NURS 8002  Ethics and the DNP-Prepared Nurse
NURS 8002  Ethics and the DNP-Prepared Nurse

NURS 8002 Ethics and the DNP-Prepared Nurse

Module 5, Week 10 Initial Post (Stein)
COLLAPSE

There are many ethical issues that the DNP-prepared nurse will encounter throughout their journey; however, from an executive leadership lens these dilemmas will be plentiful and evolve over time. In the acute care setting, “relevant collectives in health care—including groups of clinicians, patients, nonclinical workers, administrators, and institutions themselves—have diverse and often overlapping memberships and interests that might conflict (Phelan, 2020).” This can be related to the long standing ethical dilemma of healthcare providers feeling as though they are advocating for the care their patients need, while “the hospital” is pushing them to get those same patients discharged. It seems in this setting business and care providing, mixed in with regulation agencies and reimbursements makes the best plan of care for a patient confusing and can feel rushed. Another layer specific to Maryland is the use of a Global Budget Revenue (GBR) system that causes another set of obstacles for providers and patient care plans in the acute care setting. “Under GBR contracts, each hospital’s total annual revenue is known at the beginning of each fiscal year. Annual revenue is determined from a historical base period that is adjusted to account for inflation updates, infrastructure requirements, population driven volume increases, performance in quality-based or efficiency-based programs, changes in payer mix and changes in levels of UCC. Annual revenue may also be modified for changes in services levels, market share shifts, or shifts of services to unregulated settings (HSCRC, 2021).”

An additional ethical dilemma that can be encountered from higher level leadership includes, “Institutional transparency and conflicts of interest can affect patients and constituents’ relationships—most importantly, those of clinicians and their patients. Health care organizations’ interests and their potential conflict with interests of others under their authority are of great ethical significance, as partiality can threaten fiduciary obligations clinicians owe to patients (Phelan, 2020).” In the setting of rural Maryland, the population density is not high and there are a lot of clinicians who know their patients on a personal level or may have a slightly removed connection to them that is unavoidable. The description of “small world” runs true in western Maryland and can cause conflicts for clinicians and nursing staff when providing care in their workplace.

To conclude, Phelan (2020) states, “Given uncertain futures for health care systems, we should expect organizational considerations to be central in designing and delivering health care services. We can look to this issue for guidance about ensuring reasonable expectations of clinicians, responsibly navigating clinicians’ collective negotiations with employers, enabling justifiable adjudication of disciplinary action against organization members, maintaining cultures that discourage misconduct, sufficiently communicating and responsibly leveraging organizations’ aims to promote shared decision making,7 crafting solutions when there are few or no alternatives,9 and maintaining good public relations to foster trust.”

References:

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

Health Services Cost Review Commission. (2021). Global budget revenue adjustments. Retrieved 3 November 2021 from, https://hscrc.maryland.gov/Pages/gbr-adjustments.aspx.

NURS 8002  Ethics and the DNP-Prepared Nurse

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.

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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 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.

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NURS 8002  Ethics and the DNP-Prepared Nurse

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

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

Grid View
List View
  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

Name: NURS_8002_Week10_Discussion_Rubric

 

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