Roles, Ethical Considerations, and Effectiveness of the Acute Care Nurse Practitioner - Term Paper Example

?Roles, Ethical Considerations, and Effectiveness of the Acute Care Nurse  Practitioner A. Ethics Ethical Principles a) Define and discuss each of the following, giving examples for each:  Nonmaleficence is an ethical principle that requires health care providers to do no harm, promote good, and remove any harm while providing health services to patients. The principle necessitates that health care providers avoid negligence in their work and ensure that the decisions they make concerning one patient do not affect other people negatively. A good example is on confidentiality of health conditions of their patients. When faced by a problem such as a HIV positive patient wanting the status to remain confidential, the caregiver should consider the effects of such a decision. The caregiver must be sure that withholding such information will not affect other people in the community such as family (Hendrick, 2011). b) Utilitarianism is an ethical principle that emphasizes on assessing the rightfulness or wrongness of an action by considering the outcome. According to this code, the utility of any action depends on its ability to generate more good or positive outcomes than the negative consequences (Hendrick, 2011). A good example where utilitarianism applies is on the issue of abortion. In some cases complication occur during labour such that the mother’s life is in danger and only the mother or the baby has a chance of surviving. The caregiver should consider the possibility of saving either the mother or the child. If carrying out an abortion can save the mother’s life, then the action is justified since the positive consequences are more. Though abortion entails killing, failure to abort the foetus in a case like this will result in death of both mother and baby. Another example that utilitarianism is applied on cases whereby lying can help prevents mishaps. If telling a lie to a patient will help him or her abide to a procedure or medication that is helpful to them, utilitarian considers the action morally right even though it is against the caregiver’s moral obligation of truthfulness (Hendrick, 2011). c) Justice is a principle that entails relevance of fairness and equality when treating patients irrespective of their diversity. The principle insists on even allotment of health care resources. Justice in health care provision implies ignoring aspects such as gender, race, social status just to mention but a few in deciding the ease of access of health services (Boxwell, 2010) However, the factors remain trivial in deciding the form of treatment for the patients. For example, a white person and a black person seeking medical attention should be treated equally without favour (Hendrick, 2011) d) Fidelity is an ethical principle that stresses on the need for heath caregivers to remain faithful, loyal, and abiding to their promises. This enables the health professionals uphold the reputation and credibility of the profession. For example, when a medical practitioner gives an appointment to a patient, this principle requires that the practitioner keep the promise (Hendrick, 2011). e) Veracity is a principle that obliges medical practitioners to tell the truth to maintain their own credibility as well as that of the profession. Medical practitioners are required to tell the entire truth to the patients without any omissions, cloaking, or deception. The truthfulness should also be practiced in operations such as documentation as well as billing. For example, a medical practitioner should not lie to patients regarding their health condition for whatever reasons (Hendrick, 2011). f) Autonomy is the freedom or liberty to decide on one’s actions, intentions, or choices based on ones understanding without considering external factors. This principle argues that patients have total sovereignty to choose the course of treatment to be used on them as long as they are adults. However, the patients should first be provided with information that they can understand. The patients are also free to choose whether to pay attention to such information or not. A good example is on heath information concerning a patient. Patients have the right to demand for all the information concerning their medical status. The detriment of this principle is that it can result in ethical conflicts since some patients may opt to make decisions that might challenge the operation of health practitioners. A good example is a patient who may decide not to quit smoking even if the action is hazardous to his health. In such a case, the health caregiver might have little say on the decision as much as it is a dire choice (Hendrick, 2011). Ethical Issues in Patient Care Advanced Directives Advanced Directives is a proclamation given by patient and could be verbal or written. The declaration is directive on one’s wishes regarding the course of treatment to be undertaken if one gets ill to a point of being incapable of making further decisions (American Medical Association, 2012). Advance Directives are important in United States where patients have the right to either accept or decline treatment albeit being considered as life sustaining (Boxwell, 2010). Examples of Advance Directives include Health Care Proxy, which permits someone else to make decisions regarding your treatment in case of critical illnesses. Do Not Resuscitate (DNR) Order is a document written by the patient and points out their wishes concerning cardio-pulmonary resuscitation in case of heart attack or failure. Living Will is a written or verbal declaration by a patient regarding their course of medical treatment that one writes and gives to either family members or one’s physician prior to admission (Boxwell, 2012, Flushing Hospital Medical Centre, 2012). Patient Confidentiality Patient Confidentiality is a medical ethic that requires medical practitioners to maintain confidentiality regarding the patient’s health condition or any information that the patient may disclose to the healthcare provider. Code of Medical ethics obliges medical practitioners to seek patients consent before revealing any confidential information. However, the code provides some exceptions when the medical practitioner can disclose patient’s confidential information without his or her consent. Such exceptions include when the information is required for prosecution purposes, if caregiver is obliged to do so by a court order, or any other exemptions provided in the constitution (Hendrick, 2011). B. Professional Resources Identify and give an overview of some organizational, educational, on-line, and other resources that support the role of the Acute Care Nurse Practitioner (ACNP).  Acute care nurse practitioners are trained to look after patients with acute medical conditions. ACNP focus on providing preventive, curative, and rehabilitative care to patients. In addition to the nursing practice skills, ACNP are trained on assessment, diagnosis, and management of chronic and acute health conditions. A lot of research has been done on how effectiveness of Acute Care Nurse Practices with most of the research focusing on how patients can be assisted in dealing with life threatening problems (Gilligan, 2010). Resources and organizations that support ACNP in providing critical care include National Hospice and Palliative Care Organization (NHPCO), which provides supportive information on life support and resuscitative services to dying patients (Wilbeck, 2011). Cleveland Clinic Model is another organization that provides information concerning acute care and on the appropriate time to start palliative care. Joint Commission on the Accreditation of Healthcare Organization (JAHCO) supports the need for prioritising end-of-life (EOL) care by hospitals. Center to Advanced Palliative Care (CAPC) is another national organization devoted to training health care providers on palliative care. CAPC also offers free training programs on palliative care through their website (Gilligan, 2010). The Agency of Healthcare Research and Quality conducts research on management of acute diseases. Arizona Health Sciences Library offers information on all aspects pertaining to the field of medicine. Medline is an online website that provides research articles and journals on heath related research including investigations on Acute Care Nursing Practices. The Study to Understand Prognosis and Preferences for Outcomes and Risk of Treatment (SUPPORT) is an educational association that carries out research on EOL care. Other imperative sources of supportive information on the role of the acute care nurse practitioner (ACNP) include Web of Science, PubMed, and CINAHL (Hendrick, 2011). The Effectiveness of ACNP in Acute Care A lot of research has been done on assessment of the effectiveness of different Acute Care Nurse Practices. An example of such studies includes one by Wilbeck (2011), on the strategies used to evaluate ACNP skills and on how to promote the acute care procedures. The findings of this research were that there has been an improvement in the quality and competence in ACNP. However, there is a lot of diversity in the strategies applied in ACNP with no specific procedural competence assessment. The research suggested development of electronic documentation of ACNP guidelines to assist in nationalizing acute care practices. The research was comprehensible and pertinent since it relied on eleven sources dealing with ACNP assessments (Wilbeck, 2011). Selway (2011) did another research highlighting the effectiveness of ACNP in acute care, which was printed by Oklahoma Nurse Practitioner Association. The research focused on the designation of ACPN, the membership structure, collaborations, as well as reviews on duties and achievement of ACNP and the entire nursing profession. The research was credible since it involved a study carried out in almost the whole of Oklahoma State (Selway, 2011). National Organization of Nurse Practitioner Faculties also published a report on the importance of ACNP. The report also distinguishes acute care and primary care nursing practices. The research was also supposed to illustrate the commitment of different organizations and persons to advance the acute care nursing practice. This research was believable since it was based on Consensus Model, whose development had taken a lot of time and research (National Organization of Nurse Practitioner Faculties, 2011). Gilligan (2010) did a research on evaluation of therapy in management of Sepsis, which is one of the acute health conditions that require acute care. The research also focused on the importance and effectiveness of involving an Acute Care Nurse Practitioner in management of sepsis. The research was based on the authors own research as well as other published materials on sepsis and ACNP research. The paper affirmed the significant educative, palliative, and rehabilitative role played by ACNPs in sepsis management (Gilligan, 2010). References American Medical Association, (2012). Patient Confidentiality. Retrieved June 15, 2012, from http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/patient-physician-relationship-topics/patient-confidentiality.page Boxwell, G. (2010). Neonatal Intensive Care Nursing. London: Taylor & Francis. Flushing Hospital Medical Centre, (2012). Advance Directives. Retrieved June 15, 2012, from http://flushinghospital.org/patientServices/advanceDirectives.html Gilligan, J. (2010). An Evaluation of Early Goal Directed Therapy In The Management Of Sepsis And Septic Shock. Retrieved June 15, 2012, from http://www.nursing.arizona.edu/Library/Gilligan_James_MS_Report.pdf Hendrick, J. (2011). Law and Ethics in Children's Nursing. New Jersey: John Wiley & Sons. National Organization of Nurse Practitioner Faculties, (2011). Statements on Acute Care and Primary Care Nurse Practitioner Practice. Retrieved June 15, 2012, from https://www.mc.vanderbilt.edu/documents/CAPNAH/files/Resources%20&%20Links/NPPrimaryCareAcuteCarePracticeFINAL.pdf Selway, J. (2011). Federal Legislative Update for NPs. Oklahoma: Oklahoma Nurse Practitioner Association. Wilbeck, J. (2011). Evaluation Methods for the Assessment of Acute Care Nurse Practitioner Inserted Central Lines: Evidence-Based Strategies for Practice. Journal of the Association for Vascular Access, Web. Read More