Respond to your colleagues  by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described.

At least 2 references in each peer responses!

Nursing leaders face many ethical dilemmas, among these being making a choice between having limited resources and competing needs. Resources tend to be finite, thus there is immense competition for them in healthcare settings. Nationally, one of the most pressing issues is data security in the health care sector. The industry has experienced multiple incidences in the past where criminals have stolen private patient data records and data (Kruse et al., 2017). This has resulted in a lot of policy changes, thus the need for healthcare facilities to consider them along other needs associated with the healthcare system.

           Competing needs may affect the implementation of the policies associated implementation of sufficient data and patient record safeguards. For instance, healthcare facilities may not have sufficient resources to cater for additional employees in their information technology departments, while they also need additional nurses to enhance their quality of care. The presence of such national stressors may require nurse leaders to balance on the policy recommendations that they need. For instance, they may have to reallocate some resources for activities such as the recruitment of additional nurses. This is to ensure that they have some resources for the recruitment of additional personnel or outsourcing of some functions in the information technology department to ensure there are sufficient safeguards for patient data and compliance with the national policy requirements (Liu et al., 2017).

           One of the main impacts of the competing needs includes the lack of sufficient resources to address each of the needs sufficiently. However, policies can be able to address some of these ethical dilemmas. For instance, nurse leaders can ensure that resources are allocated based on the urgency of these needs, while at the same time ensuring there is compliance with national policies relating to an area (Naes et al., 2017). For instance, rather than establishing an entire information department, a health care facility may resort to outsourcing the function, which would be relatively cheaper.

Week 8: Question for Discussion 

Chapter 15 –  Falls & Fall Risk Reduction.
Chapter 16 –  Promoting Safety.

Question(s): Technological advances hold promises for improving quality of life, decreasing need for personal care assistance, and enhancing independence and ability to live safely.

1. Choose one of the technologies mentioned in your textbook. (Chapter Attached)

2. Discuss / explain the selected technology. Please, support your answer with a research study: Is there any research study of technological innovation related with your topic that promises advantages in the future of healthcare? 

Guidelines: The answer should be based on the knowledge obtained from reading the book, no just your opinion. If there are 3 questions in the discussion, you must answer all of them. Your grade will be an average of all answers. 

Grading Criteria: Student chose 1 technology for the book (25%) and discussed it (30%). Students support his / her answer with a research study (45%).

Reply to my peers

Begin reviewing and replying to peer postings/responses early in the week to enhance peer discussion. See the rubric for participation points. Participate in the discussion by asking a question, providing a statement of clarification, providing viewpoints with a rationale, challenging aspects of the discussion, or indicating relationships between two or more lines of reasoning in the discussion. Always use constructive language, even in criticism, to work toward the 

goal of of positive progress.

As in all assignments, cite your sources in your work and provide references for the citations in APA format. You may use this APA Citation Helper as a convenient reference for properly citing resources or connect to the APA Style website through the APA icon below

Include references with peer responses

Based on the development of therapeutic nurse-patient relationships:

• Explain the continuum of boundaries of the nurse-patient relationship.
• Describe the negative results of boundary crossing in the nurse-patient relationship.

Peer #1

The nursing professional boundaries are defined as “the space between the nurses’ power and the client’s vulnerability” (Black, 2017). These levels can be seen in a level of continuum in where behaviors range from under involvement, helpfulness to over-involvement. Samples of these behaviors include distancing, neglect, secrecy, role reversal, to money, and gifts (Black, 2017). In the nurse-patient relationship, it is not the responsibility of the patient to maintain boundaries by is the nurse’s responsibility.  It is a must that these boundaries lines never be blurred because it may result in harm to the patient (Black, 2017).  When these boundaries are crossed, it is considered a volitation of the nurse code of ethics, and is a reportable offense and may result in termination, and be reported to the board of nursing (Black, 2017). Also, as a practicing nurse, it is crucial to understand their professional boundaries. Seven principles that  should be maintained in the nurse-patient relationship are:

1. The nurse is responsible for maintaining the boundary
2. Work in the zone of helpfulness
3. Examine any boundaries crossings
4. Certain variables can affect these boundaries such as the care setting
5. Any action that oversteps established boundaries to meet nurses needs
6. Avoid dual relationships
7. Post-termination relationships (Black, 2017)

Nurses must develop trust, establish clear communication, and well-defined boundaries to prevent any confusion in the nurse-patient relationship.

Black, B. (2017). Professional Nursing Concepts &Challenges 8th edition. St. Louis, Missouri: Elsevier.

Peer #2

From the very first encounter with our patients, we are communicating and setting professional boundaries. The focus of a nurse-patient relationship includes clear definitions of the professional role, confidentiality of information, and goals for patient care and treatment (Valente, 2017).  In order for a nurse to set healthy boundaries with their patients, they need to be self-aware. Self-awareness is defined as being able to recognize one’s own emotions, prejudices, beliefs, values, and how they are seen by others (Black, 2017). By being self-aware, you can begin to see when the line starts to get crossed from a professional relationship, to that of a social relationship, and this recognition is key. If one was to find that the lines are starting to get blurred, it is wise for the nurse to step back and self-reflect and to ask themselves, “Where is this emotion coming from?” or “Why am I feeling this way?” This allows the nurse to adjust her practice and re-focus on the patient and reach their goals for their treatment. It is the nurse’s responsibility to ensure that a healthy rapport is made with their patients, setting healthy boundaries, and evaluating the therapeutic relationship so that the patients’ needs are met and not the nurses (Christensen, 2018). When keeping professional communication with patients, such as body language, feedback, and listening, it is less likely that the professional boundaries will be crossed.  

Negative results of crossing the professional nurse-patient boundaries can have a negative impact, not only on the care of your patient, but the nurse as well. Having worked in the correctional setting as a nurse, I have seen this happen on several occasions. An example is of a nurse getting “love letters” from an inmate. This nurse was flattered and would brag about it to her co-workers. When I confronted this nurse on why she accepted the note from the inmate and did not give it directly to the corrections officer, she had thought that she had done nothing wrong. I immediately walked her to the corrections officer on the unit and informed him of the incident. After an investigation, it appeared this activity had been going on for a period of time. The nurse’s actions of crossing her professional boundaries placed her at risk, as well as her co-workers. She was not following policies and protocols set in place to keep staff safe in that environment, and was ultimately fired. The patient can also suffer negative effects if the professional boundaries are not kept. For example, the nurse may be feeding into the patient’s co-dependency issues and therefore not creating a therapeutic environment for the patient, causing more harm than good.   

References 

Black, B. (2017) Professional Nursing Concepts & Challenges 8th edition. St. Louis, Missouri. elsevier 

Christensen, D. (2018). The Case of the Blurred Boundaries. ONS Voice, 33(5), 30. 

Valente, S. M. (2017). Managing professional and nurse-patient relationship boundaries in mental health. Journal of Psychosocial Nursing & Mental Health Services, 55(1), 45-51. 

In collaboration with the approved course preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Students should consider the clinical environment in which they are currently employed or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a leadership or quality improvement initiative, or an unmet educational need specific to a patient population or community. The student may also choose to work with an interprofessional collaborative team.

Students should select a topic that aligns to their area of interest as well as the clinical practice setting in which practice hours are completed.

Write a 500-750 word description of your proposed capstone project topic. Include the following:

1. The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal.
2. The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed.
3. A description (providing a high level of detail) regarding the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
4. Effect of the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
5. Significance of the topic and its implications for nursing practice.
6. A proposed solution to the identified project topic with an explanation of how it will affect nursing practice.

You are required to cite to a minimum of eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice. Plan your time accordingly to complete this assignment.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Post your PICO(T) question, the search terms used, and the names of at least two databases used for your PICO(T) question. Then, describe your search results in terms of the number of articles returned on original research and how this changed as you added search terms using your Boolean operators. Finally, explain strategies you might make to increase the rigor and effectiveness of a database search on your PICO(T) question. Be specific and provide examples.

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

• Identify and briefly describe your chosen clinical issue of interest.
• Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
• Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
• Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.