WCU Healthcare Ethical Challenge Discussion Replies

Each peer responses to students should include 100-150 words and 1 reference

NUR521 discussion 1

Peer 1: Katherine

What challenges does this present for you as a health care provider, and is this different than the challenges you have internally as an individual? Explain…

Healthcare providers often adhere to a professional code of ethics, which includes principles such as beneficence, non-maleficence, autonomy, and justice. These principles guide their actions and decisions in providing care to patients.

Beneficence: Acting in the best interest of the patient.

Non-maleficence: Doing no harm to the patient.

Autonomy: Respecting the patient’s right to make their own decisions about their health.

Justice: Treating all patients fairly and equitably.

Challenges related to these principles can arise when:

• Resource Allocation: Limited resources can make it difficult to provide the best care to all patients, challenging the principle of justice.
• Cultural or Personal Beliefs: A healthcare provider’s personal or cultural beliefs might conflict with a patient’s choices or medical needs, challenging the principles of autonomy and beneficence.
• End-of-Life Decisions: Decisions regarding life-sustaining treatments can conflict with the principles of beneficence, non-maleficence, and autonomy.
• Patient Non-Compliance: When patients do not follow medical advice, it can challenge the principles of beneficence and autonomy.

The challenges faced by healthcare providers in adhering to a professional moral code might differ from their internal values as individuals because:

• Personal Beliefs and Biases: A healthcare provider might have personal beliefs and biases that conflict with the professional code of ethics.
• Emotional Involvement: Personal emotions and attachments can sometimes make it challenging to uphold the principles of the professional moral code.
• Work-Life Balance: The demands of adhering to a strict professional code can sometimes be at odds with an individual’s needs for personal time and space, potentially leading to burnout.

In summary, healthcare providers face numerous challenges in adhering to a professional moral code, and these challenges can sometimes be at odds with their personal values and beliefs. Navigating these challenges requires self-awareness, continuous learning, and a solid commitment to ethical practice.

Reference:

Butts, J. B. (2015). Nursing Ethics (4th ed.). Jones & Bartlett Learning. https://online.vitalsource.com/books/9781284099096

Peer 2: Emily

I found it relatively easy to make confident and decisive decisions on the moral survey, as there were several questions where my beliefs aligned strongly with either agree or disagree. However, there were a few questions that required more moderate responses due to the complexity of the issues involved. Some subject areas did trigger personal emotions, such as the question regarding physician-assisted suicide and providing care for patients when there is a conflict of interest. Despite these emotions, I made a conscious effort to remain objective, considering the ethical implications.

The most difficult decisions were related to situations involving potential violations of the ANA code of ethics and the CRNA potentially stealing narcotics. These scenarios required critical thinking and resolution strategies to balance ethical principles and professional responsibilities. I considered policy and legal parameters in my decision-making process, especially in situations where they provided guidance on the ethical course of action. Additionally, in my clinical practice, I have encountered situations with ethical dilemmas, and this survey made me reflect on how I would handle similar scenarios. It has provided a framework to better navigate these challenges by weighing the ethical principles and professional guidelines involved.

A moral inventory like this survey can impact my clinical practice by enhancing my ethical decision-making skills, improving my ability to navigate complex situations, and reinforcing the importance of adhering to professional codes of ethics and legal standards in healthcare. It also encourages ongoing self-reflection and self-improvement in ethical matters, which is crucial for providing the best care to patients.

NUR521 discussion 2

Peer 1 Rosmery

A medical error is an unexpected, preventable injury caused by medical care. It happens when a planned action fails to go as anticipated or when the incorrect strategy is utilized to attain a medical aim. Errors in clinical practice are classified as active or latent, and both have serious consequences for patient care. Active errors happen right away and are frequently the outcome of a person’s actions (Rodziewicz & Hipskind, 2020). Active errors example is delivering the incorrect drug dosage as a result of a math error or misreading a patient’s paperwork. In my clinical expertise, I have seen active errors such as inaccurate drug container labeling, which leads to misunderstanding and sometimes harmful administration.

Latent errors are often hidden within the healthcare system and may not result in harm until a series of events align to expose them. The errors can be deeply ingrained and persist over time, only becoming evident when a patient is harmed (Rodziewicz et al., 2023). For instance, having a confusing or cluttered electronic health record system may lead to latent errors when critical information is missed or misinterpreted. In my clinical experience, I’ve encountered latent errors related to inadequate staffing levels, which can lead to overworked staff, fatigue, and, ultimately, lapses in patient care.

Preventing and mitigating active and latent errors requires a multi-faceted approach. Establishing robust reporting systems and a blame-free culture can capture errors and near-misses and encourage open communication and learning from mistakes. Implementing advanced technology solutions that reduce human errors, such as barcoding systems for medication administration. Additionally, commitment to continuous education, training, and quality improvement initiatives will help healthcare professionals identify and mitigate errors more effectively (Bindra et al., 2021). Addressing errors through systemic changes and process improvements can help organizations create a safer environment for patients and the healthcare team. The approaches can enhance the overall quality of patient care and improve patient outcomes.

References

Bindra, A., Sameera, V., & Rath, G. (2021). Human errors and their prevention in healthcare. Journal of Anaesthesiology Clinical Pharmacology, 37(3), 328. https://doi.org/10.4103/joacp.joacp_364_19

Rodziewicz, T. L., & Hipskind, J. E. (2020). Medical error prevention. PubMed; StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/29763131/

Rodziewicz, T. L., Hipskind, J. E., & Houseman, B. (2023). Medical error reduction and prevention. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499956/

Peer 2 Irina

Active and latent errors represent two categories of failures within healthcare systems that can significantly impact patient care. Active errors are direct, often immediate mistakes made by frontline staff, such as medication administration errors or surgical mistakes (Reason, 2000). In contrast, latent errors are more subtle, systemic issues, often lying dormant within healthcare systems until they contribute to an active error. These can include poor design of equipment, inadequate staff training, or flawed communication systems (Carayon et al., 2019). For instance, a nurse might administer the wrong medication dose (active error) due to poorly labeled drug containers (latent error).

Preventing these errors necessitates a multifaceted approach. Active errors can be mitigated through strategies like real-time decision support tools and rigorous training focused on practical skills and critical thinking (Westbrook & Raban, 2020). Latent errors, however, require broader organizational changes, such as improving healthcare IT systems, redesigning work processes to enhance safety, and fostering a culture where staff feel empowered to report potential safety issues. Importantly, understanding the interplay between active and latent errors can lead to a more holistic approach in enhancing patient safety and care quality (Carayon et al., 2019; Westbrook & Raban, 2020).

References

Carayon, P., Wetterneck, T. B., Rivera-Rodriguez, A. J., Hundt, A. S., Hoonakker, P., Holden, R., & Gurses, A. P. (2019). Human factors systems approach to healthcare quality and patient safety. Applied Ergonomics, 45(1), 14–25. https://doi.org/10.1016/j.apergo.2012.11.002Links to an external site.

Reason, J. (2000). Human error: Models and management. BMJ, 320(7237), 768–770. https://doi.org/10.1136/bmj.320.7237.768Links to an external site.

Westbrook, J. I., & Raban, M. Z. (2020). Measurement and reduction of prescribing errors: A review of the evidence. British Journal of Clinical Pharmacology, 86(6), 1105-1117. https://doi.org/10.1111/bcp.14275

NUR535

discussion 1

Peer 1 Kevin:

Academic success is the goal of teaching nursing students. To reach academic success, student engagement is critical (Iduye et al., 2021). Currently, student engagement face barriers as diversity in the overall population increase. However, it is imperative to increase the diversity of nursing students to meet the demands of the diverse patient population with various health needs (Iduye et al., 2021). The healthcare system’s ability to satisfy workforce demands has raised concerns, leading to a greater focus on recruiting and retaining nursing students from various backgrounds (Iduye et al., 2021). This includes considerations of color, ethnicity, culture, gender, language, and disabilities. Inclusive classroom environments are needed to increase the satisfaction of nursing students from diverse backgrounds. As a result, teachers must be culturally competent to teach diverse backgrounds students without any sign of discriminatory behavior.

Engagement relates to the student’s interest in learning and a sense of connection with their classes (Iduye et al., 2021). Engagement strategies from a culturally diverse manner are readily available and should be used by professors to promote the students to be connected to their classes. Due to its widespread nature in a technologically driven society, online learning has emerged as a critical nursing school strategy (Iduye et al., 2021). This tool will engage nursing students as most of our population is technology-driven.

On the other hand, the tools mentioned above will help students be engaged, but more is needed to solve the feeling of being disconnected due to their different cultural backgrounds. Most students may feel discriminated against by the attitudes and behaviors the teachers may adopt against minorities. Faculty presence ensures that the professor is present and aware of all the students’ diverse backgrounds. Inclusivity is the term used to promote the professor on knowing the students’ different cultural backgrounds and inquire about strategies to make the students feel included despite cultural differences in the classroom. Therefore, nurse educators should thoroughly evaluate the level of institutional support for inclusive teaching, as well as the effectiveness of particular classroom practices employed to promote inclusivity (Billings & Halstead, 2015).

References

Billings, D. M., & Halstead, J. A. (2015). Teaching in nursing: A guide for faculty (5th ed.). Elsevier.

Iduye, D., Vukic, A., Waldron, I., Price, S., Sheffer, C., McKibbon, S., Dorey, R., & Yu, Z. (2021). Educators’ strategies for engaging diverse students in undergraduate nursing education programs: a scoping review protocol. JBI evidence synthesis, 19(5), 1178–1185. https://doi.org/10.11124/JBIES-20-00039

Peer 2 Piunik

In the continuously evolving world of nursing education, the distinctive blend of students and faculty requires several considerations to enable successful teaching and learning. The classroom becomes a meeting point for gender, race, cultural differences, and generational variations within the nursing community. In our teaching, we can use these unique characteristics as powerful tools for connection and comprehension. By acknowledging and incorporating nursing students’ diverse backgrounds and experiences, we can transform these differences into an opportunity for critical thinking and problem-solving in patient care. For instance, as an oncology nurse, I can utilize real-world scenarios that connect with diverse student experiences, enhancing comprehension of oncology nursing principles. As an oncology nurse, I could present a scenario involving a patient with limited English proficiency navigating a cancer diagnosis. This real-world example encourages students to explore the challenges of language barriers in healthcare, enabling them to develop communication strategies and cultural awareness in delivering effective oncology nursing care. Students develop a better knowledge of healthcare concerns by including real-life scenarios and promoting open discussions. This method allows us to build a group that understands diverse cultures and shows empathy (Gradellini et al., 2021). It also improves teamwork in handling patient care challenges by enhancing critical thinking skills and encouraging collaboration.

Reference:

Gradellini, C., Gómez-Cantarino, S., Dominguez-Isabel, P., Molina-Gallego, B., Mecugni, D., & Ugarte-Gurrutxaga, M. I. (2021). Cultural Competence and Cultural Sensitivity Education in University Nursing Courses. A Scoping Review. Frontiers in Psychology, 12(12). https://doi.org/10.3389/fpsyg.2021.682920

NUR535 Discussion 2

Peer 1 Hanny

Designing effective learning experiences for nursing students involves creating an inclusive and adaptable environment that accommodates various learning styles and abilities. There are various strategies to promote positive and effective learning for all students in both class and clinical environments. One of them is varied teaching methods. To address diverse learning styles, the instructor should use a mix of teaching methods such as lectures, group discussions, case studies, simulations, and hands-on activities (Designing and reviewing a safe and effective learning environment and experience, 2019). This allows students to engage with the content in different ways and caters to various learning preferences.

The second is active learning. The instructor should encourage active learning techniques, which involve students in the learning process. This can include problem-solving exercises, role-playing, and collaborative projects. Active learning helps students apply theoretical knowledge to real-world scenarios (Ghasemi et al., 2020). The third is the multisensory approach. One can incorporate visual aids, audio resources, and tactile materials to appeal to different sensory preferences. This helps students with various learning styles, whether they are visual, auditory, or kinesthetic learners.

The third is flexible assessment methods. The instructor ought to assess students through a variety of methods, including written exams, oral presentations, group projects, and skills demonstrations. This allows students to showcase their understanding in ways that suit their learning style and abilities. There ought to be room for personalized feedback. The instructor should provide individualized feedback to help students understand their strengths and areas for improvement. This can guide them in adapting their learning strategies and becoming more versatile learners. There also needs to be a supportive environment (Designing and reviewing a safe and effective learning environment and experience, 2019). The instructor ought to create a supportive and inclusive classroom or clinical environment where students feel comfortable expressing their unique learning needs and challenges. Encourage peer support and collaborative learning.

Regarding the question of whether students should use their preferred learning styles exclusively or be open to different methods of learning, it’s important to strike a balance. One of the ways of achieving this is acknowledge learning preferences. The instructor ought to recognize that students may have preferred learning styles, but also help them understand that being open to different methods of learning can enhance their adaptability and problem-solving skills. Nursing is a dynamic field, and healthcare professionals often encounter novel situations that require flexible learning approaches (Ghasemi et al., 2020). He or she should also encourage adaptability. While it is essential to cater to students’ learning preferences, educators should also encourage them to be open to different methods of learning. Encourage them to step out of their comfort zones and develop the ability to learn in diverse ways. This adaptability will serve them well in their nursing careers, where they will need to continuously learn and adapt to changing patient needs and healthcare practices.

Striking a balance between accommodating students’ preferences and promoting adaptability is the ideal approach. Educators should expose students to a variety of learning methods and support them in developing a well-rounded skill set. In summary, nursing educators should design learning experiences that accommodate various learning styles and abilities while also encouraging students to be open to different methods of learning. Balancing preference with adaptability will prepare nursing students for the complexities of the healthcare field and ensure they can effectively serve diverse patient populations.

References

Designing and reviewing a safe and effective learning environment and experience. The Nursing and Midwifery Council. (2019). https://www.nmc.org.uk/supporting-information-on-s…

Ghasemi, M. R., Moonaghi, H. K., & Heydari, A. (2020). Strategies for sustaining and enhancing nursing students’ engagement in academic and clinical settings: A narrative review. Korean Journal of Medical Education, 32(2), 103–117. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC72723…

Peer 2 Maria

Creating learning experiences for a varied student body necessitates a complex approach that promotes growth and adaptation while also accommodating different learning styles and competencies. Here are some examples and techniques that can help:

Using a variety of instructional techniques, such as group projects, discussions, hands-on exercises, and case studies. By using this method, students with varying learning styles can interact with the content in ways that works best for them. Another example, students should be guided to explore and develop alternative learning strategies in addition to being encouraged to determine their preferred learning style. Creating lesson ideas that play to their strengths and encourage them to venture a little bit outside of their learning comfort zones. To accommodate learners who are tactile, visual, and auditory, for example, employ hands-on practice, videos, pictures, vocal explanations, charts and diagrams.

Teachers need to create a balance when it comes to the preferred learning styles and adaptability issues. It is beneficial to help students identify and use their preferred learning styles since it can improve their educational experiences. For example, as per the learning style quiz I resulted to be a visual learner which is true, I learn best by visualizing things but I also learn best by doing hands on. It’s critical to encourage flexibility and an openness to try out new teaching strategies that may also benefit students in learning and understanding materials better.

Educators should push students to venture outside of their comfort zones and experiment with various learning styles as to help them prepare to be more flexible and be ready for a variety of learning environments in the workplace. This doesn’t imply ignoring their chosen learning style, but rather equipping them with a wide range of skills that will enable them to learn efficiently under a variety of conditions and environment in the workplace. The intention is for students to become more skilled and well-rounded nurses by enabling them to recognize their own preferences and strengths and to learn how to adjust to various learning environments.

NUR561 Discussion 1

Peer 1 Emily

As a registered nurse in the pediatric ICU setting, I encountered a scenario that empowered a young patient to believe they could make essential lifestyle modifications despite the barriers in their environment. I was caring for a teenage patient with asthma who had frequent hospital admissions due to poorly managed symptoms. This patient lived in a neighborhood with limited access to green spaces and faced economic barriers to obtaining the necessary medications and resources to control their asthma effectively. To empower the patient, I engaged in a conversation with the patient and their family, acknowledging the challenges they faced. I emphasized the importance of medication adherence and the use of preventive measures, such as avoiding triggers and maintaining a clean and dust-free environment. To make the information more accessible, I used plain, non-medical language and relatable metaphors to explain concepts like the inflammation in the airways or the role of rescue inhalers.

In my experience, these strategies to improve patient health literacy have been highly effective. Using plain language and relatable comparisons can significantly enhance a patient’s understanding of their condition and the importance of adherence to the prescribed treatment plan. This approach not only empowers patients to take control of their health but also builds a strong nurse-patient relationship based on trust and effective communication.

On the other hand, I have encountered challenges in improving health literacy among young patients and their families. Families in the pediatric ICU setting often experience high levels of emotional stress, which can affect their ability to absorb and retain information. Patients and families may have varying levels of health literacy, making it essential to tailor education to each individual’s needs. To manage these challenges, it is important to involve other healthcare professionals, such as clinical educators and social workers, to share the responsibility of patient education and support. Additionally, utilizing visual aids, such as diagrams and pamphlets, would help to complement verbal explanations, making complex medical information more accessible.

Peer 2 Luis

I work in an extremely fast paced environment as a Pediatric Registered Nurse (RN) in a Level 1 Pediatric Trauma Center. The experiences I have working as a RN in this environment are both dynamic, however, short lived at the same time. In the world of Emergency Medicine we often say that there are 3 outcomes which will emerge from visiting an Emergency Department:

• Discharge home after receiving treatment or outpatient referral for further care
• Admission to the hospital for inpatient continuation of care
• Death

The unfortunate side of ER medicine is that we have very limited time to spend with our patients or to follow-up with any future referrals or outcomes.

Nevertheless, as a Pediatric Emergency Medicine – RN, I take the personal choice and responsibility to make the most of the time I have with both my patients and parents, and I try to accomplish the following 3 tasks during each visit.

1. Home health teaching and injury prevention
2. Growth and development education
3. Parental teaching in recognizing early disease processes and conditions

For example: Strep Throat in our children population

Strep Throat is a common bacterial infection that we see in children during various times of the year. Most commonly, this condition is prevalent when children go back to school and are exposed to other children and become infected among themselves.

Strep Throat, a bacterial infection of the throat and tonsils, is caused by a bacteria called group A streptococcus. Many of our parents bring their children to the Emergency Department with a “fever” and “decrease appetite” that does not seem to get better over a few days. A lot of parents attempt to treat the fevers at home, however, are not effective in treating the condition once the symptoms are advance and require antibiotics to treat it.

Strep throat can be prevented through hand washing, keeping hands away from mouth, nose, eyes, and not sharing drinks or food from other individuals. Unfortunately, school age children are really bad at adhering to all these prevention strategies and ultimately become infected with Strep Throat and end up in our Emergency Departments often.

ER TEACHING ROLES:

1. Home health teaching and injury prevention

During the Emergency Department After-visit summary (AVS), I take the time to teach the parents and patient (if age appropriate), the importance of disease transmission by making healthy modifications at home and school. I highlight certain parts of the AVS paperwork and have the parents teach back to me what they understand and what it is confusing to them regarding the disease process. I break down medical terminology and use plain english explanations that can be easily understood and remembered from the AVS.

1. Growth and development education

I also take advantage of the ER visits and share one or two facts of child development teaching which is focus on home safety and injury prevention appropriate to the age of the child now and something for the future. For example, the parent of a 3 month infant, I might teach them that at 4 to 5 months, an infant will begin to have motor movement and will be able to turn from their back to stomach and stomach to back. I teach the parents to NOT leave the infant unattended on a bed to avoid them from turning and falling to the ground.

1. Parental teaching in recognizing early disease processes and conditions

Parental teaching in recognizing early symptoms is crucial because it can avoid children from becoming seriously ill and having to be admitted at a hospital. During each visit, I make it a point to teach parents easy ways to treat early symptoms such as fevers and cough. Additionally, I will take the time to teach parents how to identify irregular breathing patterns such as accessory muscle usage, tachypnea, nasal flaring, etc…

Reference:

Kudzma, C.E. E. ([Insert Year of Publication]). Health Promotion Throughout the Life Span (10th ed.). Elsevier Health Sciences (US). https://online.vitalsource.com/books/9780323846295

NUR561 Discussion 2

Peer 1 Melanie

Two emerging populations that I would like to compare are Latino/Hispanic Americans and Asian Americans/Pacific Islanders. As a Hispanic myself, I am aware of the health issues that are predominant in the Cuban population. In the Hispanic Health and Nutrition Examination Survey, 20.5% of Cuban-American men and 13.8% of Cuban-American women between the ages of 19 and 74 had high blood pressure (n.d.). Some of the risk factors that may contribute to the high incidence of high blood pressure is the high prevalence of obesity. My culture places a big emphasis on eating lots of food when it is available because my Cuban parents did not always have food growing up. Therefore, it was viewed as an insult when my mother cooked a meal, regardless of the high sodium and fat content, and I did not leave the plate spotless.

Asian Americans are known for living long healthy lives, however, they are at most risk for cancer, heart disease stroke, and diabetes (‘Asian American Health’, n.d.). A lot of this has to do with the culture barriers in place, not attending doctors visits, and lack of health insurance (‘Asian American Health’, n.d.).

Cangiano, J. (n.d.). Hypertension in Hispanic Americans. Cleveland Clinic Journal of Medicine. https://www.ccjm.org/content/ccjom/61/5/345.full.pdfLinks to an external site.

Asian American Health. OMH U.S Department of Health and Human Services Office of Minority Health. https://minorityhealth.hhs.gov/asian-american-health#:~:text=Asian%20Americans%20are%20most%20at,(accidents)%2C%20and%20diabetes

Peer 2 Hanny

Health issues can vary significantly between different racial and ethnic groups, including Asian Americans/Pacific Islanders and Black/African Americans. These disparities can be attributed to a combination of genetic, socioeconomic, cultural, and healthcare access factors. It is important to note that within each of these broad racial and ethnic categories, there is considerable diversity, and health outcomes can differ among subgroups. One of the aspects pertaining to health issues in Asian Americans/Pacific Islanders is chronic conditions. Some Asian American subgroups, such as South Asians, have a higher risk of developing chronic conditions like heart disease, type 2 diabetes, and certain cancers (Nadeau et al., 2023). This can be influenced by genetic factors and lifestyle choices. One of these chronic conditions is Hepatitis B. Chronic hepatitis B infection is more common among some Asian American populations. Regular screening and vaccination are essential to prevent the transmission of this virus.

Another issue of concern is mental health. Mental health stigma can be a significant barrier to seeking care within some Asian American communities. Consequently, issues such as depression and anxiety may be underreported and untreated. They also experience significant challenges pertaining to access to care (Ndugga & Pillai, 2023). Limited English proficiency, cultural differences, and immigration status can present barriers to accessing healthcare for some

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