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DNP-815A Topic 4 DQ 1 Describe a recent or current ethical issue you have faced in nursing practice or which has attained national attention
DNP-815A Topic 4 DQ 1 Describe a recent or current ethical issue you have faced in nursing practice or which has attained national attention
Topic 4 DQ 1
Jul 28-30, 2022
Describe a recent or current ethical issue you have faced in nursing practice or which has attained national attention. Discuss the application of ethical theories or principles to the issue. Provide examples or use your DNP Project if you have any potential ethical issues /concerns and describe how you will address this? Provide literature support.
REPLY TO DISCUSSION
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Elizabeth Vidales
Jul 30, 2022, 7:22 PM
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An ethical issue paced in nursing practice is inadequate resources and staffing. This ethical issue has affected health care providers across the board. The problem was already presented before COVID; however, the pandemic made this problem more evident. The lack of appropriate staffing ratios places patients at risk of not receiving the care they need. Yang et al. (2021) studied 35 studies and found evidence of how patients were negatively impacted. Lower nursing staff have a higher association between death and falls (Yang et al., 2021). Patients with a surgical procedure were found more likely to die secondary to the nursing care received versus the procedure and or comorbidities (Yang et al., 2021).
Nurses in these scenarios are forced to make extremely difficult decisions. During the pandemic, frontline workers not only had to take care of these complicated cases but also placed personal health and safety at risk. Health care workers were expected to care for patients despite the limited personal protective equipment. This event caused a physical, emotional, and mental health burden to patients and those involved in providing services. The American Nurses Association acted and urged the administration to take immediate action to short- and long-term solutions in 2021 (ANA’s proposed policy solutions to address the nurse staffing shortage crisis, 2021).
Ethical theories applicable to these issues are beneficence. Health care professionals had to place aside personal worries and risks to care for the communities. Nurses did not think about potential lawsuits from working in these compromising situations. At that time, providing care was an obligation due to the evident shortage. Opting to provide services was in the patient’s best interests.
Staffing and limited resources can cause potential ethical issues in future direct practice improvement. The primary care clinic is in a rural area of Arizona. As a clinician is obligated to improve and protect the patient’s wellbeing when practicing beneficence, this is a theory the project is based on (Bester, 2020). Despite limitations, the idea is to improve patient clinical outcomes with the project. To not burden staff, the project is expected to not interfere with current workflows. The learner hopes to create a simple non-tedious process, answer questions, and address concerns on the project.
References:
ANA’s proposed policy solutions to address the nurse staffing shortage crisis. (2021). South Carolina Nurse, 28(4), 10–11.
Bester, J. C. (2020). Beneficence, Interests, and Wellbeing in Medicine: What It Means to Provide Benefit to Patients. The American Journal of Bioethics : AJOB, 20(3), 53–62. https://doi.org/10.1080/15265161.2020.1714793
Yang, B. K., Carter, M. W., & Nelson, H. W. (2021). Trends in COVID-19 cases, deaths, and staffing shortages in US nursing homes by rural and urban status. Geriatric Nursing, 42(6), 1356–1361. https://doi-org.lopes.idm.oclc.org/10.1016/j.gerinurse.2021.08.016
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Lydia Williams
Jul 30, 2022, 6:05 PM
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They need to be present all day, month, and even the year. It is nevertheless nurse practitioners are performing the most hectic jobs in the world and they are exposed to more ethical dilemmas as compared to other professionals in their workplace. According to studies conducted on ethical dilemmas in nursing, it is observed the most frequently occurring ethical issues are related to rights, staffing, advanced care planning, and making the right
decisions (Morrell et al., 2019 ). The inexperienced nurses are further exacerbating the situation due to a lack of knowledge and training. This creates the most challenging situation for the experienced nurses to deal with issues with healthcare needs in healthcare facilities. Following is the example of the most common ethical issue faced by the manager nurses in their job location. To deal with the medical complexities of chronic patients the practitioners or nurses need to collect medical information not only from patients but also from their family members. But in
most cases, the family members and even the patients are reluctant to share their medical information and create a dilemma for nurses in terms of disseminating accurate information and protecting their emotions. They undergo apprehension while deciding the dissemination of information without going against the beliefs of the patients and their family members.
According to the ANA code of ethics, the significant factor in the nurse-patient relationship is
telling a truth. In such a situation the nurse practitioners may undergo distress when they are incapable of translating their moral ethics into moral activities. The practical application of AACN nursing theory at this point can help the nurse managers to avoid moral disturbance by asking, affirming, assessing, and acting following the moral values while collecting and disseminating information from the patients. The development of an ethical care environment
will further help the nurse managers to avoid moral distress and collecting the maximum possible
information from the patients (Morrell et al., 2019 ). It is because of the fact the dissemination of accurate information will help to avoid the dissatisfaction of the patients. Thus, nurse capability of dealing with ethical dilemmas in the workplace using their experience and training can help them to take benefit of establishing professional limitations with their patients.
References
Bruchem-Visser, Z., Dijk, G., Beaufort,I. and Mattace-Raso,F. (2020). Ethical frameworks for complex medical decision making in older patients: A narrative review. Archives of Gerontology and Geriatrics, 104-160, https://doi.org/10.1016/j.archger.2020.104160.
Morrell, J., Konda, S.and Grant-Kels, M. . (2019 ). Response to a letter to the editor regarding "The ethical issue of cherry-picking patients. J Am Acad Dermatol, e127.
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Usama Saleh
Jul 30, 2022, 3:23 PM
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Ethical Principles and Theories in Nursing
Students,
ANA has a publication of Ethical Principles and Theories that are used in nursing. You can find the definitions, examples, and resources of the major ethical principles: Autonomy, Beneficence, Nonmaleficence, Fidelity, Justice, and Paternalism. As well, ethical theories include Ethical Relativism, Feminist Theory, Deontology, and Utilitarianism.
The ANA publication can be found by clicking the below link.
http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Resources/Ethics-Definitions.pdf
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Usama Saleh
Jul 30, 2022, 3:22 PM
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Ethical Principles or Codes
Students,
Ethical principles or codes are formal expressions of ethical knowledge that reflect the philosophic ideals on which ethical decisions rest. Ethical knowledge does not describe or prescribe what a decision or action should be. Rather, it provides insight about which choices are possible and direction with regard to choices that are sound, good, responsible, and just!
Chinn, P. & Kramer, M. (2014). Integrated Theory and Knowledge Development in Nursing. (8th Ed). Saint Louis, MO-Elsevier Mosby
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Usama Saleh
Jul 30, 2022, 3:22 PM
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Replies to Elizabeth Vidales
Ethics in Nursing
Students,
Ethics in nursing is focused on matters of obligation: what ought to be done. The moral component of knowing in nursing goes beyond knowledge of the norms or clinical codes of conduct: it involves making moment-to-moment judgments about what ought to be done, what is good and right, and what is responsible. Ethical knowing guides and directs how nurses morally behave on their practices, what they select as being important, where their loyalties are placed, and what priorities demand advocacy!
Ethical knowing also involve clarifying conflicting values and exploring alternative interests, principles, and actions. There may be no satisfactory answer to an ethical dilemma or moral distress; rather, there may only be alternative, some of which are more satisfactory than others. Ethical knowing in nursing requires an experiential knowledge of social values and mores from which ethical reasoning arises as well as knowledge of the formal principles and codes within the discipline.
Chinn, P. & Kramer, M. (2014). Integrated Theory and Knowledge Development in Nursing. (8th Ed). Saint Louis, MO-Elsevier Mosby
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Lydia Williams
replied toUsama Saleh
Jul 31, 2022, 8:24 PM
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Replies to Usama Saleh
Inadequate resources and staffing
Although this may not be an ethical issue put on individual nurses, healthcare executives and nurse managers should understand the lack of resources and inadequate staffing regarding patient care. As healthcare costs continue to rise, nurse managers are at odds regarding budgeting constraints and patient needs. When medical facilities have scarce resources, patients are at risk of not receiving proper care leaving nurses to make difficult decisions.
Hard decisions may also need to be made when facilities are faced with inadequate staffing levels. When there is not enough staff for patients, nurses do not have the time to do everything needed for each patient. Patient needs can include recovery times or even addressing the patient’s emotional and physical needs. A nurses’ moral obligations to patients are compromised due to work restraints and stress overload. They are left with mental struggles trying to decipher where they should focus their priorities.
This study revealed a gap between nurses’ thoughts and practices through the ethical decision-making process. They failed to lead their thought to moral practice. It also implies that moral sensitivity could positively affect nurses’ ethical decision-making. To make nurses morally sensitive, exposing them to various clinical cases would be helpful. Additionally, ethics education and clinical ethics supporting services are valuable for improving nurses’ ethical decision-making. If nurses improved their ethical decision-making regarding end-of-life care, their patients could experience a better quality of death.
Reference
Abou Hashish E. A. (2017). Relationship between ethical work climate and nurses’ perception of organizational support, commitment, job satisfaction and turnover intent. Nursing ethics, 24(2), 151–166. https://doi.org/10.1177/0969733015594667
Grading Rubric Guidelines
Performance Category | 10 | 9 | 8 | 4 | 0 |
Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic decisions. |
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Performance Category | 10 | 9 | 8 | 4 | 0 |
Application of Course Knowledge –
Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations |
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Performance Category | 5 | 4 | 3 | 2 | 0 |
Interactive Dialogue
Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. (5 points possible per graded thread) |
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Summarizes what was learned from the lesson, readings, and other student posts for the week. |
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Minus 1 Point | Minus 2 Point | Minus 3 Point | Minus 4 Point | Minus 5 Point | |
Grammar, Syntax, APA
Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition |
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0 points lost | -5 points lost | ||||
Total Participation Requirements
per discussion thread |
The student answers the threaded discussion question or topic on one day and posts a second response on another day. | The student does not meet the minimum requirement of two postings on two different days | |||
Early Participation Requirement
per discussion thread |
The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. | The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT. |