NRS 430 Outline the process for the development of nursing standards of practice for your state

Green (2022) describes eight ethical principles that healthcare professionals should uphold when caring for patients. These are simply codes of conduct or principles, not laws. The principle I chose to describe is autonomy, which means the nurse advocates the patient’s right to choose what is best for them, their value and choice about their healthcare decisions. Often autonomy is difficult for a nurse to possess, especially when the nurse or healthcare provider does not agree with the choices of the patient.

For example, a patient who has been diagnosed as terminally ill and is suffering from chronic pain from their illness may choose to enter into hospice care and stop treatment. What if that patient is young, or has young children to think about, or hasn’t sought out every treatment option, but still made the choice to end their life. Not everyone will agree on what is the best option, but truly the patient’s opinion or choice is the only choice that matters in the situation. As a nurse that vowed to uphold these ethical principles, the nurse must respect and honor the patients’ choice and ultimately support them in whatever decision they make.

Reference

Green, S. Z. (2022). Advancing professional standards. In Grand Canyon University, Dynamics in Nursing: Art & Science of Professional Practice. (2nd ed.). Grand Canyon University.

I absolutely agree with you that nurses should respect patient’s wishes even sometimes when we are challenged with sensitive and sad situations. I recently cared for a young female patient who was recently diagnosed with an aggressive brain tumor and is married with twin toddlers. Patient came in very ill with dehydration and failure to thrive. This was one of my hardest nursing duties witnessing seeing her toddlers and husband at her bedside really triggered my motherly instincts to wanting to do more. However, patient had an advance directive for comfort care and do not resuscitate. Basically, my duty was to make her comfortable and provide palliative care. Sometimes I was tempted to do extra but respecting my patient’s wishes was ethically right with this particular situation. Nurses exercise choice to follow the principles as a part of the profession’s inherent respect for humankind. Choosing to follow ethical principles displays the nurse’s commitment to the profession and those receiving health care (Green,2022).

References

Green, S. Z. (2022). Advancing professional standards. In Grand Canyon University, Dynamics in Nursing: Art & Science of Professional Practice. (2nd ed.). Grand Canyon University.

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Ethical issues occur in every health care environment, and they are part of every nurse’s practice (Green,2022). Amongst the eight ethical principles of nursing, I chose the principle of autonomy. This ethical principle plays a significant role in nursing. It simply means patients have the right to self-determination. Autonomy in nursing is about providing sufficient information to allow patients to make their own decisions based on their personal beliefs and values, even if they aren’t the ones the nurse thinks is right (Green,2022). For example, I recently had a patient who was admitted with anemia and critically low blood values which required emergency blood transfusion, however the patient was a Jehovah’s Witness and refused all blood products despite being aware of her blood situation. Due to this patients’ personal beliefs other alternatives had to be considered in order to respect the client wishes.

Another situation where patients’ autonomy plays a huge role in their plan of care is determining the code status. The code status is listed in a patient’s medical chart each time they are admitted to the hospital. It lets the patient’s medical team know what the patient’s wishes in the event of a medical emergency are such as their heart stopping. The code statuses a patient can choose are full code, do not resuscitate, and do not intubate. During my clinical exposure I have noted that patients with chronic diagnoses practice autonomy usually through participating with the doctors to discuss their end-of-life care and wishes. The involvement of primary caregivers in discussing code status with patients with terminal illnesses is crucial. A study by a group of researchers among the terminally ill patients in Taiwan revealed that the disclosure of the patients’ poor prognosis should not be overlooked, and there is a need to emphasize the importance of truth telling the patients’ families and discussing end of life care medical decisions with patients without overriding their wishes. Thus, patients’ preferences toward end-of-life care medical decisions can be respected, thereby enhancing their quality of end-of-life care and life before death (Chang et al.,2022).

References

Green, S. Z. (2022). Advancing professional standards. In Grand Canyon University, Dynamics in Nursing: Art & Science of Professional Practice. (2nd ed.). Grand Canyon University.

Hui Yu Chang, Naomi Takemura, Pui Hing Chau, Chia-Chin Lin, BMC Palliative Care,2022. Vol 21, Iss 1, Pp 1-15 (2022), Prevalence and predictors of advance directive among terminally ill patients in Taiwan before enactment of Patient Right to Autonomy Act: a nationwide population-based study.

Beneficence is the ethical principal of doing right by a person. It is the act of doing good and looking out for what is best for the patient. I chose this ethical principle because it was appropriate for a situation that happened today at work. I had a patient who I previously injected with hyaluronic acid filler (HA) to her orbital rim for tear trough support. She came in for her follow up and was happy with her results but felt that there was still an area that could use additional improvement with HA filler. I assessed the area and determined from my professional experience that correction with HA filler would not improve or correct her concern. I felt that adding the filler would give her an unnatural outcome and could lead to other complications. I explained that it would not be in her best interest and no good would come out of adding filler to the area. As a professional I am obligated to always and without exception do right by the patient and have there well-being and interest as priority (Kinsinger, 2019). My patient is looking at more for guidance and is feeling vulnerable and may not understand what the HA filler can and cannot fix. I am in the position where I have to educate her and look out for her well being because as a professional the foundation of what I do it act for the greater good of my patient with professionalism, and morals (Kinsinger, 2019). In her case injecting her would not be acting for the greater good.

Kinsinger, F. S. (2009, December). Beneficence and the professional’s moral imperative. Journal of chiropractic humanities. Retrieved May 2, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342811/

Ethical values are essential for any healthcare provider (Green,2022). Amongst ethical principles of nursing, I chose the principle of beneficence.

The beneficent practitioner provides care that is in the best interest of the patient. Beneficence is the act of being kind. The actions of the healthcare provider are designed to bring about a positive outcome (Haddad and Geiger, 2022). Beneficence always raises the question of subjective and objective determinations, of benefit versus harm. A beneficent decision can only be objective if the same decision would be made regardless of who was making it.

An example in my place of work is allowing someone to go ahead in a long checkout line and donating money to help someone in dire straits are examples of acts of beneficence, specifically ideal beneficence. If one helps others because they are required or obligated to do so, this is called obligatory beneficence.

References

Green, S. Z. (2022). Advancing professional standards. In Grand Canyon University, Dynamics in Nursing: Art & Science of Professional Practice. (2nd ed.). Grand Canyon University.

Haddad, L. M., & Geiger, R. A. (2022). Nursing Ethical Considerations. In StatPearls. StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/30252310/

In New York State, the Nurse Practice Act provide state rules and regulations that guides nursing practice. The law states for anyone receiving nursing care, that care should be practiced under a licensed professional nurse. Nursing standards of practice were developed by many professional organizations. Such organizations are, the American Nursing Association, The State Nurse Practice ACT, Agency Policy and Procedure, Federal Regulators and many more. However, to make sure competent and safe care is provided, New York State ruses must follow seven standards of practice that were provided by these regulatory organizations. These standards are, to provide safe and quality health services, partnering with consumers, preventing, and controlling health care, medication safety, patient identification and procedure matching, blood, and blood products safety.

Nursing care is much the same across the board except each state have their own state regulated standard of practice. Nurses working from state to state must follow these guidelines to work within their scope of practice and competencies. Failure to do so can result in the charge of personal misconduct (ANA, 2021).

Its important for nurses to be aware of the laws affiliated with patient care. Both the judicial and civil law protects the patient rights (Green, 2022). Nurses are held to the highest of standards and patients put their trust in us. Failure to uphold that standard can have very negative results and serious consequences. I once had a patient who was due for a blood transfusion. The order was placed during the day shift. I came in on the night shift and the report was given to me. I had no problem transfusing the blood. My problem was the nurse tried to cover herself by sending for the blood just at the end of her shift. The blood arrived shortly after I took her report and the patient had not consented. That became a big problem because the blood had to be sent back to the blood bank since the patient did not have the capacity and family member had to be contacted to give consent. I had to report this incident to my charge nurse and an incident report was done.

I never forget situations like this because many things could have gone wrong and thereby putting the patient life at risk.

Reference:

Council on Nursing Practice. New York State Nurses Association. (n.d.). Retrieved May 3, 2023, from https://www.nysna.org/nursing-practice/practice-resources/council-nursing-practice#.ZFEyJS3ML_Q

Green, S. Z. (2022). Advancing professional standards. In Grand Canyon University (Eds.). Dynamics in nursing: Art and science of professional practice (2nd ed.). Grand Canyon University

American Nurses Association (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association.

The nursing process book.

NRS 430 Outline the process for the development of nursing standards of practice for your state