Academic Misconduct in Nursing Whats the Big Deal

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Academic Misconduct in NursingWhats the Big
Deal?

• Andrea McCrink, EdD., WHNP-BC
• Assistant Professor of Nursing
• Adelphi University

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• A really good nurse needs to be of the highest
  class of character chaste, sober, honest,
  truthful and trustworthy, punctual, quiet yet
  quick, cheerful and hopeful, clean and thoughtful
  of her patient.
• Florence Nightingale as cited in Seymer, 1954

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Ethical Practice and Caring

• Core Values
• of the Nursing Profession

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Ethical Standards of the Nursing Profession

• Code of Ethics
• Integral part of who we are as nurses
• Non-negotiable commitment to society
• Our promise to society do always do our best when
  caring for our patients
• American Nurses Association, 2001
• Ethical nursing happens when a good nurse does
  the right thing
• Kelly, 1992

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Caring and the Profession of Nursing

• Caring, a core value within the nursing
  profession, demonstrates the importance of
  concern for and dedication to the patient
• Cook Cullen, 2003
• Commitment to society as a whole to practice
  morally and ethically

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• Ethical practice and the ethic of caring go hand
  in hand
• Ethical practice is the antecedent of caring
• Lemonidou, Papathanassoglou, Giannakopoulou ,
  Patiraki Papadatou, 2004

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Does ethical practicewhich demonstrates caring
ALWAYS happen?
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• Academic Misconduct in Higher
• Education
• Parr, 1936 Drake, 1941 Baird, 1980 Harnest,
  1986 Sierles, Kushner Krause 1988 Sheer
  1989 Polding, 1995 McCabe Trevino, 1997
  Russian, 2003 Arvidson, 2004
• Academic Misconduct in Nursing Education
• Hilbert, 1985 Harnest, 1986 Sheer, 1989
  Roberts, 1997 Bailey, 2001 Russian, 2003
  Baxter Boblin, 2007 McCrink, 2008
• Academic Misconduct Professional and Workplace
  Ethics
• Hilbert, 1985 Nonis Swift, 2001 Papadakis,
  Hodgson, Teherani, Kohatsu, 2004 Papadakis,
  Teherani, Banach, Knettler, 2005 McCrink, 2008

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Academic Misconduct in Nursing Education
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• Variety of Methods
• Systems of hand and feet positions
• M Ms
• Making a paper flower and writing notes on it
• Tiny cameras and micro-recorders
• Hand-held scanner pens
• Programmable watches
• Skirts with pleats
• Cheat At School Exams Professionally

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Study on Academic Misconduct

• Second year nursing students enrolled in
  associate (two-year) degree National League for
  Nursing accredited nursing programs in the
  northeastern United States.
• Gender
• 89.1 female
• 10.4 male

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• Age
• Range 20 56 years
• Average age 33.5 years
• GPA
• Range 2.50 4.00
• Average GPA 3.38
• Marital Status
• 40.4 Single
• 50.8 Married
• 8.3 Divorced
• 0.5 Missing Data

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• Research Question
• How often do nursing students engage in behaviors
  of academic misconduct?
• The mean score (of 21.58) indicated that as a
  group, the respondents for this study did not
  engage often in behaviors of academic misconduct.
  

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• Research Question
• How unethical do nursing students perceive
  behaviors of academic misconduct?
• The mean score (of 81.54) indicated that as a
  group, the respondents for this study perceived
  behaviors of academic misconduct to be unethical
  to extremely unethical.
• HOWEVER.

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Reporting and/or recording vital signs that were
not taken or recalled accurately.
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Reporting and/or recording vital signs that were
not taken or recalled accurately.
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Reporting and/or recording treatments that were
not performed or observed.
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Reporting and/or recording treatments that were
not performed or observed.
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Recording medications as given when they were not
given.
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Recording medications as given when they were not
given.
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Discussing patients in public places or with
non-medical personnel.
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Discussing patients in public places or with
non-medical personnel.
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• Ethical Standards
• Majority of respondents in this study agreed to
  strongly agreed with the ethical standards of the
  nursing profession.
• Ethic of Caring
• Majority of respondents in this study agreed to
  strongly agreed with the ethic of caring within
  the nursing profession.

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• Neutralization Behaviors
• A minority of respondents in this study agreed on
  the use of neutralization behaviors to
  rationalize behaviors of academic misconduct
  which allow the individual to engage in
  unacceptable behaviors without serious injury to
  self-image

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Academic Misconduct Professional and Workplace
Ethics
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• Nurse in Indiana falsified medication
  administration records by initialing the MAR for
  meds not actually given. Decision to fire the
  nurse was upheld by the US District Court.
• Tucker vs. St. Joseph Care Center, 2007
• Home health nurse in Arkansas terminated for
  charting patient findings before actually seeing
  patient. Decision to fire the nurse was upheld by
  the US District Court.
• Legal Eagle Eye Newsletter to the Nursing
  Profession, 2008

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• Nurses accused of photographing a patient and
  posting the pictures on the Internet have been
  fired (2009)
• Retrieved from http//www.wisn.com/news/18796315/d
  etail.html
• Nurse in Sweden was suspended for posting surgery
  photos on FACEBOOK (2008)
• Retrieved from http//www.wisn.com/cnn-news/187963
  15/detail.html
• Nurse in Philadelphia admits to removing body
  parts from 244 corpses for black market
  transplants
• Fox News, 2008

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• American Journal of Nursing, March 2009
• National Council of State Boards of Nursing
• 40 of nurses who were on probation for
  professional misconduct in 2001 committed another
  act of misconduct between 2001 and 2005.
• 33 of the disciplined nurses changed employers
  during their probation

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What is the Future of Nursing Practice?
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Nursing Faculty The Journey of Becoming a Nurse

• Cultural uniqueness of each student
• Cultural values, beliefs and principles
• Socialization into the profession of nursing
• Ethical standards and ethic of caring as core
  values
• Provide nursing students with clearly written and
  comprehensive school policies and expectations on
  academic misconduct.

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• Inform students about the consequences of
  academic misconduct.
• Zero tolerance policy
• Need to be hyper-vigilant in their efforts to
  decrease and halt episodes of academic
  misconduct.
• Be aware of student pressures and obligations.

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Nursing LeadershipBeing a Registered Nurse

• Continue socialization into the profession of
  nursing
• Foster of culture of ethical practice and caring
• Foster professionalism and accountability
• Supportive and caring
• Be aware of pressures in the clinical area

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Ethical behavior is not the display of ones
moral rectitude in times of crises. It is the
day-by-day expression of ones commitment to
other persons and the ways in which human beings
relate to one another in their daily
interactions. Levine, 1990, p. 41