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Leadership for Advanced Nursing Practice

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DNP-840A- Leadership for Advanced Nursing Practice

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Discuss the importance of the ethical delivery of care and regulatory reporting as it relates to the doctorally prepared advanced nurse’s practice. How might ethical principles informed by a Christian perspective be beneficial for Christians and non-Christians alike?

Shabnampreet Kaur

Any profession relies heavily on ethics. In nursing, ethical and moral issues act as beacons, guiding nurses to identify difficulties in the healthcare system, make good decisions, and create a positive impact. Ethical care and regulatory reporting are vital aspects of nursing practice. DNP-prepared nurses must provide high-quality care by adhering to the ethical principles and professional standards of nursing practice. Failure to comply with ethical regulations and principles might cause harm to patients and can give rise to legal issues. The tumultuous history of violations of fundamental human rights, as evidenced by the infamous Nuremberg Trials, taught the world to respect people as individuals. Respect for Persons, Beneficence, and Justice was listed as three rights while conducting research with human subjects in 1974 by the Belmont report(Office for Human Research Protections, 2022). While protecting human subjects in delivering care and leading quality improvement projects, the DNP-prepared nurse must explain the practice/project, including the benefits and risks associated with the same. The nurse must avoid medical paternalism and allow the individual to decide whether or not to participate in the project and make decisions about it. Beauchamp and Childress’ ethical principles are autonomy, beneficence, nonmaleficence, and justice(The Ethics Centre, 2021), and the rights enumerated in the Belmont Report are some of the methods that could be used to provide ethical delivery of care.

DNP-prepared Nurses should be scientifically inclined and promote the advancement of their profession through evidence-based practice. Patient privacy and confidentiality must be protected. Nurses must practice with dignity and protect the vulnerable population by informing them of their rights. The DNP-prepared nurse must make an equitable distribution of healthcare services so that every section of society receives assistance from a Christian perspective. Regulatory reporting is essential in the practice of a doctorally prepared advanced nurse. This refers to the requirement for specific events, such as adverse patient outcomes, to be reported to regulatory agencies. Failure to report these incidents can lead to disciplinary action, fines, and legal liability. DNP-prepared nurses are seen as leaders in healthcare who can lead society by learning from past mistakes, so regulatory reporting not only keeps track of patient information and healthcare organizations’ performance but also helps to improve patient care.

From a Christian perspective, ethical principles such as love, compassion, and justice can inform the delivery of care in a way that reflects Christian values (Reig et al.,2018). For example, nurses who follow Christian ethics may prioritize treating patients with kindness and respect, seeking to alleviate suffering, and promoting the value of human life. These principles, however, are not limited to Christians; nurses of any faith or no faith can benefit from using ethical principles to guide their practice. In conclusion, the doctorally prepared advanced nurse’s practice requires honest care delivery and regulatory reporting. Adherence to ethical principles and regulatory requirements is necessary to provide quality care while avoiding legal ramifications. Ethical principles informed by a Christian perspective can provide a valuable framework for guiding healthcare practice, but these principles apply to all healthcare providers regardless of religious beliefs.

Office for Human Research Protections. (2022, September 27). The Belmont Report. HHS.gov. https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/index.html

Rieg, L. S., Newbanks, R. S., & Sprunger, R. (2018). Caring from a Christian worldview. Journal of Christian Nursing, 35(3), 168–173. https://doi.org/10.1097/cnj.0000000000000474

The Ethics Centre. (2021, November 4). Big Thinkers: Thomas Beauchamp & James Childress. ethics.org. https://ethics.org.au/big-thinkers-thomas-beauchamp-james-childress/

 

Bonnie Flores

Nurses care for patients when they are at their most vulnerable; therefore, they are held to a high standard. Many who enter the profession are drawn to wanting to help people, and the nursing profession aligns with their innate altruistic beliefs and values (DeNisco, 2020). As such, it is important that nurses maintain their ethical identity and belief system when they enter the profession. It can be challenging to be a new graduate faced with a situation where under other circumstances, they may speak up but may be reluctant to do so for fear of getting fired or pressure they are facing from co-workers and supervisors (DeNisco, 2020). As doctoral-prepared nurses, we may be faced with ethical issues as it pertains to reporting hospital-acquired injuries, patient safety issues, and privacy issues. Doctoral-prepared nurses must hold themselves to the highest moral and ethical standards of care as they are role models for those with whom they work. They may hold positions where they need to report to regulatory agencies, and when reporting errors, it could lead to penalties for the organization. It may not be a desirable thing to do, but it is the right thing to do, and that cannot be understated. That is not to say that it will be easy, people may struggle to do what is right, but when we place the patient at the forefront of our mind, we must consider what is best for them, and act accordingly.

As doctoral nurses mentoring will be an aspect of the role. When mentoring new nurses or staff nurses within the organization, it would be beneficial to emphasize the valued characteristics and why they remain important (DeNisco, 2020). If nurses ignore their inner voice and avoid uncomfortable situations because there are conflicts, then decision-making may be impaired, which can negatively impact patient care (American Nurses Association, n.d.). When nurses continually witness other nurses, physicians, and managers going against what they were raised to believe and what they were taught in nursing school about ethics, they may face conflict and struggle with what is right (Albert et al., 2020). The ethical principles that many were raised with (e.g., treat all people with respect, be kind to others, etc.) are based on Christian values that have been rooted in who we are. Compassion for others is another element of those values and is a key value in the American Nurses Association (ANA) Code of Ethics (Papadopoulos et al., 2020). Though these values may have been formed at a young age, they carry over to all aspects of our life regardless of our religion. Maintaining high ethical principles benefits people of all races, religions, and cultures regardless of whether they are Christian or non-Christian.

References

Albert, J. S., Younas, A., & Sana, S. (2020). Nursing students’ ethical dilemmas regarding patient care: An integrative review.  Nurse Education Today,  88. https://doi.org/10.1016/j.nedt.2020.104389

American Nurses Association. (n.d.). Why ethics in nursing matters. American Nursing Association. Retrieved on April 11, 2023, from, https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/why-ethics-in-nursing-matters/

DeNisco, S. M. (2021).  Advanced Practice Nursing: Essential Knowledge for the Profession. (4th ed.). Jones & Bartlett.

Papadopoulos, Irena, Runa Lazzarino, Christina Koulouglioti, Magdeline Aagard, Özlem Akman, L‐M. Alpers, Paraskevi Apostolara et al. (2020). Obstacles to compassion‐giving among nursing and midwifery managers: an international study.  International Nursing Review 67(4), 453-465.

 

Veronica Montemayor

Mar 31, 2023, 10:35 AM

As DNP-prepared nurses, the delivery of care provided to patients must be ethical, as the care and outcomes are reported for all future patients to view. Reporting how healthcare organizations perform allows customers to choose where they would like to receive treatment. Kim et al. (2021) believe that sometimes, nurses may have difficulty in recognizing the right course of action; historically, the medical field has lacked a clear definition of an ethically challenging situation in nursing. They further state, for example, that nurses in the emergency department reported that ethically challenging situations involve being close to the suffering or death of people, being unsure how to express their feelings, and having a heavy responsibility. I agree with the authors that nurses require ethical competence, and we must ensure they have the resources to provide such expectations. Tone et al. (2021) noted that ethics is the generic term for the different ways of understanding and examining moral life; in nursing, for example, it includes professionals’ behavior towards persons in their care; reflection lies at the heart of the close connection between ethics and person-centered care. Professional nurses often have to act in patients’ best interests and think critically to identify issues that can lead to ethical dilemmas; therefore, minimizing dissatisfaction with healthcare requires ethically skilled staff delivering person-centered care.

Ethical principles informed by a Christian perspective may benefit Christians and non-Christians as the core values ensure we treat others how we would want to be treated. We care for our patients as if they were our loved ones because one day, they will be our loved ones. God has given us the tools to do his work through him, and for him, regardless of the patient’s religious beliefs, we must provide the necessary care, respect their culture and values, and know our boundaries. Patients do not choose to be admitted to the hospital; they are there because they need our expertise to help them get better and back to their regular lives; we advocate for them to ensure they are getting the best care. Holding each other accountable or speaking up when we see something is wrong is critical in preventing near misses or never events. As I continue to grow as a nursing leader, I see the importance of advanced practice nurses who are becoming better equipped with skills that can be used to improve patient outcomes. Following our ethical principles and utilizing evidence-based practices when caring for patients is the best nursing practice.

References

Kim, Y. H., Kang, Y., Ok, J. H., & Choe, K. (2021). Expert nurses’ coping strategies in ethically challenging situations: a qualitative study.  BMC Nursing,  20(1), 1–8. https://doi-org.lopes.idm.oclc.org/10.1186/s12912-021-00709-w

Tone, K., Knudsen, O., Anne-Lise, G., Loftfjell, L., Brandt, M., & Sørensen, K. (2021). Nursing students’ experience of learning ethical competence and person-centered care through simulation.  International Practice Development Journal,  11(2), 1–13. https://doi-org.lopes.idm.oclc.org/10.19043/ipdj.112.007

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