NR719 The DNP-Prepared Nurse and Ethical Accountability Essay
Healthcare personnel face substantial hurdles when faced with ethical concerns, especially balancing patient autonomy and safety. This paper aims to investigate the ethical and legal consequences of this dilemma, focusing on the contribution that DNP-educated nurses can make to solving such intricate problems. Since it affects individual patient care and healthcare quality, this is a critically important problem. Patient autonomy is central to healthcare ethics because it allows individuals to exercise responsibility in making healthcare decisions consistent with their values and priorities. There may be tensions between patient autonomy and the duty of healthcare practitioners to deliver effective and secure care. Patient safety, interpersonal conflicts, legal battles, and brand damage could all result from ignoring this problem. The paper will focus on critical issues, including open dialogue and consensus-building among medical staff. In addition, it will examine how various parties feel about the dilemma and how the issue affects different people in different ways. The paper will also address the role of the DNP-prepared nurse, with an emphasis on the value of a focus on the patient and taking leadership responsibility.
Ethical Dilemmas in Healthcare
Keeping patients safe while still honoring their autonomy is a common ethical and legal challenge in healthcare. This problem occurs when patients decline medical care or voice reservations about their prescribed medications. Medical personnel are responsible for safeguarding patients’ rights to participate actively in healthcare decisions, considering their values, priorities, and preferences (Varkey, 2020). On the other hand, healthcare providers have a moral and ethical obligation to ensure the safety and well-being of their patients, which may involve using specific interventions.
This problem has profound implications for healthcare delivery. Promoting patient empowerment and respecting patient decisions, patient autonomy is a cornerstone of healthcare ethics. Patients involved in their care have a higher rate of plan adherence and better outcomes (Rees, 2023). Patient’s well-being is paramount, but doctors and nurses are also responsible for protecting them from harm. Inadequate response to this challenge may jeopardize patient safety, result in unfavorable outcomes, strain relationships between patients and healthcare providers, and even result in legal consequences.
From a legal perspective, it involves questions of patient rights, healthcare providers’ duty of care, and the necessity of obtaining patients’ informed consent. Regarding ethics, healthcare providers should never put patient autonomy above their responsibility to seek the patient’s best interests (Bolcato et al., 2021). The legal side of things, meantime, calls for strict compliance with the rules and regulations that govern healthcare practice to avoid legal issues.
Effective communication, patient education, shared decision-making, and teamwork among healthcare practitioners is essential to solving this problem. Patients can better express their concerns, and healthcare providers can better advise them of the benefits, risks, and alternatives to recommended therapies when there is open and respectful communication between the two parties. Respect for patient autonomy can coexist with attention to safety concerns when patients, their families, and healthcare practitioners work together to make decisions.
Several key issues can occur if this moral and legal dilemma is not resolved promptly. When patients lose faith in healthcare professionals, it can harm their health. A patient’s health condition may worsen, or preventable problems may arise from a lack of care or drug adherence. Furthermore, unaddressed ethical issues may lead to legal proceedings, affecting patients, healthcare providers, and the institution’s reputation.
Various perspectives and interests add complexity to the ethical and legal dilemma of balancing respect for patient autonomy with the need to ensure patient safety in healthcare. Understanding the complexity of the challenge and its potential effects on staff, patients, and the community requires an in-depth analysis of these contrasting perspectives. Patients, medical professionals, hospitals, healthcare systems, and communities at large are all affected by this problem. Patient’s autonomy is at the heart of the problem, and as such, they play a pivotal part in the decision-making process. Patients’ opinions and choices about their healthcare are crucial as they seek a compromise between independence and safety.
Nurses, doctors, pharmacists, and the rest of the care team are all directly affected by this moral issue. They have to balance the need to ensure patient’s safety and well-being with the need to honor each person’s right to decide about their treatment. The healthcare industry is a stakeholder because it develops decision-making frameworks like policies, procedures, and systems. This problem affects more than just the people who are directly impacted. Staff, and especially healthcare professionals, may experience moral distress and emotional hardship when faced with competing values of patient autonomy and safety (Alimoradi et al., 2023). If their decisions are questioned, or a patient is harmed as a result of them exercising their right to refuse treatment, they may also suffer professional and legal consequences.
The dilemma could have varying effects on individual patients. Patient autonomy promotes independence and self-reliance by letting people make their own choices about medical care. However, patients who resist treatments or medications out of personal belief or misunderstanding may experience adverse health effects or a slowed recovery. Actions in such cases can impact public view and trust in the healthcare system; hence the ethical and legal dilemma may have repercussions beyond the immediate crisis. Culture, socioeconomic status, religion, generation, and ethnicity can all influence public opinion. In deciding whether or not to pursue a particular course of treatment, patients may consider how well that course of therapy fits in with their personal value system and long-held customs, including their cultural and religious beliefs. Healthcare services and information access may differ by socioeconomic class, affecting decision-making.
Perspectives on the relative value of patient autonomy and the need to ensure safety may vary by generation and ethnic background. Regarding healthcare, people of different ages may value other things. In contrast, younger people may lean towards autonomy; older adults may prefer to have faith in the advice given by healthcare professionals. Ethnic variety may give rise to contrasting cultural values and beliefs that influence perspectives on healthcare decision-making and, thus, the ethical problem may result.
The Role of the DNP-Prepared Nurse in Resolving Legal and Ethical Dilemmas
The role and responsibilities of a nurse with a Doctor of Nursing Practice (DNP) degree in resolving legal and ethical challenges are essential to providing high-quality, patient-centered care. My research has led me to believe that adopting a patient-centered strategy that emphasizes protecting patients while respecting patient autonomy is the best course of action. This view is consistent with patient-centered care principles, stressing the importance of patient participation in decision-making and individualizing treatment plans. When healthcare workers treat their patients as partners, patients are more likely to feel safe confiding in them and eager to help make treatment decisions.
Kuosmanen et al. (2021) found that patient engagement in decision-making was associated with higher treatment plan adherence and better health outcomes. Rees’s (2023) research emphasizes the ethical and legal importance of respecting patient autonomy, highlighting the necessity for healthcare providers to strike a balance between patient autonomy and patient safety. Faiman and Tariman’s (2019) research highlights the benefits of shared decision-making for patient satisfaction and active participation in their care, which include favorable patient outcomes, less legal issues and an increase in the overall quality of care accorded to patients.
Achieving success as a DNP-prepared nurse requires one to show leadership accountability. Facilitating honest dialogue, teamwork, and moral judgment among healthcare professionals is a hallmark of strong leadership. Patient-centered care must ensure that patients can access complete and objective information about their treatment options. The DNP-prepared nurse can encourage collaborative decision-making and patient engagement in healthcare by modeling clear and courteous communication.
Several measures can be used to reduce risk to the organization. The DNP-prepared nurse must uphold the values of informed consent and patient rights while working within the legal and regulatory frameworks that regulate healthcare practice. Following institutional standards and policies are necessary, such as getting proper treatment consent and documenting talks and decisions. The nurse can also reduce the likelihood of making a mistake by working with interdisciplinary teams and asking for and receiving feedback from other professionals in the field. Regularly educating and training employees on ethical and legal concerns is another great way to foster a proactive attitude toward risk management and ensure everyone is current on the latest best practices.
This paper has looked at the healthcare industry’s ethical and legal challenges. This paper set out to examine the complexities of this problem, highlight its effect on healthcare outcomes, and show the importance of the DNP-prepared nurse in addressing these complex challenges. It covered some of the most critical aspects of this ethical and legal issue, such as open dialogue, group decision-making, and interprofessional collaboration. It was clear that delivering patient-centered care and attaining positive healthcare outcomes depended on respecting patient autonomy while protecting patient safety. The paper underlined the need to handle the issue properly to minimize patient harm, strained relationships, and legal problems.
As a leader in healthcare, the DNP-prepared nurse is responsible for promoting a culture of open communication, collaboration, and ethical decision-making; this role was emphasized, as was the importance of the DNP-prepared nurse in addressing legal and ethical issues. Involving patients in decision-making, providing evidence-based information, and encouraging shared decision-making are all part of a nurse’s scope of practice. The DNP-educated nurse helps reduce hazards to the organization and improves patient care by being open and following all rules and regulations.
The DNP-prepared nurse plays a crucial role in leading and navigating these complex situations since they require a holistic and patient-centered approach to resolve ethical and legal challenges in healthcare. The DNP-educated nurse makes a difference in healthcare outcomes and builds trust among patients, healthcare providers, and the community by preserving ethical values, supporting teamwork, and campaigning for patient autonomy and safety.
Alimoradi, Z., Jafari, E., Lin, C.-Y., Rajabi, R., Marznaki, Z. H., Soodmand, M., Potenza, M. N., & Pakpour, A. H. (2023). Estimation of moral distress among nurses: A systematic review and meta-analysis. Nursing Ethics, 096973302211352. https://doi.org/10.1177/09697330221135212
Bolcato, M., Shander, A., Isbister, J. P., Trentino, K. M., Russo, M., Rodriguez, D., & Aprile, A. (2021). Physician autonomy and patient rights: lessons from an enforced blood transfusion and the role of patient blood management. Vox Sanguinis. https://doi.org/10.1111/vox.13106
Faiman, B., & Tariman, J. (2019). Shared decision making: Improving patient outcomes by understanding the benefits of and barriers to effective communication. Clinical Journal of Oncology Nursing, 23(5), 540–542. https://doi.org/10.1188/19.cjon.540-542
Kuosmanen, L., Hupli, M., Ahtiluoto, S., & Haavisto, E. (2021). Patient participation in shared decision‐making in palliative care – an integrative review. Journal of Clinical Nursing, 30(23-24). https://doi.org/10.1111/jocn.15866
Rees, M. (2023). Patient autonomy and withholding information. Bioethics, 37(3), 256–264. https://doi.org/10.1111/bioe.13130
Varkey, B. (2020). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119
The DNP-Prepared Nurse and Ethical Accountability
The purpose of this assignment is to examine the leadership decisions of the DNP-prepared nurse when dealing with ethical and legal dilemmas that present in today’s complex healthcare systems, to ensure safe and effective patient-centered care.
For this assignment, select an ethical or legal dilemma that you have personal experience with or have witnessed and examine the accountability of the DNP-prepared nurse in resolving ethical and legal dilemmas to ensure safe and effective patient-centered care.
To create flexibility, we are providing you options on this assignment. For this assignment, each of the sections can be presented either as a narrative or as a concept map. Concept maps are an effective way to express complex ideas, especially for visual learners.
Please note that you are not required to complete any or all sections as a concept map. If you choose to use a concept map for a section, it should be created in Microsoft Word and placed in that section of your paper. The concept map must meet all the requirements of the assignment rubric for that section. The rubric and page length requirements of the paper are the same whether you complete the sections of this assignment as a narrative or as a concept map.
Concept Map Resources
If you need additional information on concept maps and how to create a concept map in Microsoft Word, review the following resources:
Link (video): Microsoft Word: Creating a Flowchart, Concept Map, or Process MapLinks to an external site. (4:03)
Concept Map (2:48)
Include the following in your paper:
Introduce the paper’s topic and establish its importance.
Present a clear purpose statement.
Provide the reader with a brief organizing statement of what will be discussed in the paper.
Ethical Dilemmas in Healthcare: Explain the ethical or legal dilemma in healthcare.
Describe the ethical or legal dilemma and its impact on healthcare outcomes.
Explain if the dilemma is an ethical issue, a legal issue, or both.
Identify the key issues surrounding the dilemma.
What are the consequences if the dilemma is not resolved appropriately and timely?
Differing Views: Identify and examine differing views that create the dilemma.
Determine the stakeholders most impacted by the dilemma.
Describe the impact on staff, patients, and the community.
Are the views influenced by culture, socio-economic status, religion, generational differences, ethnic diversity, or other factors?
The Role of the DNP-Prepared Nurse in Resolving Legal and Ethical Dilemmas: Base analysis on a review of the literature.
Explain the position you would choose as a DNP-prepared nurse.
Cite at least three (3) scholarly sources to defend your position.
How would you demonstrate leadership accountability to reach a positive outcome?
How would you mitigate risk to the organization?
Recap the paper’s purpose statement and organizing criteria.
Draw major conclusions from the body of the paper.
Summarize the DNP-prepared nurse’s accountability for resolving legal and ethical dilemmas in the healthcare setting.
References (minimum of 3 scholarly, peer-reviewed sources)
Create the reference page.
Ensure each reference has a matching citation.
Support your position and the impact of the dilemma on healthcare by using evidence from at least three (3) scholarly, peer-reviewed journal sources (preferably research or systematic reviews) that are retrieved from the Chamberlain library databases. Do not use textbooks, government sources, or organizational websites for the three sources in this assignment.
Review the rubric for the grading criteria.
Use the current Publication Manual of the American Psychological Association (APA Manual) and the Chamberlain Guidelines for Writing a Professional Paper (located in the APA Basics section of the Writing Center) to complete this assignment. Follow these guidelines when completing each component. Contact your course faculty if you have questions.
Use the APA Paper Template (located in the Writing Center) to format this assignment.
Turn on Grammarly to check the correctness of the grammar and punctuation as you write. (Note: if you have not already done so, please download the free version at Grammarly.com before construction of the assignment.)
Construct a title page using the APA paper template (Example: The Nurse Leader and Impaired Nursing Staff) based on your selected ethical or legal dilemma.
Use the following prescribed Level I headings for the paper:
Ethical and Legal Dilemmas in Healthcare
Role of the DNP-Prepared Nurse in Resolving Ethical and Legal Dilemmas
Writing Requirements (APA format)
Length: 5-7 pages (not including title page or references page) The length requirement is the same for a narrative or a paper using concept maps.
12-point Times New Roman font or 11-point Arial
Headings & subheadings
Standard English usage and mechanics
This assignment enables the student to meet the following program outcomes:
Integrates scientific underpinnings into everyday clinical practice. (POs 3, 5)
Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
Uses analytic methods to translate critically appraised research and other evidence into clinical scholarship for innovative practice improvements. (POs 3, 5)
Appraises current information systems and technologies to improve health care. (POs 6, 7)
Analyzes health care policies to advocate for equitable health care and social justice to all populations and those at risk due to social determinants of health. (POs 2, 9)
Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)
Translates a synthesis of research and population data to support preventative care and improve the nation’s health. (PO 1)
Leads others in professional identity, advanced clinical judgment, systems thinking, resilience, and accountability in selecting, implementing, and evaluating clinical care. (POs 1, 4)
This assignment enables the student to meet the following course outcomes:
Apply leadership practices that support interprofessional collaborative practice and team effectiveness. (PCs 2, 4, 5, 6, 8; POs 2, 4, 6, 8)
Translate quality improvement initiatives to provide safe and effective patient-centered care. (PCs 1, 3, 6, 7, 8; POs 1, 3, 5, 8)
Apply ethical leadership to the role of the advanced practice nurse. (PCs 7, 8; POs 1, 4)
By 11:59 p.m. MT on Sunday
Late Assignment Policy applies
Week 3 Assignment Grading Rubric
Week 3 Assignment Grading Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIntroduction
1. Introduce the paper’s topic and establish its importance.
2. Present a clear purpose statement.
3. Provide the reader with a brief organizing statement of what will be discussed in the paper.
Includes all requirements and provides an excellent introduction.
Includes all requirements and provides a very good introduction.
Includes fewer than all requirements and/or provides a basic introduction.
Includes fewer than all requirements and/or provides a poor introduction.
This criterion is linked to a Learning OutcomeEthical Dilemmas in Healthcare: Explain the ethical or legal dilemma in healthcare. (APA Narrative or Conceptual Map)
1. Describe the ethical or legal dilemma and its impact on healthcare outcomes.
2. Explain if the dilemma is an ethical issue, a legal issue, or both.
3. Identify the key issues surrounding the dilemma.
4. What are the consequences if the dilemma is not resolved appropriately and timely?
Includes all requirements and an provides an excellent analysis of the ethical dilemma.
Includes all requirements and provides a very good analysis of the ethical dilemma.
Includes fewer than all requirements and/or provides a basic analysis of the ethical dilemma.
Includes fewer than all requirements and/or provides a poor analysis of the ethical dilemma.
This criterion is linked to a Learning OutcomeDiffering Views: Identify and examine differing views that create the dilemma. (APA Narrative or Conceptual Map)
1. Determine the stakeholders most impacted by the dilemma.
2. Describe the impact on staff, patients, and the community.
3. Are the views influenced by culture, socio-economic status, religion, generational differences, ethnic diversity, or other factors?
Includes all requirements and provides an excellent evaluation of differing views.
Includes all requirements and provides a very good evaluation of differing views.
Includes fewer than all requirements and/or provides a basic evaluation of differing views.
Includes fewer than all requirements and/or provides a poor basic evaluation of differing views.
This criterion is linked to a Learning OutcomeThe Role of the Nurse Leader in Resolving Legal and Ethical Dilemmas: Base analysis on a review of the literature. (APA Narrative or Conceptual Map)
1. Explain the position you would choose as a nurse leader.
2. Cite at least three (3) scholarly sources to defend your position.
3. How would you demonstrate leadership accountability to reach a positive outcome?
4. How would you mitigate risk to the organization?
Includes all requirements of the role of the nurse leader and this section is excellently written.
Includes all requirements and presents a very good explanation of the role of the nurse leader.
Includes fewer than all requirements and/or presents a basic explanation of the role of the nurse leader.
Includes fewer than all requirements and/or presents a poor explanation of the role of the nurse leader.
This criterion is linked to a Learning OutcomeConclusion
1. Recap the paper’s purpose statement and organizing criteria.
2. Draw major conclusions from the body of the paper.
3. Summarize the nurse leader’s accountability for resolving legal and ethical dilemmas in the healthcare setting.
Includes all requirements and provides an excellent summary in the conclusion.
Includes all requirements and provides a very good summary in the conclusion.
Includes fewer than all requirements and/or provides a basic summary in the conclusion.
Includes fewer than all requirements and/or provides a poor summary in the conclusion.
This criterion is linked to a Learning OutcomeReferences
1. Create the reference page.
2. Ensure each reference has a matching citation.
3. Support your position and the impact of the dilemma on healthcare by using evidence from at least three (3) scholarly peer-reviewed journal sources (preferably research or systematic reviews) that are retrieved from the Chamberlain library databases. Do not use textbooks, government sources, or organizational websites for the three sources in this assignment.
Includes all requirements of the Reference section. At least three references are scholarly. All references have a matching citation and the reference page is excellently formatted.
Includes all requirements for the references, and the format is very good.
Includes fewer than all requirements for the references, and/or references are basically formatted.
Includes fewer than all requirements for the references and/or references are poorly formatted.
This criterion is linked to a Learning OutcomeAPA Style and Standards
1. Use appropriate Level I headers as described in the assignment guidelines.
2. Reference and citations are in current APA style.
3. Paper length is 5-7 pages excluding title, reference pages, and appendix.
Includes all requirements and provides an excellent APA style and standards.
Includes all requirements and provides very good APA style and standards.
Includes fewer than all requirements and/or provides basic APA style and standards.
Includes fewer than all requirements of APA style and standards and/or provides poor style and standards.
This criterion is linked to a Learning OutcomeClarity of Writing
1. Use of Standard English usage and mechanics
2. No spelling or typographical errors
3. Organized presentation of ideas
Includes all requirements and demonstrates excellent clarity of writing.
Includes all requirements and demonstrates very good clarity of writing.
Includes fewer than all requirements and/or demonstrates basic clarity of writing.
Includes fewer than all requirements and/or demonstrates poor clarity of writing.
Total Points: 300