Nursing Assignment: Specialist Nurse Roles, Ethics, and Safety

This nursing assignment report explores the roles and responsibilities of a specialist nurse, specifically focusing on advanced heart failure nursing. It delves into the multifaceted duties of the nurse, including meeting patient needs (pharmacological and non-pharmacological), providing education, consulting with care managers, developing treatment plans, and monitoring patient progress. The report emphasizes patient safety measures, such as immediate assessment, recognizing and managing conditions in emergency settings, and ongoing monitoring. It also addresses ethical and legal implications of sharing patient information, highlighting the importance of privacy, confidentiality, and acting in the best interest of the patient. The report combines the writing assessment tasks from module 1, 2 and 3, and includes references from various sources.

NURSING ASSIGNMENT
Nursing assignment
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Course
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Module 1
A specialist nurse is a nurse who peruses certification in a given field and is able to
demonstrate the capabilities. In such a case, the nurse is required to meet certain education
and experience requirements. This paper will focus on a specialty nurse who has advanced
heart failure nursing (Bosler, 2016). The specialist heart failure nurse ensures is responsible
for meeting a variety of needs ranging from pharmacological needs to non-pharmacological
needs. Other responsibilities include providing education to staff, consulting with the patient
care manager, reviewing the available alternatives as well as current practices (Mancini,
2017). Moreover, the nurse is in charge of deciding on where various resources will be
allocated, development of special treatment plans once a patient has gone through
examination; provide education to the patient as well as their families on how to manage the
heart failure condition (Gifkins, Loudoun, & Johnston, 2017). Other additional
responsibilities include promoting staff teamwork and analysing outcomes as well as the
patient’s data (David, 2013).
Another important role of a nurse specialized nurse in heart failure is the role of
following up with the patient. This helps to determine whether the patient needs re-admission
as well as monitor the progress of the patient. Such a role has been documented to have had
significant improvements for patients. In the course of the follow-up, most nurses ought to
take safety measures that will help prevent and control the heart failure condition (Auricchio
et.al., 2012).
Some of the safety measures that the heart failure specialist nurses need to take
include, immediate assessment, and triage. This assessment is crucial as most patients seek
professional health care when it is too late or when their personal care fails. As a nurse, one

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ought to conduct the assessment, which can be identified with the shortness of breath, weight
changes and loss of appetite as well as symptoms of oedema (Jolly, 2018).
Another safety measure that is required while dealing with patients experiencing
chronic heart failure, is to ensure that once the patient arrives in the emergency department,
the condition is recognized managed and the patient is transferred to a favourable
environment. This is necessary to ensure that symptoms of breath shortness both emotional
and physical are dealt with (John, 2018). Moreover, the nurse is required to assess the
patient’s history as well as the severity of the condition and convey the information to the
relevant team.
Other safety measures that the nurse should observe ongoing monitoring and
management of the patient’s condition. Such safety involves administering dyspnoea, which
will work to reduce fluid congestion by balancing positive action with any negative action in
the renal function (Latimer, et.al. 2017). Moreover the measure will require that a catheter is
used to monitor closely the renal function through urine output. However, according to the
national and international guidelines, the use of catheters should be restricted to patients with
cardiopulmonary instability (Neuenschwander, & Peacock, 2009).
In addition, the monitoring prompts a close monitoring of haemodynamic parameters
throughout the process of stabilization. In addition, managing diuretics and vasodilators
aggressively might lead to hypotension (Souter, 2014).
Another safety measure that is required is ensuring that the close monitoring takes
place in an environment that provides expertise and time to identify and respond to changes
in the physiological data.

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Finally, after the patient is out of danger, the nurse is required to the patient’s
compliance. This is done to help the patient manage potential effects such as lower systolic
blood pressure. This can be achieved through reminding a patient to stand up slowly so that
they do not fall due to dizziness, teach the patient how to manage diuretics while they are
away from home to ensure they get the required assistance when necessary. The heart failure
team, as well as the heart failure specialty nurse in such cases, as well as the heart failure
specialty nurse in such cases, can further facilitate this effort where in-patient care is not
provided (Gully& Richardson, 2016).
Module 2
There is a huge responsibility bestowed on Nurse’s in terms of l of ethical and
regulatory implications when it comes to sharing of patient information with anyone. The
law, as well as ethics, requires nurses not to dispense any of the information relating to the
patient, they are looking after without their permission (Latimer et al., 2017). Moreover,
besides seeking permission from the patient regarding their health, the patient ought to
consider the implications that might emanate because of sharing particular information in an
effort to improve care. This, therefore, calls for the nurses and the caregivers as a whole to
maintain privacy and confidentiality of information while they are taking care of the patient.
Moreover, the nurse should not provide any patient information to any organization or
individual who has no contribution in assisting the patient (Margaret, 2015). However, there
are some cases where such ethics and policies can be overlooked with the aim of improving
the welfare of the patient. For instance, the woman who came in with acute heart failure
would have been saved if at all her health information had been shared with the laboratory
administrator (Medspace, 2018).

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This would have been possible since blood sample would have been taken for testing
without her consent. Another case that would have necessitated for the ethics to be
overlooked is if the patient was not of sound mind or a minor. In such a case, the individual
brought in the patient or represents the patient, such as the parents of a minor are allowed to
give the consent and at the same time ensure the privacy and confidentiality of the patient’s
health information (Philip, & Poole, 2018). In the case of the old woman, a family member
that brought her would take the position of a custodian, unfortunately, she brought in by an
ambulance, and no one had accompanied her. This, therefore, proved to be a challenge in
obtaining consent from the patient as acting without the consent would have been a violation
of ethics (Mitty, 2013).
On the other hand, when it comes to acting in the best interest of the patient, nurses
need to be given the right to obtain the information from their patient without consent.
However, this might be viewed as controversial nurses having understood the ethical
requirements regarding patient information, in the case of minors, there are no specific rule
has been put down elaborating about the age of a mature person or the age of a minor
(Nohria, & Desai, 2015).. When dealing with an individual whose mind is not sound, it is a
requirement that the patient has a representative who has the authority to give consent to
ensure the decisions and steps taken are in the interest of the patient (Saunders, & Wallis,
2017)).
Therefore, the issue regarding ethical procedures has many gray areas and therefore
seems to be a dilemma. However, in the midst of all the dilemmas, the overriding goal should
act in the interest and welfare of the patient as the main goal of a caregiver is to ensure
patients get well.

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References
Auricchio, A., McMurray, J. J., Adamopoulos, S., Anker, S. D., Böhm, M., ... & Sanchez, M.
A. (2012). ESC Guidelines for the diagnosis and treatment of acute and chronic heart
failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic
Heart Failure 2012 of the European Society of Cardiology. Developed in
collaboration with the Heart Failure Association (HFA) of the ESC. European journal
of heart failure, 14(8), 803-869.
Bosler, B. (2016). Legislature Update on the Family Caregiver Support and Designated
CareGiver Acts. Home healthcare now, 34(9), 528-529.
David, M. (2013). Regulations and policies for nursing programs.Albuquerque, N.M.: The
Board, pp.221-298.
Gifkins, J., Loudoun, R., & Johnston, A. (2017).Coping strategies and social support needs of
experienced and inexperienced nurses performing shif-twork. Journal of advanced
nursing, 73(12), 3079-3089.
Guly, U. & Richardson, D. (2016). Acute medical emergencies.1st ed. Oxford: Oxford
University Press, pp.76-80.
John, F. (2018). Hyponatremia Treatment & Management: Approach Considerations,
Medical Care, Diet. [online] Emedicine.medscape.com. Available at:
https://emedicine.medscape.com/article/242166-treatment [Accessed 3 Oct. 2018].
Latimer, S., Hewitt, J., Stanbrough, R., & McAndrew, R. (2017). Reducing medication
errors: Teaching strategies that increase nursing students' awareness of medication
errors and their prevention.Margaret, B. (2015). Patients' Rights, Law and Ethics for
Nurses.2nd ed. Brisbane: Hodder Education, pp.345-480.

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Medspace (2018). Heart Failure Treatment & Management: Approach Considerations,
Nonpharmacologic Therapy, Pharmacologic Therapy. [online]
Emedicine.medscape.com. Available at:
https://emedicine.medscape.com/article/163062-treatment [Accessed 3 Oct. 2018].
Mitty, E. L. (2003). Policy Perspectives: Assisted Living and the Role of Nursing: As many
as half a million people reside in assisted living facilities, the regulations of which
vary from state to state. Nurses have an opportunity—and an obligation—to help
develop policies. AJN The American Journal of Nursing, 103(8), 32-43.
Neuenschwander, J. & Peacock, W. (2009). Management of heart failure in the emergent
situation.Philadelphia, Pa.: Saunders, pp.653-801.
Nohria, A., & Desai, A. S. (2015). Reducing Readmissions With Novel Cardiac
Resynchronization Therapy Programming: Is Meeting the 30-Day Metric Enough?.
Philip, L., & Poole, R. (2018).Double trouble: managing diabetic emergencies in patients
with heart failure. Practical Diabetes, 35(4), 139-143.
Saunders, N. A., & Wallis, B. J. (2017).Learning decision‐making in clinical medicine: a card
game dealing with acute emergencies for undergraduate use. Medical
education, 15(5), 323-327.
Souter, K. (2014). Understanding and Dealing With Heart Disease. Summersdale Publishers
LTD-ROW.