NURS521 Ethics in Healthcare

NURS521 Ethics in Healthcare
Week 1 Discussion Forum

Discussion Prompt #1

Reflect upon the survey you took. In your initial response, address some of the following questions. Explain your answers.

Did you find it easy to make confident and decisive decisions with several strongly agree or strongly disagree answers, or did you select mostly moderate responses?

Did any subject areas trigger personal emotions or issues? If so, do you feel you were able to remain objective?

Were any of the decisions especially difficult to make?

Did you employ any critical thinking or resolution strategies to determine a response?

Did you rely on policy or legal parameters to make your decisions?

Would you be comfortable making your answers to the survey public, or do you prefer anonymity?

Have you dealt with similar situations and could you perceive similar situations occurring in your clinical practice?

How might a moral inventory such as this survey impact your clinical practice?

Please share additional thoughts as well.

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Discussion Prompt #2

Identify examples of active and latent errors. Provide examples from your clinical experience, if possible. How can such errors be avoided to support better patient care?

NURS521 Ethics in Healthcare Essay Assignments – Week 2 discussion

Discussion Prompt #1

Explain the statement, “What may be an ethical dilemma for one registered nurse may not be an ethical dilemma for another registered nurse.” Be sure to define an ethical dilemma in the course of your discussion. Describe a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. (Be sure to respect and maintain patient and colleague confidentiality.)

Discussion Prompt #2

Apply the framework of The Five R’s approach to ethical nursing practice from this week’s reading to answer the questions about values and choices.

What are values?

Q. What are your personal values?

Q. Why do you value them?

Q. What are the values in your society?

Q. How do you make choices?

Q. Are your choices based on your values?

Q. What values are useful in society?

What are the limits to personal choice?

Q. Who limits your choices?

Q. Are limits to choices good?

Q. Do you limit other people’s choices?

Q. Should the health care organization or the government limit people’s choices? If so, how, and under what circumstances?

In your responses to peers, feel free to agree, disagree, question, compare, and discuss each other’s responses in a way that fosters thoughtful and respectful dialog. You may also address the following: Did any responses surprise you? If so, how? Did reading your peers’ responses to the questions expand your own view of ways to answer questions?

Finally, consider this: A common idea in health care is that if you are drawn to health care as a profession, you are inherently guided by an inner compass that is composed of a strong moral framework. Why is this a dangerous assumption?

NURS521 Ethics in Healthcare Essay Assignments – Week 3 discussion

Discussion Prompt #1

Discuss the potential controversy when considering a patient’s right to know whether a caregiver has AIDS, and the caregiver’s right to privacy and confidentiality. Consider the following: A physician cut his hand with a scalpel while he was assisting another physician. Because of the uncertainty that blood had been transferred from the physician’s hand wound to the patient through an open surgical incision, he agreed to have a blood test for HIV. His blood tested positive for HIV and he withdrew himself from participation in further surgical procedures. Discuss the ethical and legal issues.

Discussion Prompt #2

The following questions refer to your experience in this week’s exercise, Conducting Moral and Ethical Dialog in Clinical Practice. Describe your overall experience with the moral and ethical dialog exercise, and address at least three (3) of the following:

Did you find any of the scenarios more difficult to deal with than others?

Did you feel any internal conflict with any of the scenarios?

How did your personal and professional background impact how you decided to interact with the patient?

Do you feel the responses the patient gave to the practitioner’s response were reasonable or typical?

Were you taken aback by any of the patient reactions?

How might this activity contribute to your role as a nurse advocate in a moral and ethical practice?

Did you utilize an ethical decision making model to explore a systematic way to evaluate any of these ethical dilemmas? If so, describe the effectiveness.

NURS521 Ethics in Healthcare Essay Assignments – Week 4 discussion

Discussion Prompt #1

Apply the differences between negligence and malpractice to the practice of nursing. Provide examples to illustrate your points.

Discussion Prompt #2

Read the following article and view the video on the same case. How can this example be used as an illustration of maintaining patient safety and providing safe, effective care? Identify some of the possible barriers that nurses face when acting on what they believe to be the morally correct action in this particular case.

Patient Safety Advocate Carole Hemmelgarn

NURS521 Ethics in Healthcare Essay Assignments – Week 5 discussion

Discussion Prompt #1

Specifically define the role of the registered nurse in patient advocacy. Describe situations in which nursing advocacy can assist patients within the healthcare environment. Defend why nurses are, or are not, adequately prepared, in prelicensure education, to act as patient advocates.

Discussion Prompt #2

The ANA Code of Ethics currently emphasizes the word “patient” instead of the word “client” in referring to nursing care recipients. Do you agree with this change? Why or why not? Review the ANA Code of Ethics for Nurses with Interpretive Statements found in Appendix B of your Butts text.

NURS521 Ethics in Healthcare Essay Assignments – Week 6 discussion

Discussion Prompt #1

Identify two issues that a nurse might bring to an institutional ethics committee. Describe why the nurse should bring these issues to the ethics committee. Elaborate on how a nurse should prepare to present one of the issues to the ethics committee.

Discussion Prompt #2

Betty, the chief nursing officer, had to make a decision about buying 120 new hospital beds for patient rooms. After she interviewed nurse mangers at the units where the beds were going to be placed, Betty compiled her findings and decided to contact a well-known equipment company to obtain prices and contracts. The equipment company’s executive salesperson, Jim, discussed options at length with her and invited her and her significant other to an upcoming all-expenses-paid lavish retreat at a five-star hotel in Hawaii to see demonstrations of the beds and to hear a comprehensive sales pitch. Betty thought to herself, “We badly need some relaxation and stress relief. Hawaii would be so much fun. Would it be wrong for us to go?”

If you were Betty, what would you do? Give your rationale. Justify your answer with an ethical framework—a theory, approach, or principle.

Do you consider this situation a conflict of interest? Why or why not? Give your rationale.

What policies, if any, should be in place regarding a scenario such as this one? Do you have any such policies in place at work for similar situations? Do such policies impact day-to-day activities in any way? Explain.

NURS521 Ethics in Healthcare Essay Assignments – Week 7 discussion

Discussion Prompt #1

Discuss the elements of informed consent and provide a clinical example about what can happen when some elements are not adhered to.

Discussion Prompt #2

Describe an organizational environment that would facilitate the ethical practice of nurses caring for chronically ill patients. As you read about patient rights, describe one patient right that is often not fully implemented in the patient care environment. Identify specific strategies to help ensure that this right is supported within the patient care environment. Explain how the registered nurse can assist in protecting patient rights.

NURS521 Ethics in Healthcare Essay Assignments – Week 8 discussion

Discussion Prompt #1

Describe a clinical situation in which a registered nurse may encounter moral distress. Answer the AACN’s Four A’s found on page 84 in your Butts and Rich text to further explain the situation, and the possible mitigation strategies.

Discussion Prompt #2

Describe different ways that social media use can violate ethical nursing practices. How can ethical social media use be beneficial to health care professionals and their patients?

NURS521 Ethics in Healthcare Essay Assignments – Week 1 Virtue Ethics Essay

Respond to one of the following three “news clippings” related to virtue ethics from your Pozgar text. Write a 1- 2 page essay addressing the discussion questions posed for the one you selected. Be sure to clearly identify the news clipping you selected.

Adhere to APA formatting and cite all sources. Review the rubric for further information on how your NURS521 Ethics in Healthcare Essay Assignments will be graded.

Due: Sunday, 11:59 p.m. (Pacific time)

Points: 40

Watch the following 3 videos and choose one to address for your assignment.

#1. Wrong-Operation Doctor

Download Script

Find Out More: You may use these and other outside sources to frame your discussion.

The Pain of Wrong Site Surgery

Judgment Upheld in Arkansas Brain Surgery Lawsuit

National Quality Forum

Assignment Discussion Questions

1. Discuss the issues of integrity in this case.

2. Should criminal charges be considered in this case, if accurately reported? Discuss your answer.

3. Why did you choose to respond to this story?

4. How is integrity displayed in your clinical setting?

#2. Cheney’s Staff Cuts Testimony on Warming

Download Script

Find Out More: You may use these and other outside sources to frame your discussion.

The full story Cheney’s Staff Cut Testimony On Warming

CDC on Air Quality

Assignment Discussion Questions

1. Discuss how headlines such as this affect your opinion of politicians.

2. At the end of our days, the most basic principles of life–trust and survival–are on trial. What is your verdict, if you believe there was a cover-up?.

3. Why did you choose to respond to this story?

4. How are government and political trust displayed in your clinical setting?

#3. Surgeon Uses Ministry in Medical Practice

Download Script

Find Out More: You may use these and other outside sources to frame your discussion.

The full story: Praying with patients: A Dallas surgeon finds a way to put ministry into practice

Should Your Doctor Pray With You?

South Korean Hospitals Shut Over MERS Fears; 11th Person Dies

Note the picture in this article

Assignment Discussion Questions

1. Discuss the pressure, if any, placed on the patient to responding to the suggestion of prayer prior to surgery.

2. Describe how you, as the surgeon, or nurse, would address a patient’s religious or spiritual needs if the risks of a complex surgical procedure appear to be threatening.

3. Why did you choose to respond to this story?

4. How is religion or faith displayed in your clinical setting?

NURS521 Ethics in Healthcare Essay Assignments – Week 2 Ethical Frameworks Essay

Consider the “Four Topics Approach” (or Four Box method) to ethical decision making on page 61, Table 2.1 in Butts (below). Apply this model to a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. Specifically apply and address the questions within each topic area as they pertain to your situation.

In your conclusion, discuss the impact of the Four Topics process. Did applying these principles shape your decision making in any way? Does this seem like a valid process for you to apply in your practice?

Your NURS521 Ethics in Healthcare Essay Assignments paper should be 1-2 pages. Adhere to APA formatting throughout, and cite any outside sources you may use.

Review the rubric for further information on how your assignment will be graded.

Optional: You may download this pdf, complete it using correct grammar and APA, and submit it as your assignment in lieu of writing a paper. *You will need Adobe Acrobat in order to utilize this fillable .pdf form.

Due: Sunday, 11:59 p.m. (Pacific time)

Points: 60

TABLE 2-1 Four Topics Method for Analysis of Clinical Ethics Cases

Medical Indications: The Principles of Beneficence and Nonmaleficence

1. What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal?

2. What are the goals of treatment?

3. In what circumstances are medical treatments not indicated?

4. What are the probabilities of success of various treatment options?

5. In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?

Patient Preferences: The Principle of Respect for Autonomy

1. Has the patient been informed of benefits and risks, understood this information, and given consent?

2. Is the patient mentally capable and legally competent, and is there evidence of incapacity?

3. If mentally capable, what preferences about treatment is the patient stating?

4. If incapacitated, has the patient expressed prior preferences?

5. Who is the appropriate surrogate to make decisions for the incapacitated patient?

6. Is the patient unwilling or unable to cooperate with medical treatment? If so, why?

Quality of Life: The Principles of Beneficence and Nonmaleficence and Respect for Autonomy

1. What are the prospects, with or without treatment, for a return to normal life, and what physical, mental, and social deficits might the patient experience even if treatment succeeds?

2. On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or express such a judgment?

3. Are there biases that might prejudice the provider’s evaluation of the patient’s quality of life?

4. What ethical issues arise concerning improving or enhancing a patient’s quality of life?

5. Do quality-of-life assessments raise any questions regarding changes in treatment plans, such as forgoing life-sustaining treatment?

6. What are plans and rationale to forgo life-sustaining treatment?

7. What is the legal and ethical status of suicide?

Contextual Features: The Principles of Justice and Fairness

1. Are there professional, interprofessional, or business interests that might create conflicts of interest in the clinical treatment of patients?

2. Are there parties other than clinicians and patients, such as family members, who have an interest in clinical decisions?

3. What are the limits imposed on patient confidentiality by the legitimate interests of third parties?

4. Are there financial factors that create conflicts of interest in clinical decisions?

5. Are there problems of allocation of scarce health resources that might affect clinical decisions?

6. Are there religious issues that might influence clinical decisions?

7. What are the legal issues that might affect clinical decisions?

8. Are there considerations of clinical research and education that might affect clinical decisions?

9. Are there issues of public health and safety that affect clinical decisions?

10. Are there conflicts of interest within institutions and organizations (e.g., hospitals) that may affect clinical decisions and patient welfare?

Week 3 Contemporary Issue Position Essay

Choose a case from the AMA Journal of Ethics Case Index and take a position. For this assignment you will evaluate the ethical arguments for or against the issue. Identify the potential legal arguments (consider current federal guidelines), indicate any potential professional code conflicts you foresee, and support your position with an explanation of your own ethical/moral foundation.

In your 2-3 page paper:

Identify the issue and state your ethical position.

How might this scenario play out or impact you in your role as a nurse practitioner?

Defend your position with legal, ethical, and professional evidence.

As part of your position, propose strategies and solutions for addressing the issues.

What other ethical issues does this case bring to light, if any?

Support your position with at least one scholarly source (it may be your text). Be sure to cite the article you choose, use APA format, and include a title page and reference page.

Review the rubric for further information on how your assignment will be graded.

Week 4 Article Summary and Review Essay

Choose one of the articles below, and address the essay prompt associated with it. You will need to log in to the WCU library to access the full article.

Park, M. (2009). Ethical issues in nursing practice. Journal of Nursing Law, 13(3), 68-77. doi:10.1891/1073-7472.13.3.68

Link: Ethical issues in nursing practice

Essay Prompt: Identify primary areas for legal and ethical issues faced by oncology nurses in this study (Park, 2009), and strategies they may have developed to work with those ethical issues.

Or,

Croke, E. (2006). Nursing malpractice: determining liability elements for negligent acts. Journal of Legal Nurse Consulting, 17(3), 3.

Link: Nursing malpractice: determining liability elements for negligent acts

Essay Prompt: Identify primary problems that led to the malpractice suits (Croke, 2006), and identify the role the nurse played and what the nurse did wrong.

Your 1-2 page paper should include adhere to APA formatting and references/ citations for the article. Additional sources are optional.

Review the rubric for further information on how your assignment will be graded.

NURS521 Ethics in Healthcare Essay Assignments – Week 5 Field Activity Paper

This NURS521 Ethics in Healthcare Essay Assignments paper will have three parts addressing two important pieces of legislation related to the right of individuals to make health care decisions for themselves.

Part I

The Advance Health Care Directive

Locate a copy of an advanced directive (AD) that complies with the laws of the state in which you work. The organization in which you work should have a copy of an advance directive that is given to patients. If not, download your state’s Advance Directives here http://www.caringinfo.org/i4a/pages/index.cfm?pageid=3289.

Complete the advance directive for yourself. Do not turn in your AD with your paper. The AD is for your personal use.

In your paper, Part I:

Identify where you obtained the AD and explain its compliance with state law.

Conduct research (1-2 sources) to learn more about the AD in your state and explain how it works.

Discuss how easy or difficult it was to complete the AD. Your comments should be specific and both objective and subjective. For example, when you state your personal feelings, you must relate them to the literature (textbook and research) that discusses this process and the difficulties that many people face when completing an advance directive.

(Cite/ reference any sources you use to explore these questions, including your texts.)

Part II

Physician Orders for Life-Sustaining Treatment (POLST) Form

What is a Physician Orders for Life-Sustaining Treatment (POLST) form?

When should this form be completed?

Who can complete the form?

Who needs to sign the form to make it a legal document?

(Cite/reference any sources you use to explore these questions, including your texts.)

Part III

Tie the two first sections together by writing a summary and conclusion.

This section should address:

1. the differences between an Advance Health Care Directive and the POLST,

2. the RN’s important role in assuring the patient’s right to autonomy in choosing the healthcare interventions the patient does or does not want.

Use current APA format.

The NURS521 Ethics in Healthcare Essay Assignments paper should be between 3-5 pages in length excluding the title and reference page(s).

Cite and reference the course text and at least two (2) additional appropriate professional sources.

Review the rubric for further information on how your assignment will be graded.

Week 6 Organizational Ethics Presentation

This week, you will submit your presentation using the Kaltura recording tool within Blackboard. See the Getting Started with Kaltura link listed under the Resources area in your course menu to learn how to use this tool. Your presentation must include both audio and visual components and be professional in nature.

You will submit your final NURS521 Ethics in Healthcare Essay Assignments presentation here for grading, and you will submit it to the discussion board this week as a draft for your peers to review and as a final product to share. See the discussion board for details.

1. Choose a topic below.

Taken from the assigned reading in Butts chapter 12, page 401, “Ethical Reflection: Typical Unethical or Illegal Behaviors in Organizations”

2. Create a presentation of 10-15 slides or screens excluding the title and references.

Your slides/screen should include titles, main ideas, bullet points, and relevant images, charts, graphs, etc.

3. In your presentation:

Describe an ethical situation, based on the chosen topic, that can get in the nurse’s way of practicing ethically. Describe the situation clearly and concisely.

Identify how this situation relates to one provision within the Code of Ethics for Nurses.

Identify two ethical principles that may arise when facing this situation.

Discuss how a nurse might lessen the impact of the situation on the nurse’s practice.

In addition to the course texts, cite and reference a minimum of two (2) additional scholarly sources to support your work.

Close with a summary of your topic, and APA formatted reference slide(s).

Audio is optional.

Review the rubric for further information on how your assignment will be graded.

NURS521 Ethics in Healthcare Essay Assignments – Week 7 Advocacy Paper

Choose a patient-care situation in which the RN should intervene and advocate for the patient. An example of such a situation might be when a patient has not been given complete informed consent.

Include the following in your paper:

Describe the clinical situation concisely and descriptively. It can be an actual situation or a hypothetical one.

Apply the Bioethical Decision Making Model to the specific clinical ethical situation that you choose. Address each section of the model in your paper.

Conclude with a discussion of nursing advocacy in the clinical setting and the nurse’s role as a patient advocate.

Your paper should be 4-5 pages.

You must reference and cite 1-2 scholarly sources other than your text. Include a title page and a reference page to cite your text and adhere to APA formatting.

Review the rubric for further information on how your assignment will be graded.

Week 8 Nine Tenets Essay

Reviewing Appendix B in Butts, choose two of the Nine Tenets of the Code of Ethics for Nurses and describe how you will personally apply each tenet in the practice setting with your patients. Describe in detail the purpose of the tenet and provide examples of the tenet applied in practice. Explain why it is important to uphold the tenet in maximizing the quality of patient care, and identify how it enhances your own practice as a nurse.

Your NURS521 Ethics in Healthcare Essay Assignments paper should be 1-2 pages.

Include a title page and a reference page to cite your text. Adhere to APA formatting throughout, and cite any outside sources you may use.

Review the rubric for further information on how your NURS521 Ethics in Healthcare Essay Assignments assignment will be graded.

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