NRS 433V Topic 1 DQ 2 Nursing research is used to study a dilemma or a problem in nursing

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Topic 1 DQ 2

Jul 25-29, 2022

Nursing research is used to study a dilemma or a problem in nursing. Examine a problem you have seen in nursing. Provide an overview of the problem and discuss how addressing the problem through nursing research can improve patient outcomes. Provide rationale and support for your answer.

Krishna Turner

Jul 29, 2022, 10:45 PM

Replies to Krishna Turner

Dilemma is often an issue that appears in nursing. Nurses are place in a sometime difficult and uncompromising position. From giving advice to a patient about their health or decision regarding care. (Dilemmas in nursing, 2022) Example: a patient refused having an x-ray done at bedside due to chronic pain. Patient has several decubitus and because the film will need to be placed underneath the patient back it will cause more pain and pressure to the patient. As a nurse we must explain the reason and benefit of having the x-ray done. Patients have a right to refuse treatment or any procedures. Although the patient refuses the x-ray the patient knew that continuing treatment was important regardless of having the diagnostic test. Patient did understand the importance of the test but is also aware that for the providers to further treat the disease or disorder a diagnostic test need to be done.

To address the issues or dilemmas that the patients maybe experiencing is not to have any judgement but to understand their concern. This can be done be letting the patient know that they are being heard. As nurses we need to help figure out an alternative method of helping the patient with their fear and pain to eventually move forward with getting an x-ray done. The patient has lack of control of most treatments done in the hospitals, the question to ask is what can be done to gain more control in the hospital. It will help the patient achieve a better outcome if you negotiate and express what you and the patient both cares about. (Robert A., 2015)

Reference:

20 common examples of ethical dilemmas in nursing + how to deal with them. 20 Most-Common Examples of Ethical Dilemmas in Nursing. (n.d.). Retrieved July 29, 2022, from https://www.nursingprocess.org/ethical-dilemma-in-nursing-examples.html

What to Do When a Patient Refuses Treatment Robert Arnold MD Download PDF. (2015). What to do when a patient refuses treatment. Palliative Care Network of Wisconsin. Retrieved July 30, 2022, from https://www.mypcnow.org/fast-fact/what-to-do-when-a-patient-refuses-treatment/

Sheranda Fesler

replied toKrishna Turner

Jul 30, 2022, 6:41 AM

Replies to Krishna Turner

Can you identify a specific dilemma you have seen or experienced in your facility or career?

Krishna Turner

replied toSheranda Fesler

Jul 30, 2022, 8:15 PM

Replies to Sheranda Fesler

Hi Dr. Fesler,

I have experience families having to make a tough decision for their loves ones during a code. The decision was to have the patient continue to be intubated and not being their old self again, or making the decision to take them off life support. Imagine having a 29year old daughter who was pregnant and had 4 other kids, and while in labor she had a seizure. This then warrant for them to take the patient into the OR to have emergency c-section. During the procedure the patient had multiple seizures, was losing a lot of blood and coded on the table 4 times. After the patient received several units of RBC, plasma, and platelet 4 hours later became stable enough to be transferred to the ICU. Once on the unit she coded 3 more times and the mother was present. The last time the patient coded the doctor went and talk to the mother to make a difficult decision. The mother wanted us to continue to work on the patient, although she was asystole. By this time we were in the 6 hour of working on her and the doctor had to call the time of death. It’s hard to make certain calls when the patient does not do advance directives. “Nurses must advocate for the autonomy and rights of patients.” (20 common examples of ethical dilemmas in nursing + how to deal with them) End of life decisions are hard not only for the families but those that have to bring it to the families attention.

Reference;

Hannah Haywood

replied toKrishna Turner

Jul 31, 2022, 10:48 PM

Replies to Krishna Turner

Hello Krishna,

Ethical dilemma’s are very common in health care. The ethical dilemma in your post sounds horribly sad because of the age of the young mama and that she had just birthed her 5th child. The ethical dilemma’s commonly seen in the adult ICU in my area are mostly related to elderly patients who are put through painful lifesaving procedures (intubation, CPR, continuous dialysis, etc.) because their families do not know what their wishes are and they do not want to be the one to make the fateful decision. It poses and ethical dilemma for the nurse, then, who is responsible for carrying out each of the physician’s orders and is putting the elderly patient through all of these treatments that they may not have wanted. I have found that due to those sad situations, I ask the difficult questions like “would you like us to do compressions on you if your heart stops? Or, “Would you like a breathing tube if you fail to breath successfully on your own?” If they answer that they would not like any artificial, lifesaving measures, I alert the physician and have them second that important conversation and write the proper orders before anything happens. Arizona has a packet called “Life Care Planning Packet” that includes information about all of the important documents for the patient and their family to fill out (Attorney General AZ, n.d.).

References:

Attorney General AZ (n.d.). Life care planning packet.https://www.azag.gov/sites/default/files/docs/seniors/life-care/2018/Life-Care-Planning-Packet-Complete.pdf

Kadija Tejan-deen

replied toKrishna Turner

Jul 30, 2022, 11:25 PM

Replies to Krishna Turner

Hello Krishna,

Good post. Evidence-based care refers to the practice of factoring in patients’ specific preferences, as well as the findings of relevant

NRS 433V Topic 1 DQ 2 Nursing research is used to study a dilemma or a problem in nursing

research and clinical studies, when making decisions on their medical treatment. The majority of medical professionals work hard to provide care that is not just effective but also compassionate and suited to the requirements of their patients. Therefore, it is encouraging when there is solid study evidence that tells us what works and what does not work, as well as with whom and where it works best. Evidence from the fields of science and economics, as well as the findings produced by collaborative efforts such as the Cochrane Collaboration, should be utilized to the fullest extent possible (Larsen, et al., 2019). On the other hand, nurses and people who use health care services have a clear need for more evidence, which arises from questions that cannot be stated in scientific or economic terms.

references

Larsen, C. M., Terkelsen, A. S., Carlsen, A. M. F., & Kristensen, H. K. (2019). Methods for teaching evidence-based practice: a scoping review. BMC Medical Education, 19(1), 1-33.

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Grading Rubric Guidelines

Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
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	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
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)*	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	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 Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	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	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	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.