https://www.nursingworld.org/coe-view-only

  • Outline and discuss a plan to promote the value of the APN model to the public.
  • Using the latest statistics and evidence, provide a compelling argument and a brief background to the public about why APNP care is essential.
  • Discuss how you would promote the value of utilizing an APN as a provider of services.
  • Use data from sources that illustrate how efficient, and cost containing APNPs are versus other health care provider roles. This is not an exercise that diminishes our other colleagues, but one that promotes the value of the APNP role.

Students are expected to:

  1. Post an initial substantive response of 250 words to each question
  2. Please be sure to validate your opinions and ideas with citations and references in APA format.
  3. References and citations should conform to the APA 6th edition.
  4. Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.
  5. The peer postings should be at least one paragraph (approximately 100 words) and include references and in text citation
Helen’s post:
Define and describe legal, ethical and risk management (insurance):

Legal issues for NPs: Legal issues involve regulation and the law. Legislation and regulation are in place to ensure quality and to increase the value of healthcare (Buppert, 2018). Regulation is set up through policy and statute (Buppert, 2018).

Ethical issues are defined as doing what is right. Ethics encompasses acting in the interest of patient safety and performing duties only if one is competent to perform them. According to the ANA Code of Ethics, NPs should display moral courage, or stand up for one’s beliefs in the face of controversy (Dolan, 2017).

Risk management is the forecasting of financial risk by insurance companies that cover NPs with malpractice insurance. After the forecasting of risk, many companies create procedures to minimize the impact of the risk. Insurance companies may use a risk management forecast to generate the cost of malpractice insurance to the NP.

Describe how each of these is interrelated:

For NPs, following rules of regulation, policy and law is legal decision-making (Dolan, 2017). Ethical decision-making involves the synthesis of legal and moral influences, including social expectations and traditions (Dolan, 2017). Ethical decision-making is broad, involves the ponderance of right and wrong. In NP practice, there is a presumption that to practice ethically, one most practices legally (Dolan, 2017). Risk management comes into play if the NP makes an error, such as performing outside of the legal scope of practice. This is why it is important for NPs to know their scope of practice and to act in an ethical manner, abiding by the law.

Example of how ethics is interrelated in practice:

In one scenario a pregnant teenager presents to a gynecology office for an elective abortion with her mother who signs consent (Dolan, 2017). The teen decides she does not want the abortion but the mother insists that the minor have the abortion, telling the teen that it will not hurt. The procedure was performed by an NP, it did hurt and the teen protested during the entire procedure. In this example, patient autonomy is violated but no law is violated. Reasonable care suggests that the patient’s concerns should be prioritized (Dolan, 2017).

Journal Summary:

NPs in controversial situations in practice must meet patient care goals while maintaining moral integrity (Dolan, 2017). In this way, challenges are opportunities to benefit the common good (Dolan, 2017). The ANA Code of Ethics is a resource of professional guidelines that is applicable to advanced practice. The ANA Code of Ethics encourages APNs to stand up for core beliefs in the face of adversity (Dolan, 2017).

References:

Buppert, C. (2018). Nurse practitioner’s business practice and legal guide. (6th ed.). Burlington, MA: Jones & Bartlett Learning

Dolan, C. (2017). Moral, ethical, and legal decision-making in controversial NP practice situations. The Journal for Nurse Practitioners, 13(2), 57-67. Doi: 10.1016/j.nurpra.2016.10.007

Rebecca’s Post

Legalities, Risk Management, and Ethics

Legal issues, risk management, and ethical considerations go hand in hand when it comes to care provided by NPs. Legal standards are standards that are set forth in governmental laws. All the statutes and laws that lawyers point to are legal standards. Legal standards are useful because they help health care providers to know what they can and cannot do. With legal standards in place, authorities are allowed to enforce rules when providers do something illegal (Angela, 2016).

Ethical standards, on the other hand, don’t necessarily have a legal basis. Ethics is a branch of philosophy concerned with moral principles that guide decisions on how to live and how to behave. It is also defined as an evaluation of a moral choice based on ideas about what is morally right or wrong. Ethics provides an opportunity to describe and understand standards of conduct in nursing practice. The nursing profession has long held to high ethical standards with the most recent benchmark being the development of the Code of Ethics for Nurses with Interpretive Statements (American Nurses Association, 2018). The Principles of Medical Ethics and the Opinions of the AMA Council on Ethical & Judicial Affairs make up the AMA Code of Medical Ethics. This is a helpful tool NPs can use when faced with a difficult ethical decision or predicament. Using these standards, the provider will be able to help patients to participate meaningfully in decisions about their health care. Providers have a responsibility to provide information and help patients understand their medical condition and options for treatment (American Medical Association, 2018). Using these ethical standards, the best care is able to be provided to patients.

Risk management also plays a crucial role when it comes to NPs and the services they give to their patients. Risks to patients, staff, and organizations are common in healthcare. Therefore, it is necessary for an organization to have qualified healthcare risk managers to assess, develop, implement, and monitor risk management plans with the goal of minimizing exposure. There are many priorities to a healthcare organization, such as finance, safety and most importantly, patient care (The University of Scranton, 2015).

Ethical standards are based on human rights and wrongs while legal standards are based strictly on what it written within the law. It is possible that an action may be legal but not ethical. Unfortunately, sometimes making a difficult decision for a patient’s best health care plan, the provider is stuck and must decide between decisions where the correct legal route may not fall under the best ethical route. This is when risk management comes into play and can help the NP provide the best choice with the best outcomes. Together, legal, ethical, and risk management sections all must work together to provide the best patient care.

Medical malpractice has been defined in professional literature as ”any act or omission by a physician during treatment of a patient that deviates from accepted norms of practice in the medical community and causes an injury to the patient.” In the United States, the laws that govern medical malpractice come from the individual states. Each state has its own boards of professionals who create the licensing requirements and basic laws governing practice for the various practitioners. For example, the Nurse Practice Act in each state covers the definition of the nurse’s scope of practice, the educational requirements, and the grounds for disciplinary action for violations of the act. However, laws that govern medical practice are derived from common law. This means that they evolve from court rulings that have taken place over the years (Jankowski, 2017). The interrelationships between medical ethics and the law are perhaps nowhere as starkly apparent as in the realm of medical malpractice. Although ethical and legal conduct and practices are often in harmony, in many areas ethical principles and the issues surrounding medical liability appear to come into conflict. Disclosure of errors; quality improvement activities; the practice of defensive medicine; dealing with patients who wish to leave against medical advice; provision of futile care at the insistence of patients or families, and the various protections of Good Samaritan laws are just a few of these (Solomon, 2016).

References

American Medical Association. (2018). Code of Medical Ethics: Consent, Communication & Decision Making. Retrieved October 14, 2018, from https://www.ama-assn.org/delivering-care/code-medi…

American Nurses Association. (2018). Ethics. Retrieved October 14, 2018, from https://www.nursingworld.org/practice-policy/nursi…

Angela. (2016). What is the Difference Between Legal & Ethical Standards? Retrieved October 14, 2018, from https://study.com/academy/lesson/what-is-the-diffe…

Jankowski. (2017). Legal Liability in Healthcare: Negligence & Malpractice. Retrieved October 14, 2018, from https://study.com/academy/lesson/legal-liability-i…

Solomon. (2006). Ethical issues in medical malpractice. US National Library of Medicine National Institutes of Health, 24(3), 733-735. Retrieved October 14, 2018.

The University of Scranton. (2015, February 02). The Purpose of Risk Management in Healthcare. Retrieved October 14, 2018, from https://elearning.scranton.edu/resource/business-l…

 
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