Ethical Issues in professional Nursing Practice Florida National University Nursing Department BSN Program Nursing Role and Scope Prof. Lourdes Castaneda 12/04/2019 Question 1 Several signs can show one the potential professional boundary crossing or violation since nursing practice requires ethical guidance for proper socialization and the betterment of the lives of the patients in the healthcare units. One of the signs of boundary-crossing or violation by the nurse occurs when the patient offers a gift for no good reason. A nurse may be tempted to receive the gift that may be patient uses to convince the practitioner to provide excellent care than others within the healthcare unit. When an incidence of the same happens to many patients in the hospital, then the practitioners may end up forgetting the ethical issues surrounding nursing practice as per the code in American Nurses ’Association (King 2019). Another instance of a possible boundary crossing is when the nurse-patient relationship develops into intimate feelings. Once a nurse realizes that the patient has weird or unnecessary intentions, it is crucial to avoid such by doing only the basic or the usual roles to enhance nursing professionalism. The physical and emotional behavior of a patient can help a nurse to know the thoughts and ideas that the patient has. Therefore, as a professional nurse, one should not allow for involvement up to the level of accepting intimacy and thus should uphold integrity. Again, the other sign of professional boundary crossing in nursing practice is the collective action of abuse and neglect. Neglect comes as a result of nurses ’attitudes towards some patients, while abuse may be intentional when the nurses do literary the unexpected of them. When one, as a nurse, realizes that some patients discriminated in the treatment and nursing habits, it is necessary for changes to be made (Go n.d). A nurse may exhibit unethical behavior unknowingly, but it is essential for one to reorganize the roles to ascertain that every patient receives fair handling and treatment. Question 2 The three terms have their meanings and concerns but though still collectively; revolve around suicide, a common experience worldwide in the healthcare units or at any given place. Ethical Issues in professional Nursing Practice Discussion

Firstly, terminal sedation occurs when a patient gets induced by sedatives to sleep, of which later, due to the intention done, one dies. This type of death is so common though postmortem may declare the cause of death that happens later. It is very unethical when a healthcare provider gets involved in such inhuman activities. Terminal sedation may prolong the death of the patient since maybe the time of sleep overlaps, limiting the next procedures of medication by the practitioner. A suicide that occurs simultaneously over a very long period with the practitioner or nurse’s awareness can be termed as rational suicide. World Health Organization (WHO) has recorded a large number of rational suicide cases over the past years. The nurses may help the patient commit rational suicide since the people will not understand how the patient suddenly dies after a long time that could have allowed one’s recovery (Briscoe 2017). Consequently, an instance of rational death by the patient is always much unethical since the nurse facilitates one’s death in awareness and a sober mind. Lastly, physician-assisted suicide is also a type of suicide that takes place when the practitioner or the healthcare provider deliberately gets involved in the death of a patient instantly. The situation is also common though it may be facilitated majorly when the patient cannot retain much pain and suffering and, therefore, convinces the physician to assist for a cool death. Physician-assisted suicide is also unethical in the professional nursing practice as described in the American Nurses ’ Association (Masters, 2014). References Briscoe, J., & Kinghorn, W. (2017). Spirituality, Religion, and Rational Suicide. In Rational Suicide in the Elderly (pp. 187-202). Springer, Cham. Go, R. A. Maintaining Professional Boundaries in Nursing. King, M. (2019). Boundary violations between nurses and patients. British Journal of Mental Health Nursing, 8(1), 7-9. Masters, K. (2014). Nursing Practice. Role Development in Professional Nursing Practice, 235. Dilsy Ricardo Florida National University December 4, 2019 Professional boundaries Question 1 Professional boundary refers to the space that exists between the power of the nurse and the vulnerability of the patient. They are departures from the accepted practices which place the treatment process or the client at risk. Violation of the professional boundaries can cause distress to the patients which may or may not be felt or recognized until tremendous effects happen. It is the responsibility of all the medical personnel to uphold their code of ethics and serve their clients with a great sense of commitment (Eymard, A. S.2015). The medical personnel should be act ethically, be in a position to police his ranks as well as be accountable to the public so as to earn public trust. Boundary violations can be harmful or can be potentially harmful and can arise from either the medical personnel or from the patient. There are different signs of a potential professional boundary crossing or violation. One sign of professional violation is discussing personal or intimate issues with the patients. A nurse is required to maintain a professional relationship with the patient and going beyond this may be a red flag for professional boundary violation. A nurse and the patient are required to keep their conversation professional and nothing is said to compromise the professional code of ethics. Physicians are not required to wear revealing or seductive clothes while attending to their clients. The physicians should avoid regular conversations; their task is to listen and not to talk. Spending more time with a certain patient can is also a red flag. If the medical personnel spend a lot of time with the most attractive patients as compared to the less attractive ones, it is a sign of a professional boundary violation (Hudspeth, R.2006). Scheduling for special visits with the patient or during odd hours such as late appointments and frequent follow-ups than it is medically required is an indicator the physician needs are being met before the needs of the client which is a violation. Showing favors at the workplace is also a red flag of professional boundary violation. Ethical Issues in professional Nursing Practice Discussion

Patients need to be treated in a similar manner when it comes to where to offer treatment as well as the location of the consultation. Offering gifts to physicians is a medical favor therefore, considered unethical. Additionally, keeping secrets for or with a patient as well as engaging in a sexual relationship with the clients are signs of professional boundary violations. Question 2 Terminal sedation refers to medications which are administered until the time death takes place. The process reduces the suffering that the patient is going through as the death process takes place (Walsh, D. (2001). It is normally used in patients who have terminal illnesses where normal treatments offered are not able to relieve symptoms that are severe like pain and agitation and the physicians do not have any other option but to get rid of the perception of the symptoms. Terminal sedation decision is normally accompanied by decisions to forego hydration and artificial nutrition in the patients. Rational suicide is on the rise in the U.S as most Americans want to exercise control over their deaths. Rational suicide occurs when an individual is in a position to reason properly, they have sufficient information to have real-world vies and act as per their individual essential interests. Old people, who are tired of living, have reduced quality of life or have a disability may express their wish to die and these are made legal. The individuals do not have any anxiety or mood disorder underlying their wishes to die. Suicide has been considered as a taboo in our culture (Werth Jr, J. L.2016). However, with the evolution of time it is being considered to be a competent decision if it is made according to realistic beliefs and in relation to the long-term values and fundamental interests of a person. It is meant to relieve pain without hastening death in patients who are severely ill. Physician-assisted suicide is death undertaken with the help of a physician or any other health care provider. A physician offers medication which is potentially lethal to a terminally ill and suffering patient at their own requests (Rapin, C. H.2003). The practice is illegal in most countries and can only be undertaken as a secret. In some nations, it is, however, legal and when the individual meets all the requirements under the laws of assisted suicide, a physician’s assistance is provided which is only limited to prescribing the dosage of lethal. References Cowan, J. D., & Walsh, D. (2001). Terminal sedation in palliative medicines–definition and review of the literature. Supportive Care in Cancer, 9(6), 403-407. Hudspeth, R. (2006). Professional boundary crossings and boundary violations and their implications. Nursing administration quarterly, 30(4), 375-376. Materstvedt, L. J., Clark, D., Müller-Busch, H. C., … & Rapin, C. H. (2003). Euthanasia and physician-assisted suicide: a view from an EAPC Ethics Task Force. Palliative Medicine, 17(2), 97-101. Manfrin-Ledet, L., Porche, D. J., & Eymard, A. S. (2015). Professional boundary violations: A literature review. Home healthcare now, 33(6), 326-332. Smith, L. L., Taylor, B. B., Keys, A. T., & Gornto, S. B. (1997). Nursepatient boundaries: crossing the line. AJN The American Journal of Nursing, 97(12), 26-31. Werth Jr, J. L. (2016). Rational suicide? The implication for mental health professionals. Taylor & Francis. …