Practicum Journal Entry: Analyzing an Ethical Decision

Practicum Journal Entry: Analyzing an Ethical Decision

Practicum Journal Entry  Analyzing an Ethical Decision

 

Mental diseases pose significant threat not only in the US but also across nations worldwide. Victims of mental illness should be treated and rehabilitated by mental health professionals. In doing so, these professionals have faced complex situations when caring for the mentally ill patients at different stages.  Some of these challenges emanate from ethical considerations where the nurses may find it difficult to balance conflicting ethical practices. Often, psychiatric nurses are expected to uphold nursing ethics, codes, and institutional rules to guide them in caring for clients. However, internal and external constraints including contradicting ethical expectations may cause moral distress to the psychiatric nurses. Therefore, this paper seeks to explore ethical concerns in psychiatric and mental health nursing practice (PMHNP) and moral distress.

Moral/Ethical Issue in the Article Chosen

The article identified is Ohnishi et al. (2019), which highlight the impact of moral sensitivity on moral distress among psychiatric nurses. The article postulates that moral distress happens when an individual is aware of the right thing to do, but the institutional restrictions makes it challenging to follow the right action. The study found that moral distress leads to undesirable outcomes such as burnout, negative feelings, and high turnover rates. As such, the issue of moral distress is critical to psychiatric mental health nurses. This is so particularly where the existing ethics become unusable and they must accommodate the consequences is making decision that the institution considers right but is injurious to patient. It implies that the nurse lacks the power and control over the ethical responsibility to satisfy the nursing obligation to the patient. This issue is worsened in psychiatry by the possibility that patients often lack the capacity for rational and accurate judgment and ability to identify the reality. Moreover, the article argues that moral sensitivity, which is recommended in nurses, could exacerbate moral distress where the nurse is compelled to subvert ethical actions due to institutional constraints (Yeom, Ahn & Kim, 2017).

The Moral/Ethical Dilemma Surrounding the Issue

The major ethical dilemma on this issue is the manner in which the psychiatric mental health nurse should balance their

responsibilities to adverse parties in a situation characterized by an ethical dilemma. Of course, it is ethical for a mental health nurse to intervene by upholding their ethical responsibilities to various stakeholders. However, the major concern herein entails the determination of the party with the upper hand where there is a controversy. While a nurse is expected to act in the best interest of the patient, they are also expected to comply with institutional or state laws and with concerns of legal redress. As a result, the nurses will often bear the burden of insufficiency and guilt in the professional practice.

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Comparison of Ethical Issue with State Law

In the state of California, the moral distress in psychiatric mental health nurses can be attributed to various existing laws and regulations that are systematic and work distinctively. For instance, the state has general laws that regulate the interaction between patients and nurses. Besides, there are laws governing ethical nursing practice. Also, there are nursing boards and accreditation compliance laws that nurses are expected to follow. Essentially, the application of these laws often causes considerable distress wherein a controversy arises as regards balancing what is in the best interest of the patient against the institutional and state requirements.

The Process of Ethical Decision Making to Address Ethical Dilemma

When a nurse is encumbered by a moral distress regarding the determination of what is in the best interest of a patient and the existing laws and regulations, they can apply the following steps. The first step entails the fact that a nurse should engage the patient in open, honest, and respectful communication to explain the prevailing conditions and reason for the decision taken. However, the opinion of patients must also be considered. The second stage should involve institutional levels where the nurse should refer to the previous similar cases to help in informing the case at hand. The third step should encompass an initiative involving the entire nursing profession through a collaborative approach to analyze the ethical culture, policies, and practices that correlate with the case at hand (Hamric & Epstein, 2017).

Practicum Journal Entry: Analyzing an Ethical Decision Conclusion

Psychiatric nurses experience various challenges while caring for mentally ill patients, especially ethical challenges. Several factors can influence ethical dilemmas and moral distress among psychiatric nurses. The moral distress is associated with adverse impacts to the individual life of nurses including burnout, and to the organization including high turnover rates. Therefore, there is need to employ holistic solution in the PMHNP to reduce the moral distress.

Assignment: Practicum Journal Entry: Analyzing an Ethical Decision
In your role as a PMHNP, you will encounter several situations that will require your ability to make sound judgments and practice decisions for the safety and well-being of individuals, families, and communities. There may not be a clear-cut answer of how to address the issue, but your ethical decision making must be based on evidenced-based practice and what is good, right, and beneficial for patients. You will encounter patients who do not hold your values, but you must remain professional and unbiased in the care you provide to all patients regardless of their socio-demographic and ethnic/racial background. You must be prepared to critically analyze ethical situations and develop an appropriate plan of action. For this Assignment, you review the literature and discover the various ethical dilemmas PMHNPs encounter and how these issues are typically addressed in your state.
Learning Objectives
Students will:
Analyze salient ethical issues in psychiatric mental health practice
Compare ethical dilemmas with state health laws and regulations
Analyze ethical decision-making processes
To prepare:
Review literature for moral/ethical issues encountered by a PMHNP.
Select one of the articles you found that was published within the last 5 years to use as a focus for this assignment.
Write a 2-page paper in which you do the following:
Summarize the moral/ethical issue in the article (no more than 1 paragraph).
Describe the moral and ethical dilemmas surrounding the issue.
Analyze the ethical issue and compare them to the state health laws and regulations in your state.
Outline the process of ethical decision making you would use to address this ethical dilemma.
Note: Be sure to use the Practicum Journal Template, located in this week’s Learning Resources.

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Important information for writing discussion questions and participation

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I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed
• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• Student paper example
• Citing Sources
• The Writing Center is a great resource