NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care

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NURS 6051 Transforming Nursing and Healthcare Through Technology – Step-by-Step Guide

The first step before starting to write the NURS 6051 Transforming Nursing and Healthcare Through Technology, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. 

It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.

How to Research and Prepare for NURS 6051 Transforming Nursing and Healthcare Through Technology

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last words and go through each to check for credibility. Ensure that you obtain the references in the required format, for example, in APA, so that you can save time when creating the final reference list. 

You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for NURS 6051 Transforming Nursing and Healthcare Through Technology

The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested to read through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.

How to Write the Body for NURS 6051 Transforming Nursing and Healthcare Through Technology

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence conducted from the research, ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between each paragraph by using transition words and a flow of ideas.

How to Write the In-text Citations for NURS 6051 Transforming Nursing and Healthcare Through Technology

In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.

How to Write the Conclusion for NURS 6051 Transforming Nursing and Healthcare Through Technology

When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.

How to Format the Reference List for NURS 6051 Transforming Nursing and Healthcare Through Technology

The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456

Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.

NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care Instructions

Advanced practice nursing in all specialties is guided by codes of ethics that put the care, rights, duty, health, and safety of the patient first and foremost. PMHNP practice is also guided by ethical codes specifically for psychiatry. These ethical codes are frameworks to guide clinical decision making; they are generally not prescriptive. They also represent the aspirational ideals for the profession. Laws, on the other hand, dictate the requirements that must be followed. In this way, legal codes may be thought to represent the minimum standards of care, and ethics represent the highest goals for care.

For this Discussion, you select a topic that has both legal and ethical implications for PMHNP practice and then perform a literature review on the topic. Your goal will be to identify the most salient legal and ethical facets of the issue for PMHNP practice, and also how these facets differ in the care of adult patients versus children. Keep in mind as you research your issue, that laws differ by state and your clinical practice will be dictated by the laws that govern your state.

To Prepare

  • Select one of the following ethical/legal topics:
    • Autonomy
    • Beneficence
    • Justice
    • Fidelity
    • Veracity
    • Involuntary hospitalization and due process of civil commitment
    • Informed assent/consent and capacity
    • Duty to warn
    • Restraints
    • HIPPA
    • Child and elder abuse reporting
    • Tort law
    • Negligence/malpractice
  • In the Walden library, locate a total of four scholarly, professional, or legal resources related to this topic. One should address ethical considerations related to this topic for adults, one should be on ethical considerations related to this topic for children/adolescents, one should be on legal considerations related to this topic for adults, and one should be on legal considerations related to this topic for children/adolescents. 

By Day 3 of Week 2

Briefly identify the topic you selected. Then, summarize the articles you selected, explaining the most salient ethical and legal issues related to the topic as they concern psychiatric-mental health practice for children/adolescents and for adults. Explain how this information could apply to your clinical practice, including specific implications for practice within your state. Attach the PDFs of your articles.

Upload a copy of your discussion writing to the draft Turnitin for plagiarism check.  Your faculty holds the academic freedom to not accept your work and grade at a zero if your work is not uploaded as a draft submission to Turnitin as instructed. Have a look at NRNP 6665 Week 3 Assignment 1 Prescribing For Children and Adolescents.

Read a selection of your colleagues’ responses.

By Day 6 of Week 2

Respond to at least two of your colleagues on 2 different days by sharing cultural considerations that may impact the legal or ethical issues present in their articles.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply! 

NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care Example

Ethical and Legal Foundations of PMHNP Care: Child and Elder Abuse Reporting

Psychiatric Mental Health Nurse Practitioners’ responsibilities encompass clinical decision-making and navigating complex ethical and legal landscapes. This discussion focuses on the intersection of these two domains through the lens of child and elder abuse reporting. I aim to explore the ethical dilemmas and legal mandates shaping this critical practice area by conducting a targeted literature review. Based on four scholarly articles, this analysis will address key considerations for adult and child populations. Furthermore, the discussion will highlight the implications of these findings for PMHNP practice in North Carolina, where specific state laws guide mandatory reporting.

Topic Selection: Child and Elder Abuse Reporting

Child and elder abuse reporting represents a pervasive issue with profound ethical and legal ramifications. My choice of this topic stems from over 16 years of experience as a psychiatric mental health nurse, during which I encountered numerous cases involving vulnerable populations. The United States, like many other countries, faces widespread issues of child abuse, often manifesting in physical, sexual, emotional, or neglectful forms, with many children experiencing multiple types of abuse simultaneously (Liu & Vaughn, 2019).

Similarly, elder abuse is frequently underreported, with older adults particularly susceptible due to cognitive decline, self-neglect, and physical disabilities (Hall & Lichtenberg, 2024). Reporting such cases involves navigating definitions and standards set by various entities, including law enforcement, healthcare agencies, and social services, each may interpret abuse differently (Aday, Wallace, & Scott, 2017).

Literature Review: Ethical and Legal Considerations in Child and Elder Abuse Reporting

Ethical Considerations in Elder Abuse Reporting

Aday et al. (2017) conducted a study examining generational differences in attitudes toward elder abuse reporting. The findings revealed significant variability in ethical perspectives. Younger individuals were more likely to report abuse perceived as severe, such as sexual abuse, but hesitated when the abuse was financial. Older adults, on the other hand, often avoided reporting altogether, fearing potential retaliation or worsening of the abuse (Aday et al., 2017). This highlights the need for PMHNPs to educate communities about abuse definitions and reporting procedures while addressing cultural and generational nuances.

Ethical Considerations in Child Abuse Reporting

Mulya (2018) explored societal perceptions of child sexual abuse and the reluctance of some victims to report their experiences. The study illuminated how children often frame themselves as survivors rather than victims, opting not to disclose abuse due to stigma or mistrust. This underscores the PMHNP’s responsibility to build trust and create a safe environment for children to share sensitive information.

Legal Considerations in Elder Abuse Reporting

Hall and Lichtenberg (2024) examine financial exploitation (FE) among older adults, emphasizing its status as a critical public health issue. FE is defined as the illegal or improper use of an elder’s funds or property for personal gain, affecting between 5% and 11% of older adults annually(Hall & Lichtenberg, 2024).

The authors introduce the Successful Aging through Financial Empowerment (SAFE) program, which employs empowerment-based financial coaching to mitigate the impacts of FE. This intervention addresses the financial fallout experienced by victims and improves their emotional and mental well-being, as evidenced by reduced stress levels at a six-month follow-up. The program participants also reported high satisfaction with the services provided (Hall & Lichtenberg, 2024).

The SAFE program highlights the systemic barriers to addressing elder financial exploitation, such as underreporting, lack of resources, and the complexity of legal processes. These barriers are compounded by older adults’ reluctance to report abuse by trusted individuals due to fear of retaliation or further harm. The study underscores the importance of education and multidisciplinary approaches to enhance reporting mechanisms and prevent FE (Hall & Lichtenberg, 2024).

For Psychiatric Mental Health Nurse Practitioners (PMHNPs), the insights from this study are critical. PMHNPs can be pivotal in identifying vulnerable individuals, educating communities about FE, and advocating for legal and financial protections for older adults. By fostering empowerment and resilience among elderly patients, PMHNPs mitigate the adverse effects of financial exploitation and promote well-being.

Legal Considerations in Child Abuse Reporting

Liu and Vaughn (2019) examined mandatory reporting laws for child abuse, noting significant discrepancies in how abuse is defined across jurisdictions. The authors pointed out that while mandatory reporting increases awareness, it also increases unsubstantiated claims, which can overwhelm the system. For PMHNPs, understanding state-specific definitions and reporting processes is crucial to ensuring compliance and effectively addressing abuse cases.

Application to Clinical Practice in North Carolina

In North Carolina, all individuals are legally obligated to report suspected cases of child abuse, neglect, or dependency, as outlined in North Carolina General Statute § 7B-301. Reports must be submitted to the director of the Department of Social Services in the county where the child resides and can be made orally, by phone, or in writing, including the reporter’s contact information.

However, anonymity does not hinder the investigation. Failure to report or obstructing others from reporting constitutes a Class 1 misdemeanor. Similarly, North Carolina General Statute § 108A-102 requires anyone with reasonable cause to suspect that a disabled adult requires protective services to notify the county’s Department of Social Services director (North Carolina General Assembly, 2023).

As a future Psychiatric Mental Health Nurse Practitioner (PMHNP) in North Carolina, I believe being well-versed in these legal obligations is imperative. This includes recognizing signs of abuse or neglect and understanding the appropriate reporting procedures. Additionally, addressing the ethical challenges that patients may face when disclosing abuse is crucial. Education and support can empower patients to report within the legal framework, ensuring their safety and well-being.

Conclusion

Child and elder abuse reporting represents a complex interplay of ethical and legal considerations. The reviewed articles highlight the multifaceted nature of abuse, its cultural and societal underpinnings, and the legal systems designed to address it. For PMHNPs, understanding these dynamics is essential to advocating for vulnerable populations and ensuring the delivery of ethically sound and legally compliant care. In my future practice, I aim to integrate these insights, promoting awareness and facilitating reporting processes to protect the well-being of those at risk.

References

Aday, R., Wallace, J. & Scott, S. (2017). Generational differences in knowledge, recognition, and perceptions of elder abuse reporting. Educational Gerontology, 43(11), 568–581.

Boland, R., Verduin, M. L., & Ruiz, P. (2021). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.

Hall, L., & Lichtenberg, P. A. (2024). Successful aging through financial empowerment (safe): Financial coaching with older adult victims of financial exploitation. Journal of Gerontological Social Work. https://doi.org/10.1080/01634372.2024.2373288

Hilt, R. J., & Nussbaum, A. M. (2024). DSM-5-TR® pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.

Liu, B.C. & Vaughn, M. (2019). Legal and policy issues from the United States and internationally about mandatory reporting of child abuse. International Journal of Law and Psychiatry, 64, 219–229.

Mulya, T.W. (2018). Contesting the dominant discourse of child sexual abuse: sexual subjects, agency, and ethics. Sexuality & Culture, 22, 740–757.

North Carolina General Assembly. (2023). § 7B‑301. Duty to report abuse, neglect, dependency, or death due to maltreatment. Retrieved from https://www.ncleg.gov/EnactedLegislation/Statutes/PDF/BySection/Chapter_7B/GS_7B-301.pdf

NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care Example 2

Ethical and Legal Foundations of PMHNP Care – Autonomy

Autonomy in medical practice is the right of competent adults to make decisions on their own healthcare based on information from medical professionals. The principle of autonomy requires healthcare professionals to acquire consent from the patient before engaging in any investigations or treatments.

Typically, a decision is considered autonomous when two conditions are met; the individual must have all relevant mental capacity to make rational decisions and must be unaffected by external constraints (Chapman et al., 2019). In the healthcare field, a decision is viewed as autonomous when the patient has sufficient information, the capacity to make a decision and arrives at a decision voluntarily.

According to Chapman et al. (2019), medical practitioners are expected to respect the principle of autonomy by disclosing medical information, including the available treatment options, to allow patients to make their own decisions. The principle of autonomy is not applicable to people who do not have the capacity or competence to make autonomous decisions such as infants and young children and patients who lack competence due to mental, developmental, or physical disorders (Chapman et al., 2019). To make informed consent, there are several requirements; the patient must have the capacity to understand and decide based on the information provided to them, understand the disclosure, and acts voluntarily to give consent.

According to the article by Gómez-Vírseda et al. (2020), patients have the legal right to make decisions as long as they are in their right mental state. Patients can decide whether or not to get treatment even if their decisions do not align with the physicians’ recommendations. Legal precedents have advanced the necessary requirements for patient autonomy such that patient autonomy is now the dominant principle instead of the physician’s beneficence.

McGee et al. (2016), note that the welfare and health of children are maintained by their guardians. However, children and adolescents should also be involved in the decision-making process on the types of treatment they receive. Medical professionals should explain the medical issues and possible treatment options in a way that both the children/ adolescent patient and the guardian can understand.

The child/adolescent should then be allowed to participate in decisions about the care they will receive to the best of their abilities to act rationally and comprehend their options. Children or adolescents have the right to agree or disagree with the treatment options presented to them. The guardians of the children or adolescents have the right of proxy consent where they can make decisions for the minors under their care.

In some jurisdictions, the consent of adolescents of a certain age is required. The psychiatrist of the child/ adolescent is required to obtain the minor’s assent whenever it is reasonable as well as the legal guardian’s consent before any medical actions take place. However, as noted by McGee et al. (2018). There are some provisions for emergencies and in the case of emancipated minors.

During emergency medical care, medical professionals are allowed to consider assent and consent as secondary considerations in order to provide urgent medical care to the minor patient. Emancipated minors are legally responsible for their own care and their consent must be obtained before any actions take place. In some jurisdictions, minors involved with sexually-related situations, minors are allowed to make autonomous decisions regarding their care.

Song et al. (2020) argue that there are cases when the decisions of the child or adolescent and the guardians are in conflict. In situations where the guardian consents to treatment while the minor dissents, medical practitioners may opt to treat the minor patient in spite of their dissent. It is up to the minor patient’s psychiatrist to determine the consequences of treating the patient without their consent and encourage the minor and guardians to collaborate to enhance the health of the minor.

Psychiatrists and all medical professionals have the ethical responsibility to maintain their patient’s autonomy through providing the all necessary information and allowing them to make their own decision. In my practice, I will strive to maintain my patient’s autonomy and in cases where my ethical responsibilities conflict with the law or other governing legal authority, I will take the necessary steps to resolve the conflicts using the Ethical Standards of Ethics Code and General Principles. I will also ensure that I never use any conflicts or standards to violate my patients’ right to autonomy.

References

Chapman, S. A., Toretsky, C., & Phoenix, B. J. (2019). Enhancing psychiatric mental health nurse practitioner practice: impact of state scope of practice regulations. Journal of Nursing Regulation, 10(1), 35-43. https://doi.org/10.1016/S2155-8256(19)30081-XLinks to an external site.

Gómez-Vírseda, C., De Maeseneer, Y., & Gastmans, C. (2020). Relational autonomy in end-of-  life care ethics: a contextualized approach to real-life complexities. BMC Medical Ethics, 21, 1-14. https://doi.org/10.1186/s12910-020-00495-1

McGee, M. E., Dingle, A. D., & Edelsohn, G. A. (2018). Review of the revised 2014 American   Academy of Child and Adolescent Psychiatry code of ethics. Journal of the American   Academy of Child and Adolescent Psychiatry, 55(4), 257-261. https://doi.org/10.1016/j.jaac.2015.12.017

Song, S. Y., Wang, C., Espelage, D. L., Fenning, P., & Jimerson, S. R. (2020). COVID-19 and school psychology: Adaptations and new directions for the field. School Psychology Review, 49(4), 431-437. https://doi.org/10.1080/2372966X.2020.1852852