Participation Responses: No later than the due date assigned, review and comment on the discussion question responses posted by at least two of your peers and faculty. Continue to monitor your question and responses until the end of the week.

Peer 1 

An ethical dilemma that was experienced by the NP was when she was encouraging the 30 year old patient to transition to hospice care. End of life discussions are always tough conversations to have. This was considered an ethical issue to me because at the beginning, the patient stated he wanted to do whatever he could do in order to prolong his life expectancy and the NP was in a way, coercing him to make the decision to transition from his home to a hospice center. Though the patient was bed bound, he was still coherent and should be able to make his own decisions without the encouragement of others to do otherwise. If I was the NP in this scenario, I would allow the patient and his mother to come to the decision at their own timing. I would still provide honest, realistic answers, but still give them the opportunity and time to make their own decision. Ethics within healthcare are important because workers must recognize healthcare dilemmas, make good judgments and decisions based on their values while keeping within the laws that govern them (Haddad, 2020). A mechanism to overcome this ethical dilemma would be to just take in account each patient scenario and continue to gain experience in this realm. Learning ways to navigate through these types of scenarios would make it more comfortable for the patient and the provider. 

The NP in the documentary is noted as a disruptive innovator because she provides primary care to patients in their own homes. Traditional visits to a primary care clinic are often wrought with friction-inducing barriers such as scheduling, commutes, and long wait times for a condensed provider visit that carries a high price tag. Now, health care consumers can have their provider visit them for their primary care needs in the comforts of their own homes where they will experience primary care in a very different way (Fuller, 2019). The need for primary care providers is at an all time high with the population across the nation increasing and primary care physicians not being available, makes a need for NP’s to provide the primary care for these patients in an affordable fashion. 

References: 

Fuller, Ryan MSN, RN, CNML; Hansen, April MSN, RN Disruption Ahead, Nursing Administration Quarterly: July/September 2019 – Volume 43 – Issue 3 – p 212-221 doi: 10.1097/NAQ.0000000000000354

Haddad LM, Geiger RA. Nursing Ethical Considerations. [Updated 2020 Sep 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526054/

Peer 2

• How is the NP in the documentary a Disruptive Innovator?

A Disruptive Innovator is described as someone that meets the needs of the undeserved, unserved population. In the documentary The Invisible Patients, Jessica, NP goes to four homebound patients and provides them with care. “Changes to medical models are generally regarded with reticence, but we have been proving our worth by silently meeting the health care needs of underserved populations or special medically complex patients for decades. Disruptive innovation in nursing does not happen overnight or without a strategy, but it does happen, and it is powerful” (Journal of Pediatric Surgical Nursing, 2016). Jessica goes above and beyond to bridge disparities for these patients. 

Jessica faces an ethical dilemma when Ron’s brother, Louie, ask her for a prescription. The brothers clearly do not have a lot of resources. It unlikely they have a vehicle or other supporting family members. She could have possibly written Louie a prescription just to help him out. Jessica chose to have the honest response of she can only do that for her established patients. “The first theme encountered in many ethical dilemmas is the erosion of open and honest communication. The erosion begins when clinicians fail to speak up in crucial situations” (Tracy & O’Grady, 2018). It may have been less awkward for Jessica to just write the prescription, but she handled the situation correctly by directly telling the family member no. Not only can it be an ethical problem, writing prescriptions and providing care to individuals that are not established patients, can cost the Nurse Practitioner and company money. 

America Reframed. (2018, March 20). America Reframed: The Invisible Patients. Retrieved January 28, 2021, from https://www.bing.com/videos/search?q=how can i watch the invivisble patients&docid=607999196040858628

Journal of pediatric surgical nursing. (2016, October 12). LWW. Retrieved January 28, 2021, from https://journals.lww.com/journalofpediatricsurgicalnursing/Fulltext/2016/10000/Disruptive_Innovators__Are_We_Ready_.2.aspx

Tracy, E.O.M. F. Hamric and Hanson’s Advanced Practice Nursing. [South University]. Retrieved from https://digitalbookshelf.southuniversity.edu/#/books/9780323447751/