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Mia 521-D1: This survey was kind of tough, I’m not sure if I would answer the same in real life situations. A few of the questions I had more than one response and some did require me to think of legal parameters and use critical thinking. A couple questions did trigger an emotional response and I think I was able to remain objective still. One particular question I felt I couldn’t remain objective; I would’ve had to resign or leave the situation somehow. I was really stuck on it, and I tried to be objective, but I couldn’t, and I know in real life it’ll be the hill I’ll gladly die on. Thank God I haven’t had to deal with any of these situations personally in my professional life. When I think of the ethically decisions, I’ve dealt with they have mostly been family and physicians disregarding a patient’s dnr status. As disheartening it is, it’s very common and during the pandemic I saw it a lot more than usual. I get it and I understand why but I strongly believe if a patient makes that decision, it should be upheld by all including and especially family members. I wouldn’t have a problem with my answers being public, I feel I have a fairly decent moral compass and try to be ethical in all situations. Not really having had to deal with these situations I would hope that I could do so ethically and remain completely objective. Sometimes it’s hard to say what one would do or not do in certain situations not experienced before.
Amanda 521- D1: I could confidently answer completely agree or disagree to six questions, but I was not right on them all. I got three wrong technically. The fertility clinic one initially threw me off, but after reading the reasoning, I understood why the doctor would be held responsible. He was being negligent and irresponsible by agreeing to five in the first place. I have read about this in the news before, and doctors can get in a lot of trouble for this, which I should have gone off of that and answered correctly. When I answered it, I thought it was up to the patient, but in reality, safety comes first. Another one I got wrong was the last question about tapering off a narcotic. I did not know there were so many steps to take to prevent patients from coming off a drug too quickly. It does make sense now, though. The last one I will talk about really threw me off. I believe I read the question wrong on delivering cross-sex hormones to minors because I support their decision. My nephew is non-binary, and I wholeheartedly support his decision to become whatever he wants to become. Although, I don’t know much about puberty blocking cross-sex hormones. If my nephew wanted to do this, I would research it with him and see if it is the best option. I think that was an emotional question for me, which may be why it threw me off. I thought it was illegal to have puberty-blocking cross-sex hormones before the legal age, but it is not (Mayo Clinic, 2022). I tried to rely on policies or legal parameters to guide me in the right direction, but some were hard to answer. I wouldn’t mind having my answers go public if I retook the test knowing the reasoning behind the questions to respond correctly to my ability but looking at the three I got wrong and why I would not want to show that. I have dealt with co-workers coming to work intoxicated, and I have reported them. This was when I started my nursing career too, so I talked to my co-workers, and they agreed with me and my findings and thought I should report it too. I felt like I was morally correct, but at the same time, it felt weird. I was genuinely worried about them and the patients. This survey puts my moral inventory in check. As nurses, we have a lot of power; sometimes, it can go to one’s head. Answering these questions made me think about how I have acted in the past and how I should act in the future. I can appreciate the puberty-blocking cross-sex hormones question because it taught me that there is an innovative treatment for transgender children that I did not know about.
Active Errors: Errors that occur at the point of contact between a human and some aspect of another system. Usually, active errors include individuals that are on the frontline. Active errors are noticed first because they are completed by the individual that is closest to the patient.
Example: I experienced active errors during my nursing practice in the emergency department while precepting a new nurse. She had set up an IV in the right AC and was ready to infuse normal saline IV fluids. While assisting another patient, my nursing student told me the patient’s IV had infiltrated. Active errors can be avoided by patient education. By letting the patient know the IV is in a sensitive spot and is more likely to infiltrate the AC than another area, it is essential to keep the arm as straight as possible. Also, let the patient know if any discomfort is felt to let a healthcare provider know immediately.
Latent Errors: Less apparent errors are also looked at as failures of an organization or errors in design, also known as “errors waiting to happen.”
Example: Organizational aspects play a huge role in latent errors. Some aspects include work pressure and long hours. Due to short staffing, and long hours, I had forgotten to give a medication to one of my patients at the time allotted. Fortunately, only a vitamin did not affect their medication regimen. Latent errors must be addressed immediately, or the likeliness of repeated errors is high. Implementing safe working procedures and environment and having additional resource personnel to assist would prevent latent errors in the future.
Andrew 510- D1: I believe that access and coverage of healthcare should be universal and available to every citizen in the US. That being said, I believe the market and choice should still play a role in how healthcare is delivered. Australia is an example of how healthcare can be delivered both publicly and privately. They have a universal system (Medicare) that is funded by the government via a tax and provides access to healthcare for free for everyone. They also have a regulated private system with private insurers similar to what we have here in the US (BUPA, n.d.). This allows Australian citizens to have options for their access to healthcare but at the same time there is a universal option to ensure that everyone is covered. I do not think there is a perfect solution for the delivery of healthcare. There are positives and negatives to viewing it as either a commodity or as a right. Australia’s system is one that is built on a compromise but attempts to blend the benefits of both options. I feel that here in the US we should adopt a similar approach of regulating private insurances to keep costs down, but also allowing a market so both patients and providers have options. At the same time, we should have a true universal option that encompasses every citizen so that nobody is denied care if they need it.
Idalmi 510- D1: Access to medical treatment has been the subject of debate due to the ambiguity surrounding its status as either a right or a privilege, as well as the question of whether or not it should be determined by an individual’s socioeconomic class. I have a strong conviction that access to quality medical treatment should not be contingent on a person’s socioeconomic standing since it is one of the requirements that help define what it is to be a human being. The argument in favor of this viewpoint is predicated on the premise that a person’s access to other fundamental human rights is contingent on whether or not they receive adequate medical treatment. For instance, the United States of America is recognized as one of the countries in which citizens have access to a variety of rights, such as equal employment and educational opportunities (Douthit et al., 2015). However, since they have health problems, some individuals are unable to exercise their rights. As a result, it is essential to make certain that everyone, irrespective of socioeconomic situation, have access to treatment options. Because healthy people contribute more to society, governments ought to make it their top priority to guarantee that everyone has access to adequate medical care.
Andrew 510-D2: Our text describes some major barriers that nurses face when attempting to advocate for healthcare policy: lack of educational training, institutional barriers or fear of retaliation (Gardner et al., 2015, p. 34). One of the main tenants of nursing is that the nurse should be the patient’s advocate, and this has ingrained advocacy into the art of nursing itself. For that reason, I believe that politics is overall the biggest barrier nurses face when attempting to advocate for policy change. I feel that most nurses naturally want to be advocates for themselves and others, however, they must balance the obligations to their profession with the obligations to their employment. For this reason I feel like many nurses just stay out of it as they do not find the politics or possibility of retribution worth it. Additionally, even though advocacy and policy are so important to nursing, it is not routinely taught in educational programs. Nurses feel as though they need to learn advocacy from peers (Gardner et al., 2015, p. 35). It is also hard to advocate for your profession or a policy change until you yourself understand it. Many new nurses will not feel comfortable at first and this would lead to a delay in advocating for policy change until they are more ready.
Idalmi 510-D2: In the United States, nurses have a hand in drafting the laws that govern state and national healthcare. They are unable to completely engage in this progression as a result of the obstacles. Misrepresentation is one of several problems. The right of nurses to participate in the process of formulating policies is underrepresented. The inability of nurses to openly communicate the challenges and sentiments they have regarding policies is a source of difficulty. This may have an effect on their morale, which might result in subpar care for patients. All of these features make it more difficult to collaborate, which in turn results in less effective service. Because physicians view their own profession as more noble than nursing, they behave inappropriately toward their nursing nurses. They seldom take the opinions of nurses into consideration. Because doctors and medical organizations don’t want to collaborate with nurses, the former tend to have a condescending attitude toward the latter. They are unable to make a contribution to the company’s healthcare program as a result of this (Mason et al., 2016). They are obstacles due to the fact that nurses do not understand the policy-making process and hence cannot assist. They are unable to participate in legislative procedures and provide professional expertise at the same time. This presents a barrier during the therapy since there are not enough resources available. Nurses, in contrast to physicians, do not participate in the free market as independent actors. They are not taken into consideration by these bodies that make policy.