Advocacy Paper

Advocacy Paper
Choose a patient-care situation in which the RN should intervene and advocate for the patient. An example of such a situation might be when a patient has not been given complete informed consent.
Include the following in your paper:
Describe the clinical situation concisely and descriptively. It can be an actual situation or a hypothetical one.
Apply the Bioethical Decision Making Model ( attached) to the specific clinical ethical situation that you choose. Address each section of the model in your paper.
Conclude with a discussion of nursing advocacy in the clinical setting and the nurse’s role as a patient advocate.
Your paper should be 4-5 pages.
You must reference and cite 1-2 scholarly sources other than your text. Include a title page and a reference page to cite your text and adhere to APA formatting.
Review the rubric for further information on how your assignment will be graded.
Rubric
NURS_521_DE – Advocacy Paper Rubric
NURS_521_DE – Advocacy Paper Rubric
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Content
50 to >43.5 pts
Meets Expectations
Content is clear, thorough, and organized effectively. Main points are well supported. Meets all of the criteria of the written assignment.
43.5 to >37.5 pts
Approaches Expectations
Content is somewhat clear, thorough, and organized effectively. Some points are well supported. Meets most of the criteria of the written assignment.
37.5 to >29.5 pts
Below Expectations
Content is generally unclear, not thorough, and organized ineffectively. Main points are not well supported. Meets only a few of the criteria of the written assignment.
29.5 to >0 pts
Does Not Meet Expectations
Content is disconnected, unorganized, and does not meet the criteria of the written assignment.
50 pts
This criterion is linked to a Learning Outcome Clarity and Coherence
50 to >43.5 pts
Meets Expectations
Writing flows smoothly from one idea to another. Writer has taken pains to assist the reader in following the logic of the ideas expressed.
43.5 to >37.5 pts
Approaches Expectations
Sentences are mostly structured to clearly communicate ideas. Transitions between paragraphs make the writer’s points easy to follow.
37.5 to >29.5 pts
Below Expectations
Sentence structure and word choice sometimes interfere with clarity of content and distract the reader.
29.5 to >0 pts
Does Not Meet Expectations
Poor sentence structure, sentences do not make sense; no clarity evident in the paper.
50 pts
This criterion is linked to a Learning Outcome References and Citations Within the Body of the Paper
12.5 to >10.88 pts
Meets Expectations
The required number of scholarly references is used and cited skillfully throughout the paper.
10.88 to >9.38 pts
Approaches Expectations
The required number of scholarly references is used but some may not be cited accurately or skillfully throughout the paper.
9.38 to >7.38 pts
Below Expectations
The required number of scholarly references is not used and most are not cited accurately or skillfully throughout the paper.
7.38 to >0 pts
Does Not Meet Expectations
References or citations are not included in the body of the paper and writing indicates none were used.
12.5 pts
This criterion is linked to a Learning Outcome Mechanics and APA
12.5 to >10.88 pts
Meets Expectations
The assignment consistently follows current APA format and is free from errors in formatting, citation, and references. No grammatical, spelling, or punctuation errors. All sources are cited and referenced correctly.
10.88 to >9.38 pts
Approaches Expectations
The assignment consistently follows current APA format with only isolated and inconsistent mistakes and/or has a few grammatical, spelling, or punctuation errors. Most sources are cited and referenced correctly.
9.38 to >7.38 pts
Below Expectations
The assignment generally follows current APA format with several mistakes and grammatical, spelling, or punctuation errors. Most sources are cited and referenced incorrectly.
7.38 to >0 pts
Does Not Meet Expectations
The assignment does not follow current APA format and/or has many grammatical, spelling, or punctuation errors. Sources are missing.
12.5 pts
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Solution
Describe the clinical situation concisely and descriptively. It can be an actual situation or a hypothetical one.
A Clinical situation in which a registered nurse should intervene and advocate for a patient is a situation in which a patient has not received clear instructions for self-care. For example, in a healthcare facility, a physician can focus on only the diagnosis and administration of medication to a diabetes patient, which might mainly include insulin therapy. As a result of having a heavy workload, a physician can sometimes forget to recommend important self-care strategies that can be adopted to effectively manage their condition. In an instance where a patient receives unclear self-care instructions, the registered nurses can therefore act as an advocate for a patient by either alerting the physician or the medical facility to effectively resolve the issue and ensure that a diabetes patient has received adequate self-care instructions that can effectively support the pharmacological treatments that they receive.
Apply the Bioethical Decision Making Model to the specific clinical ethical situation that you choose. Address each section of the model in your paper.
Utilizing the bioethical decision-making model, the first step is defining the dilemma (Forte et al., 2018). In the case study where a diabetes patient does not receive instructions related to their self-care activities, the ethical dilemma will be related to the principle of beneficence and nonmaleficence. By deciding not to provide a diabetes patient with clear self-care instructions, a physician can therefore be placing the health of a patient at significant risk or even place the patient at risk of not fully managing their diabetes condition. By not providing clear self-care instructions, a physician can be directly acting against the interest of the patient, which is against the principle of beneficence. By not providing clear self-care instructions, a physician can also be said not to be following the ethical principle of nonmaleficence which calls on all healthcare practitioners to be actively involved in preventing direct harm to their patients (Forte et al., 2018).
The medical facts that are relevant to an ethical dilemma in which a physician does not provide clear self-care instructions to a diabetes patient include the patient struggling to have proper glycemic control as a result of poor diet and lack of physical activity and even being obese in many instances. As a result of high blood sugar, which is one of the major symptoms of diabetes, it is therefore vital for patients to control their blood sugar through a combination of a healthy diet including fruits and vegetables, physical activity, and insulin therapy. By not providing self-care instructions such as regular physical activity and a healthy diet made up of fruits and vegetables, a physician will therefore be creating ethical issues related to the principle of beneficence and nonmaleficence.
The non-medical facts related to a patient with diabetes who does not receive adequate self-care instructions relate to their culture, religion, social and economic status. For a diabetes patient who comes from a culture that values foods that may contribute to a rise in blood sugar, such as high sugar and oil diet, the lack of self-care instructions can contribute to the worsening of their condition. Diabetes patients from low socioeconomic classes and statuses can also struggle to take the right diet to maintain their blood sugar.
The situation in which a physician does not provide adequate health care instructions to a diabetes patient relates to the second provision of the nurses’ code of ethics, which highlights the primacy of patient interests and also states that the primary commitment of nurses should be to the patient whether they are groups, families, individuals, populations, or communities (Porter, 2013). In a case scenario in which a physician does not provide adequate self-care instructions to a diabetes patient, it is the duty of the registered nurse to be committed to the patient and to ensure the patient receives adequate health care.
Considering the ethical dilemma in which a physician does not provide sufficient health care instructions for diabetes patients, the facts of the case include that definition does not follow the ethical principles of beneficence and nonmaleficence. Self-care instructions, which include requesting a diabetes patient to be involved in physical activities such as walking and taking a healthy diet made up of vegetables and fruits, are also central to the recovery of a patient.
In the ethical dilemma in which a physician does not provide sufficient self-care instructions to a diabetes patient, the items that need clarification to include that the diabetes patient requires to be involved in self-care activities such as taking a healthy diet and physical activities in combination with insulin therapy in order to effectively control their blood sugar.
The decision-makers in the ethical dilemma include the patient who is 65 years old and who is competent in making their own choices. For adult patients who are of the right frame of mind to make their own decisions, healthcare practitioners, including physicians and registered nurses, need to provide adequate advice related to self-care instructions and then allow such patients to make a decision on whether to follow the instructions or not.
In the case study where a diabetes patient does not receive instructions related to their self-care activities, the ethical dilemma will be related to the principle of beneficence and nonmaleficence. By deciding not to provide a diabetes patient with clear self-care instructions, a physician can therefore be placing the health of a patient at significant risk or even place the patient at risk of not fully managing their diabetes condition. By not providing clear self-care instructions, a physician can therefore be directly acting against the interest of the patient, which is against the principle of beneficence. By not providing yourself care instructions, a physician can also be said not to be following the ethical principle of nonmaleficence which calls on all healthcare practitioners to be actively involved in preventing direct harm to their patients(Forte et al., 2018).
In the case where a diabetes patient receives unclear self-care instructions from a physician, there are several steps that a registered nurse can take, including escalating the issue to the unit manager or reminding the physician to provide self-care instructions for the diabetes patient. The main shortcomings of reporting the physician to the unit manager would be undermining teamwork and collaboration in a given health care department. On the other hand, by opting to request the physician to provide more self-care instructions for diabetes patients in a diplomatic way, a nurse can enhance collaboration and teamwork in a healthcare facility while also advocating for the rights of the patient (Nsiah et al., 2019).
The process that can be utilized for the ethical dilemma related to a diabetes patient who does not receive adequate self-care instructions from a physician includes using diplomacy to remind the physician to provide the necessary instructions to the patient.
Conclude with a discussion of nursing advocacy in the clinical setting and the nurse’s role as a patient advocate.
Nursing advocacy is important in the clinical setting in that it can help different members of the health care team to uphold the right standards of care. Nursing advocacy can also help to improve the outcomes of patients. Nurses are important patient advocates (Nsiah et al., 2019).
References
Forte, D. N., Kawai, F., & Cohen, C. (2018). A bioethical framework to guide the decision-making process in the care of seriously ill patients. BMC Medical Ethics, 19(1). https://doi.org/10.1186/s12910-018-0317-y
Nsiah, C., Siakwa, M., & Ninnoni, J. P. K. (2019). Registered Nurses’ description of patient advocacy in the clinical setting. Nursing Open, 6(3), 1124–1132. https://doi.org/10.1002/nop2.307
Porter, R. B. (2013). The American Nurses Association Code of Ethics. Journal of the Dermatology Nurses’ Association, 5(1), 31–34. https://doi.org/10.1097/jdn.0b013e31827d9eaa