Western Governors University
Nursing Roles and Value
Competency 724.7.1 Ethical Leadership
Competency 724.7.2 Continuing Competency in Nursing
Marisha Grimley Course Mentor
March 04, 2012
Nursing Roles and Value
The purpose of this paper is to evaluate a case study addressing ethical leadership, analyzing application of standardized code of ethics on nursing practice, and discussing issues in safety for quality patient care. This paper will support the importance of confidentiality when discussing protected patient information. In addition, the need for continuing education and training for nursing through identification of Federal and State regulations as applied to nursing practice will be addressed. The discussion will touch on how these regulations are applied in specific care settings and the professional role of nursing in the ever changing health care delivery system. State regulation or standard of nurse practice
The contemporary definition of nursing according to the Scope and Standards of Practice (2010) is: “Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.” (p. 66).
According to the Standards of professional Nursing Practice, this scenario violates nursing Standard 7 – Ethics which states: “The registered Nurse: Delivers care in a manner that preserves and protects healthcare consumers’ autonomy, dignity, rights, values, and beliefs.” (The Standard of professional Performance, 2010, p. 47).
The nurse does not follow the standards of practices leading to the several implications. When asked by Dr K. to look in the chart to determine if anyone was responsible for Mr. E’s medical decision making, the nurse failed to inform Dr K that the patient had an Advance Directive (AD) that specified he not be placed on a ventilator or have cardiopulmonary resuscitation. By not bringing forward this information the nurse did not fulfill her duty of protecting the patient’s autonomy. She ignored the AD that Mr. E, despite being a mildly developmentally delayed, had put into place before this hospital admission. Mr. E accomplished this task with the help of the nursing home patient advocate thus providing documentation about his medical wishes. Seven years prior, Mr. E had shown the ability to make his own health care decisions. He chose the pathway of his care by checking himself into a nursing home. The nurse assumed, because the provider had stated that the patient was hypoxic (88% room air is hypoxic), that Mr. E could not make his own medical decision. Mr. E verbalized understanding of what his progression of care would be by stating to Dr. K, shaking his head and saying “Go away! No! No! Take me home.” In this instance, the nurse did not act as a patient advocate. The nurse should have relayed this information to Dr. K. If Dr. K had insisted that the patient was in an impaired hypoxic state, the nurse should have reported the situation to her immediate nursing supervisor who could have intervened as a patient advocate, working to insure that the patient’s wishes be granted. The nurse’s failure to act as a patient advocate and respect Mr. E’s right to self-determination resulted in the patient being intubated and placed on a ventilator against his wishes. The nurse also failed to uphold a patient right to confidentiality. She violated the Federal Health Insurance Portability and Accountability Act (HIPAA) confidentiality laws. The nurse did not speak up and question the provider when the patient’s wishes were being questioned, leading to the patient’s rights, values and beliefs being disregarded.
Nursing Code of Ethics by ANA
The nurse violated more than one provision from the Nursing Code of Ethics. One of the provisions...