NURS 8002 Discussion Ethics and the DNP-Prepared Nurse

NURS 8002 Discussion Ethics and the DNP-Prepared Nurse

NURS 8002 Discussion Ethics and the DNP-Prepared Nurse

Week 10-discussion
COLLAPSE

            Ethics play a crucial role in healthcare for those who perform patient care and especially for clinicians in leadership roles. As a DNP-prepared nurse, clinical staff will look to you for answers. A common issue in primary care is caring for a person who’s losing the ability to care for themselves. The case study that Rejno et al. (2020) present about “Anna” discusses an elderly woman who thinks she is doing fine, but the family sees the patient not eating, losing weight, and appearing disheveled. These situations are prevalent scenarios that can be very difficult for all parties involved. The patient is losing autonomy and dignity, it can be challenging for the family to see their loved ones like this, and providers have to make hard decisions about how to proceed. Often in my practice, families come in concerned about a family member who may be unsafe to drive, but taking away the ability to drive can cause quite a stir. These types of situations can often escalate, and as a DNP-prepared nurse working in leadership roles, you may be the person who has to step in deciphering what is best.

Considering many DNPs are nurse practitioners (NPs) and over three-quarters of NPs are in family practice, caring for patients with dwindling autonomy is an ethical dilemma that is often encountered (Vermeesch et al., 2018). Collaboration can be essential in these situations to assure the patient’s needs, and desires are met. Collaboration with colleagues like physical/occupation therapists, neuropsychologists, equipment companies, and care facilities can make a big difference. Vermeesch et al. (2018) did a study where NPs and nurses with PhDs collaborated to help educate students on ethical challenges and strategies. Considering DNP-prepared nurses have an education-based less on research and more on clinical practice. It seems collaboration with a Ph.D. for challenging ethical situations could be a largely beneficial care approach.

Another example of an ethically difficult situation is end-of-life scenarios. As a hospital nurse, there are often situations where the patient is not going to survive. End-of-life can be pretty difficult for the family to accept, especially if it is unexpected. As a DNP-prepared nurse, there are many possible roles in the hospital setting where you may encounter end-of-life dilemmas. You may be asked to oversee these patient scenarios or tasked to monitor and structure procedures for these situations. How the hospital system handles end-of-life care can make a significant impact in the community. Pavlish et al. (2020) show how having a team-based approach could lead to improved communication and better patient outcomes in an intensive care unit. By implementing regular evaluations of patient situations and educating staff, patients and families received more communications and spiritual support (Pavlish et al., 2020). I have seen these end-of-life situations on a poorly organized unit versus a unit that ran like a well-oiled machine, even within the same hospital system. Many factors play a role in poor outcomes for end-of-life situations. A significant problem is provider communication; providers are not communicating well with the new shift. They may not be doing well at keeping families up to date. They may not know when to call the Chaplin or palliative care services. Having a systematic approach and getting more education to providers seems like an excellent way to improve this healthcare gap.

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

Rejnö, Å., 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

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.

According to Henly et al. (2015), nursing is a research-based profession that builds on the practice of its science.  Therefore, one would agree that both degrees are terminal degrees where one focuses on clinical practice and research and analysis.  The Doctor of Nursing Practice (DNP) and the Philosophy in Nursing degree (Ph.D.) engage in leadership and collaboration where science and practice are required to provide high-quality care.  Also, one can not deter that there will be challenges obtaining a degree at this highest level. Still, it is essential to strive for excellence and be role models within the profession to participate in forums and enhance performance matrixes to improve the quality of patient care.  One would agree that mental health has its challenges, but it is crucial to understand the individual despite their conditions.  The topic of crisis prevention intervention (CPI) is essential within the healthcare setting because it provides a basis for all personnel to engage and intervene safely with the mental health specialty while striving to improve the quality of care for this patient population.  One needs to consider engaging with departments such as; quality control, nursing leaders, and educators to prepare the role out of a crisis prevention program within the facility. In conclusion, the role of the DNP is to scope areas or topics that need improvement and identify how to improve clinical practice supported by evidence-based research.

References

Henly, S. J., McCarthy, D. O., Wyman, J. F., Alt-White, A. C., Stone, P. W., McCarthy, A. M., Heitkemper, M. M. (2015). Emerging areas of nursing science and PhD education for the 21st century: Response to commentaries. Nursing Outlook, 63, 439–445.

Photo Credit: ibreakstock / Adobe Stock

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.

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

NURS 8002 Discussion Ethics and the DNP-Prepared Nurse

NURS 8002 Discussion Ethics and the DNP-Prepared Nurse

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

Post by Day 3 of Week 10 and Respond by Day 5 of Week 10

To Participate in this Discussion:

Week 10 Discussion

What’s Coming Up in Week 11?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will consider the role of the DNP-prepared nurse as an advocate for promoting positive social change.

Next Week

To go to the next week:

Week 11

Module 5: Ethics and Issues for Social Change Advocacy

Ethics and the application of ethical principles is of supreme importance in nursing practice and healthcare delivery. So much of what nurses and healthcare professionals do daily stems directly from an ethical point of reference or frame. Providing patient care and ensuring patient safety while enhancing quality and diminishing costs are all well-intended and ethical practices that you likely already engage in your nursing practice. A strong ethical awareness and adherence to ethical guidelines is just one way you will positively impact your patients in your role.

What’s Happening This Module?

Module 5: Ethics and Issues for Social Change Advocacy is a 2-week module—Weeks 10–11 of the course—in which you examine the role of the DNP-prepared nurse in upholding and abiding by professional standards for the delivery of ethical nursing practice. You will also reflect on how the role of the DNP-prepared nurse is central to social change advocacy for the improvement of healthcare and nursing quality, the positive impact on patient outcomes, and positive impacts on the community as a whole. In Week 10, you will review resources that highlight potential ethical issues in healthcare and nursing practice. You will engage with your colleagues in a Discussion that will focus on the significant ethical issues you reviewed that are relevant to the DNP-prepared nurse. In your Blog Assignment for Week 11, you will consider how you anticipate enacting a personal and professional commitment toward social change advocacy as a DNP-prepared nurse.

What do I have to do? When do I have to do it?
Review your Learning Resources Days 1–7, Weeks 10 and 11
Discussion: Ethics and the DNP-Prepared Nurse Post by Day 3 of Week 10 and respond to your colleagues by Day 6 of Week 10.
Blog: Positive Social Change and the DNP-Prepared Nurse Post by Day 3 of Week 11 and respond to your colleagues by Day 6 of Week 11.

Go to the Week’s Content

Week 10

Week 11

Week 10: The Doctorally Prepared Nurse: Ethics

What does it mean to uphold ethics in advanced nursing practice? What strategies and considerations are important for ensuring the ethical and safe delivery of healthcare as a DNP-prepared nurse?

This week, you will examine ethical issues relevant to the role of the DNP-prepared nurse. You will explore ethical issues you may likely encounter in nursing practice and reflect on potential strategies to mitigate ethical violations in practice.

Learning Objectives

Students will:

  • Analyze ethical issues related to the role of the DNP-prepared nurse
  • Analyze ethical issues encountered in professional nursing practice

Learning Resources

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Required Readings (click to expand/reduce)

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

Phelan, P. S. (2020). Organizational ethics for US health care today. AMA Journal of Ethics, 22(3), 183–186. https://doi.org/10.1001/amajethics.2020.183

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

Torkaman, M., Heydari, N., & Torabizadeh, C. (2020). Nurses’ perspectives regarding the relationship between professional ethics and organizational commitment in healthcare organizations. Journal of Medical Ethics and History of Medicine, 13(17), 1–10. https://doi.org/10.18502/jmehm.v13i17.4658

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

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NURS_8002_Week10_Discussion_Rubric

  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:
Writing		 6 (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 participation		 5 (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:
Writing		 6 (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.
Second Response:
Timely and full participation		 5 (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.
Total Points: 100

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