Consequences of Ethical Issues in Advanced Nursing Practice
“Ethics is not definable, is not implementable, because it is not conscious; it involves not only our thinking, but also our feeling.”
— Valdemar W. Setzer
Brazilian anthropologist, Department of Computer Science, University of São Paulo, Brazil
Advanced Practice Nurses are constantly challenged with ethical issues and dilemmas in clinical practice. Indeed, ethics requires NPs to use their knowledge, wisdom, critical thinking, and decision making skills to do what is right for individuals, families, and communities. There is a process that is used to make ethical decisions. A primary question to ask in every patient encounter is, “Am I doing what is right and good for the patient?”
The NP Core Ethics Competencies include integrating ethical principles in decision making, evaluating the ethical consequences of decisions, and applying ethically sound solutions to complex issues related to individuals, populations and systems of care. This week you will examine the process of using ethical principles in decision making and meeting the NP Core Ethics Competencies.
Learning Objectives
By the end of this week, students will:
Analyze salient ethical issues in Advanced Nursing Practice
Compare ethical dilemmas with state health laws and regulations
Outline the process of ethical decision making
Learning Resources
Required Readings
Buppert, C. (2018). Nurse practitioner's business practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones Learning.
Chapter 16, “Resolving Ethical Dilemmas” (pp. 471-479)
This chapter provides examples of ethical dilemmas in NP practice and enables you to analyze the ethical choices inherent in these situations. Ethical analyses are provided in this chapter.
Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (2014). Ethical decision making. In Advanced Practice Nursing: An Integrative Approach (5th ed.) (328 – 354). St. Louis, MO: Elsevier Saunders.
This chapter covers characteristics of ethical dilemmas in nursing, ethical issues affecting advanced practice nurses, ethical decision making competency of advanced practice nurses, evaluation of the ethical decision making competency, and barriers to ethical practice and potential solutions.
MidlevelU: The Online Hub for Midlevels. (2013, January 14). Should Providers Treat Their Friends and Family? [Blog post]. Retrieved from http://midlevelu.com/blog/should-providers-treat-their-friends-and-family
Lachman, V. D. (2012). Applying the ethics of care to your nursing practice. MEDSURG Nursing, 21(2), 112-116.
Thomas, A. C., Crabtree, M. K., Delaney, K. R., Dumas, M. A., Kleinpell, R., Logsdon, C.,…Nativio, D. G. (2012). Nurse Practitioner Core Competencies. Retrieved from http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/competencies/npcorecompetenciesfinal2012.pdf
Required Media
HEAT Inc., Health Education & Training. (2010, May 12). Ethical Issues In Nursing -- Commitment: Patients, Professionalism, and Boundaries. Retrieved from https://www.youtube.com/watch?v=XtuanLybaZs
Note: The approximate length of this media piece is 7 minutes.
Optional Resources
Buppert, C. (2004). Can NPs prescribe for family members or themselves? Medscape. Retrieved from http://www.medscape.com/viewarticle/478418
Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine, & Institute of Medicine (2011). The future of nursing: Leading change, advancing health. Retrieved from http://www.nap.edu/catalog/12956/the-future-of-nursing-leading-change-advancing-health
Wood, D. (2015). Everyday ethics for nurses: Addressing ethical challenges - Turning the Nurses Week theme into year-round ethical practice. Retrieved from http://essynursingservices.com/everyday-ethics-for-nurses-addressing-ethical-challenges/
Assignment 1: Analyzing an Ethical Decision
In your role, as an advanced practice nurse, 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 sociodemographic and ethnic/racial background. You must be prepared to critically analyze ethical situations, and develop an appropriate plan of action. For this Assignment, you will review the literature and discover the various ethical dilemmas advanced practice nurses encounter and how these issues are typically addressed in your state.
To prepare:
Review literature for moral/ethical issues encountered by advanced practice nurses in clinical practice.
Select an article that was published within the last five years.
Write a two page paper that answers the following questions:
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