RESPONSE DISCUSSION
konxidum
RESPONSENUR8002.docxQuestions to respond on the discussion below:
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
DISCUSSION:
As a DNP prepared nurse, research is used to implement evidence-based practice from research. Within the both the research and practice domains ethical issues can arise that both DNP and PhD nurses will encounter and need to know how to work through. As Peirce & Smith (2008) described, some examples are voting on whether a noncompliant post-transplant patient should get a second liver, a physician should be taking information before IRB and HIPPA forms completed and determining someone selling prescriptions over the counter. According to Suhonen et al. (2013), older patients should have the choice to be part of research with a transparent informed consent process that is described within the studies published. Patients should first and foremost have the most understanding of what the study is, by a healthcare professional breaking the information down according to education level, an unbiased explanation, as well as time to process whether they would or would not like to proceed. Patients should not feel rushed in this decision, and nurses have the responsibility of respecting the patients right to their own choice, as well as making sure social justice, Beneficence/non-maleficence are all principles followed when making treatment decisions, especially in research (Campbell-Crofts et al., 2013).
Explain how these issues might compare to the types of issues you have already encountered in your practice
Working in Oncology and Blood and Marrow Transplant, I have observed issues with noncompliant patients that in rare, extreme cases have been deemed a danger to themselves by being noncompliant and pose more of a risk to themselves by not following guidelines. In the future, a way to prevent this from happening is to further study the informed consent process, and psychosocial evaluation process done prior to admission for BMT as Suhonen et al. (2013) did with the older population that consented to studies.
Another issue observed is the delay of speaking to family about goals of care when a patient becomes terminally ill and the likelihood of survival becomes nearly impossible. A potential solution brought up could be for patients at the beginning or even middle of a cancer or other chronic diagnosis that health care goals, and advanced directives are discussed by the provider or by a multi-disciplinary palliative care team in order to achieve transparency with judiciousness (Milton, 2010).
References
Campbell-Crofts, S., Field, J., & Fetherstonhaugh, D. (2013). Ethical considerations for nurses undertaking research with a potentially vulnerable population with chronic kidney disease. Renal Society of Australasia Journal, 9(2), 74–79.
Milton, C. (2010). Nursing ethics and power in position. Nursing Science Quarterly, 23(1), 18-21.
Peirce, A. G., & Smith, J. A. (2008). The ethics curriculum for Doctor of Nursing Practice programs. Journal of Professional Nursing, 24(5), 270-274.
Suhonen, R., Stolt, M., & Leino-Kilpi, H. (2013). Older people in long-term care settings as research informants: Ethical challenges. Nursing Ethics, 20(5), 551-567. doi:10.1177/0969733012463722
