NRNP 6635 Week 2 Discussion Ethical and Legal Foundations of PMHNP Care

Walden University NRNP 6635 Week 2 Discussion Ethical and Legal Foundations of PMHNP Care-Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NRNP 6635 Week 2 Discussion Ethical and Legal Foundations of PMHNP Care   assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for  NRNP 6635 Week 2 Discussion Ethical and Legal Foundations of PMHNP Care                                                                                       

Whether one passes or fails an academic assignment such as the Walden University  NRNP 6635 Week 2 Discussion Ethical and Legal Foundations of PMHNP Care    depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NRNP 6635 Week 2 Discussion Ethical and Legal Foundations of PMHNP Care                                                                                     

The introduction for the Walden University NRNP 6635 Week 2 Discussion Ethical and Legal Foundations of PMHNP Care   is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NRNP 6635 Week 2 Discussion Ethical and Legal Foundations of PMHNP Care                                                                                     

After the introduction, move into the main part of the  NRNP 6635 Week 2 Discussion Ethical and Legal Foundations of PMHNP Care    assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NRNP 6635 Week 2 Discussion Ethical and Legal Foundations of PMHNP Care                                                                                     

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for  NRNP 6635 Week 2 Discussion Ethical and Legal Foundations of PMHNP Care                                                                                       

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NRNP 6635 Week 2 Discussion Ethical and Legal Foundations of PMHNP Care

As a current nurse working inpatient mental health, I have been able to take care of acutely ill psychiatric patients that have been involuntarily hospitalized or committed. Involuntary hospitalization requires legal actions for psychiatric evaluations or treatment through the court system. The purpose of this discussion is to explain the legal and ethical considerations of involuntary hospitalization due to commitment in both adults and children/adolescents.

Commitment Process in Mississippi 

In my state of Mississippi, specific actions must be taken before starting a commitment process. According to the Mississippi Department of Mental Health (2021), an affidavit is filed through the chancery clerk along with a one–hundred and fifty dollar filing fee. A writ is issued to the county sheriff to take that person into custody for pre-evaluation screening at a local community mental health center. Two healthcare providers must evaluate the client within forty-eight hours to determine if the client meets the criteria for commitment. A hearing is set between seven to ten days, and the judge will make the final decision based on the evidence presented in court. Based on availability, the judge can order a civil commitment to a crisis stabilization unit, state, or outpatient program.

Ethical Considerations in Adults and Children/Adolescents 

 The purpose of involuntary civil commitment is to help protect one that is an immediate threat to themselves or others; however, there are specific ethical and legal considerations to be aware of while considering commitment. An ethical concern that may arise during the commitment process is viewing human rights. For example, pregnant women involuntarily committed related psychosis and required treatment with antipsychotics. The rights of the patient and the fetus must be considered during treatment, and the clinician must identify the risk and benefits of untreated mental illness (Friedman et al., 2018).

The rights of children and adolescents are essential to treatment as well. A controversial treatment area is seen in adolescents with eating disorders, such as anorexia nervosa. Severe cases of anorexia nervosa can lead to irreversible effects that can be detrimental to the patient’s health which meets the criteria for involuntary commitment (Ramasamy, 2021). It is essential to understand what ethical considerations may lead to legal concerns.

Legal Considerations in Adults and Children/Adolescents

Legal concerns can arise when patients feel they have the right to refuse treatment. The example provided previously of pregnant women with psychosis who require treatment is an excellent example in identifying the legal concerns in this situation. States like California recognize fetuses as “human beings.” If the mother chooses to refuse treatment, this poses a threat to her and the fetus. According to Nau, Bender, and Street (2011), clinicians must be aware of the rules and regulations of the state when it comes to decision-making for treatment.

The challenges that may arise during the involuntary commitment of children and adolescents may be due to the age requirements that vary from state to state. The parents of a child play a significant role in the commitment process. The example provided of the adolescent with anorexia nervosa requires a parent or guardian to decide and sign consent for treatment. According to Neiman and Pelkey (2016), minors are protected by constitutional and state laws that provide treatment based on clinical needs.

Conclusion

 In conclusion, involuntary commitment requires ethical and legal considerations before initiating the process. As a clinician, it is essential to know the state laws for commitment.

References

Friedman, S. H., Hall, R. C., & Sorrentino, R. M. (2018). Involuntary treatment of psychosis in pregnancy. The journal of american academy of psychiatry and the law, 46(2), 217-223. https://doi.org/10.29158/JAAPL.003759-18

Mississippi Department of Mental Health. (2021). Civil Commitment. Mississippi Department of Mental Health. Retrieved December 8, 2021, from http://www.dmh.ms.gov/civil-commitment/

Nau, M., Bender, E., & Streeter, J. (2011). Psychotic denial of pregnancy: Legal and treatment considerations for clinicians. Journal of american academy of psychiatry and the law, 39(1), 31-39. http://jaapl.org/content/39/1/31

Neiman, E. J., & Pelkey, E. (2016). An analysis of legal issues—Child and adolescent behavioral health, Part III: Patient safety— Identifying and addressing legal issues involved when treating pediatric patients with behavioral health needs. American health lawyers association, 1-22. https://lewisbrisbois.com/assets/uploads/email-files/Child_and_Adolescent_Behavioral_Health%2C_Part_III_-_Patient_Safety.pdf

Ramasamy, R. S. (2021). Involuntary treatment of minors with severe and enduring anorexia nervosa. Journal of the american academy of psychiatry and the law, 49(3), 361-370. https://doi.org/10.29158/JAAPL.210004-21

Sample Answer 2 for NRNP 6635 Week 2 Discussion Ethical and Legal Foundations of PMHNP Care

The code of ethics for nurses represents the values, obligations, and responsibilities of professional nursing practices (Hegge et al.,2015). The provisions of the nurses’ code of ethics with its interpretive statements are unambiguous about the nursing profession’s value, morals, and responsibility to the community that we serve. It is, therefore, a guiding principle on which nurses, including Advanced Practice, Registered Nurses (APRN), must carry out their responsibilities to our patients and communities (Hegge et al.,2015). The nurses’ code of ethics has nine provisions with the further interpretative statement; hence the analysis of this paper is based on the ethical principle of respect and right to self-determination, also known as autonomy.

Autonomy (self-determination) is the respect for human dignity and a universal right to determine one’s faith. In the context of nursing care and practice, a patient has the right to accept or reject treatment after being adequately and correctly informed of the advantages and disadvantages of such choices. Also important is ascertaining the patient’s comprehension/understanding of information (Hegge et al.,2015). The nurses’ code of ethics mandates the APRN to be aware of the patient’s legal and moral right to make informed decisions and for the clinicians (APRN) to support, protect and preserve such choices in the absence of any ethical conflict. Furthermore, the nurses’ code of ethics mandates the APRN to be aware of the patient’s legal and moral right to make informed decisions and for the clinicians (APRN) to support, protect and preserve such choices in the absence of any ethical conflict (ANA,2015). Where an ethical conflict exists, the APRN works to resolve such conflicts within the scope of the code of ethics for nurses (Hegge et al.,2015).

Article 1: Ethical Consideration when dismissing patients for noncompliance.

This article addressed the ethical responsibilities of an Advanced Practice Registered Nurse (APRN) as a care provider to a patient that is non-compliant to treatment management or lifestyle that negates the goal of accomplishing optimal treatment outcomes. A non-compliant patient in this article has the autonomy to choose not to be compliant to treatment, and that right must be respected. With physician providers, the American Medical Associations (AMA) code of medical ethics allows for explicit avenues by which a physician can refuse or disengage services ethically/legally to a non-compliant patient (Olsen,2019).

Unfortunately, the APRN, guided by the nurses’ code of ethics, does not enjoy such privileges but can only discharge a non-compliant patient for one of the following reasons:

(1.) If the patient cannot receive optional care from the APRN (Olsen,2019).

(2.) If another clinician is more qualified to provide care to the same patients (Olsen,2019).

(3.) If the clinician does not have the competency to provide the special care needed by the non-compliant patient.

(4.) If the care management/treatment is completed (Olsen,2019).

Article 2 on Autonomy: Balancing Act: Public Health and Autonomy in Covid -19 vaccination decision.

This article addresses the rights and respect for individual patients to self-determination (autonomy) in the context of global (Society) health. With the COVID-19 pandemic ravaging the world, societies and governments are indecisive about enforcing mandatory vaccination for the good of all citizens and allowing individuals autonomy to decide whether to be vaccinated or not (Young,2021). The notion of compulsory vaccinations appears to contradict the democratic and human rights values of self-determination (right to accept/reject treatment) (Thapar et al., 2018). This article articulates the larger good behind mandatory vaccinations of all citizens and the emotional, psychological, physical, and financial distress experienced by both vaccinated and unvaccinated citizenry, depending on what side of the dichotomy one stands (Young et al.,2018).

In summation, autonomy is debated on a broader spectrum of the safety and Wellness of the larger society, country, and world against an individual preference.

Article 3: Relational Autonomy in Informed Consent (RAIC) as an ethics of approach to the concept of informed consent.

This article addressed the question of autonomy and informed consent in the context of patients as interdependent social beings. Therefore, the rights and respect for self-determination (autonomy) /informed consent should be relational to cultural beliefs and discussed with family, friends (Osuji,2018). The ability of individuals to be autonomous does not imply isolation but that we are social, relational, and interdependent beings that learn the concept of autonomy from relating with another person (Osuji,2018). Therefore, with the concept of care known to be moral and universal, children and adolescents (minor) agree to parental nurturing and care(treatment) by accenting, while adults, parents/guardians by consenting (Thapar et al.;2018).

Article 4: In defense of a single body of clinical and public health, medical ethic. 

Finally, this article looked at the role of health care providers in articulating individual and community patient autonomy in private and public health settings. This article also questions the constraints of clinician autonomy in delivering patient-centered care in the face of managed care/commodity care delivery systems aimed at cost savings (Unger et al.,2020). With the code of ethics as a motivational driver of care delivery, providers’ autonomy constricted by insurance companies impairs the quality of care delivered. In conclusion, clinicians have a responsibility to reinforce individual or community autonomy by providing information and knowledge of social, cultural, and economic determinants of health to enable informed decision-making (Unger et al.,2020).

Reference

Hegge, M., Fowler, M., Godfrey, T., Lee, C., Lioce, L., Ngai, M., Robichaux, C., Schroeter, K.,

Shije, J., Swanson, E., Tanner, M., Thomas, E., Wocial, L., and Zanni, K., 2015. Code of ethics for nurses with interpretive statements. 2nd ed. Silver Spring, Md.: American Nurses Association.

Olsen, D., 2019. Ethical Considerations When Dismissing Patients for Noncompliance. AJN,

American Journal of Nursing, 119(2), pp.64-66. [PDF]. https://doi.org10.1097/01.NAJ.0000553208.51836.4a.

Osuji, P., 2017. Relational autonomy in informed consent (RAIC) as an ethics of care approach

to the concept of informed consent. Medicine, Health Care, and Philosophy, 21(1), pp.101-111. [PDF]. https://doi.org10.1007/s11019-017-9789-7.

Thapar, A., Pine, D., Leckman, J., Scott, S., Snowling, M., and Taylor, E., 2018. Rutter’s child 

and adolescent psychiatry. 6th ed. Chichester: Wiley Blackwell.

Unger, J., Morales, I., De Paepe, P., and Roland, M., 2020. In defence of a single body of clinical

and public health, medical ethics. BMC Health Services Research,20(S2). [PDF]. https://doi.org10.1186/s12913-020-05887-y.

Young, J., 2021. Balancing Act: Public Health and Autonomy in COVID-19 Vaccination

Decisions. Professional Case Management, 26(6), pp.313-315. [PDF]. https://doi.org10.1097/NCM.0000000000000536.

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