Introduction:

Advanced practice nurse (APN) denotes all nurses working in expanded nursing roles. The professional responsibilities of APN are based on the philosophical understandings about factors that constitute good human action, including the circumstance and reasons affecting it. The professional healthcare practice is achieved through legal and moral accountability for professional decisions and actions that follow it. A good practice from a philosophical standpoint is equivalent to ethical practice, which is attained from interdisciplinary knowledge, skills, experience and personal traits to identify the needs of the individual or society (Grace, 2017). Krautscheid, (2014) pointed out that accountability is a core concept underlying professional nursing practice. Some important ethical principles involved in APN include: Autonomy, Beneficence, Non malfeasance, Fidelity, Justice and Paternalism (Nursingworld.org , 2018).

1. My response to Mr. Newcomb’s request.  

Considering that Mr. Newcomb is terminally ill, and currently in hospice care, it is pertinent to be considerate of his final wishes. Johansson & Lindberg, (2015) states that terminal diseases can threaten the quality of life (QOL), therefore palliative care is vital to allow the maintenance of well the being of the patient. This also implies caring for the patient’s psychological and physiological needs. Henoch, Danielsson, Strang, Browall & Melin-Johansson, (2013) adds that the need of terminally ill patients to express their thoughts and feelings makes the involvement of palliative care for them a necessity. With such consideration, I would offer help to set up an arrangement for the patient to meet his mistress, hoping to make him feel at peace. I would hence respond positively to his request.

2. How I have applied the principles of beneficence, non-malfeasance, autonomy, and justice to the scenario.

Within the scope of nursing practice, Beneficence refers to compassion, and taking positive actions to assist others (patients)with the desire to help them. Non malfeasance refers to the avoidance of any direct or indirect harm to the patient. Autonomy refers to the respect of the right of the patient to determine the course of their own action, and support to their independent decision making. Justice refers to the commensurable and unbiased distribution of resources, based upon an measure of gain and onus of the decision, ensuring equal rights to care (Beauchamp & Childress, 2001; Butts &Janie, 2005). The decision to comply with the request of Mr. Newcomb is in support of Beneficence, as it can help the mental well being of the patient (making him happy), as well as supporting Non malfeasance, as the patient can become sad if his final wish were not headed. Additionally, the autonomous of the patient’s wish is implacable, that allows him to make independent decisions about his like and course of action, and ensures the providence of justice and equal rights of the patient.

3. How personal beliefs and values influenced my response to the scenario.

My personal beliefs are based upon promotion of ethical practice within nursing. I believe that every individual has their own rights to make decisions regarding their own lives (autonomy), and medical care and help should be provided without any discrimination (justice). Shrestha &Jose (2014)argued that nurse have the responsibility of maintaining the wel being and quality of life of patients, and must possess both technical and ethical compeytence. Moreover, an RPN should keep the philosophies of beneficence and  Non malfeasance at the core of their practice, to ensure the well being of the patients above all (Jarrin, 2013). My decision to assist the patient to fulfill his last wish is based upon such principles, and my belief that by meeting his mistress, Mr. Newcomb will feel happy, and thus can have an improved perception of his quality of life.

4. Three strategies to promote self-care suggestible in the scenario.

Self care is indispensible to personal health, maintain continued care for others and foster professional growth (CA, 2014). Blum, (2014) points out the commonplace themes of self care as balanced diet, physical exercise and stress reduction strategies. This is based upon the adult learning theory, that allows self identification of stressors and indulge in self care practice that can address them. Three strategies that can be utilized to include self care practice for the patient includes: Feng Shui, Music Therapy, Tai-Chi or Yogatherapy. These practices can help the patient to relax, develop a positive attitude, and foster physical, mental and spiritual well being of the patient.  Weber & Sculthorp (2016)suggested that yoga therapy can be adapted ad different age groups, from children to senior citizen, and can foster a ‘culture of health’. Further it is low cost, affordable and easily accessible, and improve patient’s experience of care. Additionally, activities like gardening have also been found beneficial to the mental health and mental well being of individuals (Soga, Gaston & Yamaura, 2017; Shanahan et al., 2016; Network, 2017).

Conclusion:

In professional nursing practice, the providence of efficient care within ethical boundary is an important aspect of the practice. This fosters actions that are taken with the best interest of the patient, and prevent or discourages actions that can have adverse effect on the patient, either directly or indirectly. It can therefore be concluded that fulfilling the wish of a terminally ill patient to meet his mistress can help the patient’s well being, while refusal of the same can make the patient unhappy, and hence adversely affect the mental well being.

References:

Beauchamp, T. L., & Childress, J. F. (2001). Principles of biomedical ethics. Oxford University Press, USA.

Blum, C. (2014). Practicing Self-Care for Nurses: A Nursing Program Initiative. Nursingworld.org. Retrieved 24 January 2018, from https://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-19-2014/No3-Sept-2014/Practicing-Self-Care-for-Nurses.html

Butts, D. S. N., & Janie, B. (2005). Nursing Ethics: Across the Curriculum and Into Practice Book Review. Online Journal of Health Ethics, 2(2), 2.

CA, B. (2014). Practicing Self-Care for Nurses: A Nursing Program Initiative. – PubMed – NCBI. Ncbi.nlm.nih.gov. Retrieved 24 January 2018, from https://www.ncbi.nlm.nih.gov/pubmed/26824151

Grace, P. J., & DRN, P. (Eds.). (2017). Nursing ethics and professional responsibility in advanced practice. Jones & Bartlett Learning.

Henoch, I., Danielson, E., Strang, S., Browall, M., & Melin-Johansson, C. (2013). Training intervention for health care staff in the provision of existential support to patients with cancer: a randomized, controlled study. Journal of pain and symptom management, 46(6), 785-794.

Jarrin, I. (2013). The Place of Ethics in Mental Health Nurses’ Clinical Judgment in the Use of Seclusion. University of Manitoba (Canada).

Johansson, H., & Lindberg, L. (2015). How nurses in Kerala experience caring of terminally ill patients: and how they promote the wellbeing of the patient.

Krautscheid, L. C. (2014). Defining professional nursing accountability: a literature review. Journal of Professional Nursing, 30(1), 43-47.

Network, C. R. (2017). A countryside for health and wellbeing: the physical and mental health benefits of green exercise. Cancer.

Nursingworld.org  (2018) . Short Definitions of Ethical Principles and Theories Familiar words, what do they mean?. Retrieved 24 January 2018, from https://www.nursingworld.org/MainMenuCategories/EthicsStandards/Resources/Ethics-Definitions.pdf

Shanahan, D. F., Bush, R., Gaston, K. J., Lin, B. B., Dean, J., Barber, E., & Fuller, R. A. (2016). Health benefits from nature experiences depend on dose. Scientific Reports, 6, 28551.

Shrestha, S., & Jose, P. (2014). Knowledge & Practice of Nursing Ethics and Laws. Journal of Universal College of Medical Sciences, 2(3), 30-33.

Soga, M., Gaston, K. J., & Yamaura, Y. (2017). Gardening is beneficial for health: A meta-analysis. Preventive medicine reports, 5, 92-99.

Weber, K., & Sculthorp, B. (2016). Yoga Therapy: Meeting the Needs of The Triple Aim. Yoga Therapy Today, 22-23.