Feb 23, 2024 NURS 8002 Week 10 Discussion: Ethics and the DNP-Prepared Nurse
A Sample Answer For the Assignment: NURS 8002 Week 10 Discussion: Ethics and the DNP-Prepared Nurse
Expressing respect for patient’s autonomy means acknowledging that patients who have decision-making capacity have the right to make decisions regarding their care, even when their decisions contradict their clinicians’ recommendations (Sedig, 2016). As human, we have our own beliefs, but as health care providers, we must learn to respect the belief of others, even if it does not coincide with our own.
According to Sedig (2016), when taking care of patients as a DNP-prepared nurse, you must respect patient’s autonomy by giving them the information needed to understand the risk and benefits of a proposed intervention, as well as the reasonable alternatives, so they can make independent decisions.
Fidelity as an ethical principle, is about ensuring that you’ve done everything possible to make sure your actions align with high standards and values. For health care professional the only thing guiding their choices in patients care is strong morals and a nursing code of ethics (Team, 2022). As healthcare providers, our clients will normally trust us, it is important that we keep up those values.
As you stated above, while working, as a risk manager, I have seen many cases where patient’s autonomy or fidelity were not valued. Most of the time when we make an encounter with these patients, they are at a vulnerable period and the last thing they need is not to trust the people that are taking care of them.
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Reference
Sedig, L. (2016). What’s the Role of Autonomy in Patient- and Family-Centered Care When Patients and Family Members Don’t Agree? AMA Journal of Ethics, 18(1), 12–17. https://doi.org/10.1001/journalofethics.2017.18.1.ecas2-1601
Team, S. E. (2022, October 18). Fidelity in Nursing: Nursing Ethical Principles – SimpleNursing. Simple Nursing. https://simplenursing.com/fidelity-in-nursing/#:~:text=Fidelity%2C%20as%20an%20ethical%20principle
Doctoral level-prepared nurses play an essential role in addressing the actual and potential health needs of their communities. They collaborate with the community members to identify the resources that can be used to optimize their health outcomes.
The nurses also promote change to ensure continuous improvement in the implementation of initiatives to enhance their health. Therefore, this blog examines the most important challenges in my community, their importance, and practice interventions that can be implemented to address them.
Challenges
One of the most important challenges in my community is the rise in lifestyle diseases. There has been a rise in the rate of lifestyle diseases including diabetes, obesity, overweight, and hypertension in the community. The rise is attributed to the minimal engagement of the community members in healthy lifestyles and behaviors that include healthy diets and active physical activity. The problem affects mostly the young and middle-aged populations (Sathe & Hiwale, 2020).
The population’s predisposition is linked to its increased access to unhealthy foods and sedentary lifestyles such as too much screen time and consumption of sugar-rich diets. The second most important challenge in my community is substance abuse.
A significant proportion of the young population in the community abuses drugs such as amphetamine, marijuana, and cocaine. Factors such as peer pressure, low level of knowledge, and easy access to drugs have contributed to the problem (Sathe & Hiwale, 2020). Interventions that aim at addressing the issue should be implemented to enhance the overall health and wellbeing of the community members.
Importance of the Challenges
The rise in lifestyle diseases and substance abuse in the community is important in several ways. First, lifestyle diseases such as obesity, hypertension, and overweight affect the quality of life of the affected populations. It lowers their productivity through the time and resources spent in managing them (Meyer et al., 2019).
NURS 8002 Week 10 Discussion Ethics and the DNP-Prepared Nurse
Lifestyle diseases also increase the burden experienced by the community members. Often, the affected populations require frequent hospital visits and hospitalizations, which affect their productivity and community development. Lifestyle diseases also predispose the affected to early mortalities due to disease-associated complications (Atroshi, 2020).
Substance abuse is also important due to its health effects. Accordingly, substance abuse predisposes the community members to drug dependence. It also increases their risk of other health problems that include cancer, upper respiratory tract infections, low immunity, and premature mortality (Meyer et al., 2019). Consequently, interventions that address the issues should be implemented to ensure optimum public health.
Practice Change Interventions
One of the practice change interventions that can be implemented to address the above challenges is health education. Community members should be educated about the importance of healthy lifestyles and the effects of their current challenges. Health education is an important tool for creating awareness and stimulating change from the affected and populations at risk. Health education will also strengthen the effective utilization of community resources to address the challenges (Bednarek et al., 2018).
The other practice intervention that can be implemented to address the challenges is the adoption of effective and responsive policies. Accordingly, community policies that eliminate easy access to drugs by the community members should be adopted. The policies should also strengthen the creation of safe communities that support healthy living and enhanced access to healthy diets (Meyer et al., 2019). Therefore, the above interventions will minimize the population’s vulnerability to health challenges.
Conclusion
Doctoral-prepared nurses play an essential role to play in the promotion of optimum public health. They explore issues of priority in their communities and implement responsive interventions to address them. The identified issues in my community include a rise in lifestyle diseases and substance abuse. Therefore, interventions to address them should be implemented for the overall health and wellbeing of the community members.
References
Atroshi, F. (2020).Personalized Medicine, in Relation to Redox State, Diet and Lifestyle.BoD – Books on Demand.
Bednarek, A., Bodajko-Grochowska, A., Zarzycka, D., Emeryk, A., &Cichosz, E. (2018).Physical activity of adolescents in the prevention of lifestyle diseases.Pielegniarstwo XXI wieku / Nursing in the 21st Century, 17(3), 32–37. https://doi.org/10.2478/pielxxiw-2018-0025
Meyer, J. P., Isaacs, K., El-Shahawy, O., Burlew, A. K., &Wechsberg, W. (2019). Research on women with substance use disorders: Reviewing progress and developing a research and implementation roadmap. Drug and Alcohol Dependence, 197, 158–163. https://doi.org/10.1016/j.drugalcdep.2019.01.017
Sathe, N., &Hiwale, A. (2020).Achieving Wellness by Monitoring the Gait Pattern with Behavioral Intervention for Lifestyle Diseases.In X.-S. Yang, S. Sherratt, N. Dey, & A. Joshi (Eds.), Fourth International Congress on Information and Communication Technology (pp. 209–218). Springer. https://doi.org/10.1007/978-981-32-9343-4_17
Discussion: Ethics and the DNP-Prepared Nurse
You are likely already upholding ethics in nursing and healthcare delivery in your current nursing practice experience. As mentioned in the introduction for this week, a patient-focused approach that promotes the delivery of safe, quality, and cost-effective healthcare for promoting positive patient outcomes represents a fundamental alignment to ethical principles for the delivery of healthcare.
In your journey toward becoming a DNP-prepared nurse, you will continue to uphold ethical principles in your nursing practice and will likely continue to serve as an advocate for adhering to these principles in all you do.
Nurses at all levels of practice and care will encounter ethical issues. It is important for a DNP-prepared nurse to be aware of significant ethical issues they may encounter. DNP-prepared nurses “are on the frontline of patient care as ethical leaders and advocates” (Vermeesch et al., 2018). This means that DNP-prepared nurses not only need to be aware of ethical issues they may encounter, but also understand how their role impacts the resolution of ethical issues.
As a DNP-prepared nurse, we will be the ones other nurses and medical professionals look to in a variety of ethical situations. For this discussion post, I focus on two significant ethical issues: collaboration between health care providers and patient’s families during critical illness and patients with reduced consciousness.
Initiating and collaborating communication between health care providers and family members during times of critical illness can be an ethical challenge. Sometimes this communication is not intiatied until late in the patient’s disease progression, and this can be an issue. The families might not understand the severity of the patient’s illness and be unable to make health care decisions.
By involving the family members early on, the nurse may alleviate some of the misunderstanding. According to Pavlish et al. (2020), “families not only benefit from family conferences but also value the opportunity, especially if provided time to share their perspectives.” Initiating the family’s involvement early on can help reduce ethical predicaments that may arise.
Patients with reduced consciousness, whether they are under sedation or not, is an ethical concern. A patient may arrive to a emergency room or medical unit unconscious, with no identification or family present, and the health care providers must make decisions based on what they believe is best for the patient.
This can become an ethical issue because since the patient has altered consciousness, the health care team does not know that patient’s health care wishes. “Patients with reduced consciousness are vulnerable and completely dependent on the care and concerns of others” (Rejno et al., 2020). This can be a tricky ethical situation for a nurse to navigate.
There are many times patients are unable to sign consent for surgical procedures and their families or legally authorized persons are not available. Sometimes there is conflict on which family member should be informed or make decisions for the patient when they are unable to provide consent. Oftentimes there is confusion because the nurse on the unit taking care of the patient does not know who to contact, and when the patient arrives to the surgical unit, it becomes even more confusing. This causes delays with care and brings up ethical concerns.
In the postanesthesia care unit (PACU), patients have received anesthesia and other sedatives and may be unable to make decisions or express their needs. This means the PACU nurse must maintain the patient’s dignity as best as they can.
Although a patient will wake up form the anesthesia, they are still in a vulnerable state, since the anesthesia medication can affect their judgment and decision-making skills for up to 24 hours. It is up to the PACU nurse to provide safe care and also help the patient make decisions.
References
Pavlish, C. L., Henriksen, J., Brown-Saltzman, K., Robinson, E. M., Warda, U. S., Farra, C., Chen, B., &Jakel, P. (2020). A team-based early action protocol to address ethical concerns in the intensive care unit. American Journal of Critical Care, 29(1), 49-61. https://doi.org/10.4037/ajcc2020915
Rejno, A., Ternestedt, B.-M., Nordenfelt, L., Silfverberg, G., &Godskesen, T. E. (2020). Dignity at stake: Caring for persons with impaired autonomy. Nursing Ethics, 27(1), 104-115. https://doi/org/10.1177/0969733019845128
Vermeesch, A., Cox, P. H., Baca, S., & Simmons, D. (2018). Strategies for strengthening ethics education in a DNP program. Nursing Education Perspectives, 39(5), 309-311. https://doi.org/10.1097/01.NEP.0000000000000383
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For this Discussion, reflect on the case studies/scenarios related to ethical challenges presented in this week’s Learning Resources. Think about how these ethical challenges may mirror your own experiences in nursing practice. Consider what other ethical challenges may arise in your own nursing practice or as you continue your program of study.
To prepare:
Review the case studies/scenarios related to ethical challenges presented in this week’s Learning Resources.
Reflect on ethical challenges related to the organization or at the point of care that you may have encountered in your nursing practice.
Consider what new ethical challenges you might face once you obtain your doctoral degree.
By Day 3 of Week 10
Post an explanation of at least two significant ethical issues relevant to the DNP-prepared nurse. Then explain how these issues might compare to the types of issues you have encountered in your practice. Be specific and provide examples.
NURS 8002 Week 10 Discussion: Ethics and the DNP-Prepared Nurse
By Day 5 of Week 10
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by expanding upon your colleague’s post or suggesting an alternative approach to the ethical issue described by your colleague.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 10 Discussion Rubric
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Post by Day 3 of Week 10 and Respond by Day 5 of Week 10
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Thank you for your post. I found the two ethical topics you discussed informative. Informed consent, in my opinion, has a very simplistic principle, all patients have a right to determine what level of care they receive. Healthcare professionals provide educational information and alternatives to the interventions they will provide and the patient makes an informed decision on the treatment they desire (Shah, 2022).
Medical professionals have a legal and ethical obligation to provide informed consent and must ensure that the decision is made by cognitively stable individual or face substantial consequences (Shah, 2022). As DNP-prepared nurses this may not always be so simple, as there are several barriers that could arise in any given situation, therefore we must remain unbiased and do what is right for the patient.
While working in the NICU I confronted several cases of parental medical decision making which required some heavy consideration and explanation to allow the parent to make an informed decision on an infant’s care. Often in the NICU, premature infants’ comorbidities are reduced when they are provided a mother’s breast milk as opposed to artificial formulas (McGlothen-Bell et al., 2019).
Unfortunately, in this situation the mother was unable to develop a sufficient amount of breast milk to provide the infant, therefore, it was recommended that donor breast milk be used. The mother was appalled when this was first recommended but with several medical professionals’ educational information presented, the mother of the infant was able to make an informed decision of care for her child. Despite the barriers that DNP-prepared nurses may face we must determine a proper way for individuals to make an informed decision no matter the circumstances.
References:
McGlothen-Bell, K., Cleveland, L. M., & Pados, B. F. (2019). To consent, or not to consent, that is the question. Advances in Neonatal Care, 19(5), 371–375. https://doi.org/10.1097/anc.0000000000000651Links to an external site.
Shah, P. (2022, June 11). Informed consent. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK430827/
Name: NURS_8002_Week10_Discussion_Rubric
Grid View
List View
Excellent
90%–100%
Good
80%–89%
Fair
70%–79%
Poor
0%–69%
Main Posting:
Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
40 (40%) – 44 (44%)
Thoroughly responds to the Discussion question(s).
Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
No less than 75% of post has exceptional depth and breadth.
Supported by at least three current credible sources.
35 (35%) – 39 (39%)
Responds to most of the Discussion question(s).
Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.
50% of the post has exceptional depth and breadth.
Supported by at least three credible references.
31 (31%) – 34 (34%)
Responds to some of the Discussion question(s).
One to two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Cited with fewer than two credible references.
0 (0%) – 30 (30%)
Does not respond to the Discussion question(s).
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible references.
Main Posting:
Writing
6 (6%) – 6 (6%)
Written clearly and concisely.
Contains no grammatical or spelling errors.
Adheres to current APA manual writing rules and style.
5 (5%) – 5 (5%)
Written concisely.
May contain one to two grammatical or spelling errors.
Adheres to current APA manual writing rules and style.
4 (4%) – 4 (4%)
Written somewhat concisely.
May contain more than two spelling or grammatical errors.
Contains some APA formatting errors.
0 (0%) – 3 (3%)
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style.
Main Posting:
Timely and full participation
9 (9%) – 10 (10%)
Meets requirements for timely, full, and active participation.
Posts main Discussion by due date.
8 (8%) – 8 (8%)
Meets requirements for full participation.
Posts main Discussion by due date.
7 (7%) – 7 (7%)
Posts main Discussion by due date.
0 (0%) – 6 (6%)
Does not meet requirements for full participation.
Does not post main Discussion by due date.
First Response:
Post to colleague’s main post that is reflective and justified with credible sources.
9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings.
Responds to questions posed by faculty.
The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.
7 (7%) – 7 (7%)
Response is on topic and may have some depth.
0 (0%) – 6 (6%)
Response may not be on topic and lacks depth.
First Response:Writing6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues.
Response to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues.
Response to faculty questions are mostly answered, if posed.
Provides opinions and ideas that are supported by few credible sources.
Response is written in standard, edited English.
4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication.
Response to faculty questions are somewhat answered, if posed.
Few or no credible sources are cited.
0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication.
Response to faculty questions are missing.
No credible sources are cited.
First Response:Timely and full participation5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation.
Posts by due date.
4 (4%) – 4 (4%)
Meets requirements for full participation.
Posts by due date.
3 (3%) – 3 (3%)
Posts by due date.
0 (0%) – 2 (2%)
Does not meet requirements for full participation.
Does not post by due date.
Second Response:Post to colleague’s main post that is reflective and justified with credible sources.9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings.
Responds to questions posed by faculty.
The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.
7 (7%) – 7 (7%)
Response is on topic and may have some depth.
0 (0%) – 6 (6%)
Response may not be on topic and lacks depth.
Second Response:Writing6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues
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