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Discussion Board

Being in the nursing field you will come across many different ethical dilemmas. Reflect on the story of Josie King (video and article found in Ethical Concepts in Nursing ) and answer the following questions. Answer must be 150-200 words in total length.

Identify at least one instance in this story where you believe an error in patient safety occurred.
In your opinion, what is one thing the nurse could have done to prevent the error?
Which ethical dilemmas (not necessarily in this story) are you most concerned about facing in your nursing practice?
JOSIE KING VEDIO LINK:

Being in the nursing field you will come across many different ethical dilemmas. Reflect on the story of Josie King (video and article found in Ethical Concepts in Nursing ) and answer the
1 CORE Standards

Title of Policy/Procedure: DUN Core Performance Standards (Core)* Approval Responsibility (Title & Name):

UG Department Chair, Jeanean Boyd DNP,

MSN, RN

Approved by (Title & Name): UG Department Chair, Jeanean Boyd Last Date of Approval: April 2018

Communication Requirement and Date: BSN upper-division

acceptance letters, BSN Handbook, CONHI website

Date for Next Review: August 2021

Official SharePoint Location Name and Path:

SharePoint Undergraduate Policies and Procedures

Comments: All changes brought to UEPC for

review and approval

All applicants to and students of the University of Texas at Arlington College of Nursing Program (UTA

CON) must be able to adhere to and perform the essential skills included in this document either with

or without ADA accommodations. These core performance standards (core) are congruent with the

Texas State Board of Nursing expectations for a registered nurse. The use of trained intermediaries is

not permissible, in that the candidate’s judgment would be mediated by someone else’s power of

observation and selection. Only applicants and students diagnosed with disabilities covered by the ADA

may be granted special accommodations in nursing classroom, laboratory, and clinical settings.

Core statements which apply to students in the nursing major are congruent with:

1. The Differentiated Essential of Competencies of Graduates of Texas Nursing Programs (2010).

2. The criteria and guidelines for the evaluation of baccalaureate and higher degree programs in nursing established by the Commission on Collegiate Nursing Education (CCNE).

3. The Essentials of Baccalaureate Education for Professional Nursing Practice established by the American Association of Colleges of Nursing (AACN)

4. The Standards of Clinical Nursing Practice established by the American Nurses Association.

5. The Social Policy Statement of the American Nurses Association.

6. The Essentials of Masters Education for Professional Nursing Practice established by the American Association of Colleges of Nursing (AACN).

7. The National Institute for Occupational Safety and Health (2015).

To practice nursing, a licensee must possess a multitude of knowledge, skills and abilities in order to provide safe and effective patient care (National Council of State Boards of Nursing, Inc., 1992). It is the UTA CON’s responsibility to assure that this requirement is met before a graduate is certified.

The Core are the required basic cognitive, psychomotor, affective activities and professional behaviors essential to successful completion of the UTA CON. They are categorized as communication, cognitive, motor and sensory skills, and ethical and professional Integrity. Students enrolled in the pre-licensure nursing program at UTA CON must be able to perform the Core with or without reasonable accommodations.

Pursuant to Title II of the ADA of 1990, as amended in 2008 (“ADA”) and Section 504 of the Rehabilitation Act of 1973 (“Section 504”), UTA must provide reasonable accommodations to disabled students. This means UTA must make reasonable modifications in its practices, policies and procedures, and/or provide auxiliary aids and services for persons with disabilities, unless doing so would fundamentally alter the nature of the program to be modified or constitute an undue administrative or financial burden. For more information on reasonable accommodations, or to learn how to apply for a reasonable accommodation based on a disability, contact UTA’s Student Access and Resource Center at (817) 272-3364 or visit their website at UTA SARC.

https://www.uta.edu/disability/index.php
2 CORE Standards

Communication

Applicants and students must communicate effectively and sensitively with patients and their families as

well as with other students, staff, faculty, professionals, agency personnel, community residents, and

others relevant to their areas of study. Expression of ideas and feelings must be clear and appropriate.

Applicants and students must demonstrate a willingness and ability to give and receive feedback.

Communication examples include complete verbal and written command of the English language in

order to explain procedures to patients, give oral reports (e.g., report on client’s condition to others),

interact with others (e.g., health care workers, faculty), speak on the telephone, direct activities of

others, convey information through writing (e.g., progress notes), read and comprehend printed

materials and documents, document clearly and correctly on patient’s medical record, and transmit

information through written documents that use proper grammar, syntax, spelling, and punctuation.

ELEMENT DESCRIPTION EXAMPLES

Communication Communication abilities sufficient for Explain treatment procedures, initiate interaction with others in verbal and written health teaching, document and interpret form. Communication is understandable to nursing actions and patient/client others. responses.

Interpersonal Interpersonal abilities sufficient to interact with Establish rapport and maintain individuals, families, and groups from a variety professional demeanor with

of social, cultural, and intellectual backgrounds. patient/client, family, and colleagues.

Cognitive

Creative problem-solving and clinical reasoning require certain intellectual abilities. Applicants and students must be able to reason, analyze, integrate, synthesize, prioritize, and evaluate in the context of the nursing activities of their programs/areas of study. In addition, applicants and students must be able

to comprehend three dimensional relationships and understand spatial relationships (i.e. X-rays, CT

Scans, concept maps, etc.)

ELEMENT DESCRIPTION EXAMPLES

Critical Critical thinking Ability to handle multiple tasks and problem solve simultaneously. Thinking sufficient for clinical Identify cause-effect relationships in clinical situations; utilize the nursing Cognitive judgment. process in developing nursing care plans; and perform dosage calculations Ability in a time frame to deliver safe care.

Motor and Sensory Skills

Applicants and students need to have sufficient motor function and sensory skills in order to be able to execute movements and make observations required in the domain of nursing care or nursing activity in their chosen programs/areas of study.

EXAMPLE DESCRIPTION EXAMPLES Motor Skills

Gross and fine motor abilities sufficient to provide safe and effective nursing care.

Motor skills of lifting, carrying, pushing, and pulling are required. Physical ability to lift and transfer 50 pounds and carrying of objects up to 25 pounds. Physical ability of bending or stooping 1 inch from the floor and of reaching overhead to retrieve or place items on patient/unit shelves; to intermittently push objects over 100 pounds; stand/walk for 8 -12 hours.

Observation

3 CORE Standards

Visual to accurately observe items both close at hand and at a distance in order to learn skills and to

gather data (e.g., observe an instructor’s movements, a patient’s gait or nonverbal response, draw up

correct quantity of medication into syringe, read very fine print on medication labels, monitor strips, and

equipment calibrations, etc.). Applicants and students must possess functional use of the senses that

permit such observation, including being able to accurately visualize a computer screen (e.g. access a

patient’s electronic medical record, ascertain patient’s vital sign information from patient monitor,

perform all nursing exams on computers, etc.)

ELEMENT DESCRIPTION EXAMPLES

Visual Visual ability sufficient for observation Assess and observe patient/client responses; able to and assessment necessary in nursing identify and distinguish colors and shades of the same care. color.

Tactile

Applicants and students must have tactile ability to sufficiently perform physical assessments,

examinations, and procedures, palpate pulses, palpate veins, identify body landmarks, skin turgor, rashes, and vibrations, feel differences in sizes, shapes, detect temperature, feel differences in surface characteristics, and detect environmental temperature.

ELEMENT DESCRIPTION EXAMPLES

Tactile Tactile ability sufficient Finger dexterity to perform palpation and percussion functions of

for physical physical examination and/or those related to therapeutic intervention, assessment. e.g., insertion of a catheter. Perceives attributes of object such as size,

shape, temperature, or texture.

Hearing

Applicants and students must be able to accurately hear normal speaking level sounds (e.g. person-to- person report), hear faint voices, hear faint body sounds (e.g., blood pressure sounds, assessment

placement of tubes), hear in situations when not able to see lips (e.g., when masks are in use), hear auditory alarms (e.g. monitors, fire alarms, call bells), and hearing acuity sufficiently enough to assess changes in heart, breath, abdominal, vascular sounds.

ELEMENT DESCRIPTION EXAMPLES

Hearing Auditory ability sufficient to provide Hears, with and without background noises, monitor safe and effective nursing care. alarms, emergency signals, ausculatory sounds, and cries

for help.

Smell

Applicants and students must be able to smell sufficiently to: Detect odors from clients (e.g., foul smelling drainage, alcohol breath, etc.), detect smoke, detect gases or noxious smells, and detect odors exhibited by the body or body fluids which may be indicative of disease processes.

ELEMENT DESCRIPTION EXAMPLES

Smell

Ability to detect variety of smells, including noxious odors.

Identify distinct body odors or body fluids, such as C. diff and alcohol breath. Detect gas smells

4 CORE Standards

Psychomotor Skills Applicants and students must have sufficient motor capacities and mobility to execute the various tasks

and physical maneuvers to fulfill the professional roles toward which each program educates. For

example, be able to move within confined spaces (e.g. accompany immobile patients on hospital beds in

elevators), sit and maintain balance, stand and maintain balance, reach above shoulders (e.g. IV poles),

reach below waist (e.g., plug electrical appliance into wall outlets), perform cardiopulmonary

resuscitation (e.g. move above patient to compress chest and sustain repetitive movements), squat (e.g.

empty a Foley catheter urinary drainage bag), move quickly (e.g., respond to a code or emergency),

climb (e.g., ladders/stools/stairs), push/pull (e.g. transport a stretcher, transfer a patient), lift at least 35

lbs., and complete assigned clinical practice and duties within a safe time period.

ELEMENT DESCRIPTION EXAMPLES

Mobility Physical abilities sufficient to Moves around in patient’s rooms, work spaces, and treatment move from room to room areas and can administer cardiopulmonary procedures. Able to and maneuver in small coordinate eyes and hands or fingers rapidly and accurately in spaces. making precise movements with speed when providing patient

care.

Ethical and Professional Integrity In addition to the UT Arlington Honor Code, the College of Nursing recognizes the strong link between honesty in academic work and professional integrity. See the College of Nursing Undergraduate Student Handbook Honor Code, section 2.23. Any act of academic dishonesty, including cheating in the classroom or fabrication of reports or records of interactions with clients, is considered incompatible with ethical standards of nursing practice. Students must be able “to promptly and fully self-disclose facts, circumstances, events, errors, and omissions when such disclosure could enhance the health status of patients/clients or the public or could protect patients/clients or the public from unnecessary risk of harm (Board of Nursing).” See the Board of Nursing, Rule 213.27 Good Professional Character for additional examples and details.

Students will have access to confidential medical records and sensitive information regarding the patients, families, and community agencies while providing nursing care as a student. Students must agree to maintain the highest standards of professional integrity with regard to this information and comply with all legal requirements regarding the privacy of patient records. This includes but is not limited to written, verbal, and electronic social-networking transmission of information. For more information see: http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html

EXAMPLE DESCRIPTION EXAMPLES

Academic Integrity

Cite resources using APA format; Avoid collusion;

Any act of academic dishonesty, including cheating in the classroom or clinical setting violates standard.

Ethical Practice

Abide by Code of Ethics for Nursing Students ; Comply with all legal requirements regarding the privacy of patient records

Protect client privacy and comply with all legal requirements r/t patient records. Avoid fabrication of reports or records of interactions with clients, social networking violations.

Professional Character

Truthfulness, caring, equality, respect. professional attire

Accountable for behavior; self-disclose errors. Show respect and compassion for all clients without regard to gender, age, race, ethnicity, sexual orientation, religious background, and social status. Adhere to dress code; Arriving on-time to class and the clinical setting.

Emotional and Behavioral Students must possess the emotional stability to function effectively under stress and demonstrate

https://www.uta.edu/conhi/students/policy/index.php
https://www.uta.edu/conhi/students/policy/index.php
http://www.bon.texas.gov/nursinglaw/rr.html
http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html
https://www.uta.edu/conhi/students/policy/nursing-ethics.php
5 CORE Standards

mental and emotional stability in order to make appropriate decisions related to the care of clients and their families. Students must understand professional boundaries and maintain professional relationships under stressful situations with clients, peers, faculty and other professionals. Students must demonstrate compassion, empathy and caring for others.

Concept DESCRIPTION EXAMPLES

Emotional stability

Emotional stability is the capacity to maintain emotional balance and a stable mood when faced with psychological stressors.

Adapt to and make sound clinical judgments in stressful situations. Remain calm, think clearly and stay focused in a pressured and distracting environment. Cope with environmental changes. Ability to regulate and suppress negative emotions. Perceive and appraise challenges with resilience. Display effective coping mechanisms. Effectively deal with strong personal emotions.

Professional boundaries

Professional Boundaries are the lines within which a client’s best interests are consistently served.

Recognize the need for vigilance in maintaining professionalism and boundaries in diverse practice settings. Behaviors are consistent with the duty to always act in the best Interest of clients. Set limits to the nurse-client relationship that ensure a safe, therapeutic relationship.

Empathy Empathy is the use of emotional resonance to understand a client’s experience of distress.

Use of cognitive skills to evaluate a client’s experience. Attentive to client’s emotional cues, identify their emotional state and reflect understanding of that experience. Demonstrate an understanding of what a client is communicating, feeling and needing.

Compassion Compassion is an awareness of another’s suffering accompanied by the desire to alleviate it.

Provide a safe and comforting environment. Respect clients’ rights, dignity and their involvement in decision making. Focus on client’s needs and focus the emotion generated by their circumstance into an active response.

Accommodations The CON is committed to ensuring that qualified students with disabilities are given equal access to its programs

through reasonable accommodations. The CON is not required to provide requested accommodations that would fundamentally alter the program, including patient and/or student safety in the clinical setting. Students who desire more information or wish to request reasonable accommodations may contact the UTA Office for Students with Disabilities (OSD).

Upon BSN program acceptance, students must attest to their ability to meet these standards with or without an accommodation. If at that time a student requests an accommodation, the UTA OSD and the CON must determine if the accommodation is reasonable PRIOR to the student beginning upper division coursework.

If a student requires an accommodation to meet these standards, then within five (5) business days of being accepted into the BSN Program, and in order to prevent a delay in the start of their programs, the student must contact OSD to initiate the review process. Students are responsible for obtaining the necessary testing to document the existence of the disability and to what extent the disability substantially limits a major life activity. The OSD will require the student to provide sufficient documentation in this regard, including requiring additional evaluations if necessary. Once received, students should immediately provide their accommodation letter to the CONHI course lead teacher.

Unexpected Health Care Changes Occurring During Program Conditions that result in the inability to complete a clinical rotation include acute illness, physical injury, mental health issue, or complications due to pregnancy, surgery, or chronic illness. Changes in a student’s physical or mental condition that require activity limitations or the inability to participate in clinical or lab will require documentation from the student’s healthcare provider. Documentation must be on facility letterhead and signed by the healthcare provider or designate.

Students must receive a full release with no limitations to return to clinical. Limitations or restrictions may result in the need to withdraw from or take an incomplete in a clinical course. *Core standards based on University of Houston (UH) Core Performance Standards. Used with permission of K. Tart, Dean UH College of Nursing

http://www.uta.edu/disability
http://www.uta.edu/disability
6 CORE Standards

SharePoint Undergraduate Policies and Procedures July 2021

Communication
Cognitive
Motor and Sensory Skills
Observation
Tactile
Hearing
Smell
Psychomotor Skills
Ethical and Professional Integrity
Accommodations
Unexpected Health Care Changes Occurring During Program