NURS 8002 Week 10: ETHICS AND THE DNP-PREPARED NURSE

Walden University NURS 8002 Week 10: ETHICS AND THE DNP-PREPARED NURSE– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 8002 Week 10: ETHICS AND THE DNP-PREPARED NURSE 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 NURS 8002 Week 10: ETHICS AND THE DNP-PREPARED NURSE

Whether one passes or fails an academic assignment such as the Walden University NURS 8002 Week 10: ETHICS AND THE DNP-PREPARED NURSE 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 NURS 8002 Week 10: ETHICS AND THE DNP-PREPARED NURSE

The introduction for the Walden University NURS 8002 Week 10: ETHICS AND THE DNP-PREPARED NURSE 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 NURS 8002 Week 10: ETHICS AND THE DNP-PREPARED NURSE

After the introduction, move into the main part of the NURS 8002 Week 10: ETHICS AND THE DNP-PREPARED NURSE 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 NURS 8002 Week 10: ETHICS AND THE DNP-PREPARED NURSE

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 NURS 8002 Week 10: ETHICS AND THE DNP-PREPARED NURSE

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 NURS 8002 Week 10: ETHICS AND THE DNP-PREPARED NURSE

Ethical Issues Relevant to the DNP-Prepared Nurse

Most of the ethical issues relevant to a doctoral-prepared Nurse are combined into two essential components patient confidence or satisfaction and Research integrity. Ethical values are critical to all healthcare workers. Ethical conflicts complicate clinical practice and often compromise patient, family, clinician, communication and teamwork. As ethical conflicts escalate, patient and family distress and dissatisfaction with care increase, and trust in clinicians erodes reducing care quality and patient safety (Pavlish, C.L. et al. (2020). Expertise and researchers say that ethical practice is a foundation for all healthcare workers and plays a vital role in ethical issues. As registered Nurses in a healthcare organization, we always face one or more challenges in daily practice. Also, all levels of nursing care and practices will encounter ethical issues. A DNP-prepared nurse plays a critical role in identifying ethical issues and finding ways to avoid dilemmas. Ethical guidelines for practice and research in nursing have been widely discussed. Yet examining ethical dilemmas that emerge from engaging in the dual role of a nurse–researcher is rare; Vechter, T., Drach, Z.A. and Goldblatt, H. (2022). DNP-prepared nurses are advocates and ethical leaders providing evidence-based care to all patients in the healthcare system. In this discussion post, I would like to explain two significant ethical issues relevant to DNP-prepared nurses: autonomy, privacy, and confidentiality, and inadequate Resources and Staffing.

 Issues of Autonomy, privacy, and confidentiality

Patients have the right to make decisions regarding their health and treatments. Patient autonomy is defined as the right of patients to make decisions about their care. Respect for confidentiality is important to safeguard the well-being of patients and ensure the confidence of society in the doctor-patient relationship. Autonomy is an ethical issue based on three essential points: informed consent, veracity, and confidentiality. Before doing any care or administering medications, as registered nurses, we must explain everything to the patients so the patient can get an idea about their health conditions and treatments. In some cases, the family members or any healthcare team members are pressured to do the care without the patient’s permission, which will violate the patient’s autonomy. Some patients do not always make decisions correctly, and some need clarification about making decisions and look to nurses for advice about their health and treatments, and care. As healthcare workers, we must respect the patient’s religion and beliefs.in some circumstances, the medical considerations or treatments contradict a patient’s religious beliefs. In this situation, an ethical dilemma will occur. The American Nurses Association’s position statement on reproductive health explains that healthcare workers, especially nurses, have the right to refuse to involve in a particular scenario on ethical grounds. But if any patient’s life is in danger or an emergency, the nurses commit to providing care for the patient’s safety to avoid abandonment. Health professionals have a limited attitude toward patient confidentiality but have relatively good knowledge. Providing a continuing medical ethics training package for health workers before joining the hospital and in between working time could enhance health professionals’ knowledge and attitude toward patient confidentiality, Tegegne M.D. et al. (2022). All Patients have the right to keep their records and personal information confidential and private. While doing a physical examination, treating a patient, or giving care, the patient shares all their health information with the health care providers and builds a professional therapeutic relationship between health care workers and patients. If the health care workers, especially nurses, and physicians, discuss the patient’s health conditions with others without the patient’s permission or share the patient’s health conditions outside the hospital setting with others, this will violate the privacy and confidentiality issue including Nurse- patient relationship and trust would be diminished. If any changes occur in the patient’s condition or delivering new care or new treatments, new procedures, or new medication changes, we must inform the responsible party preferred or allowed by the patient. Healthcare workers should not share information about patients with others unless the patient gives access or consent. A Nurse must confirm whether it is an appropriate person or the patient’s responsible party before discussing the patient’s information. If it violates, causing ethical dilemmas. The rules, laws, and regulations vary and are not the same in all states. If any healthcare worker, especially a Nurse, violates the patient’s privacy and confidentiality, they will face severe consequences, including termination from the job or license jeopardy. So, it is essential and critical for nurses to know the rules, policies, procedures, regulations laws of the particular state where they work.

Inadequate resources and staffing.

Inadequate resources and staffing are the most important ethical issue in clinical settings. Insufficient resources affect the whole organization, including all the healthcare workers; leading to delayed care also increases healthcare workers’ workload, and the main issue is it reduces workers’ productivity, and overall, it will affect the safety of the patients. In addition, it will affect the quality of patient care. For example, most geriatric patients need an advanced Hoyer lift to transfer the patients. In some places, they need more equipment, especially for patients above 300 pounds weight. So, it will critically put the patients and healthcare workers at risk. Sometimes, the healthcare workers do not know how to find the patient’s code status, clearly showing a lack of knowledge and orientation to that particular unit. All organizations and facilities must have adequate resources to care for the patients to prevent these situations. Frequently checking crash carts to ensure enough emergency medications and equipment are there or not, including expiry dates of emergency medications. For example, no surgical dressing kits or topical emergency stocked antibiotics are available for surgical patients. As a result of this, the invasion of bacteria occurs and leads to infection and major complications. Another ethical issue is inadequate staffing, which is critical in all healthcare facilities organizations nowadays. Inadequate staffing affects the safety of the patients, resulting in poor patient outcomes. Short staffing leads to job dissatisfaction and emotional distress in healthcare workers. Because of these issues, nurses cannot provide quality-based care to each patient. Emergency medication scarcity delays critical patient care, thereby Increasing mortality rates. This will cause an ethical dilemma. To avoid the consequences of short staffing, the nurses must prioritize care according to the patient’s needs.

How might these issues compare to the types of issues you have encountered in practice?

All healthcare workers, especially nurses, must make ethical decisions in their daily practice. In my practice, I have dealt with many patients with different decisions that contradict their physician’s recommendations. We all know that all patients have the right to decide about their health treatments and care. Sometimes, it may contradict or go against the medical advice because of the patient’s religion or beliefs; All healthcare providers must respect the patient’s beliefs and religion. For example, one of my patients seemed so confused about his upcoming surgical procedure, need to be done within two weeks, and the patient was worried and unable to make a decision. It’s an urgent procedure required and recommended by the physicians; however, the patient does not believe in that particular kind of surgical procedure, and it’s against their beliefs and religion. During my rounds, the patient frequently asked questions and finally tried to leave the decision to the Nurse. In this case, I educate the patient and encourage the patient to talk to the patient’s significant family members or any spiritual person or person or seek advice from the appropriate responsible party. And I conducted a conference meeting with physicians to discuss the alternative options and decisions before the deadline to perform the surgical procedure. Sometimes in most circumstances, some patients leave the decisions to the nurses or want advice from healthcare workers, and this causes ethical dilemmas. As I mentioned earlier, all patients have the right to refuse their care and the right to make decisions on their own. In case of emergencies or the patient’s life is in jeopardy, the healthcare providers must provide the appropriate care to save the life for the patient’s safety and to avoid abandonment. In another case in my unit, one of my patients was fully alert, awake, and oriented, understood everything about his health conditions, and refused the appropriate treatments and medicines. I informed the assigned physicians and discussed the situation. I educated the patients regarding the importance of treatments and medicines, including the consequences. The patient still denied and refused the care/treatments.so in this case, I would document everything in the system regarding the treatment refusal and the education given, the patient’s response, including the reason for declining the appropriate care / treatments /medicines. Sometimes the patient or the family members change their decisions later and may think to that particular treatment should have been provided, I believe the proper documentations will protect the healthcare workers including the Nurse to avoid any legal issues and also protect the health care workers licensure and the organizations. Another important ethical issue I mentioned earlier was inadequate resources and inadequate staffing. Short staffing is a critical issue in most healthcare facilities. I was working on a ventilator-lung transplant unit, and our hospital had a policy that the nurse-patient ratio was supposed to be five patients per Nurse, and one Nurse called in. A total of 24 patients were in the unit, and four nurses were there to provide care. This situation causes ethical dilemmas. This will cause risk to patients and the Nurse. As a result, we can see decreased productivity in healthcare workers. We all know that a staff shortage is a common problem in most healthcare facilities and organizations. However, in some circumstances, a staff shortage is unexpected and unavoidable. The managers and the directors should work proactively by implementing appropriate efforts to keep the nurse-patient ratio accurate according to the facility’s policies. In this case, the nurses must prioritize the care and assignments based on the patient’s conditions and needs. My recommendation to solve the ethical in some circumstances, a staff shortage is unexpected and unavoidable. The managers and the directors should work proactively by implementing appropriate efforts to keep the nurse-patient ratio accurate according to the facility’s policies. In this case, the nurses must prioritize the care and assignments based on the patient’s conditions and needs. My recommendation to solve the ethical issues in healthcare settings from affecting the nurse-patient relationship is to create a trustful environment because most healthcare workers are not taking any initiative to speak up or address the violation of practices to the management. Most nurses know how to deal with ethical issues through their long-term experiences and patient interactions. Studies consistently show that adverse job characteristics-high, workload, low staffing levels, long shifts, and low control are associated with burnout in nursing. The potential consequences for staff and patients are severe. (Dall’ Ora, C. et al. (2020).

References

• Tegegne, M.D. et al. (2022) ‘Health professionals’ knowledge and attitude towards patient confidentiality and associated factors in a resource-limited setting: a cross-sectional study,’ BMC Medical Ethics, 23(1), pp. 1–10. doi:10.1186/s12910-022-00765-0
• Dall’Ora, C. et al. (2020) ‘Burnout in nursing: a theoretical review,’ Human resources for health, 18(1), p. 41. doi:10.1186/s12960-020-00469-9.
• Vechter, T., Drach,Z.A and Goldblatt, H. (2022)” Emergency ethical dilemmas while judging nursing and research roles’, Journal of Nursing Management, 30(7), pp.2278-2290. Doi: 10.111/jonm.13735
• Pavlish, C.L. et al. (2020) ‘ A Team-Based Early Action Protocol to Address Ethical Concerns in the intensive care unit,’ American Journal of Critical Care, 29(1), pp. 49-58. Doi: 10.4037/ajcc2020915

Sample Answer 2 for NURS 8002 Week 10: ETHICS AND THE DNP-PREPARED NURSE

Doctorate-prepared nurses (DNPs) may encounter challenging ethical decisions where they must make perplexing choices between two or more options; their recognition of an effective solution to these issues is critical (Vermeesch et al., 2018). Ethics are vital in the nursing profession as they improve health care outcomes. DNPs are responsible for providing patients and families with comprehensive information about treatment and possible effects. If DNPs do not address these ethical issues appropriately, these may lead to a decline in patient care, tense clinical relationships, and moral distress. This post aims to discuss the two ethical issues relevant to the DNP-prepared and how these issues are in comparison to what I encountered in practice.

Two Ethical Issues Relevant to the DNP-Prepared Nurse

The first ethical issue is dealing with end-of-life care planning. Advanced care planning is often a challenging conversation between patients and healthcare providers, especially when patients must plan for their future health care if they pass away or are left too ill to make their own decisions. Whether patients can no longer speak for themselves or their family members or have difficulty describing what their loved ones prefer, advanced practice nurses may experience a break of communication during the decision process. End-of-life decisions are always hard to discuss, but healthcare providers must ensure these preferences are laid out and honored in medical emergencies. Therefore, it is vital to develop an understanding of legal and ethical issues that underpin DNPs’ ability to function at the highest professional level, to prevent complications and litigations by knowing patients’ rights, responsibilities, and concerns of the patients (Podgorica et al., 2021).

The second ethical issue is in connection with addressing patients with compromised autonomy. For instance, language and cultural barriers can hinder communication between patients and clinicians, exacerbating health inequity. Rejno et al. (2020) explained that cultural values can also impact perception and expressions of dignity, which must be considered. DNPs must have a moral obligation and strive to address these potential issues to ascertain how patients prefer to receive information and make decisions about their care. Healthcare providers must implement accessible resources such as professional medical interpreters and other institutional services by upholding patients’ and families’ unique cultural or social dynamics.

How Are These Issues in Comparison to What I Have Encountered in Practice

 Advanced Care Planning: Ms. A was our 84-year-old female patient with oxygen-dependent emphysema from 60 years of smoking. She developed pneumonia and is slow to improve on the ventilator in the ICU. Also, she developed kidney failure, and the health care providers in my institution think she will unlikely survive the hospitalization. The pulmonologist discussed with Ms. A that she is in the last phase of her life and that decisions about her medical care will be needed. Ms. A explained that she would not want to be ventilator dependent for an extended period, so her daughters were poised to disagree when the decision was required regarding the ventilator. Still, we explained that Ms. A’s preference to avoid long-term ventilator use is noted in her advance directive and will be followed.

Patient with compromised autonomy: Mrs. Z was our 70-year-old Pakistani widow who lives with her children and with limited English proficiency. She was diagnosed with an aggressive B-cell lymphoma, and her son told us the healthcare providers not to tell her the diagnosis as she may be unable to cope emotionally with her diagnosis nor physically tolerate the chemotherapy. However, we knew that age was a factor for this patient in predicting patient response to treatment, and oncologists must develop an individualized treatment plan which includes a discussion of the risks and benefits of the treatment. Also, we determined that Mrs. Z’s decision-making ability was intact, which means that her son’s role as a decision-maker only comes into play if she cannot make a specific medical decision. We informed the son that with assistance from an interpreter, we could compassionately and thoroughly explain to her the lymphoma diagnosis, along with the benefits and risks of treatment options.

References

Podgorica, N., Flatscher-Thöni, M., Deufert, D., Siebert, U., & Ganner, M. (2021). A systematic review of ethical and legal issues in elder care. Nursing Ethics, 28(6), 895–910. https://doi.org/10.1177/0969733020921488Links to an external site.

Rejno, A., Ternestedt, B. M., Nordenfelt, L., Silfverberg, G., & Godskesen, T. E. (2020). Dignity at stake: Caring for persons with impaired autonomy. Nursing Ethics, 27(1), 104–115. https://doi.org/:10.1177/0969733019845128Links to an external site.

Vermeesch, A., Cox, P. H., Baca, S., & Simmons, D. (2018). Strategies for strengthening ethics education in a DNP program. Nursing Education Perspectives, 39(5), 309–311. https://doi.org/10.1097/01.NEP.0000000000000383

Sample Answer 3 for NURS 8002 Week 10: ETHICS AND THE DNP-PREPARED NURSE

Ethical values are universal rules of conduct that provide a practical basis for identifying what kinds of actions, intentions, and motives are valued. It is the moral principles that govern how the person or a group will behave or conduct themselves. The focus pertains to the right and wrong of actions and encompasses the decision-making process of determining the ultimate consequences of those actions (Haddad & Geiger 2021). Individuals have a set of personal ethics and morals.  Ethics within healthcare are important because it enables providers to recognize healthcare dilemmas, make good judgments and decisions based on their values while keeping within the laws that govern them. For a provider to practice competently with integrity, they must have regulation and guidance within the profession.

Significant ethical issues relevant to DNP

The practice of nursing is based on a set of ethical guidelines. These guidelines assist nurses to work through difficult situations and provide them with a moral compass to do their jobs fairly and promote high levels of care and attention to the patients. To achieve high quality and efficient care requires the observance of principles of professional ethics and organizational commitment. The code of ethics is essential as it reiterates the fundamental values and code of conduct, identifies the boundaries of duty and loyalty, and indicates the nurses’ role that goes beyond patient encounters (Pavlish et al., 2020). Some significant issues include honesty, confidentiality, dignity, financial constraints, negligence, and physician-assisted suicide.

Honesty and confidentiality

Honesty and confidentiality are significant ethical issues affecting DNP nurses in their area of practice. It is important for the nurse to understand all privacy guidelines in regard to patient care and patient identifiers. Violating patient confidentiality can have legal and ethical repulsions for the nurses. The health care act requires healthcare workers to protect and safeguard patients’ privacy (Rejnö et al., 2020). In my workplace through HIPPA, providers have an obligation of confidentiality prohibiting the health care provider from disclosing information about the patient’s case to others without permission and encourages the providers and health care systems to take precautions to ensure that only authorized access occurs. Despite the restriction, there are exceptional cases where the nurses need to make a critical decision. For instance, withholding a patient’s health condition may be unethical because it may cause harm to other patients or the provider in question, the reverse can also be harmful to the patient. In this instance, the provider can breach patient confidentiality to protect a patient’s or anyone else safety. For instance, a provider can disclose information from a patient’s medical record without consent if the doctor reasonably believes the patient may cause imminent and serious harm to themselves, an identifiable individual, or a group of persons.

Healthcare needs and resources allocation

Resource allocation is an ethical issue because it fundamentally involves the question of justice. The goal of resource allocation is to make fair decisions. Balancing between Healthcare needs and resources allocation is another ethical issue facing healthcare providers. The primary ethical obligation of a healthcare provider is to promote the well-being of their patients however policies for allocating scarce health care resources can impede their ability to fulfill that obligation. The escalating healthcare costs and increasing demand for healthcare services are gradually putting providers at odds with budgeting constrain and patients’ needs (Vermeesch et al., 2018). Most medical facilities have inadequate resources which deny the patients the care they need (Torkaman et al., 2020). Considering that very few people have health insurance coverage, those without the coverage have difficulties accessing medical services. For example, some hospitals charge their patients hefty amounts of cash for an emergency medical service that doesn’t require complex treatment. In my practice, one of the major areas of concern I have encountered while providing patient care is that uninsured patients are being denied basic health care screening such as annual Pap smear annual flu vaccine due to their inability to pay. I have encountered instances that after completing an annual well-woman exam (Pap smear), just because the patient was uninsured and unable to provide out-of-pocket co-payment for something as simple as basic screening, I was instructed by the medical director to discard the test sample.

As professionals dedicated to protecting the interests of our patients, we have a responsibility to contribute our expertise to developing allocation policies that are fair and safeguard the welfare of patients. Nurses should advocate for policies and procedures that allocate scarce health care resources fairly among patients.

References

Haddad LM, Geiger RA. Nursing Ethical Considerations. [Updated 2021 Aug 30]. In: StatPearls

[Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526054/

Pavlish, C. L., Henriksen, J., Brown-Saltzman, K., Robinson, E. M., Warda, U. S., Farra, C.,

Chen, B., … Jakel, P. (2020). A Team-Based Early Action Protocol to Address Ethical Concerns in the Intensive Care Unit. American Journal of Critical Care, 29, 1, 49-60.

Sample Answer 4 for NURS 8002 Week 10: ETHICS AND THE DNP-PREPARED NURSE

Going through this week’s readings, I encountered some ethical cases and scenarios that caught my attention from the learning resources. In these readings, I have discovered that ethical conflicts can complicate the clinical practice and can result in bleach of communication and collaboration among patients, their families, the providers, and the clinicians which will result in disruptions, distress, and dissatisfaction with care that is being delivered.

As a result of the concerns, I have learnt that ethical conflicts can cause trust issues among stakeholders which can lead to compromised quality adherence and safety aspects of care. In the learning resource by Pavlish et al., (2020), I have learnt that the effectiveness of a team-based and proactive ethics protocols in routine management of care is by identifying the ethics-related concerns first, then additional supports, and goals of care to be able to improve the patient outcomes as well as quality and safety of care. I learnt from this article that ethics consultations resulted in an increased outcome of care, enhanced quality, and safeguarded safety aspects of care. I totally agree and understand that with this resource, encouraging healthcare teamwork and collaboration increased ethical consultations and routine communication on the goals of care resulting to improved ethical practice in addressing diverse patient needs and engagement with families and community members.

Another learning resource by Phelan (2020), I came up with the fundamental differences between traditional health care ethics and organizational ethics to be the scope. In traditional ethics, the focus was mainly on the individuals while organizational ethics today has attention on collectives. This means contextualizing the overlapping role of different professionals in healthcare could complicate delivery of care and decision-making practices. Being transparent and having some level of trust among professionals involved in care delivery could promote the level of ethical practice in an organization.

In the learning resources, I also learn from these two learning resources by Rejnö et al. (2020) and Torkaman et al. (2020) that the concept of dignity forms an important ethical consideration targeting the dignity of identity and human dignity. Fortunately, caring situations face scenarios that could require decision making on autonomy by patients with cognitive impairment and evaluating approaches that could impair the autonomy or disrespect of patient’s dignity. When it comes to patients with impaired autonomy, I established that ethical challenges or dilemmas are prevalent in the scenarios since the patient in question has impaired autonomy. I can use the human dignity aspect of ethics to lead me in developing patient-centered care and skills that will be effective when taking care of impaired patients.

In my experience as a registered nurse, I am aware of the ethical issues identified in these learning resources. I have some instances that I remembered that happened when I work with other professionals to derive an ethical decision from a dilemma situation. In some of those cases, I remember that one of my colleagues and I had to escalate an ethical dilemma to the Hospital Ethics Board to enhance decision making in life-threatening situations that a patient refuses treatment or the patient proxy in health-related decisions was not able to be reached. Such situations could be addressed effectively via an interdisciplinary collaborative team approach. I have also noted the value and significant of the ethical principles of patient autonomy, beneficence (do good), non-maleficence (do not harm), and social justice as fundamental principles for application of ethics-related decisions (Vermeesch et al., 2018). In my experience as a registered nurse, I have identified other areas of ethical concerns to include balancing the needs of the facility for profits and commitment to promote high standards of safety and quality of care. Another area of ethical dilemma I have identified is patient’s refusal of medications or treatment involving a life-threatening disease and conditions that have a proven intervention for treatment or management (Torkaman et al., 2020). In such decisions, I think that the stakeholders, family and other clinicians could provide an effective ground for addressing these ethical concerns.

References

Pavlish, C. L., Henriksen, J., Brown-Saltzman, K., Robinson, E. M., Warda, U. S., Farra, C., & Jakel, P. (2020). A team-based early action protocol to address ethical concerns in the intensive care unit. American Journal of Critical Care, 29(1), 49-61.

Phelan, P. S. (2020). Organizational Ethics for US Health Care Today. AMA Journal of Ethics, 22 (3), 183-186.

Rejnö, Å., Ternestedt, B. M., Nordenfelt, L., Silfverberg, G., & Godskesen, T. E. (2020). Dignity at stake: Caring for persons with impaired autonomy. Nursing ethics, 27(1), 104-115.

Torkaman, M., Heydari, N., & Torabizadeh, C. (2020). Nurses’ perspectives regarding the relationship between professional ethics and organizational commitment in healthcare organizations. Journal of Medical Ethics and History of Medicine, 13.

Vermeesch, A., Cox, P. H., Baca, S., & Simmons, D. (2018). Strategies for strengthening ethics education in a DNP program. Nursing education perspectives, 39(5), 309-311.