Ethics is one of the fundamental components that form the key to a successful nursing career. Most of the nursing practices, primarily handled at the Advanced Nursing Practice (ANP), are based on a different theoretical basis that ensures nurses work in harmony. Theories help nursing practitioners to understand different situations as act according to established and tested standards. Although they do not have to follow the theories to the letter, they get a better understanding of the issue at hand hence make an informed decision. There is a good connection between ethics and theories since nurses are expected to apply theories, but to the extent they are ethical. Ethics issues are prevalent in practice, and it is essential to understand some of the problems considered unethical before engaging in any action. The paper discusses Watson’s theory and ANA code of conduct as a theoretical and ethical basis of Advanced Nursing Practice as it pertains to pertain to the Phenomenon of Interest (POI) discussed in previous papers

The phenomenon of interest (POI), as discussed previously, refers to the factors that influence the health status and hence relevant to the nursing profession. The phenomena can influence the individual, family, or entire population. The POI discussed in on sex trafficking and how this affects healthcare. Victims of sex trafficking first reach the healthcare professionals when rescued and hence have to devise ways of treating them. Victims of sex trafficking suffer from both physical and physiological effects. Healthcare professionals and particularly advanced care nurses are at the forefront of helping such victims and hence should be properly trained on how to handle such cases. If such cases are not adequately addressed, the nurses can handle them in an unethical manner, which is central to the nursing practice.

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One of the theoretical foundations of nursing is Watson’s theory of nursing, which was developed by Jean Watson, an American. Watson’s theory focuses on caring, where nursing professionals are supposed to offer the utmost care to their patients. It is a holistic nursing approach that requires nurses to focus on the body mind and soul for proper healing. In formulating the theory, Watson was guided by the ethical, philosophical, and moral basis of the universal values of love and belongingness. Caring in healthcare is not about offering the physical items but goes beyond this to include a “spirit-to-spirit” connection. Care is transpersonal according to this theory, and the nurse must create connectedness with the patient. Nurses are encouraged to protect and enhance human dignity every time they are interacting with clients or patients. The provision helps when nurses are dealing with patients like victims of des trafficking who require protection to shield them from stigma.

The theory also calls for nursing professionals to practice wholehearted care when dealing with patients. In this case, healthcare should be heart-centered, and the caring process should address the mind, the body as spirit as a whole, targeting the nurse and the patient. Healthcare should not just seek to heal the disease and then release the patient and the nurse, but the two must create a connection for them to work together. Each patient visiting the healthcare is unique, and ANP nurses are equipped with skills to deal with a wide range of patients. The diversity of the advanced practicing nurse allows him or her to honor the uniqueness of each patient. According to Watson, the uniqueness can range from needs, routines, and wishes where the patients follow a certain unique root and hence respond appropriately.

Caring is a conscious act that is two way, meaning the nurse cares for self and others. Caring attracts the concept of connection in that one cares for those connected to them in one way or the other. Watson called on nurses to avoid being static when dealing with others but maintain a caring, conscious attitude. The attitude is necessary since it bridges the gap that naturally exists between the patients and nurses, often due to work reasons. However, the gap just separates the two and plays an insignificant role in reducing the severity of the illness. The consciousness is enhanced by the cultivation sensitivity, especially when dealing with patients. Nurses are supposed to be sensitive when dealing with their patients and themselves to realize the best results. Sensitivity is achieved by acknowledging and then understanding that other people have different beliefs and practices. The theory calls for a concerted effort by maintaining consciousness and sensitivity on the clients to ensure that the care is based on the best practices and does not contradict their beliefs.

Watson’s theory is based on ten therapeutic factors and four key concepts that form the foundation of ANP. The four concepts include human beings, health, environment, and nursing. A preview of these concepts shows their connection with healthcare and hence the basis of any ANP based on the theoretical framework. The human being is viewed as one who is valued and respected and greater than a sum of his or her parts. In this case, healthcare treats the different body parts that are sick but for the overall health of the person. Health is the absence of illness where all the physical, mental, and social functions are effectively taking place. Based on Watson’s theory, caring has been there for long, and hence the professional culture has a great role in transferring the caring attitude in a way that copes with the surrounding. To sum up all these concepts, Watson defined nursing as the act of promoting health, preventing illness, and caring for the sick to restore their health.

The first three factors advanced by Watson are based on philosophical reasons as the theoretical underpinning for nursing practice. The other seven are based on the first three, meaning there is a great connection with all of them. Nurses need to have a lot of faith and hope when dealing with different categories of patients, which means that a nurse has a role to go beyond science and ensure the patient is comfortable even when treatment is not bearing fruits. The nurses are exposed to ordinary life at an early age, which is essential in mediating between personal experiences and learning and the key to the development of humanistic-altruistic values. Watson calls on nursed to develop a helping trust relationship with the patients, which is possible through proper communication to build a rapport.

A caring environment allows for free expression of one’s feelings, which is mainly influenced by the nurse. Watson’s theory proposes that nurses should enable patients to express their feelings and thoughts where they are positive or negative. The expression is useful in the practice since it allows them to understand the problems associated with them and hence develop a remedy. Caring is a science that requires nurses to apply scientific problem-solving methods in every decision made, which also allows self-correction in case of a problem. Advanced Nursing Practice engages in both learning and teaching, which seek to teach the nurses about the emerging changes. Education helps them to develop a cognitive plan to approach specific patients while teaching inculcates the caring attitude to fellow nurses and patients. Caring is a holistic process and involves both the internal and external environment in nursing. In this case, nurses are advised to be ready to provide supportive and protective mental, spiritual, and physical environments. Lastly, Watson ordered the arrangement of needs as required ensuring ANP is genuinely caring. The agreement provided resembles that of Maslow’s theory of needs, which underscores the importance of theory in nursing practice. For instance, low-level requirements include food, air, activity, and fluids. The high-level needs entail achievement, self-actualization, and affiliation. Watson called for the merging of existential-phenomenological forces in caring for the patients. In this case, the nurse understands the clients based on their perspective and hence attends them as a whole while considering their unique needs based on hierarchy.

Nursing professionals provide unique services to the community, and hence the ethical consideration is a vital issue. Ethics in APN is not the same as in other professionals, and this has improved over time. Ethics is basically what constitutes a good or bad action. Most of the issues are written down, but not all meaning human discretion is required to distinguish between good and wrong actions. One of the documents guiding nurse’s ethics in the US is The American Nurses Association (ANA) code of ethics (2015). Ethics is closely related to moral philosophy, which entails an understanding of the goodness or badness of actions in one’s life. Nurses sometimes find themselves trapped in situations that demand moral reasoning to come up with the best solution or choice.

The principal ethical basis of APN is the ANA code of ethics, which broadly and specifically outline what nurses are supposed to do or not do. The code is a broad foundation of the ethical requirements for nurses, although more laws are created to cater to specific fields. For instance, nurses are expected to practice concerning upholding the dignity of all involved persons. The primary role of the nurse is to cater to the patient and nobody either individual, or in the group, and offer the best care possible. All the things done must be geared towards promoting the health of the patient and those around them. According to this code, nurses must collaborate with other professionals to protect human rights, which also forms the basis of ethical decision making.

The phenomenon of interest (POI) discussed at the beginning explores the issue of sex trafficking as it relates to nursing ethics. In most cases, the victims of the crimes are very young children who require special attention from the nurses without compromising their ethics. In connection to this Fawcett, described the metaparadigms that steer the discipline. The paradigms include person, health, nursing, and environment. Based on Watson’s theory also discussed above, the person in the sex trafficking case refers to the victims, who find themselves at the care of nurses. The environment is the emergency department where the cases first stop for treatment and generally the healthcare setting. The health status is examined when the victims are harmed by the captors and injured or sexually transmitted diseases. In this case, the quality of health is usually less than the optimum. Health is, however, a far-fetched idea for the victim unless the captors volunteer to take the patients to the healthcare facility. Nursing involves healing through the mind, soul, and body, which is key to the population, particularly patients.

The sex trafficking case is among the many instances that form the ethical foundation of APN and calls them to remain ethical. Nursing is mostly an ethical professional and, as such, requires the nurses to remain ethical all the time. Ethics helps the nurses to deal with situations like sex trafficking and also enhance the health wellbeing of the victims. In this case, for instance, the nurse handling the victims is expected to remain quiet and not to expose the victims since this is not only unethical but a risk to life from the captors. `Nurses must ask the victims questions to establish whether they went through the ordeals or not. Ethics plays out in this case since the issues must be ethical and hence attract ethical solutions. Even if the nurse wants to get answers to help the patient effectively, the questions must respect the dignity of both, which underscores the importance of ethics. Nurses cannot accomplish this without proper training on ethics, which calls on the importance of training nurses on ethics as the foundation of ethical practice.

Ethical issues arise from other wide range of problems that are either pre-determined or not. For instance, one of the most significant concerns today relates to patients’ data. Some of the healthcare professionals and particularly record nurses are not careful with client information, which leads to its loss, which is a huge problem in the United States. Some malicious individuals access health records and steal the data, which risks the patients’ privacy. Since the nurses play a significant role in this data, they need to be ethical and prevent such a breach. Other forms of unethical conduct include undue influence and pain management for chronically ill patients. These issues, among others, necessitate the need for an ethical foundation so that the nurses can realize the set goals unbiased.

In conclusion, nurses must be very ethical, which attracts the application of critical theoretical perspectives and ethical standards. One of the theories that form the basis of ANP is Watson’s theory that requires the nurses to focus on the holistic individual in the treatment process. Nurses are needed based on this theory to focus on four critical areas while handling patients, including the person, health, environment, and nursing. Ethics is a vital part of successful nursing practice and is broad-based. Ethics are based on the ANA Code of ethics that explains what a nurse should and should not do. These eventually ensure that the nurses are effective in their work and protect human dignity.


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