Nursing Ethics and Leadership

This assignment delves into the crucial intersection of ethics and leadership within the nursing profession. It examines ethical decision-making processes, the impact of nurse managers' leadership styles on staff nurses' work engagement, and the importance of ethical conduct in shaping professional behavior. The analysis draws upon nursing theories and real-world examples to illustrate these concepts.

Running head: PROFESSIONAL ROLES AND VALUES IN NURSING
PROFESSIONAL ROLES AND VALUES IN NURSING
Name of the Student
Name of the university
Author’s note

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A. Among the various nursing theories that can be followed by the nurses to provide a
comprehensive care to the patient, is the Ida Jean Orlando's nursing process Discipline theory.
1. Orlando's theory of nursing theory was based on few assumptions and the current nursing
practice can be easily influenced by that assumption. According to the assumptions of Orlando,
as patients are unable to cope up with their needs they become distressed, it is the duty of a nurse
to support the patient both spiritually and physically (Alligood, 2014). Orlando says that patients
are often secretive about their needs and perceptions, a nurse's intuition should act in place for
understanding the needs of the patient. The nursing metaparadigm mainly consists of four
concepts, the person, health, environment and nursing. Current nurses should be able to maintain
the dynamic nurse patient relationship. According to Orlando nursing action should be patient-
specific (Alligood, 2014).
2. Orlando's nursing principle mainly focuses on concepts-
Function of professional nursing- As a nurse I should be able to find out the grievances of the
patient by assessing the verbal and the non verbal signs and provide the desired care.
Presenting behavior- As a nurse I should be able to assess the presenting behavior of the patient
which would cause an automated response in me to provide care (Alligood, 2014).
Immediate reaction- A nurse should initiate the care as per the requirement and should practice
evidence based care.

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Nursing process discipline- investigation- As a nurse I should be able to communicate with the
patient in order to evaluate whether the type of care provided had been successful or not.
B. The two historical nursing figures of 19th century are Florence Nightingale and Margaret
Sanger.
Contribution of Florence Nightingale - Florence Nightingale was considered as the founder of
modern nursing. She is the stalwart in introducing the new professional training standards for the
nurses. She is cherised for her nursing contribution during the Crimean war (1853-56). She is
regarded as the pioneer towards implementation of modernized hospital care, which extremely
relevant in today’s healthcare domaisn and continue to provide care to quality everyone
(Alligood, 2014).
Contribution of Margaret Sanger in nursing- Margaret Sanger has dedicated her entire life
towards taking effective measures in birth control. She has also provided a strong voice towards
reproductive choices to millions of women (Sanger, 2012).
1. Difference in contributions of Florence Nightingale and Margaret Sanger
Florence Nightingale on the other hand saved millions of lives in the Crimean War and set
the standards of nursing. Her contribution is based on the fact, that nurses should extend their
steps beyond their zones of comfort to give a comprehensive care to the patients (Rich, 2013).
Although Margaret Sanger was a nurse but she is famous for her contribution of
providing reproductive freedom to millions of women all over the world. She favored reduction

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of reproduction rates in individuals considered for unfit. She also favored the sterilization of
profoundly mental patients, or those with hereditary diseases.
2. A role of a nurse is to help out the patients in addressing their physical, cognitive, emotional,
and social and the spiritual needs. In the Crimean war Nightingale took a notice of the
dirtiness and the deterioration of the military hospitals. I have learnt the basics of sanitary
improvements and establishing the standards of safe and clean hospitals. From her theories I
have learnt that nursing is not a mere profession but also entitles education and
responsibilities.
The theories of Margaret Sanger had provided an insight of the sufferings of numerous
women with unwanted pregnancies or complications related to pregnancy.
C. 1. Nursing State Board- The Nursing state board is the state specific regulatory and the
licensing organization that is responsible for setting the safe nursing standards. The board of
nursing determines the scope of legal nursing practice in the state.
America’s nursing association- The American Nursing association (ANA) represents the
nation's population of the registered nurses. ANA provides support for advancement in the
nursing population via promoting an ethical and safe work place environment, reinforcing the
health and the well being of the nurses as well as solving the nursing issues that affect quality
care (American Nurses Association, 2018).
2. The norms and the regulations set up by these two organizations have helped me to stick to the
nursing standards of practice and avoid any adverse situation. It has also served as a legal
guard against any litigation or fowl play against the patients or the nurses ("U.S. Nursing
Licensure for Internationally Educated Nurses | NCSBN", 2018).

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3. Professional license renewal in United States, Texas- In order to renew the license of a nurse
many states in U.S have a certain number of contact hours for the renewal of the license.
Many requires education requirement regarding a particular clinical topic ("U.S. Nursing
Licensure for Internationally Educated Nurses | NCSBN", 2018). In order to renew the
license all that is required is the license number and the last 4 digits of the social security
number. Effective criminal background checkup is required for the applicants for
licensure in Texas. It is to be checked whether the nurse has defaulted on a Texas
guaranteed student loan or not. Licenses may take up two weeks for processing if
submitted online. In order to avoid the additional charges, applications should be post
marked before the last day of the month the license expires.
a. Consequences of failure to maintain license requirements in Texas-
A license becomes lapse if the nurse does not renew the license and 30 days have elapsed
since the expiration of the date. A nurse will not be able to provide nursing practice to the patents
without an active license. The nurse having a lapsed license is also subjected to pay a penalty of
a certain amount ("U.S. Nursing Licensure for Internationally Educated Nurses | NCSBN",
2018). It is important for the licensees to update their name and addresses with all the BONs
such they get a licensure renewal notice. This license enables a nurse to practice across lines in
the member states with only one multistate license. A compact or multistate license can be
obtained by a registered nurse if they legally reside in an enhanced Nurse Licensure compact
state or have graduated from an international education program or have passed an NCLEX-PN
examination. A person whose license has been expired for 90 days or less may renew
the license by paying to the Board the required renewal fee and a late fee.

5PROFESSIONAL ROLES AND VALUES IN NURSING
The nursing licensure compact enables a nurse (RN or licensed practical) to acquire a
multistate license. It permits practice license in both home and other compact states. If a nurse
wishes to work in a non compact state then he or she has to apply for the licensure in the state in
which one wishes to work ("U.S. Nursing Licensure for Internationally Educated Nurses |
NCSBN", 2018).
D. Food and drug administration- FDA is an agency of the U.S federal government which is
being authorized by the congress for inspecting, testing, approving and setting safety
standards for drugs, food additives, chemicals, cosmetics, household and medical devices ("U
S Food and Drug Administration Home Page", 2018).
Center for Medicare and Medicaid Services- The (CMS) is a section of the department of health
and human services of U.S government. the agency covers a number of federal health
care programs like use of the electronic health records, incentive program, federal health
insurance programs for the elderly (Medicare) and federal needs based programs for
helping out with the medical costs (Medicaid).It is also responsible for setting up the
Children health insurance program ("Home - Centers for Medicare & Medicaid
Services", 2018).
1. As a nurse I should be sure that all the medications and the food items provided to the patient
pass the FDA approval. The Medicare and the Medicaid services enable a nurse to provide
health information to the patient regarding the insurance schemes that they are entitled to get,
the way to use the electronic health records. It also provides opportunities to elderly to get
hospice support, home based care and support in medication costs.

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a. The usefulness of alternative therapy is controversial, yet some alternative therapies have
been found to show considerable effects. A nurse should first asses the presence of any
alternative therapies present and should check whether the complementary medicines
interfere with the ongoing medicines. It is necessary to consult with the doctor before the
application of any complementary therapies.
E. The Nurse practice Act set up rules and regulation for the nurses and enforce law to save the
patient from harm as well as lay norms for the specific levels of the educational and the
licensure requirement of the nurses. The profession of nursing poses several risks to the
public, if practiced by inefficient or incompetent professionals. The rules of NPA enable
a nurse to abide by all the safety parameters within the work as well as protect the patient
form unsafe and unprofessional nursing practice ("U.S. Nursing Licensure for
Internationally Educated Nurses | NCSBN", 2018).
1. Scope of practice for a RN in United States- Registered nurses in United States are health care
professionals who are licensed and can perform medical exams, oversee the enrolled nurses,
decide the medications and hand over the activities to other staffs like licensed practical nurses
and other assistive professionals (Smolowitz et al., 2015).
2. Delegation for the RN- The National council for the state board of nursing are responsible for
addressing the delegation of the nursing licensure of an RN. The delegation process begins with
the decisions taken at the administrative level and then extending to the staffs accountable for the
delegation (Smolowitz et al., 2015). The process involves efficient communication and
empowering the staffs for making the decisions based on the judgment and support from every
level of health care settings.

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F. Professional practice of a nurse-
 A scientist- Current day nursing is much different from the age old nursing practice that
depended on conventional protocols but focus more on evidence based practice. Use of
EBP in nursing enables a nurse to research various scientific articles and journals,
critically analyzing the hypothetical case studies and remaining updated with the present
day researches related to nursing (Chism, 2017).
 A manager of the healing environment- A nurse is entitled to provide a physical, social
and spiritual support to the patient. As a healer the nurse should be able to help the
individuals, families and the communities, promoting heath and well being, reducing the
health risking behavior and increase self care management.
 A detective- A nurse encompasses the role of a detective, as in many cases nurses have to
act on the basis of their intuition to take up a particular therapy for a patient or the nurses
have to detect the patient’s condition and act accordingly before the arrival of the medical
reports (Swengros et al., 2014). For example the triage nurses investigate, interview and
listen to the caller and the background noises that could be potentially of some help, for
example the quality of the cough or intensity of the problem by assessing their voices.
G. Two provisions from the American Nurses Association (ANA) Code of Ethics-
Provision 1- The nurse practices with compassion and should help to preserve the human
integrity and human dignity present in every individual. A nurse should develop a therapeutic
relationship with the patient regardless of the disease, functional status, and disability ("About
Code of Ethics", 2018). A nurse should be able to maintain caring and a compassionate

8PROFESSIONAL ROLES AND VALUES IN NURSING
relationship with her colleagues and should not engage in collaboration with others for ensuring
the provision of health care services.
Provision 2- A nurse is responsible for maintaining the safety and rights of the patient. A nurse
should act as an advocate for the service user’s right to privacy and confidentiality ("About Code
of Ethics", 2018). As a patient advocate it is important to take inform the patient about the type
of treatment undertaken. The professionals should be competent enough for the profession.
1. The two provisions of nursing ethics makes us understand that a nurse is entitled to
understand the rights to self determination of the patient and would practice nursing
giving autonomy to the patient. As a nurse I may encounter with situations where
conflicts of interest may exist. I have learned that a patient should never be exploited for
any personal interest and should involve in a care process even if there are differences
with opinion with the patients. In order to elevate my competence level, I should always
participate in the continuous quality improvement skills. As per the ethics we also
maintain the confidentiality of the patient and have to be careful that the auditory
information regarding the patient is not overheard during the discussions.
2. A common error that generally occurs in a nursing practice is the medication errors,
which may cause mortality or adverse drug reactions.
3. One of the facts of the provision 2 of the ANA codes of ethics states the importance of
the standards and the review mechanisms in nursing. Only professionals having basic
competency skills should be allowed in the practice. Inefficient nurses may cause
medication errors that may be lethal for the patient. A skilled professional nurse should
promote a safe care by cross checking the medications ("About Code of Ethics", 2018).

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H. Four leadership qualities in nursing:-
 An efficient knowledge of technologies (Adelman-Mullally et AL., 2012)
 Collaborative team building skills
 Excellent decision making skills (Weiss & Tappen, 2014).
 Prioritization of safety and quality
1. Significance of the four leadership qualities identified in part H in the nurse’s role as each
of the following:
• A leader at the bedside -Nurse Leaders should provide care that is not limited to homes and
should extend to the communities (Shaw et al., 2012). A nurse leader encompasses patient care at
its core by its excellent decision making skills, collaborative team building skills and overseeing
patient’s safety and standards above everything. Leader is the one who will be able to influence
and inspire others. Bedside nurses are flexible and generally posses a 'can do' attitude and
motivate the patients and other nurses. They have a direct influence on nosocomial infections,
pressures, ulcer development, quality improvement and safety procedures. Bedside nurses also
influence the length of the hospital stays, patient satisfaction and resumption of the task of daily
life (Chism,2017).As a bed side leader, nurses will be able to promote advocacy for the patient
by helping out the patient and the family to choose the correct choice of care. Nurses as bedside
leaders should act as detectives or scientists for detecting any clinical condition may be before
the diagnosis, which is again possible by practicing evidence based nursing. Being bedside
leaders nurses are expected to remain updated regarding the latest technologies such that they
can be used in the care of the patient. The cast world of networking can actually help out the
nurses to disseminate any information or gain any knowledge all over the world.

10PROFESSIONAL ROLES AND VALUES IN NURSING
• Within a nursing team or interdisciplinary team- Being a part of an interdisciplinary team
nurses have to take several crucial decisions alongside with the doctors that requires decision
making skills especially while caring for the terminally ill patients (Cerit & Dinç, 2013). Every
decision should focus entirely on the safety of the patient instead of satisfying one’s personal
interests. A nurse should be able to make use of the electronic health records and other health
informatics required for caring patients with serious clinical conditions that requires use of
scientific instruments (Cerit & Dinç, 2013). As a team leader a nurse should be able to empower
his or her team to be strong and flexible, supporting each other in difficult times. As leaders
nurses can identify their personal values and communicate them to their colleagues. Being
acquainted with the latest technologies enables a nurse to develop social skills and expand
knowledge which can also be shared to the peer nurses. The skills related to the team building
capacity of the nurses involves - skills related to managing self, such as the emotional
competencies, time management and active listening. The most distinguishing characteristic of a
team is the collective vision towards the accomplishment of any goal. In recent days, primary
care services for acute or preventive care are managed successfully by collaborative efforts.
Teamwork is an essential tool for high quality of patient care.
2. Identify how your work environment impacts the following: -
• nursing leadership- nurse leaders should be able to motivate the peer nurses from
compassion fatigue that takes place due to the work pressure that prevails in my clinical
setting, yet not compromising the type of care to the patient.

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• Decision making –In my academic career of nursing I have often encountered ethical
dilemma, especially while dealing with the elderly patients with cognitive problems. An
excellent decision making skill is required to get a fruitful solution in case of such dilemma.
• Professional development- My work place encourages me to engage in lifelong learning
and maintaining the competencies. My work place has encouraged me to excel in working in
a fast- paced technical environment.

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