Patient Rights, Ethics, and Care Fundamentals
Patient Rights
- To be informed of their rights and duties.
- Respect in which their dignity and privacy are maintained.
- To be informed of the service provider who will deliver healthcare.
- That all associated information is confidential.
- That their information is not used for classes or research without consent.
- To choose their doctors and other health professionals.
- To know the name of the doctor who is treating them.
- To obtain the medicines they need.
- A choice of treatments that their doctor will propose.
- To refuse the proposed treatment.
Basic Ethical Principles in Healthcare
- Respect the decisions of the patient.
- Do good for the patient (Beneficence).
- Do no harm to the patient (Non-maleficence).
- Treat all patients equally, regardless of differences (Justice).
Professional Conduct and Rules
- Knock before entering a patient’s room.
- If the patient has problems, do not stream them (likely means do not broadcast or share their issues).
- Be respectful to patients and treat them with ‘usted’ (formal ‘you’) and not ‘tú’ (informal ‘you’).
- Attend to all patients equally.
- Only the nurse can receive orders from the doctor by phone.
- Take care of the sick by handling objects carefully (likely means avoid spreading germs).
- Do not work under the influence of alcohol or drugs, as this can harm everyone.
- Do not waste provisions and treat equipment well.
- Do not leave the work area during working hours without authorization.
- Do not share your personal problems with patients.
- Do not disclose patient intimacies or discuss them publicly.
Evolution of Patient Rights
This change was based on the Enlightenment and represents a shift in how patients are treated. Before, doctors often did not inform patients, and the only interaction was when patients were asked to be heard by physicians. Patients were not afraid to speak up until 1978, when the first patient rights to be heard and informed appeared.
Professional Secrecy and Confidentiality
Secrecy is the obligation of professionals not to disclose information learned in the workplace. Discussions about patient history and conditions should only occur within the hospital, never outside. If necessary to discuss with colleagues, do so respectfully and do not ridicule or exaggerate the information.
Fundamental Patient Needs
- Learn / Mental Retardation: Difficulty in acquiring knowledge.
- Food and Drink / Person in a Coma: Inability to self-feed or drink.
- Communicate / Autistic Person: Challenges in verbal or non-verbal communication.
- Rest and Sleep / Insomnia: Difficulty achieving adequate rest.
- Distract or Have Fun / Person with Blindness: Difficulty engaging in leisure activities due to sensory impairment.
- Sanitation / Colon Cancer: Issues with elimination or hygiene due to illness.
- Avoid Hazards / Deaf Person: Difficulty perceiving auditory warnings.
- Maintain Skin Clean and Protected / Person with Burns: Need for specialized skin care.
- Maintain Normal Body Temperature / Person with Fever: Difficulty regulating body temperature.
- Move and Maintain Good Posture / Invalid Person: Difficulty with mobility and maintaining position.
- Breathing / An Asthmatic: Difficulty with respiration.
- Work Performed and / A Mentally Diminished Person: Difficulty performing tasks or work.
- Dress Clothes Suitable / Person with Colorblindness: Difficulty selecting appropriate clothing based on color.
- Live According to Their Beliefs and Values / Dementia: Difficulty maintaining personal identity and practices.
Levels of Patient Assistance
- Needs: Biological, psychological, and sociocultural activities a person needs to meet.
- Complete Unit: When a person needs help to meet all their needs, such as severe dementia.
- Partial Unit: When a person needs help to satisfy a portion of their needs.
- Temporary Unit: When a person needs help to meet temporary needs, such as a leg injury.
- Independence: When a person does not need assistance to meet their needs.
- Cause of Difficulty: The reasons why patient autonomy is incomplete.
Barriers to Patient Autonomy
- Physical Barriers: Physical fitness of the person, mechanical skills, and sensory deficits.
- Psychological Obstacles: Their feelings and emotions, mood, intellectual ability.
- Social Obstacles: Their relationship with their partner, family, and community, economic difficulties, and their physical surroundings at home and work.
- Lack of Knowledge: About health and illness, about themselves, about needs and reactions.
Barthel Index Activities
- Food: 10 5 0
- Urination: 10 5 0
- Defecation: 10 5 0
- Bathing: 10 5 0
- WC Use: 5 0
- Bathroom Use: 5 0
- Dressing: 10 5 0
- Transfers: 15 10 5 0
- Walk on Level Surface: 15 10 5 0
- Stairs: 10 5 0
Lawton Instrumental Activities of Daily Living Scale
- Ability to use the phone: 3-0
- Shopping: 3-0
- Food preparation: 3-0
- Domestic work: 4-0
- Washing Clothes: 2-0
- Transportation: 4-0
- Disclaimer medication (likely means taking medication): 2-0
- Ability to take charge of finances: 2-0