NURS 8002 Ethics and the DNP-Prepared Nurse
The will face numerous ethical concerns during their career, but from the perspective of executive leadership, these problems will be numerous and change with time. Relevant health care collectives in the acute care setting, such as those representing groupings of physicians, patients, nonclinical staff, administrators, and institutions themselves, frequently have overlapping memberships and conflicting interests (Phelan, 2020). This is connected to the long-standing ethical conundrum faced by healthcare professionals who believe they are fighting for the treatment their patients require while “the hospital” is pressuring them to discharge those same patients. The ideal plan of treatment for a patient may seem rushed and complex in this environment, when businesses and care providers are combined with regulatory bodies. The implementation of a Global Budget Revenue (GBR) system, which creates a new set of challenges for clinicians and patient care plans in the acute care context, is another layer that is unique to Maryland. “Under GBR contracts, the total annual revenue for each hospital is known at the start of each fiscal year. Annual income is calculated using a historical base period that has been updated for infrastructure needs, population-driven volume growth, performance in quality- or efficiency-based initiatives, payer mix changes, and changes in UCC levels. The amount of annual revenue may also change due to adjustments to service levels, changes in market share, or relocation of services to unregulated environments (HSCRC, 2021).
Another ethical conundrum that higher-level leaders may face is that “institutional openness and conflicts of interest can undermine patients and constituents’ relationships, particularly those of professionals and their patients.” Because bias may jeopardize experts’ fiduciary duties to patients, health care organizations’ interests, as well as any potential conflicts with those of people under their control, are of fundamental ethical importance. Rural Maryland has a low population density and many therapists who personally know their patients or have an unavoidable, slightly distant interaction with them. In western Maryland, the phrase “small universe” is accurate, and it can lead to disagreements between clinicians and nursing staff while providing care.
Given the uncertainty surrounding the future of healthcare systems, Phelan (2020) concludes that “organizational considerations must be taken into account.”
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.
You are likely already upholding ethics in nursing and healthcare delivery in your 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.
Photo Credit: ibreakstock / Adobe Stock
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
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. |
Also Check Out:
Go to the Week’s Content
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
Rubric Detail
Select Grid View or List View to change the rubric’s layout.
Name: NURS_8002_Week10_Discussion_Rubric
| 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
