Application: Taking a Stand
In Leadership Roles and Management Functions in Nursing, Marquis and Huston discuss the opportunities—nay, the imperative—for a nurse to advocate on behalf of him- or herself, others, and the environment. No doubt, at some point in your career, you will encounter an ethical or moral dilemma that requires you to take a stand and defend your position.
For this Assignment, you evaluate an issue and consider how you could act as a moral agent or advocate, facilitating the resolution of the issue for a positive outcome.
To prepare:
• Consider the examples of leadership demonstrated in this week’s media presentation and the other Learning Resources. (Will attach this separately for your use if you need it see below)
• Mentally survey your work environment, or one with which you are familiar, and identify a timely issue that requires you to perform the role of moral agent or advocate to improve a situation (e.g., speaking or acting on behalf of a vulnerable patient, the need for appropriate staffing, a colleague being treated unfairly).
• What are the potential outcomes if you do not execute that role?
• What skills, dispositions, and/or strategies would help you to fulfill this role?
• Finally, consider the values and principles that guide the nursing profession; the organization’s mission, vision, and values; the leadership and management competencies addressed in this course; and your own values and reasons for entering the profession. What motivation do you see for taking a stand on an important issue even when it is difficult to do so?
To complete:
Write a 3- to 4-page paper that addresses the following:
• Describe your role as a moral agent or advocate for a specific issue in your work environment or an organization with which you are familiar.
• Explain one or more negative outcomes that may result if this role is not fulfilled.
• Analyze the skills, dispositions, and/or strategies that would help you to fulfill this role.
• Explain your motivation for taking a stand even when it is difficult to do so.
Attachment refer to above
“Ethical, Moral, and Legal Leadership”
Program Transcript
TERRY MAHAN BUTTARO: The moral, legal, ethical implications of practice are
all back to the value of providing the best patient care for the community and for
the individual patient. That’s what being a health care provider is all about. And
those values are reflected in the American Nurses Association, the Academy of
Nurse Practitioners. Those are all values that we all ascribe to, physicians also.
All right. Well, come on in and sit down.
It guides practice every day. It’s why we explain the risks and benefits to patients
about medicines or about different procedures or about choosing not to do
something.
Good. OK, excellent.
MALE SPEAKER: All right.
TERRY MAHAN BUTTARO: All right. Now, make sure-
–
You have to have integrity to be a health care provider. You have to explain
clearly and succinctly about what it is that patients face. You know, we have a
patient in an adjacent state who was brought in recently by her home health care
worker. And she actually had to get permission from the home health ca
re
agency for this woman to drive her here.
This woman is older. None of her family lives close by. She’s outlived many of
her friends. And she came in because in our practice, it is kind of an unwritten
rule, but it’s well-spoken to help, that we don’t j
ust continue to renew medicines.
Patients need to be seen at least once a year, and for some meds, possibly more
often.
So she had to come in to see us to get her prescriptions, and I actually saw her.
So she didn’t have complaints. She really said, I jus
t want my medicines. And
she said, I can never come back, because I can’t get a ride here.
I said, well, you need to have some blood tests, ’cause you’re on medicines that
will affect your kidneys and some other things. And I need to be able to figure out
a way to help you. So, I renewed her prescriptions.
I sent her home, but she did go and get labs. And the home health care worker
actually took her to get labs right away. Because our problem here is we don’t
have labs and diagnostics right on site, so t
hey have to go to the hospital to get
these done.
© 2012 Laureate Education, Inc.
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But her labs came back, and she was really anemic. But she can’t get in here. So
now, what are we going to do? So the girls in office were really helpful in
brainstorming about how can we get this patient back into the practice.
We could try Neurontin for her.
FEMALE SPEAKER: OK.
TERRY MAHAN BUTTARO: Has she tried that?
FEMALE SPEAKER: Yeah.
TERRY MAHAN BUTTARO: She did try that. Hmm.
The visiting nurses were kind of the best idea about doing this. But in other
situations, it’s been calling patients about, can we talk to your family member?
We’re really concerned about this.
FEMALE SPEAKER: Nothing to eat or drink after midnight. OK. Thanks a lot.
Bye.
TERRY MAHAN BUTTARO: I can also do home visits, which I’ve done before.
And I can draw labs and bring the labs to the hospital. So that is another way that
we’ll try to provide the best patient care for patients. And that is something in the
future that’s going to be really imperative–
that if we want
to keep people in the
home, we have to have providers who can go into the home.
Hi.
MALE SPEAKER: Hi, good morning.
TERRY MAHAN BUTTARO: How are you?
MALE SPEAKER: Good.
TERRY MAHAN BUTTARO: What’s going on?
MALE SPEAKER: Ah, just general checkup, I guess.
TERRY MAHAN BUTTARO: I think nurse practitioners always have to remember
that medicine is very humbling. One day you can feel great about what you’ve
done and the care you provided. And another day, you mig
ht say, oh my god,
how did I miss that? Or why did I think to prescribe that drug instead of another
drug? So every day is a new day.
Here we go. So just give this to Miss Pixie, and we’ll see. OK?
© 2012 Laureate Education, Inc.
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MALE SPEAKER: OK. Thank you.
TERRY MAHAN BUTTARO: Good. Good to see you.
ABIGAIL STRIBLEA: One of the main focuses of our training with students is to
expose them to the possibility of providing for vulnerable populations, of working
in a community clinic setting. In addition to that, we’re trying to instill
in them the
value of providing care for homeless patients or those that are in a vulnerable
situation. These are patients that often have nowhere else to go, so the care you
provide is very important to them.
JANET WEIR: You know, especially working with
an under
-served population or
a homeless population, they don’t have some of the, I guess, luxuries we do. So
even just within giving them medication, sometimes they don’t have a place to
store it. Especially, when you’re talking about insulin, where you n
eed to keep it
cold.
So it’s keeping that in mind. And sometimes we have to hold onto their
medication, and then they have to come up and take it as needed. And a lot of
the homeless population also have mental illness. So just taking care of
themselves is a really big burden, even just taking care of their own health care
needs. And so taking that into consideration.
HANNAH BAMPTON: Well, you can come into the clinic as a walk-in. And we
can do just basic health maintenance stuff that you should get ever
y year.
Often, unfortunately, a lot of homeless people are treated as kind of second-class
citizens. And an example, actually–
Very recently, there was a single man. I think
he was in his ’40s. And he was discharged from a local hospital with new
amputation. He had a new
— I think it was his right foot–
below
–
the
-knee
amputation from diabetes complications. So that was a new thing he had to deal
with.
He had to learn to be in a wheelchair and how to be independent, which is huge.
And you need help doing
that. And in addition to that, he needed dressing
changes daily for the wound. And then he also had a chronic wound on his back
that was pretty bad and definitely needed daily dressing changes.
And he was discharged here. And then our clinic is kind of an outpatient clinic.
It’s not really a skilled nursing facility or an assisted living facility.
So in the meantime, we adapted. And we got him an emergency bed here in the
shelter, and then just brought him up to the clinic every day so we could do those
dressing changes. Which kind of slowed down our flow, ’cause it’s not really our
role. But we just had to do it, and we were glad to.
© 2012 Laureate Education, Inc.
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And then through case management– Antonio, one of our medical assistants, is
really good at that. He kind of knows everything around here. He knows people
by name. And so he was able to get him into a skilled nursing facility, I think after
only three or four days. So that one worked out pretty well. And in the meantime,
we could manage him and take care of him.
But he really needed that higher level of care. And he should have gone there
straight from the hospital, from being discharged. Often, people are kind of
shushed away. So we try to get them all the resources that they really need.
DR. MARY MARFISEE: As far as ethical issues, I think that to work in a
community clinic setting and to work with under
-served populations, you have to
know that you really do want to serve that population. Because it’s not always
easy to interact with somebody who may have a different kind of social agenda
than you do or may not have the same kind of social graces or customs that you
might. And I think foremost, you have to keep yourself as non-judgmental as you
can be. It really is to your benefit to be that way.
And also, consider yourself really a servant. If you get humbled by your
servantship, then I think you’ll always be in good shape.
© 2012 Laureate Education, Inc.
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