ADVANCED NURSING PRACTICE LEADERSHIP DYNAMIC
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Advanced Practice Leadership from an ethic of care Guidelines
Nurses in advanced nursing practice are considered as leaders in the community and in the organizations which they are part of. This is because they are the leaders of change and have been constantly in search of new and effective conducts to practice and advance delivery of health-care and also reshape their organizations in order to help the clients and the public and also impact the health policy (Blais, 2015). They have advocated for groups, families, communities and also individuals in relation to health care systems, treatment and policy decisions that have affected the quality of life and effect to health.
This paper therefore will the advanced nursing practice leadership dynamic and its contribution to healthcare. It will also explore and investigate on the implications of ethics of care and ethics of justice with a description of each ethics in relation to nursing practices. It will also include examples that relate the concept to current evidence in nursing practices and the application of ethics of care to advanced nursing practices.
Advanced nursing practice leadership dynamic
The leadership competencies ensure identification of learning needs and development of resources and programs to meet the needs of the client. They have also mentored and coached nursing colleagues and advocated for and promoted the importance of advanced nursing practice and the health care access. The demand for innovative and collaborative clinical practitioners to act as the leaders in the healthcare has always demanded to be stronger. Advanced nursing practices has played a key role in building the knowledge of nurses and contributing into effective and sustainable health-care.
The advanced nursing practice has a framework that includes key elements such as; support evolution and impact of advanced nursing practice. The evolution has been as a result of the government and the health care systems recognizing the role and contribution of nursing practice in expansion and effective strategy for improvement of health services.
Contributions of advanced nursing practice leadership
The advanced nursing practice include the clinical nurse specialist and nurse practitioner. Their roles have been to provide clinical leadership and guidance to nursing staff in order to ensure they manage complex care and also promote and improve evidence-base and quality care practice. Advanced practice nurses have leadership skills and understand the health policy and organization and are able to make decisions that play an important role to the health-care systems out comes of the client now and in future (Carryer, et al., 2007). Nurses in advanced nursing practice have built their expertise through displaying the certain characteristics and features. Advanced nursing practice enable the nurses to provide efficient and effective care, demonstration of leadership and also initiating change in order to improve the organization, system and client outcomes. Advanced nursing practice has focused on the clinical practice through direct relationship, consultative and supportive role.
The nurse has the mandate of demonstrating competencies in clinical and advanced nursing practice. Advanced nursing practice has ensured competencies of specific skills and knowledge that are necessary for nurses to practice ethically and safely in designated setting and role. Advanced leadership dynamic has enabled evaluation of programs that have enabled innovative approaches to intricate issues in the community and organization. They have also enabled integration and understanding the principles of allocation of resources, decision making in system levels and cost-effectiveness. Advanced nursing practice leadership dynamic has identified the health care system gap and developed partnership to manage and facilitate change. These roles have therefore facilitated to the leadership competencies in advanced nursing practices.
Description of ethic of care versus ethic of justice perspectives
The decision making in nurses had been characterized based on certain leading perspectives. Most of the nurses have relied on the care perspective and the justice perspective. These are the two different perspectives that the nurse’s may use when making decisions. Ethics of justice has constituted an ethical outlook which has involved Making ethical decsions based on the universal principles and rules. The ethic of care is also known as care ethics and have constituted to the ethical approach in terms of harmonious relations, involvement and the need to play an important role in ethical decision-making.
Ethics of care
Ethics of care have had a normative theory that has held interpersonal care and relationship as a virtue and the center of moral action (Hamric et al., 2013). Ethics of care have had values and conducts that have promoted care. The ethics of care have focused on the singular and unique harm that has been overlooked by other perspectives. Ethics of care have worked to identify uncaring structures and arrangements. It has also been able to acknowledge the interplay of value and context. For instance, in a case where the pain becomes intolerable and the patient can no longer take care of themselves, it is believed that the patient can agree on physician assisted murder. However, the focus on more interconnectedness of humanity has placed the importance of the relationship of the care-receiver and the care-giver. This therefore brings the concept of care in this case.
Ethics of justice
Ethics of justices in other terms are known as morality of justice that describe moral reasoning and ethics that deal with moral choices (Davis et al 2006). This is through the measures of solutions and rights of the people. Ethics of justice have ensured moral choice to whatever that creates less disruption and least stress. This has therefore enhanced caring as survival. For instance, for a child that has been bullied in school it is morally and healthy desirable to speak out about the abuse. Integrated caring has been the most developed in terms of ethics of justice. This has meant that the coordination of personal values and needs of other takes account and has led to the moral beliefs that are more comprehensive.
Impact of Ethical Perspectives
There are certain elements that are related to the ethics of care which include competence, attentiveness, responsibility and responsiveness which are essential in caregiving. The nurses should maintain their professional competency through participation in professional development that will promote ethics of care. Ethics of care have had a potential impact on the moral significance in the fundamental elements of dependencies and relationship in human life. They have also emphasized on the importance of concern, responsibility, relationship and caring motivation. It has also humanized ethics through centering thoughts on real people on the general ethical practices.
Through ethics of justice they will be able to make moral decisions that are based upon social order and maintenance of personal rights through fixed principles. Morality of justice has been used far less often when discussing to the legal issues that arise from moral dilemma. It is important to understand that patients depend on the care of the health personnel. Ethics of justices is particularly significant for the nurse’s honesty and in the establishment and observance to ethical standards of moral duties, moral rights, ethical principlism and moral obligations
Reflection on the application from an ethic of care perspective
Mr. Bones, a patient is 60 years old and has been admitted in a hospital. He has a long story that is related to unmanaged diabetes and alcoholism. His wife had died some few months ago. Mr. Bones claims that this is the reason as to why he stopped caring about himself. Mr. Bones has been requesting for pain medications frequently. Due to frequent care on Mr. Bones, the nurse could tell how often Mr. Bones required analgesia. Being responsive for his care, the nurse decided to talk to the physician to change the order. The physician became hesitant due to causing patient’s harm.
The nurse advocated for Mr. Bones through engagement in a conflict resolution with the doctor. This resulted to increasing the morphine dose. In the case of Mr. Jones, the nurse has relied on the four phases of caring for patients. This includes caring about, taking care of and caregiving and care receiving. The nurse in the first phase (caring about) where they realized that the increased pain on the patient required medication in order to asses the pain of the patient. In the second phase (taking care of) the nurse found it necessary to respond to the pain levels that the patient was undergoing. Taking care of in this care is going beyond having a concern about the patient’s pain.
Caregiving as the third phase of applied ethics of care means that the nurse takes action. In this case, the nurse goes ahead and calls the doctor and urges him to change the order for analgesia and increasing the morphine die. This is therefore, is working to react for the patients needs. The conflict resolution and engagement were part of care. Finally, the phase four in this case which is the care receiving where the nurse is successful in offering care and their intervention to the patient’s pain is successful. The patient is the care receiver and their needs have been satisfied by the care of the nurse. The last phase has helped preserve the nurse to patient relationship and has been considered as a distinct virtue of care.
This example has been used to illustrate the application of ethics of care through the nursing process. This has been through the problem solving and methods of solving problem that are need for efficient and effective nursing practices. The implementation of this process is dependent on the experiences of the patient about their care. In this case it is clear that curing defines medication as caring defines nursing.
The nurse has been able to attend to the patient because the patient has been able to create their dependency on care and potential needs from the nurse. Ethics of care have influenced the nurse practices in order for him to be able to apply the four phases of caring that are necessary and relevant for nursing practices (Sheer et al., 2008). In addition, there are four elements of caring that are necessary for effective caring that require certain skills and attitudes. These have been combined by good care and certain activities as the knowledge of the patient and their condition. In this case, the nurse to patient past experiences will provide knowledge and information about management of pain which will enable the nurse avoid certain judgmental attitude about the requests of pain medication.
Conclusion
Advanced nursing practices has been important in development of professional and leadership skills that are necessary for advanced practice. This has been used to prepare nurses in advance in order to understand the roles in acute and primary care. It has an intended purpose of a wide variety of advanced practices that include nursing leadership. This knowledge has been used to improve nursing practice and improve patient’s care. This, therefore, makes nurses leaders in health care and nursing. Ethics of care and justices have been related nursing practice and the ethical responsibilities that are vital for patient care. This has been important in challenging situations that require ethical decisions in health care ethics.
References
Blais, K. (2015). Professional nursing practice: Concepts and perspectives. Pearson.
Carryer, J., Gardner, G., Dunn, S., & Gardner, A. (2007). The core role of the nurse practitioner: practice, professionalism and clinical leadership. Journal of Clinical Nursing, 16(10), 1818-1825.
Davis, A. J., Tschudin, V., & De Raeve, L. (Eds.). (2006). Essentials of teaching and learning in nursing ethics: perspectives and methods. Elsevier Health Sciences.
Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (2013). Advanced Practice Nursing-E-Book: An Integrative Approach. Elsevier Health Sciences.
Sheer, B., & Wong, F. K. Y. (2008). The development of advanced nursing practice globally. Journal of Nursing Scholarship, 40(3), 204-211.