NURSING Assignment: Ethical Dilemmas, Moral Distress, Policy

This assignment addresses three key areas within nursing practice. Firstly, it explores how social media use can violate ethical principles, such as patient privacy and confidentiality, and contrasts these violations with the potential benefits of ethical social media usage for patient interaction and care quality, emphasizing the importance of professional boundaries. Secondly, it presents a clinical scenario where a registered nurse experiences moral distress due to conflicting ethical principles like patient autonomy and beneficence when a patient refuses a necessary treatment; the assignment requires the application of the AACN's Four A's framework (Ask, Affirm, Assess, Act) to analyze the situation and propose mitigation strategies. Finally, the assignment examines the impact of a nurse's educational level on their competence and influence in policy making, highlighting the value of nurses' experience and knowledge in shaping effective health policies and contributing to regulatory processes.

Running head: NURSING
Nursing
Name of the student:
Name of the University:
Author’s note

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Answer 1
Inappropriate use of social media in nursing practice is associated with many ethical
challenges due to boundary violation and violation of patient’s privacy and confidentiality. For
example, violation of the ethical principle of privacy and confidentiality occurs when any
nursing staff posts confidential information about patient in social media or share pictures of
hospitalized patient in social media sites like Facebook. This can increase legal risk for staffs as
they may have to go through disciplinary actions because of breach of patient privacy (Melnik,
2013).. Improper social media use can also violate state and federal laws related to professional
conduct in practice. For example, many staffs may develop personal relationship with patient
during the point of care and they may engage in online social contact with patient. However,
nurses have an obligation to maintain professional boundaries with patient in the online
environment (Denecke et al., 2015). Hence, staffs must be trend to avoid privacy violations while
using social media.
In contrast to the above situation, the main benefits of ethical social media use is that it
will offers physicians and nurse innovative ways to interact with patient without any risk of
privacy violation issues. If they use social media only to staffs contact patient for treatment
update, it will have positive outcome on care quality. Ethical social media usage can protect
staffs from any legal actions too (Denecke et al., 2015).
Answer 2
A registered nurse may experience moral distress when a patient does not give consent
for a treatment although it is urgently required for the safety of patient. This can create moral
distress issue because the nurse can be at risk of violation of patient autonomy or beneficence no

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matter what action he/she takes. Nurses have a responsibility to obtain consent from any patient
before providing any treatment. This is essential as part of the ethical principle of patient
autonomy (Butts & Rich, 2019). However, nurse may experience moral distress because
avoiding the treatment can cause harm to patient. This can again violate the ethical value of
beneficence as nurses have the responsibility to ensure that they take all measures to protect
patient from any harm. Hence, the situation can create moral distress for nurse as they have to
decide whether preference should be given to patient autonomy or beneficence. To resolve the
dilemma, it will be necessary for the nurse to assess the benefits of each action and decide how
far either of the process can be harmful or beneficial for patient. All alternative options should be
explored to make proper action plan that protects patient interest by all means (Cook, 2016).
Answer 3
The level of qualification obtained by a nurse significant determines the competence of a
nurse’s participation in policy making. This is said because their education and experience give
them expert knowledge to positively assess deficiencies in all aspects of care and identify ways
by which the care process can be further improved. They can make a positive contribution in
shaping effective health policy as they closely interact with client and have better understanding
about factors influences health needs. Hence, registered nurse participation in regulatory process
can be very beneficial as they will point to issues that occur at the point of care and their
suggestion will ensure action resolution of health delivery issues. Nursing education can enhance
their judgment of the high priority areas of improvement and their experience on the job can
support them to identify new policy development areas (Shariff, 2014).

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References:
Butts, J. B., & Rich, K. L. (2019). Nursing ethics. Jones & Bartlett Learning.
Cook, W. E. (2016). “Sign here”: nursing value and the process of informed consent. Plastic
Surgical Nursing, 36(4), 182-186.
Denecke, K., Bamidis, P., Bond, C., Gabarron, E., Househ, M., Lau, A. Y., … Hansen, M.
(2015). Ethical Issues of Social Media Usage in Healthcare. Yearbook of medical
informatics, 10(1), 137–147. doi:10.15265/IY-2015-001
Melnik, T. (2013). Avoiding violations of patient privacy with social media. Journal of Nursing
Regulation, 3(4), 39-46.
Shariff N. (2014). Factors that act as facilitators and barriers to nurse leaders' participation in
health policy development. BMC nursing, 13, 20. doi:10.1186/1472-6955-13-20