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?
Topic 2: Scope of Practice
- Identify regulatory bodies and industry regulations that specify certification and licensure requirements and scope of practice for advanced registered nurses.
- Relate ethical guidelines to the scope of practice of the advanced registered nurse.
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.
Topic 2: Scope of Practice
1. Identify regulatory bodies and industry regulations that specify certification and licensure requirements and scope of practice for advanced registered nurses.
2. Relate ethical guidelines to the scope of practice of the advanced registered nurse.
Advanced Practice Nursing: Essential Knowledge for the Profession
Read Chapters 11, 26, and 27 in Advanced Practice Nursing: Essential Knowledge for the Profession.
Leadership in Nursing Practice: Changing the Landscape of Health Care
Review Chapter 2 in Leadership in Nursing Practice: Changing the Landscape of Health Care.
American Nurses Association – Advanced Practice Nurses
Explore the Advanced Practice Nurses page of the American Nurses Association (ANA) website.
American Association of Colleges of Nursing – Students
Explore the Students page of the American Association of Colleges of Nursing website.
American Nurses Association
Explore the American Nurses Association (ANA) website.
Explore the Nursing Overview links on the Explore Health Careers website.
Nursing Roles Graphic Organizer Template
Use the “Nursing Roles Graphic Organizer Template” to complete the Topic 2 assignment.
Initial Course Survey
In an effort for continuous improvement, Grand Canyon University would like you to take this opportunity to provide feedback about your experience with the university. Your participation is appreciated. Click on the link to begin the survey.
Your paper must be proofread.
However, do not rely solely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part, and your grade will suffer as a result.
Papers with a high number of misspelled words and grammatical errors will be penalized.
Before handing in your paper, go over it in silence and then aloud, making any necessary corrections.
It is often beneficial to have a friend proofread your paper for obvious errors.
Uncorrected mistakes are preferable to handwritten corrections.
Use a standard 10 to 12 point typeface (10 to 12 characters per inch).
Smaller or compressed type, as well as papers with narrow margins or single spacing, are difficult to read.
It is preferable to allow your essay to exceed the recommended number of pages rather than attempting to compress it into fewer pages.
Large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and other such attempts at “padding” to increase the length of a paper are also unacceptable, wasteful of trees, and will not fool your professor.
The paper must be formatted neatly, double-spaced, and with a one-inch margin on the top, bottom, and sides of each page.
When submitting hard copies, make sure to use white paper and dark ink.
It will be difficult to follow your argument if it is difficult to read your essay.
CLASSROOM ADDITIONAL INSTRUCTIONS
Questions for Discussion (DQ)
Initial DQ responses should address all aspects of the questions posed, include at least one scholarly source, and be at least 250 words long.
Successful responses are substantive (i.e., they add something new to the discussion, they engage others in the discussion, they have a well-developed idea), and they include at least one scholarly source.
Responses of one or two sentences, simple statements of agreement or “good post,” and off-topic responses will not be considered substantive.
Substantive responses must be at least 150 words in length.
I encourage you to incorporate the week’s readings (if applicable) into your responses.
Participation every week
Your initial responses to the mandatory DQ are graded separately and do not count toward participation.
Along with the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
A scholarly source/citation is not required for participation posts (unless you cite someone else’s work).
Viewing the weekly announcement and attesting to watching it in the comments is part of your weekly participation.
These announcements are made to ensure that you are aware of everything that is due this week.
The APA Format and the Writing Quality
Learn how to use APA format and practice using it correctly.
It is used for the majority of your degree’s writing assignments.
For APA paper templates, citation examples, and tips, go to the Writing Center in the Student Success Center, which can be found under the Resources tab in LoudCloud.
Points will be deducted if the APA format is not used correctly or if the APA format is not used at all (if required).
Cite all information sources!
Cite the source whenever possible.
A citation is also required when paraphrasing.
I strongly advise you to use the APA Publication Manual, 6th edition.
Utilization of Direct Quotes
At the Masters’ level, I discourage the use of direct quotes in DQs and assignments and deduct points accordingly.
As Masters’ level students, you must be able to critically analyze and interpret information from journal articles and other sources.
Simply repeating someone else’s words does not demonstrate comprehension or critical analysis of the content.
It is preferable to paraphrase and cite your sources.
Please make sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me for assignments that must be submitted to LopesWrite.
Please review your report once you have received it.
This report will highlight grammatical, punctuation, and spelling errors that are simple to correct.
Instead of being counted off for these errors, spend a few extra minutes reviewing.
Examine your similarities.
Did you forget to include a citation?
Did you not paraphrase correctly?
Is your paper dominated by someone else’s ideas rather than your own?
Visit the Writing Center in the Student Success Center, which can be found under the Resources tab in LoudCloud, for advice on how to improve your paper and SI score.
Policy on Arrival Late
The university’s late assignment policy is a 10% penalty PER DAY LATE.
This also holds true for late DQ responses.
If you anticipate having to submit an assignment late, please contact me.
With advance notice, I am happy to be flexible.
Due to extenuating circumstances, we may be able to work out an extension.
If you do not contact me before submitting an assignment late, the GCU late policy will apply.
Unless we have worked out an extension, I will not accept assignments that are two or more weeks late.
No assignments are accepted after the last day of class, per policy.
Any assignment submitted after midnight on the final day of class will not be graded.
The importance of communication cannot be overstated.
You can contact me in a variety of ways, including:
Questions to the Instructor Forum: This is a great place to ask questions about course content or assignments.
If you have a question, chances are that one of your colleagues does as well.
This is the class’s public forum.
Individual Forum: This is a private forum where you can ask me questions or leave messages for me.
At least once every 24 hours, this will be checked.