Case Scenario: Nursing Ethics

Healthcare providers are in a profound position of trust in regards to the patients in their charge. In the case scenario, an ADN nurse and a transport tech were not sufficiently watchful of an elderly patient due to complacency and the fact that they were having a personal conversation. Although a nurse with an associates degree (ADN) and a bachelors-level prepared nurse would have different levels of expertise and thus differentiated essential competencies, it is important to note that both nurses would have greater expertise than the transport tech and would have a higher level of responsibility in the scenario. According to the Differentiated Essential Competencies (DECs) of the Texas Board of Nursing (2010), Competencies were designed to demonstrate the progression of expectations across the types of nursing programs based upon educational preparation (p.vii). Although some competencies are admittedly redundant and there is overlap between the two types of nurses, it is still important to be reminded of the fact that differences do exist.

Background of DEC and Application

The DEC was issued by the Texas Board of Nursing as a way to delineate the scope of practice from the Licensed Vocational Nurse (LVN) to the Registered Nurse (RN) at the doctoral level to ensure consistency of academic curricula and programs across the state. The scope of the competencies have been expanded to place an increasing emphasis on patient safety. For example, in regards to the above-cited scenario, an APN is required to implement measures to promote quality and a safe environment for patients, self, and others and communicate and collaborate in a timely manner with members of the interdisciplinary health care team to promote and maintain the optimal health status of patients and their families (DEC, 2004, p.8).

Bachelors-level prepared nurses have similar responsibilities in regards to promoting safety and working with all members of a healthcare team. Both types of nurses also have responsibilities in regards to...…had lower mortality rates from congestive heart failure as well as lower rates of failure to resuscitate, deep vein thrombosis, pulmonary embolism (all conditions which are linked to higher-quality care) as well as shorter lengths of patient stays. This underlines the fact that BSNs have an ethical obligation to function at the highest extent of their professional competency as teachers and leaders of other nurses and patients. They have a critical role in fostering safe outcomes by anticipating problems given their knowledge of evidence-based literature.

Conclusion

Although both an ADN and a BSN would be in the wrong in the case study, the BSN has additional modeling and leadership responsibilities. The longer preparation demands that the BSN use her ability to synthesize information and also engage in community leadership, setting a standard for other providers as to what is the correct level of vigilance around a patient. The BSN should strive to act as a nurse, role model, and teacher.