Good Example Of Scope And Standards Of Nursing Practice: Ethics Research Paper
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Ethics, the 7th standard of professional performance of ANA Scope and Standards of Practice (2010), provides a structured framework for the application of common ethical principles in nursing practice, with regard to main personal\moral values and commitments to society, boundaries of duties and resolution of conflicts. It is a tool for implementing ANA Nurses Code of Ethics (2001) in clinical practice as it both outlines the aspects of patients’ care where ethical principles and rules should be observed and shows the way they should be adhered to. The standard covers all domains of professional ethics: values and commitments in relationships with patients (use of ANA Nurses Code of Ethics (2001) as underlying document, protection of the patients’\carers’ interests primacy, assistance in informed decision-making), professional boundaries (therapeutic relationship with preservation of integrity), professional collaboration and social responsibility (conflicts resolution, interdisciplinary teams participation, safety and quality promotion). These fundamental values together with boundaries of duties in relation to the patient, the colleagues, and the society represent a clear practical guidance for a registered nurse (RN).
Implications for Practice
Individual and professional competencies are defined as important ethical value for nursing as a profession (Shahriari et al., 2013). Giving ethical-based care to the patients, or ethical thoughtfulness, comprises the ability to identify the central competencies being informed about potential conflict issues, to participate in ethical intedisciplinary groups, and to think proactively raising the questions where the competencies are affected (Bunkers, 2011). As RN unit manager, I frequently face all these situations, so ethical competencies outlined by the standard on ethics are essential for my everyday activities. Both the ANA Scope and Standards of Practice (2010) and ANA Nurses Code of Ethics (2001) are applied by me in one of my main job tasks: developing standards of care for my department. In elaborating such standards, I try to address all the ethical domains, basing our departmental nursing practices on the primacy of patients’ interests, with clear observation of professional boundaries and possibility of interdisciplinary team’s resolution of ethical conflicts. Especial attention is paid to reporting of ethical violations which always makes the nurses face the difficult dilemma of conflict of interests between nursing accountability\patients’ interests and relationships with colleagues. In such violations, the possibility of internal disclosure of misconduct to the supervisors, with a close review of such issues by several line managers if needed, lets us to resolve ethical conflicts without any external whistleblowing in the majority of cases.
Another direct application of the standard in my clinical practice is protecting patients’ autonomy and right for self-determination (the primary competency) in the situations of ethical interests’conflict. As a manager of subacute department, typically I am not faced with the situation where the patient’s safety is at very high risk if we do not act. Still, another situations occuring from time to time (e.g. refusal from a longer treatment when the acute phase is over) give rise to the conflicts of ethical principles where respecting the patient’s choice and protecting his\her autonomy may not actually be in the person's best interests clinically (Shahriari et al.,2013). In such case, we follow the informed consent rule, respecting the patient’s right to make an uncoerced and well-informed decision.
One more implication of the standars on ethics for me, in the conditions of diverse job responsibilities, both clinical (assuring the care is provided at a due level and evaluating outcomes) and administrative (day-to-day activities management, compliance supervision), is a possibility to evaluate if any “red flags” affecting my ability to provide the impeccable care for the patients of the department, exist. It also ensures open and clear ethical communication within my department as a means to resolve challenges which many decisions required in daily practice represent to the nurses (Benjamin & Curtis, 2010).
The academic program in nursing is of great value for me as it tackles 3 core practical areas where ethical challenges arise. First, it provides me with a solid theoretical knowledge how to deal in the situations of case management where I need to be prepared to accept and manage the consequences of the treatment, to monitor its effectiveness, and where the role of proper educational orientation is significant. Second, it teaches me to strike a balance in the most difficult cases of a discrepancy between the professional responsibilities and the healthcare needs of the patients (Benjamin & Curtis, 2010). Third, I see it as a next step for wider application of my nursing professional competencies, such as developing ethical guidelines and Code of Conduct at a higher organizational level. Generally, the program will contribute both to my personal development, increasing my ethical proficiency, and to organizational ethics, encouraging me to further integrate the standard in nursing practice within the department.
American Nurses Association(ANA).(2001) Code of Ethics for Nurses with Interpretive Statements. Washington, D.C.
American Nurses Association (ANA). (2010) Nursing: Scope and Standards of Practice (2d ed.). Washington, D.C.
Benjamin, M., & Curtis, J. (2010). Ethics in Nursing: Cases, Principles and Reasoning (4th ed.).Oxford, Oxford University Press.
Bunkers, S.S. (2011). Fostering Ethical Thoughtfulness. Nurs.Sci Q, 24(3), 208
Shahriari,M.,Mohammadi,E.,Abbaszadeh,A.,& Bahrami,M.(2013). Nursing ethical values and definitions: a literature review. Iran J Nurs Midwifery Res., 18(1), 1–8.
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