NUR 513 Topic 2 DQ 2 Compare two different advanced registered nurse roles with regard to ethical guidelines
NUR 513 Topic 2 DQ 2
Compare two different advanced registered nurse roles with regard to ethical guidelines. Are there any differences in the ethical guidelines that govern these roles? What situations might require one role to respond differently, depending on the ethical guidelines?
Re: Topic 2 DQ 2
The American Nurses Association (ANA), put out the Nursing Code of Ethics that serves as a guide in decision making. There are 4 main constructs of the nursing code of ethics that are autonomy, beneficence, justice, and nonmaleficence; over the years 9 provisional statements have been added to help further guide nurses in all areas of practice (ANA, 2015).
Nurse Practitioners (NPs) have the autonomy to diagnoses and prescribe, which comes with a plethora of complexed ethical issues. For example, there can be ethical issues related to prescribing narcotics to pain medication seeking patients. Are you practice the ethical value of nonmaleficence if you are giving narcotics to an addict? I’ve also witnessed examples where the entire care team has been told to withhold a cancer diagnosis from an adolescent pediatric patient who had the mental compacity to understand and make decisions in their care. In this particular case I had to watch our NP go over a CT scan with the patient without using the words tumor or cancer, at the parent’s request. At what point is withholding the true beneficial to the patient and how does this compromise the autonomy of the patient? In some cases telling the patient the truth can cause psychological harm to the patient (DeNisco & Baker, 2016).
As healthcare transforms, we rely on more technology within our practice. What stands unchanged within nursing informatics are basic ethical principles such as privacy, confidentially, nonmaleficence, virtue and autonomy (McGonigle & Mastrian, 2021). In the last year we have used telehealth and digital forms of communication. In my own practice, I found myself giving cardiology rounds to the entire care team through a Zoom call at the peak of the pandemic. I agree with McGonigle and Mastrian (2021), in the belief that ethics principles are unchanged, but what that instead we see an increase in complexity of ethical dilemmas within these principles. For example, as we rely heavily on digital forms of communication, and digital technologies including smartphone, it goes to stand that privacy issues, data breaches and increased access to electronic medical records will continue to challenge the principles of privacy, confidentially and nonmaleficence.
While the roles of an NP and informatics nurse greatly differ; one being a clinical role and the latter being a nonclinical role; the
ethical principles are the same. DeNisco and Barker (2016) state that ethics “focuses on the rightness and wrongness of actions, as well as the goodness and badness of motives and ends” (p.652). Meaning that ethical principles are used in decision making and judgement in both APRN roles even though they are applied to different circumstances.
American Nurses Association (ANA), (2015). The code of ethics for nurses with interpretive statements. https://www.nursingworld.org/coe-view-only
DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning. ISBN-13: 9781284072570
McGonigle, D., & Mastrian, K.G. (2021). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning. ISBN-13: 9781284234770
Re: Topic 2 DQ 2
Ethics refers to understanding the moral rules and the system they are made of such as the nature, purposes, and justification (Barker & DeNisco, 2016). Ethical issue is one of the dilemmas faced by nurses today, even advance practice registered nurses and it is important to make the establish good ethical nursing practice which is best for the patient’s outcome.
Psychiatric clinical nurse specialists (CNS) provide nursing care to patients suffering from psychiatric disorders using best practices and evidence-based care to achieve the best possible outcomes (American Nurses Association, 2020). The care of patients in this field may be difficult and overwhelming due to the diagnosis of mental illness. To practice ethically and prevent bias, patience and empathy must be employed. it is important for a CNS to recognize their own feelings when dealing with difficult patients and not allow emotions to prevent them from providing effective patient care. The CNS should try to remain neutral and continue to provide the best care for the patient (Laskowski, 2001).
Nurse Practitioners (NP) provide primary, acute, and specialty health care across the lifespan through assessment, diagnosis, and treatment of illnesses and injuries (APRN, 2020). Ethical issues faced by NPs include dealing with difficult patients and family members. Complexity of Patients medical issues can cause psychological or emotional problems that may lead to hopelessness and behavioral issues. Despite patient’s behavioral issues NPs are still responsible to meet patient’s needs by fulfilling ethical standards in their profession (Barker & DeNisco, 2016).
Barker, A.M., & DeNisco, S.M. (2016). Advanced Practice Nursing: Essential Knowledge for the Profession. Jones & Bartlett Burlington, MA. Retrieved from
American Nurses Association. (2020). Advanced practice registered nurse (APRN). American Nurses Association. Retrieved from
Laskowski, C. (2001). The Mental Health Clinical Nurse Specialist and the “Difficult” Patient: Evolving Meaning, Issues in Mental Health Nursing, 22:1, 5-22.
CAT (150 WORDS, 2 REFERENCES)
Ethics preparedness and confidence were significantly associated with perceived quality of care: apply this in your clinical area of practice with examples.