NRNP 6665 WEEK 2 Ethical and Legal Foundations of PMHNP Care

Ethical and Legal Foundations of PMHNP Care

Codes of ethics and ethical principles play a key role in advanced nursing practice. Hence, there is a need for APNs to be conversant with the code of ethics since they offer a framework that guides the clinical decisions made in the care settings. One of the topics that has both ethical and legal implications for PMNHP practice is patient autonomy, which focuses on ensuring that patients have the right to make their own decisions regarding their medical treatment and care. Various research articles have been published regarding this topic. One of them is an article by Laacke et al.(2021). According to this study, it is important to respect patient’s autonomous decisions. Therefore, nurses and other healthcare professionals have an obligation to fulfill such. Another source is an article by Vicens et al. (2021); this article explores the capacity of a patient living with schizophrenia and bipolar disorder to make decisions regarding their health. The authors argue that such as poor understanding and training can limit patient autonomy. Comparatively, advocacy and having an interest in patient needs can improve autonomous decision-making.

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The other source is an article by Ismail et al. (2021), which explores patient autonomy among patients with schizophrenia. According to this source, there is limited involvement of such patients in autonomous decisions. As such, there is a need for practitioners to involve them more. Calcedo-Barba et al. (2020) also found out that in some cases, patients experiencing various mental illnesses may have the ability to make autonomous decisions; as such, the professionals should encourage them to do so. The evidence obtained from these articles can be applied in my clinical practice. For example, appropriate strategies can be used to enhance patient autonomy and autonomous decisions for patients presenting with various mental health challenges. One of the implications for practice is the need to adhere to the state rules and laws regarding patient autonomy.

References

Calcedo-Barba, A., Fructuoso, A., Martinez-Raga, J., Paz, S., Sánchez de Carmona, M., & Vicens, E. (2020). A meta-review of literature reviews assessing the capacity of patients with severe mental disorders to make decisions about their healthcare. BMC Psychiatry, 20(1), 1-14. https://doi.org/10.1186/s12888-020-02756-0

Ismail, M. A., & Midin, M. (2021). Shared decision-making and role preference among patients with schizophrenia in Malaysia: A cross-sectional study. Frontiers In Psychiatry, 12, 680800.

Laacke, S., Mueller, R., Schomerus, G., & Salloch, S. (2021). Artificial intelligence, social media and depression. A new concept of health-related digital autonomy. The American Journal of Bioethics, 21(7), 4-20. https://doi.org/10.1080/15265161.2020.1863515

Vicens Pons, E., Calcedo Barba, A., Hastings, J., Männikkö, M., & Paz Ruiz, S. (2021). What is the capacity of individuals with schizophrenia and bipolar disorder to make healthcare decisions? An exploratory study of the views of patients, psychiatrists, and family caregivers—A survey on decisional capacity in mental health. Psychiatry International, 2(2), 127-144. https://doi.org/10.3390/psychiatryint2020010

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Ethical and Legal Foundations of PMHNP Care

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.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

Learning Resources

Required Readings

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements

Links to an external site.. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/coe-view-only/Links to an external site.
American Psychological Association. (2017). Ethical principles of psychologists and diagnostic formulation
Links to an external site.. http://www.apa.org/ethics/code/Links to an external site.
American Academy of Child & Adolescent Psychiatry. (2014). Code of ethics
Links to an external site.. https://www.aacap.org/App_Themes/AACAP/docs/about_us/transparency_portal/aacap_code_of_ethics_2012.pdfLinks to an external site.
American Psychiatric Nurses Association. (2020). APRN psychiatric-mental health nursing practice
Links to an external site.. https://www.apna.org/i4a/pages/index.cfm?pageID=3846Links to an external site.
Anderson, S. L. (2012).Practice parameter on gay, lesbian, or bisexual sexual orientation, gender nonconformity, and gender discordance in children and adolescents
Links to an external site.. American Academy of Child and Adolescent Psychiatry, 51(9). 957–974. https://www.jaacap.org/action/showPdf?pii=S0890-8567%2812%2900500-XLinks to an external site.
Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health

Links to an external site.. American Psychiatric Association Publishing.
- Chapter 2, “Addressing Behavioral and Mental Problems in Community Settings”Links to an external site.
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
- Chapter 19, “Legal Issues in the Care and Treatment of Children with Mental Health Problems”
Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.
- Chapter 1, “Preparing to Pass the Psychiatric-Mental Health Nurse Practitioner Certification Exam”

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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.

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_Week2_Discussion_Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning Outcome Main Posting:Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

44 to >39.0 ptsExcellent

Thoroughly responds to the Discussion question(s)… Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources… No less than 75% of post has exceptional depth and breadth… Supported by at least three current credible sources

39 to >34.0 ptsGood

Responds to most of the Discussion question(s)… Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module… 50% of the post has exceptional depth and breadth… Supported by at least three credible references

34 to >30.0 ptsFair

Responds to some of the Discussion question(s)… One to two criteria are not addressed or are superficially addressed… Is somewhat lacking reflection and critical analysis and synthesis… Somewhat represents knowledge gained from the course readings for the module… Post is supported by fewer than two credible references

30 to >0 ptsPoor

Does not respond to the Discussion question(s)… Lacks depth or superficially addresses criteria… Lacks reflection and critical analysis and synthesis… Does not represent knowledge gained from the course readings for the module… Contains only one or no credible references

44 pts

This criterion is linked to a Learning Outcome Main Posting:Writing

6 to >5.0 ptsExcellent

Written clearly and concisely… Contains no grammatical or spelling errors… Adheres to current APA manual writing rules and style

5 to >4.0 ptsGood

Written concisely… May contain one to two grammatical or spelling errors… Adheres to current APA manual writing rules and style with minor errors

4 to >3.0 ptsFair

Written somewhat concisely… May contain more than two spelling or grammatical errors… Contains some APA formatting errors

3 to >0 ptsPoor

Not written clearly or concisely… Contains more than two spelling or grammatical errors… Does not adhere to current APA manual writing rules and style

6 pts

This criterion is linked to a Learning Outcome Main Posting:Timely and full participation

10 to >8.0 ptsExcellent

Meets requirements for timely, full, and active participation… Posts main Discussion by due date

8 to >7.0 ptsGood

Posts main Discussion by due date… Meets requirements for full participation

7 to >6.0 ptsFair

Posts main Discussion by due date

6 to >0 ptsPoor

Does not meet requirements for full participation… Does not post main Discussion by due date

10 pts

This criterion is linked to a Learning Outcome First Response:Post to colleague’s main post that is reflective and justified with credible sources

9 to >8.0 ptsExcellent

Response exhibits critical thinking and application to practice settings… Responds to questions posed by faculty… The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 to >7.0 ptsGood

Response has some depth and may exhibit critical thinking or application to practice setting.

7 to >6.0 ptsFair

Response is on topic, may have some depth.

6 to >0 ptsPoor

Response may not be on topic, lacks depth.

9 pts

This criterion is linked to a Learning Outcome First Response:Writing

6 to >5.0 ptsExcellent

Communication is professional and respectful to colleagues…. Response to faculty questions are fully answered, if posed…. Provides clear, concise opinions and ideas that are supported by two or more credible sources… Response is effectively written in standard, edited English.

5 to >4.0 ptsGood

Communication is mostly professional and respectful to colleagues…. Response to faculty questions are mostly answered, if posed…. Provides opinions and ideas that are supported by few credible sources… Response is written in standard, edited English.

4 to >3.0 ptsFair

Response posted in the Discussion may lack effective professional communication…. Response to faculty questions are somewhat answered, if posed…. Few or no credible sources are cited.

3 to >0 ptsPoor

Responses posted in the Discussion lack effective communication…. Responses to faculty questions are missing…. No credible sources are cited.

6 pts

This criterion is linked to a Learning Outcome First Response:Timely and full participation

5 to >4.0 ptsExcellent

Meets requirements for timely, full, and active participation… Posts by due date

4 to >3.0 ptsGood

Meets requirements for full participation… Posts by due date…

3 to >2.0 ptsFair

Posts by due date

2 to >0 ptsPoor

Does not meet requirements for full participation… Does not post by due date

5 pts

This criterion is linked to a Learning Outcome Second Response:Post to colleague’s main post that is reflective and justified with credible sources

9 to >8.0 ptsExcellent

Response exhibits critical thinking and application to practice settings…. Responds to questions posed by faculty… The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 to >7.0 ptsGood

Response has some depth and may exhibit critical thinking or application to practice setting.

7 to >6.0 ptsFair

Response is on topic, may have some depth.

6 to >0 ptsPoor

Response may not be on topic, lacks depth.

9 pts

This criterion is linked to a Learning Outcome Second Response:Writing

6 to >5.0 ptsExcellent

5 to >4.0 ptsGood

4 to >3.0 ptsFair

Response posed in the Discussion may lack effective professional communication…. Response to faculty questions are somewhat answered, if posed…. Few or no credible sources are cited.

3 to >0 ptsPoor

Responses posted in the Discussion lack effective communication…. Responses to faculty questions are missing…. No credible sources are cited.

6 pts

This criterion is linked to a Learning Outcome Second Response:Timely and full participation

5 to >4.0 ptsExcellent

Meets requirements for timely, full, and active participation… Posts by due date

4 to >3.0 ptsGood

Meets requirements for full participation… Posts by due date

3 to >2.0 ptsFair

Posts by due date

2 to >0 ptsPoor

Does not meet requirements for full participation… Does not post by due date

5 pts

Total Points: 100