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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

PS

Nov 11 7:35am

Manage Discussion by Patrick S Drummond

Reply from Patrick S Drummond

In nursing, we have all had to make hard decisions. In my Associate degree program, they constantly drilled into our heads: “You are the patient’s advocate.” I have always prided myself on being an advocate for my patients. As an Advance Practice Provider, it became exponentially harder. I have found myself in situations where I could lose my job depending on the decisions I made. I had been an Advance Practice Provider for approximately five years when I was offered a job in a pain management clinic.

                I was extremely excited to start this new endeavor. The job offered more money than any other job I had been offered at the time, and it was not physically demanding. I was just refilling pain medicines for patients. Of course, most of the time, the regiment that was prescribed was not enough, and always more was needed. One day, I got a request that took me by surprise.

                The patient was a middle-aged female. Reportedly, she had multiple failed back surgeries that led her to the pain management clinic. Her current regimen was Hydrocodone 10 with Acetaminophen 325mg, four times daily. The patient verbalized contentment with the medications but was reportedly told by her primary care provider that her liver enzymes were on the rise. The primary provider encouraged her to have us switch her medication to a combination medication that did not include Acetaminophen.

                I recommended to the attending Physician to use Hydrocodone 10mg with Ibuprofen 200mg. The attending Physician decided it would be appropriate to switch her to Hydromorphone 4mg tablets four times daily instead of Hydrocodone 10mg with Ibuprofen tablets. I went back to the patient, and I discussed with her the recommendations of the attending physician. I informed her that if she was content with the Hydrocodone 10mg, there was a combination drug that contained Ibuprofen instead of Acetaminophen on the market. I felt there was no clinical reason to increase her to Hydromorphone,

                The patient elected to start Hydrocodone 10mg with Ibuprofen 200mg tablets for continued pain management. I ultimately lost my job for making my clinical decision. I had no concerns about losing my job for making the decision I did. I had advocated for the patient.

                Later, after I left, I read in the paper that the pain management clinic I had been employed at was raided by the Drug Enforcement Agency.

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