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Blog 1: Ethics and the DNP-Prepared Nurse

At both the bachelor and master levels, nursing programs require courses in ethics. Thus, you have likely considered point-of-care ethical dilemmas previously; however, you can never think too much about this important topic. So much of what nurses and other healthcare professionals do daily is based on a foundation of ethics. Providing patient care and ensuring patient safety while enhancing quality and diminishing costs are all ethical practices in which you already likely engage.

A patient-focused approach, which promotes the delivery of safe, quality, and cost-effective healthcare designed to provide positive patient outcomes, represents a fundamental alignment to ethical principles for the delivery of healthcare. In your journey to become a DNP-prepared nurse, you will continue to uphold ethical principles in your nursing practice and will likely serve as an advocate for these principles in all you do.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources. 


WEEKLY RESOURCES

Learning Resources

PDF Creation Resources

· Lacoma, T. (2024, February 20). 

How to save a webpage as a PDF on desktop and mobileLinks to an external site.
. Digital Trends Media Group.

· Microsoft. (n.d.). 

Save an Outlook message as a .eml file, a PDF file, or as a draftLinks to an external site.
.

· Apple. (n.d.). 

Save emails as files or PDFs in Mail on MacLinks to an external site.
.

Practicum Resources

· Walden University. (n.d.). 

Nursing practicum: Plan for practicum: Read the practicum manualLinks to an external site.
.

· Walden University. (n.d.). 

Nursing practicum: Application processLinks to an external site.
.

· Walden University. (n.d.). 

Nursing practicum: Steps to practicum successLinks to an external site.
.

· Walden University. (n.d.). 

Doctor of nursing practice (DNP) practicum manualLinks to an external site.
.

· Walden University. (n.d.). 

Nurse practitioner programs practicum manual for the master of science in nursing (MSN) and post-master’s certificateLinks to an external site.
.

· Walden University. (n.d.). 

Nursing practicum: Practicum pledgeLinks to an external site.

/practicum-pledgeLinks to an external site.

· Walden University. (n.d.). 

Practicum application tutorial for Meditrek – Graduate practicumLinks to an external site.
.

Meditrek Resources

· Walden University. (n.d.). 

Nursing practicum: Plan for practicum: Get started with MeditrekLinks to an external site.
. /plan#:~:text=Get%20Started%20with%20Meditrek
 

· Walden University. (n.d.). 

Affiliation agreement database: Searching for practicum sites in MeditrekLinks to an external site.
 [Video]. Screencast-o-Matic.

·  Walden University. (n.d.). 

Nursing practicum: Plan for practicum: Practicum planLinks to an external site.
. /plan#:~:text=Practice%20interviewing-,Practicum%20Plan,-In%20certain%20courses

· Walden University. (n.d.). 

Meditrek login for students using Walden single sign on credentials
 [Video]. ScreenPal.

· Walden University. (n.d.). 
Meditrek login and navigationLinks to an external site. [Video]. ScreenPal.

· Walden University. (n.d.). 

Practicum applications: Opening and submitting an application in MeditrekLinks to an external site.
 [Video]. ScreenPal.

· Walden University. (n.d.). 

Application status: Checking the status of Meditrek applicationLinks to an external site.
 [Video]. ScreenPal. 
to an external site.

Ethics Resources

· Clark, K., Rödlach, A., Ballesteros, M., Davis, R., Holmes, L., Miller, J., Minnich, M., & Schultz, A. (2024). 
The role of doctor of nursing practice programs’ mission, vision, and values statements in the development of students’ professional identity: A qualitative studyLinks to an external site.
Nurse Education Today, 134, Article 106096.

· Fornili, K. S. (2022). 
Expanded conceptual framework for ethical action by nurses on the “further upstream and farther downstream” determinants of health equityLinks to an external site.
Journal of Addictions Nursing, 33(3), 203–214.
 

· Green, C. (2022). 
Applying the Nightingale pledge in reducing health disparities: A hospital-acquired pressure injury case studyLinks to an external site.
Advances in Skin and Wound Care, 35(3), 180–183.

· Khaghanizadeh M, Koohi A, Ebadi A, Vahedian-Azimi A. (2023). 
The effect and comparison of training in ethical decision-making through lectures and group discussions on moral reasoning, moral distress and moral sensitivity in nurses: A clinical randomized controlled trialLinks to an external site.. 
BMC Medical Ethics, 24, Article 58.

· Torkaman, M., Heydari, N., & Torabizadeh, C. (2020). 
Nurses’ perspectives regarding the relationship between professional ethics and organizational commitment in healthcare organizationsLinks to an external site.
Journal of Medical Ethics and History of Medicine, 13(17), 1–10.

Social Change Resources

· Abu, V. K., & Moorley, C. R. (2023). 
Social justice in nursing education: A review of the literatureLinks to an external site.
Nurse Education Today, 126, Article 105825.

· Johanson, L., Urso, P. P., & Priode, K. (2022). 
Factors influencing the development of social change involvementLinks to an external site.
Journal of Excellence in Nursing and Healthcare Practice, 4(1).

· Walden University. (n.d.). 

Social changeLinks to an external site.
 [Multimedia].

· Walden University Center for Social Change. (n.d.). 

Scholars of changeLinks to an external site.
 [Videos].
Note: The approximate length is 15 minutes combined for these media pieces.

SDOH Resources

· Centers for Disease Control and Prevention. (2022, December 8). 

Social determinants of health (SDOH)Links to an external site.
.

· Davis S. (2022). 
The evolving role of social determinants of health to advance health equityLinks to an external site.. In D. Seibert, B. Malone, & P. DeLeon (Eds.), 
Shaping nursing healthcare policy: A view from the inside (pp. 1–102). Academic Press.

· National Academies of Sciences, Engineering, and Medicine. (2021). 

The future of nursing 2020–2030: Charting a path to achieve health equityLinks to an external site.
. National Academies Press.

·  Reising, V., Diegel-Vacek, L., Dadabo, L., Martinez, M., Moore, K., & Corbridge, S. (2022). 
Closing the gap: Collaborative care addresses social determinants of healthLinks to an external site..
 Nurse Practitioner, 47(4), 41–47.

· Walden Library. (n.d.). 

What are the social determinants of healthLinks to an external site.
.

· Walden University. (n.d.). 

Social determinants of health: Understanding vision health equityLinks to an external site.
.

· World Health Organization. (2022). 

Social determinants of healthLinks to an external site.
.

Optional Resources

· Bryant, S. G. (2023). 
Screening for social determinants of health in transitional care patients and partnering with the faith community to address food insecurityLinks to an external site.
Professional Case Management, 28(5), 235–242.

· Davis, S. (2023). 
Leadership for meaningful transformation: The National League for Nursing/Walden University College of Nursing Institute for Social Determinants of Health and Social ChangeLinks to an external site.
Nursing Education Perspectives, 44(6), 384–385.

· Sheingold, S. H., Zuckerman, R. B., De Lew, N., & Chappel, A. (2023). 
Social determinants of health, quality of public health data, and health equity in the United StatesLinks to an external site.
American Journal of Public Health, 113(12), 1301–1308.

To prepare:

· Review the Learning Resources for this week, paying special attention to the various ethical issues in nursing practice that are addressed.

· Reflect on any ethical challenges in nursing you have personally experienced.

· Select 
one current ethical challenge in nursing that you have personally experienced—either professionally or as a student—on which to focus for this Blog entry.

· Think about your experiences related to the ethical challenge you selected.

· What happened?

· How did you and the other stakeholders involved address the ethical challenge?

· Do you agree with the approach(es) that were taken?

Would you have done anything differently? If so, what?

Note: Be sure to review the grading rubric for this Blog so you fully understand what is expected of you. To access the rubric, click on the three dots that appear at the upper right of the Blog assignment page, then choose, “Show Rubric.”

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 
Reply button to complete your initial post. Remember, once you click on 
Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on 
Post Reply

By Day 3 of Week 6

Address the following in your Blog entry:

· Identify the ethical challenge in nursing you selected.

· Explain why you selected this ethical challenge and why you think it is important.

· Describe the specific situation you experienced. Be specific and provide examples. Explain the following:

· What happened?

· How did you and the other stakeholders involved address it?

· Do you agree with the approach(es) that were taken?

· Would you have done anything differently? If so, what?

RESPOND TO THIS DISCUSSION POST. Facts please no argument

FHW

Ethical Challenge

Ethics, as defined by Merriam-Webster (n.d.), is the set of principles that govern an individual or a group. In nursing, ethical practice is not a choice but a vital requirement for effective care delivery. The Gallup poll reports that nursing is among the most honest professions (Brenan, 2024). Professional nurses deal with ethical issues daily; one’s integrity and morals guide decisions. The four main principles of the nursing code of ethics, Autonomy, Beneficence, Justice, and Non-maleficence, form the ethical foundation of nursing. These principles and the nine nursing codes of ethics provisions guide nurses in daily practice (Haddad, 2023) and highlight the complex and often challenging ethical dilemmas we face in this profession. It also underscores the crucial role of advocacy for patients, making your audience feel the importance of their role in patient care.

Provision eight (8) of the nursing code of ethics has not only challenged me but also underscored the crucial role of collaboration in nursing ethics. It emphasizes that nurses should work with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities (Haddad, 2023). This provision serves as a powerful reminder of the significant impact nurses can make when working with other disciplines in healthcare, reinforcing the importance of your role in the healthcare system.

Working in hospice for the past three years has been rewarding but challenging. The challenges encountered in hospice nursing often stem from the scarcity of resources, particularly from the patients and their families/caregivers. This scarcity burdens nurses, requiring them to perform duties outside their standard responsibilities, such as providing food and cleaning.

 

I experienced issues related to provision (8) when my team contacted Adult Protective Service (APS) for an 82-year-old hospice patient.

 About 14 months ago, I visited an 82-year-old female patient who, thank goodness, was somewhat mobile, though with an unsteady gait. I almost did not want to leave my vehicle when I entered the driveway outside the home; it appeared like the community dump site with trash, household items, used adult underwear, animal feces, and a host of other unsanitary items. I had to wear a disposable gown over my clothing. I could have worn shoe covering but did not have any. At the door, I noticed half of the home was falling apart with a crack in the wall, the steps were uneven, and multiple dogs and cats ran wide in and out of the home when the patient opened the door. Upon entering the home, I was overwhelmed by the strong odor from the animals and the patient. There was a walking path for me to be able to step one foot in front of the other; the entire home was overcrowded with clothing, hospital supplies, soil linens, and trash. I was told the patient lives with a daughter and a grandson, and the daughter worked in fast food. The patient, despite her age and health condition, was living in such deplorable conditions.

After my visit, I contacted my direct supervisor to determine if leadership knew the patient’s living conditions since I was not the first nurse to visit. The supervisor reported that management was aware, but the supervisor gave me no further information. I contacted the social worker, who had yet to visit the patient but promised to visit the next day to assess the patient so we could complete a report for Adult Protective Services (APS). 

A report was made after the social worker visited, and APS did not consider it necessary to remove the patient from the home. My employer had to drop this patient as a client because it became unsafe to visit, especially with the house appearing like it could split in two any day.

Nursing and social work did what was needed, but APS did not advocate for this patient. The social worker has, in the past, gotten volunteers to clean homes, but this task was beyond her help due to safety concerns and the level of workforce needed to complete the task.

Reflecting on this experience, I am left with a sense of frustration. Could this issue have been reported to law enforcement since no crime was being committed? The proper authorities who could have intervened in the neglect of this senior citizen did not deem it necessary to remove her from the home. I sometimes wonder if this was due to the lack of resources, but I am also left with a strong belief in the urgent need for systemic change. It is clear that, as healthcare professionals, need to advocate for and drive these changes to ensure the safety and well-being of our patients. This sense of urgency should be felt by all of us, as it is crucial for the future of our healthcare system.

 

Reference

Brenan, M. (2024, October 16). 
Nurses retain top ethics rating in U.S., but below 2020 high. Gallup.com. 
to an external site.  

Haddad, L. M. (2023, August 14). 
Nursing ethical considerations. StatPearls. 
to an external site..

Merriam-Webster. (n.d.). 
Ethics definition & meaning. Merriam-Webster. 
to an external site.   

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