Contemporary Ethical Issues in Nursing

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The nurse caring for a patient states, "Your blood pressure is dangerously high. Are you taking antihypertensive medicine?" The patient states, "I can't afford my medicine. I have no insurance." The nurse states "I feel really sorry for that patient. I wish it wasn't against policy to give her money." The nurse wants to help and places a note on Facebook that any donations would be appreciated to help a waitress who works at the cafeteria next door to the hospital buy her medications. The nurse posts that "She was so sick last evening when she came to the ED. I can't believe they don't provide insurance. I can't give her money but you all can help." This nurse:

  • A. is showing empathy and as long as she lets the patient know the money is not from her, she is not violating any social media guidelines.
  • B. is at risk for HIPAA violations.
  • C. has properly followed policy and protected the patient by not using her name.
  • D. is demonstrating the logical fallacy of slippery slope.
Correct Answer: B

Rationale: The correct answer is B because the nurse is at risk for HIPAA violations by sharing patient information on social media. The Health Insurance Portability and Accountability Act (HIPAA) protects patients' privacy and prohibits healthcare providers from disclosing their health information without consent. In this scenario, the nurse shared specific details about the patient's health condition, visit to the ED, and financial situation, which could easily identify the patient. This violates the patient's right to privacy and confidentiality. Choices A, C, and D are incorrect because the focus should be on the HIPAA violation rather than empathy, policy following, or logical fallacies. The nurse should have found alternative ways to help the patient without compromising their privacy.

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The novice nurse arrives on the nursing unit, is introduced to the staff, is assigned a preceptor, and is asked to participate in the next staff meeting. This introduction into nursing is appropriately termed:

  • A. biculturalism.
  • B. socialization.
  • C. transition.
  • D. "going native."
Correct Answer: B

Rationale: The correct answer is B: socialization. Socialization is the process by which individuals learn and adapt to the values, norms, and behaviors of a particular group, in this case, the nursing profession. In this scenario, the novice nurse is being introduced to the staff, assigned a preceptor, and asked to participate in a staff meeting, all of which are key components of the socialization process in nursing.

A: Biculturalism refers to the coexistence of two distinct cultures within one society, which is not applicable in this context.
C: Transition is the process of changing from one state to another, which is a broader concept than just the introduction to a new profession.
D: "Going native" is a colloquial term that refers to adopting the lifestyle or customs of a foreign culture, which is not relevant to the scenario of a novice nurse being introduced to the nursing profession.

Many nursing professionals have portfolios that include:

  • A. family pictures.
  • B. letters of commendation.
  • C. articles that describe lack of quality in health care.
  • D. high school achievements.
Correct Answer: B

Rationale: The correct answer is B: letters of commendation. Nursing professionals typically include letters of commendation in their portfolios to showcase their achievements, skills, and positive feedback from colleagues or supervisors. This demonstrates their competence and professionalism. Family pictures (A) and high school achievements (D) are not relevant to a nursing portfolio. Articles describing lack of quality in healthcare (C) could reflect negatively on the professional and are not typically included in a portfolio meant to highlight accomplishments.

A hospital's policy requires that all nurse managers must have a minimum of a bachelor's degree in nursing. A BSN nurse new to the hospital has recently been hired as nurse manager for the oncology unit. An RN who has worked on this unit for many years is unable to be promoted to a nurse manager position because of his educational status and has been commenting to physicians and staff, "The new nurse manager has book sense but no leadership abilities." What is the best approach that can be used by the new nurse manager who is attempting to gain the trust and respect of the nursing staff on the unit?

  • A. Send memos to all staff except the upset nurse to invite them to a luncheon.
  • B. Ask management to transfer the upset nurse to another unit.
  • C. Assign the upset nurse to committees that do not directly affect that nursing unit.
  • D. Acknowledge the clinical expertise of the upset nurse and clearly explain the expectations for teamwork and open, honest communication.
Correct Answer: D

Rationale: Step 1: Acknowledge the clinical expertise of the upset nurse - This shows respect for the upset nurse's experience and expertise.
Step 2: Clearly explain the expectations for teamwork - Setting clear expectations fosters a collaborative environment.
Step 3: Emphasize open, honest communication - Encouraging open dialogue helps address concerns and build trust among the team.
Overall, option D is the best approach as it combines acknowledging the upset nurse's expertise, setting expectations for teamwork, and promoting open communication, which are crucial for gaining trust and respect among the nursing staff.

Summary of other choices:
A: Sending memos excludes the upset nurse and may create further resentment.
B: Transferring the upset nurse does not address the issue and may lead to more conflict.
C: Assigning the upset nurse to unrelated committees may isolate them and not address the underlying problem of lack of trust and respect on the unit.

A nurse preparing a resume for the first position is anxious to demonstrate all achievements, which included completing a rigorous accelerated program and maintaining a high GPA while also serving in many community projects and leadership positions. The applicant finds it impossible to include all the accolades on one page and researches tips for professional cover letters and resumes and learns:

  • A. margins should be at least 0.5 inch on all four sides, making conciseness important.
  • B. paper should be bright colored to catch the attention of the recruiter.
  • C. legal size paper may be used when applicants have many accolades or extensive work history.
  • D. standardized cover letters present a professional image as opposed to those that stress the applicant's perspective too heavily.
Correct Answer: A

Rationale: The correct answer is A because having margins of at least 0.5 inch on all four sides allows for a clear and organized presentation of information. By adhering to this guideline, the resume will appear neat and professional, making it easier for the recruiter to read and comprehend the content. This promotes conciseness by forcing the applicant to prioritize the most relevant achievements and information.

The other choices are incorrect because using bright colored paper (B) may come across as unprofessional and distracting. Legal size paper (C) is not recommended as it deviates from the standard letter size and can make it difficult for the recruiter to handle and file the resume. Standardized cover letters (D) may appear generic and fail to highlight the unique qualifications and achievements of the applicant.

An experienced nurse volunteers to serve on a task force intended to improve the quality of care because she possesses excellent patient care skills and has selected a career goal of working in quality management. However, the nurse is unable to concentrate on any one task or issue and is unable to view the health care milieu sensibly. Which source of energy is missing in this nurse?

  • A. Physical
  • B. Mental
  • C. Spiritual
  • D. Emotional
Correct Answer: B

Rationale: The correct answer is B: Mental. The nurse's inability to concentrate and view the healthcare milieu sensibly indicates a lack of mental energy. Mental energy is crucial for focus, problem-solving, decision-making, and critical thinking skills necessary for quality management. Physical energy (A) is related to physical stamina, spiritual energy (C) to inner peace and purpose, and emotional energy (D) to emotional resilience. However, in this case, the nurse's issue is primarily cognitive, highlighting the absence of mental energy.

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