERS
• Co-operative relationship
• Respect
• Collaborate
• Acceptance
• Respect point of view

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
ETHICS IN INDIA

Nursing …..
Universal.
rights.
Right to life.
Care to humanity.
Respect Uniqueness of the person
Indian Nursing Council : Code Of Ethics
Respect rights
of the individual
Respect privacy and confidentiality
Maintain competency
to render quality
care
Practice within
framework of ethical,
legal and professional
boundaires
Demonstrate personal
etiquettes

• Be aware about yourself and your values
• Be Knowledgeable about professional
standards
• Know your job and develop skill to perform
• Develop effective interpersonal relationship
• Develop rapport with the clients and relatives
• Participate in the ethical committee meetings
• Perform what is been taught
• Work in policy framework
• Develop and implement Team of ethics
committee and actively participate in it.
Nurse’s EthicalChallenge

Care to all without discrimination
Respect to the clients and relatives
Use words carefully
Accept patient with his /her religious belief
Take responsibility and delegate
responsibility carefully
Act as per informed decision and choices
Always act in the best interest of the client
Be aware about legal precedents
Plan and organize in-service education
programme
Nurse’s Ethical Challenge

 Rights of personal dignity:
 Calling by name.
 Give due respect as per age.
 Maintain privacy.
 Modesty : knocking doors, pulling curtains.
 Provide Best possible appearance, personal
hygiene and care.
 Listening to the patient carefully.
 Accepting the individuals feeling as real
without judging right or wrong.
Rights of the patients

• Right to receive timely and qualified care in a
setting appropriate to health care needs.
• Right to participate in decisions
• Right to refuse treatment
• Right to receive information regarding their
illness, the course of treatment, and prospects
for good health
• Right to approve and refuse the release of their
medical records.
• Patient has the right to access their medical
record.

• Right to express complaints and satisfaction
regarding services rendered without fear of
discrimination..
• Right to comment and make suggestions for
improvement of the quality of care and
services.
• Right to receive respectful care in a safe and
secure environment with respect and regard
for privacy, individuality, personal beliefs and

• Right to privacy and confidentiality of their
records – records are to be maintained in a safe
and secure environment.
• Right to know the professional status of the
person(s) treating them
• Right to know, in advance of services, the cost of
services and any applicable payment policy.
• Right to appoint a legal representative to make
decisions regarding their health care.
• Right to refuse to participate in
research/experimental activities.

Rights of the patients…
Rights to assistance towards independence
 Motivate and build self esteem for self
care
 Assist in activity of daily living
 Helping attitude and show interest while
caring
 Involve family members
 Direct or provide necessary information
for self care
 Be around

 ProvideCare based on needs
 Respect the client while performing the nursing procedure
 Allow family member to be with the client as far as possible
 Plan diet as per cultural back ground
 Allow personal belongings
 Allow religious rituals , if it is not disturbing to other and client or
treatment
Rights of the patients…
individual care

“They may forgot your name; but they will
never forget how you made them feel.”
Proud to be a nurse ,
Practice safe , be safe
Thank You

Nursing administration

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