COMMENT JAMELLA

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 I NEED A POSITIVE COMENT BASED IN THIS ARGUMENT..BETWEEN 150-200 WORDS

 

Per Beauchamp & Childress, (1994) Principalism is the framework for analyzing and comparing the moral foundations of the ethical statements of these health-related professional associations. This framework includes four core behavioural norms of importance in guiding ethical decisions involving work with patients, other clients, and human research subjects. At the core of principalism, is the idea that ethical justification rests primarily, if not exclusively, in appeals to more general or higher level moral norms under which any more particular ethical claim can be subsumed (Beauchamp, & Childress, 1994).  The four tenants of principalism elaborated below are:

-Autonomy: Recognizes a person’s right to make choices, to hold views, and to take actions based on personal values and beliefs. Support of independent decision making.

-Non-maleficence: Do no harm.

-Beneficence: do good Take actions to help others and contribute to their welfare. Refers to an action done for the benefit of others.

-Justice: social distribution of benefits and burdens and treat everybody fairly (Beauchamp, & Childress, 1994).

These principles have been extremely influential in the field of medical ethics, and are fundamental for understanding the current approach to ethical assessment in health care. We can test whether these principles can be quantitatively measured on an individual level, and then subsequently if they are used in the decision-making process when individuals are faced with ethical dilemmas (GCU, 2015). The four principles referred to here are not prioritized, meaning no one principle routinely is more important than the other. Each situation and the circumstances surrounding it should be considered. While autonomy should be of importance, there are situations in which it is not the priority, specifically if others will be directly impacted. Because there may be conflicts among the principles, other methods of resolving concerns should be established. One example of Autonomy that is practiced: There are times that we teach the patient about the importance of turning or the importance of a medication that they need to take and for the patients’ rights which is autonomy, they have the right to refuse. You can accept that answer, or you can try again later because you know that the patient needs that medication especially if it must deal with cardiovascular system, or respiratory system, or neurological system. All we can do is educate and remind, other than that, the patient has their right to their decisions and their body.  These methods may include utilizing a moral code or a just process for making decisions. In the clinical setting, these principles should serve as guidelines and not be considered absolutes due to the complexity of medical situations (McCormick, 2013).

If was to prioritize these four principles, it would be influenced by ethical concepts which are not specifically taught in Scripture but can be derived from principles which are found in God’s word. Also, with alignment in the Nightingale Pledge which has a Christian influence on nursing and embraces the roles of myself as a Christian and a nurse. . I believe the hierarchy of principles would be:

1)      Justice- (Everyone should be treated equally, as God sees each of us that way).

“I shall do all in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling.”

2)       Nonmaleficence-(No individual should ever intentionally cause harm to another- Do unto                others as you would have done to you).

I shall abstain from whatever is deleterious and mischievous, and shall not take or knowingly administer any harmful drug.”

3)       Beneficence- (God calls us to serve one another and I feel that this should frequently occur before we serve ourselves).

“I shall be loyal to my work and devoted towards the welfare of those committed to my care.”

4)       Autonomy- (Although autonomy may be used in the context of each of the above principles, it lends to the suggestion that one is only considering what is right for them and their personal beliefs without considering others).

 “I solemnly pledge myself before God and in the presence of this assembly to pass my life in purity and to practice my profession faithfully.”

                                                           References

Grand Canyon University. (2015). Biomedical ethics in the Christian Narrative. Retrieved from http://www.https://lc-ugrad1.gcu.edu/learningPlatform/user/

Beauchamp, T. L. and Childress, J. F. (1994). Principles of Biomedical Ethics, 4th ed. New York: Oxford University Press.

McCormick, T. R (2013). Principles of bioethics. Retrieved from https://depts.washington.edu/bioethx/tools/princpl.html

COMMENT SHEILA

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 I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 150-200 WORDS

 

Every few minutes someone in America commits suicide. In North America, suicide is the third-leading cause of death among people 15 to 25 years olD. And note this tragic feature of American life: among children between 5 and 14 years of age, suicide is the sixth most common cause of death (Smedes, 2000). Meilaender puts it that “Suicide as a rational project expresses a desire to be only free and not also finite-a desire to be more like Creator not creature”. As a Christian I do not condone suicide at the same time I am not at liberty to judge one’s actions as a sin or not. It is not my place. The Bible says “thou shalt not judge”.

“Euthanasia, also known as assisted suicide, physician-assisted suicide (dying), doctor-assisted dying (suicide), and more loosely termed mercy killing, means to take a deliberate action with the express intention of ending a life to relieve intractable (persistent, unstoppable) suffering” (Nordqvist, 2016). Considering the fact that one of Christian principle is to relieve suffering, when it comes to assisting to take one’s life, it becomes a difficult discussion. Meilaender emphasized that, euthanasia cannot simply be termed as an extension of one’s private autonomy or a non-interventional act in a private choice, this is because it requires the participation of another person, thus making it a communal act. This is quite difficult for me in this profession especially when it come to the point of given morphine schedules. Medicine is there to  ease the suffering. All life is precious and God oversees all of it. Nevertheless, to classify suicide and euthanasia as sin to me lies with God.

 

Reference:

Meilaender, G. (2013).  Bioethics: A Primer for Christians . William B. Eerdmans Publishing Company.

Nordqvist, C., (2016).  Euthanasia and Assisted Suicide . Retrieved from: http://www.medicalnewstoday.com/articles/182951.php

Smedes, L.B., (2000).  Christianity Today: Is Suicide Unforgivable?  Retrieved from: http://www.christianitytoday.com/ct/2000/july10/30.61.html

Peer Response

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The area of interest I selected is hand washing with soap and water more effective in Prevent Central Line Associated Bloodstream Infections (CLABSI) in ICU at Memorial Hospital West than washing hands with hand sanitizer (Latif et al., 2015). The program track for my specialty is Family Nurse Practitioner. My chosen area of interest is indeed consistent with my selected program track since it equips me with clinical experiences and practical skills on how to deal with Central Line Associated Bloodstream Infections. Central Line Associated Bloodstream Infections is one of the widespread problems being recorded at the ICU and has resulted in deaths of many patients every year. Therefore, hand washing with soap and water will not only help curb these deaths, but also help reduce the billions of dollars currently spent on healthcare system in the United States (Anderson, 2015). This intervention will be administered to all ICU staff at the hospital. The unit’s staff members include licensed practical nurses, registered nurses, health unit coordinators, and nurse externs.

            I do not want or wish to alter my area of interest. I believe my area of interest is fundamental toward preventing infections in the ICU and enhancing the optimal safety of patients (Eggers et al., 2015). As a nurse practitioner, I would like to find out how hand washing with soap and water helps safeguard patients against contracting new-fangled infections.   

            The area of interest is vital to the program specialty track. Washing hands with soap and water helps increase patient safety as well as avert Central Line Associated Bloodstream Infections. As a Family Nurse Practitioner, I will passionately advocate hand washing using soap and water since such intervention makes the patients’ immune system less vulnerable and promotes patient safety (Anderson, 2015). The area of interest will also increase my competency as a nurse practitioner.  

APA

One Reference From Peer reviewed nursing journal within the last five years

150 words 

one page

 

 

class 1 unit 7 comment 1

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The 4 P’s of Marketing

            Hamric, Hansen, Tracy, and O’Grady (2014) explain that marketing for advanced practice nurses (APNs) can be separated into two different areas (p. 539). One of these areas is the APN marketing themselves in order to obtain employment (Hamric et al., 2014, p. 539). The second area is the APN becoming an entrepreneur and marketing their business to the community and other health care professionals (Hamric et al., 2014, p. 539).

            The four P’s of marketing refer to product, price, place, and promotion (Hamric et al., 2014, p. 540). Hamric et al. (2014) describes product as the service provided by the APN and the APN themselves (p. 540). I feel that this is a very interesting idea that the APN themselves could be considered a product. I have never thought of myself as a product before, but Hamric et al. (2014) further explains that by having the APN being considered a product helps the customer realize the value of APNs (p. 540).

            Hamric et al. (2014) explains that “Price is the amount of money that an individual will be asked to pay for the product being offered” (p. 540). APNs help control costs in health care by providing preventative care, which reduces admissions of preventative illness to hospitals (Hamric et al., 2014, p. 540). Furthermore, APNs provide care at a more cost-effective price than physicians do (Hamric et al., 2014, p. 539).

            Place refers to the location that the product is available (Hamric et al., 2014, p. 540). Hamric et al. (2014) describes examples of places an APNs services can be accessed, as hospitals, classrooms, clinics, and virtual spaces (p. 540). I find it interesting that virtual space is considered a “place”. As virtual spaces continue to expand, like our very own  virtual classroom experience, I feel there will be even more opportunities for APNs to reach more people.

            Chang et al. (2001) defines promotion as communicating to the market what the value of the product is (as cited in Hamric et al., 2014, p. 540). APNs can promote their services by providing education to their patients (Hamric et al., 2014, p. 540). Additionally, APNs can promote their services by launching marketing campaigns (Hamric et al., 2014, p. 540).

            I feel that all of the 4 P’s are closely intertwined but the product is at the fore front. There must be a price assigned to the product, a place for the product to be available, and the product must be promoted. Without a product, there would be nothing to market. This being said, I feel the APN must have a solid foundation in order to be marketed successfully. 

 

References

Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. (2014). Advanced practice nursing: 

            an integrative approach (5th ed.). St. Louis, MO: Elsevier/Saunders.

COMMENT TANA

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  I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT.BETWEEN 150-200 WORDS

 

“The Scriptures tell us of a struggle between two kingdoms. Each of them, the kingdom of this world and the kingdom of God, are competing for citizens. The outcome of this struggle is secure: the heavenly kingdom will prevail” (Shelly & Miller, 2006, p. 153).  There are four parts of the Christian Biblical Narrative; Creation, Fall, Redemption, and Restoration. Creation speaks of how the universe and everything in it was created by God and was considered to be good and as it should be.  The Fall introduces sin which was created by humans, or Adam and Eve, by the event of disobeying God’s will, thus introducing sickness and disease, as well as, suffering and death. “Cancer, brain tumors and AIDS should be brought under the worldview of the fall and in doing so the church can humbly affirm that they are not part of God’s good creation, they are not the way things are meant to be” (Jonswales, 2008).  Redemption is our way of trying to receive forgiveness from God for our sins and heal our illness.  “This move against suffering may take the form of social or political action against injustice, but may legitimately find part of its expression in a healing ministry”(Jonswales, 2008).  Restoration speaks of returning to the idea of creation where everything was as it should be and there was no sin (PHI-413V Lecture 3, 2015).  This part of the Christian Narrative has not yet come to fruition.

 

The Fall describes and provides an understanding, for believers, that sickness and disease was a result of the human sin. Comfort in the light of illness or disease can be found in Redemption. Redemption is restoring a “good” relationship with God, and that our sins may be forgiven, thus providing hope in the face of illness.  This hope can be of cure, ease of suffering, or even the belief of life after death. Many of my cancer patients that have not previously been considered religious will find their relationship with God during their illness.  Many are scared and see no hope; the thought of God watching over them and the promise of heaven eases their suffering. A visit from a chaplain while in the hospital is always a worthwhile event as a nurse cannot always provide everything a patient may need spiritually. With redemption there is truth of the original creation. ‘Thy kingdom come, thy will be done, on earth as it is in heaven’.

 

Biomedical Ethics in The Christian Narrative. Unpublished manuscript. (2015). Retrieved from https://lc-ugrad3.gcu.edu/learningPlatform/user/users.html?operation=home&classId=528e0524-3c9b-4d11-a5e2-1d5338548ec0#/learningPlatform/loudBooks/loudbooks.html?viewPage=current&currentTopicname=Biomedical

Ethics in the Christian Narrative&operation=innerPage&topicMaterialId=97398c46-a5f4-4052-b68e-548d7f1928da&contentId=03c5c1df-8b1d-4f2d-8abe-897f0f09463f&15cafc8280bb&contentId=dea4915c-b10a-4b7f-a3e3-fafe866ebeb5&

Jonswales (2008). Christian Worldview, Sickness, Healing and Dying. Retrieved from https://ordinand.wordpress.com/2008/06/03/christian-worldview-sickness-healing-and-dying/

Shelly, J. A., & Miller, A. B. (2006). Called to Care A Christian Worldview of Nursing (2 ed.).

COMMENT JENNIFER

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i NEED A POSITIVE COMMENT BASED IN THIS ARGUENT..BETWEEN 120-150 WORDS

 
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            Re:Topic 4 Mandatory Discussion Question

Mucor is a fungus. It can be found in the house on bread and bread like products. It can also be in the heating and air ducts and soiled carpets. Outside it can be found in soil, hay and manure. Especially in leaves, compost and rotten wood piles. It can sometimes be in stored seeds. It can be inhaled or ingested. It affects the respiratory system. It can lead to a brain infection, paralysis, pneumonia, seizures, even death. It can also affect the digestive tract as well. The colonies if the fungus is fast growing and spread quickly. Because we are all probably exposed at times to these conditions, it is most likely for patients with weakened immune systems have a high chance to become affected. There is a lot of complications from fungal pneumonia.

The disease dissemination to other areas, like the brain, heart, eyes, adrenals, meninges, kidneys, spleen, liver and skin is one complication. Another is that the blood vessel invasion, leading to hemoptysis, pulmonary infraction, myocardial infarction, cerebral septic emboli, cerebral infarction, or even blindness. People can experience bronchopleural fistulas, chronic pulmonary symptoms, histoplasmosis, and pericarditis (Web MD, 2017). As a nurse, it is important to watch for effective airways clearance and breathing pattern, Provide oxygen if necessary. It is important to watch for fluid deficit and encourage fluids, watching for fluid overload. As a nurse always be aware of any pain and treat as needed. Give ordered antibiotics as prescribed by the doctor. It is always important to help maintain adequate nutrition.

The laboratory tests are all within normal limits except the following. The glucose fasting was 138 which is higher than the normal range. This may indicate that the patient may have diabetes. The WBC are elevated suggesting infection or inflammation. The ph is elevated meaning the blood is alkaline, low levels of concentrated carbon dioxide. The lymphocytes are low, meaning the body’s ability to fight infection is low. The PaO2 is low and this means low oxygen saturation in the blood. The PaCO2 is also low, this means low carbon dioxide in the blood.  The HCO3 is high, meaning the bicarbonate which helps determine body’s ph. These all point to respiratory alkalosis. The numbers represent an infection or inflammation. The patient has a disturbance in the acid and base exchange from alveolar hyperventilation. This decreases carbon dioxide and increases the bicarbonate which increases the ph which is the bases for respiratory alkalosis.

Treatment would include antibiotics to get rid of infection. Cough medication to give your lungs a rest and allow them to clear. Pain relief because you need to have pain under control so that you can rest. Possible steroids to reduce inflammation. The doctor would order intravenous antifungal medications and consider having surgical debridement. This involves cutting away all infected tissue. By doing the surgery it prevents infection from spreading. These antibiotics of choice are:

  • amphotericin B (given through an IV)- Concerns of nephrotoxity. Must monitor renal functions closely, as well as electrolytes
  • Posaconazole- (given through an IV or orally)- triazole antibiotic and can be used as the step down antibotic from amphotericin B.
  • isavuconazole (given through an IV or orally)- wide spectrum triazole fungal antibiotic

 

 

 

 

Centers for Disease Control and Prevention.(2015). Fungal Diseases. Retrieved August 19, 2017, from https://www.cdc.gov/fungal/diseases/mucormycosis/treatment.html

 

Medscape. (2017). Mucormycosis (Zygomycosis). Retrieved August 19, 2017, from