In an APA format paper, approximately 2-4 pages in length, address the following questions. (Please note that you will continue to write in the same document you completed for part 1, 2, 3, 4, and 5 of this assignment

Based only on the evidence you gathered, make at least 2 practice recommendations (these can be either positive – we SHOULD do this, negative – we SHOULD NOT do this, or recommendations to gather more data if the evidence is insufficient) and grade the strength of your recommendations using the GRADE criteria (see GRADE working group for more information on grading your recommendations). You should reference the GRADE criteria as it relates to the strength of your recommendations

*DUE IN THE NEXT 15HOURS PLEASE!

Being able to articulate your personal worldview can help you formulate a personal philosophy of practice and enhance your influence on patients and the industry. In this assignment, you will have an opportunity to reflect on your current and future practice, and the ways worldview and nursing theory influence that practice.   

Draft a 1,000-1,250 word paper in which you:

1. Describe your personal worldview, including the religious, spiritual, and cultural elements that you think most influence your personal philosophy of practice and attitude towards patient care.
2. Choose a specific nursing theory that is most in line with your personal philosophy of practice and approach to patient care and discuss the similarities. Explain how the nursing theory reinforces your approach to care.
3. Include in your explanation a specific example as a nurse of a past or current practice and how your worldview and the nursing theory could assist you in resolving this issue.
4. Finally, explain how your worldview and the nursing theory will assist you in further developing your future practice.

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

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

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

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

REPLY1

Moral distress has been something that every healthcare professional has encountered in their career. “Researchers have shown that moral distress is a wide spread problem for health care providers including nurses, pharmacists, social workers, physicians, and health care managers in a wide range of acute and community health care settings” (Pauly et al., 2012). A clinical situation that a nurse may encounter that may cause moral distress is when a patient in critical care unit has a poor prognosis and on the ventilator. Family would still want to have everything done on the patient and keep the patient on the ventilator even if the physicians state that the patient might not be able to be weaned off the ventilator. The Four A’s is used as a guide to identify and analyze moral distress. The four A’s are: ask, affirm, assess, and act. The first A is ask. Ask the appropriate question to be aware that moral distress is present. The questions that should be asked in this situation are: “what would the patient want,” “what are the reasons for the family to have the patient kept on life support,” “what is the prognosis of the patient.” The next A is affirming the distress. Affirming the distress is letting your fellow colleagues know and aware why you feel that way. Next A is to assess sources of moral distress to prepare for an action plan. The sources would be the patient’s prognosis and the family’s decision about the patient. Last part of the Four A’s is to act to implement strategies to preserve integrity and authenticity (Butts, 2016). By talking to family and the healthcare team, that would be acting to preserve integrity and authenticity to have the moral distress addressed.   

REPLY2

  Moral Distress is caused by nurses’ work that involves hard moral choices that result in an emotional or physical suffering, painful ambiguity, contradiction, frustration, anger, guilt and an avoidance of patients (Butts, 2015). Furthermore, it is a situation when a nurse feels that task differs from what he/she thinks it is ethically the correct thing to do. According to American Association of Critical-care Nurses (2004), nurses use the Four A’s plan as a guide to identify and analyze moral distress:

1. Ask appropriate questions to become aware that moral distress is present. For example, a nurse is faced with a situation when family members decide to remove do not resuscitate (DNR) orders for a 90 year old terminally ill patient because the family states “We are not yet ready to let go, we need to give our dad a fighting chance”. They still decided this even though they were given all the information they needed to make a decision. The nurse follows the wishes of the family to get the order done, even though the nurse feels like it is the wrong decision to do. The nurse feels angered and frustrated with this decision. The nurse then asks herself “Am I feeling this way because of this decision by my patient’s family?”
    
2. Affirm your distress and commitment to take care of yourself and address moral distress. The nurse in this situation acknowledges the feeling of distress and decides to make a commitment to address the moral distress.
    
3. Assess sources of your moral distress to prepare for an action plan. In this situation the nurse recognizes that the source is the decision of family members to remove DNR orders for the patient who is elderly and terminally ill. She feels it’s futile. She feels like the patient would suffer unnecessarily when the patient arrests.
    
4. Act to implement strategies for changes to preserve your integrity and authenticity. In this situation, she may decide to seek support from her charge nurse or other senior nurses on how they dealt with this type of situation. 

Assignment 1.1   The relationship between Nursing Theories and Advanced Practice
Instructions

• Write an Essay on the relationship between Nursing Theories and Advanced Practice.
• Use the APA style and send it via Blackboard for evaluation. Your essay must have a minimum of 1000 words and use at least 3 bibliographic references. Avoid plagiarism by submitting your work to SafeAssign.

Prepare a 10-15 slide PowerPoint presentation, with speaker notes, that examines the significance of an organization’s culture and values. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the Topic Materials for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning, and an additional slide for References at the end.

1. Outline the purpose of an organization’s mission, vision, and values.
2. Explain why an organization’s mission, vision, and values are significant to nurse engagement and patient outcomes.
3. Explain what factors lead to conflict in a professional practice. Describe how organizational values and culture can influence the way conflict is addressed.
4. Discuss effective strategies for resolving workplace conflict and encouraging interprofessional collaboration.
5. Discuss how organizational needs and the culture of health care influence organizational outcomes. Describe how these relate to health promotion and disease prevention from a community health perspective.

While the APA style format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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