Patient confidentiality and ethics in nursing

Patient confidentiality and ethics in nursing
Patient confidentiality and ethics in nursing

Patient confidentiality and ethics in nursing

In their line of duty, perioperative nurses are bound to the duty of patient confidentiality and ethics. However, in executing their responsibilities, perioperative nurses find themselves in dilemma situations with regards to ethical issues and patient confidentiality concerns accompanying the sharing of patient’s health information (Ulrich et al., 2010). According to the Nursing and Midwifery Board of Australia (2010), ensuring confidentiality of the health information of a patient is at the core of nurses establishing and maintaining trusting relationships with patients, patient’s families, and other health professionals.

With no assurance regarding the confidentiality of their health information, patients could be hesitant to provide sensitive yet important information regarding their health status/condition that can help in provision of high quality care (Price, 2015). However, perioperative nurses are faced with dilemma in situations where they consider appropriate to share a patient’s confidential health information to his or her family member(s) or caregiver for purposes of ensuring the patient continue to receive quality and safe health care.

The ethical implication of this action is the violation of ethics duty by the nurse as well as the potential loss of trust in the nurse and other health professionals in the institution by the patient or family should it be discovered that such confidential information was shared.

Additionally, in situations where the health condition of the patient deteriorates, health professionals find themselves in a dilemma state with regards to protecting the patient’s privacy whilst addressing the carers’ concerns about the patient’s condition (Price, 2015). For instance, patients that have undergone brain surgery are often mentally and physically unstable because of the nature of the surgery and as such are not in a position to interact with family as well as make important decisions concerning their health information, which could be confidential.

At the same time, the patient’s family members might request to know about the health condition of the patient, being unaware and unfamiliar of the hospital procedure and policies and health care code of ethics regarding the application of confidentiality in their context (Ulrich et al., 2010). In this situation, disclosing the patient’s confidential health information to the family members can be a complex task.

Thus, the nurse must obtain the patient’s permission about the information that can be shared, to who and under what circumstances to minimise possible misunderstanding with family member(s) as well as evade possible legal implications accompanying such (Olson & Stokes, 2016).

According to the Nursing and Midwifery Board of Australia (2010), patients have an inherent right to autonomy, which allows for their informed consent or the withheld of this consent. The law of informed consent holds that patients have the right to withhold personal information unless it is required by law to provide such information; or make decisions concerning their own treatment (Taylor, 2014).

Thus, perioperative nurses have ethical and legal obligation to respect and protect patient’s right to autonomy by allowing the patients to make their own treatment decisions or not to provide certain personal information deemed confidential. However, nurses may find themselves in a dilemma in situations where protecting and respecting patient’s right to autonomy could result in harm to the patient (Olson & Stokes, 2016).

For instance, in situations such as multiple series of surgery or uneventful incidents, letting the patient make his/ her own treatment decisions or withhold important information to health care practitioners could result in self-harm or harm others altogether.

In such scenarios, the nurse or health professional might be compelled to violate the duty of confidentiality through such means as disclosing important information concerning the patient to the family or deciding on the suitable heath care for the patient through the help of family and other health professionals without patient’s consent. This could result in an ethical break that can have legal implications on the nurse or health professional involved (Simek, 2016).


Nursing and Midwifery Board of Australia (2010). Nursing and national competency standards for Registered nurse. Retrieved from:

Olson, L., L., & Stokes, F. (2016). The ANA Code of Ethics for Nurses with Interpretive Statements: Resource for Nursing Regulation. Journal of Nursing Regulation, 7(2), 9-20

Price, B. (2015). Respecting patient confidentiality. Nursing Standard, 29(22), 50-57.

Simek, J. (2014). Specifics of nursing ethics. Kontakt, 18(2), 64-68

Taylor, H. (2014) Promoting a patient’s right to autonomy: implications for primary healthcare practitioners. Part 1. Primary Health Care, 24(2), 36-41

Ulrich, C., M., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M. & Grady, C. (2010). Everyday Ethics: Ethical Issues and Stress in Nursing Practice. Journal of Advanced Nursing, 66(11).  doi:  10.1111/j.1365-2648.2010.05425.x

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Social Attraction: Social Psychology

Social Attraction
Social Attraction

Social Attraction

Social attraction between people is very important. Aspects of social attraction such as love, understanding and care are difficult to explicate because they often go against many norms in life. It is crucial to ensure that these aspects are maintained along a certain line and many people keep it that way. For instance, love is governed by respect, trust and mutual understanding. Care is a precept of responsibility and authority while understanding stems from knowledge and wisdom (Anders,, 2016).

Attraction between people has one key aspect to it; beauty. What anyone would find attractive is often the aspect of life that they feel is appealing to them. Beauty and attraction may have a lot in common but they are not common to all (Anders, de Jong, Beck, Haynes& Ethofer, 2016). This is why it is important to analyze social factors that generate stereotypes about beauty and attraction.  

Beauty is defined as the experience of pleasure or satisfaction based on perception. That is why beauty can only be seen and not felt (Anders,, 2016). What people see as beautiful is often a creation of their social setting. For instance, people who hardly encounter persons of a different race may deem them to be more beautiful or less beautiful depending on their socialization (Weidenfeld& Leask, 2013). In many social setups, beauty is displayed by models on newspapers, article magazines and websites.

It is a form of influence that ends up making the person to feel that what they see as beautiful is not as beautiful or appealing as they suppose. Beauty is thus a form of influence that is borne out of what the society considers to be appealing or not. Beauty is however the greatest contributor to perceptions about attraction (Launay& Dunbar, 2015). Where there is attraction, beauty is often a factor that is critical and central to the theme.

Beauty is a concept that makes up most of the arguments and concepts about attraction. Attraction is vital to any relationship between people because it obscures the feeling of human weakness and inequity. Man is known to be imperfect and very unsymmetrical in many ways. Beauty however is the concept of perfection without prejudice and need to approve other concepts within the person observed.

Beauty makes it possible for people to overlook human inequities that are ever existent and often profoundly the cause for the use of derogative words on people (Sprecher, Treger, Fisher, Hilaire & Grzybowski, 2015). What is not attractive is often despised and chastised. It is vital to remember that perception is simply an illusion that may not be similarly felt by another person (Anders,, 2016). More often than not, the feeling that one is able to achieve a particular attraction or not is all about what they perceive to appeal to them. This is what beauty is all about.

The concept of beauty or appeal in attraction is very complicated because attraction between people can be out of many reasons as well. However, the urge to go beyond the necessary to please the other person is borne out of a need for appreciation or the desire to do right. This can be considered as beauty of purpose or the innocence of decision and motivation. Beauty is about purity and sanctity. There is often a significant appeal from society to get things done but hardly a similar motivation in attraction.

As explained by Talamas, Mavor& Perrett (2016) Attraction is about the traits that make one seem to have a beautiful character and to some extent, beautiful build and look. It applies to both persons of the male and those of the female gender (Talamas, Mavor& Perrett, 2016). Other traits that accompany beauty include; hard work, diligence and determination. They often seem to be of an enlightenment that sparks influence among people. Although affluence is more influential than these traits, it follows that one would find another person with such traits likely to be attractive.

However much there may be aspects that one looks for in an attractive partner beside their physical appeal, the appeal of the self is the most important (McGinley,, 2015). Attraction is about having a similar feeling towards a person at all times without altering the feel of the person based on the circumstance. Beauty is thus best explained by the features one possesses. These features make it possible for the person to ultimately influence a feeling of desire in another person.

It is about the makeup women put on or the expensive suits men wear. It is about making the other person like what one already likes (Ioerger, Henry, Chen, Cigularov& Tomazic, 2015). Attraction can thus be predetermined and premeditated. It is a factor that can easily be manipulated in people’s minds and an issue that is hardly the cause for divisive argument.

According to Englis, Solomon, & Ashmore, (2014), various cultures perceive beauty differently. This is because beauty often defines how attractive one is and since there is a difference between values from one culture to another, there is also a difference in factors making up beauty. However, as per Vacker & Key (2013), despite the variations in perception across various cultures, beauty remains to be one of the most influential factors in establishing attraction between people.

The current generation of the 21st century regards beauty as an outward appearance of an individual that is desired. Therefore, they support the definition that beauty refers to what can be seen by the eye to be appealing. However, before the current perception and definition of beauty, various cultures had unique features which if present in an individual, he or she is regarded as being attractive (Englis, Solomon & Ashmore, 2014.

The character of a person was a big determinant in whether the person is seen as beautiful or not. This is because there were people who could be attractive, win other people’s hearts, and influence others by just interacting with them. In such a case, beauty becomes defined by the intrinsic features that a person possess and not their outward appearances. Societies which belief in both intrinsic and extrinsic beauty believe that the existing inequality in appearance between people should not be a major cause for regarding someone as not being beautiful.

There are various stereotypes that are related to attraction. As explained by Vacker & Key (2013), most people tend to think that people naturally get attracted to those individuals whom they have certain common features with. This stereotyping concept involves both men and female, and in this example, the proponents of this belief argue that the existing high number of integration, interaction, marriage, and business establishments between people of the same ethnicity proves that people get attracted to others whom they share certain common features. Perceptions that people with same characteristics or origin easily see each other as beautiful is also based on culture.

In this regard, it is easier for a person to recognize\e another person as being beautiful if both of them share a common culture or origin.  Another stereotyping about beauty is that it is more pronounced in women as compared to men (Englis, Solomon & Ashmore, 2014). Therefore, it is easier for men to regard women as being beautiful as compared to seeing other men as a beautiful. As a result, it is expected that attraction will flourish easily between men and women as compared to between men and men. (Vacker and Key, 2013). 

There has been a misconception about love and beauty especially when it comes to how these two feelings ate expressed by people. As explained by Diessner, (2012), most people find it difficult to distinguish love from beauty. This is because both of the two feelings give one the desire to be or like another person so much.  However, it should be noted that love and beauty are different in the sense that love develops between individuals irrespective of whether they are beautiful or not.

In other words, one does not need to be beautiful or to possess certain features for them to be loved by another individual. Moreover, love takes a long time to appear, and in most cases, it comes involuntarily and gives little consideration to both outward and inward appearance of a person. On the other hand, attraction is mostly felt as a result of existing beauty between the attracting individuals. Moreover, it considers features that are present in an individual and may end if a person changes in certain ways. Also, attraction can be felt only after a short time whereas love mostly lasts forever (Vacker & Key, 2013).

There are various theories of beauty. However, Denis Dutton’s and Andrew Park provocative theory offers the best insight into the current beauty trends surrounding attraction (Diessner,, 2012). They do believe that beauty is specific to an individual. However, it is also a part of human nature that has very deep evolutionary origins. 

Other existing theories such as the typical beauty theory of Ruskin and the vital beauty theory try to explain the essential characteristics of an individual that constitute their beauty status. Therefore, they help propagate the notion that a person can improve his or her beauty through effort

There are two major forms of beauty that are inexistent at the moment. These are; augmented beauty and natural beauty. Whereas naturally beauty is acquired naturally and one may possess it from the time they are born, augmented beauty is acquired artificially (Diessner,, 2012). To acquire augmented beauty, a person uses various artificial beauty products and solutions to enhance their appearance by becoming more beautiful than they were previously.

Even though both these two types of beauty makes one attractive, there are various concerns about the longevity of augmented beauty. It is argued that it may cause attraction just for a short period and in the long term, the attraction may cease to exist as some of the beauty features will fail to reciprocate themselves positively. On the other hand, natural beauty is always desired as it creates the true picture of an individual on others thereby aiding in establishing trust.

The importance of being beautiful has caused some individuals to become beautiful. This is because, without beauty, a person may not be attractive to others. As a result, they may end up feeling dejected and living a lonely life. Since human beings are social species, it is wise to put in effort to enhance beauty so as to live a comfortable and soothing life with many admirers as compared to living unfulfilling life as a result of low beauty levels.

Therefore, as Englis, Solomon and Ashmore (2014) argues, it is more sensible to put in effort so as to improve a person’s beauty as compared to leaving it the way it is and undergoing a tough social life (as Englis, Solomon and Ashmore, 2014).

Many people consider the feeling of attraction to be related to the symmetrical shape of the person, shape or thing. Many people are attracted to beauty and not value. There is thus the general feeling that most human beings will often proverbially ‘read a book by its cover.’ This is a concern among persons who mask their attractive qualities by not being very outgoing and expressive about their characters.

It is thus important to ensure that one is always able to express their ‘inner beauty’ where the outer beauty does not appeal to many people in order for the rest of society to find them attractive (McGinley, Zhang,Mattila& O’Neill, 2015). This is critical in the world where perception is often the main reason for attention on certain details. This means that beauty is a form of influence that is borne out of what the society considers to be appealing or no.

Even though this is contextual, it has led to development of various techniques of acquiring beauty through artificial techniques. These means have often been sought by individuals who feel that they are not appealing in terms of beauty.


Anders, S., de Jong, R., Beck, C., Haynes, J., & Ethofer, T. (2016). A neural link between affective understanding and interpersonal attraction. Proceedings of the National Academy of Sciences of the United States of America113(16), E2248-E2257. doi:10.1073/pnas.1516191113

Diessner, R., Solom, R. C., Frost, N. K., Parsons, L., & Davidson, J. (2012). Engagement with beauty: Appreciating natural, artistic, and moral beauty. The Journal of Psychology, 142(3), 303-29. Retrieved from

Englis, B. G., Solomon, M. R., & Ashmore, R. D. (2014). Beauty before the eyes of beholders: The cultural encoding of beauty types in magazine advertising and music television. Journal of Advertising, 23(2), 49. Retrieved from

Ioerger, M., Henry, K. L., Chen, P. Y., Cigularov, K. P., & Tomazic, R. G. (2015). Beyond Same-Sex Attraction: Gender-Variant-Based Victimization Is Associated with Suicidal Behavior and Substance Use for Other-Sex Attracted Adolescents. Plos ONE10(6), 1-16. doi:10.1371/journal.pone.0129976

Launay, J., & Dunbar, R. M. (2015). Playing with Strangers: Which Shared Traits Attract Us Most to New People? Plos ONE10(6), 1-17. doi:10.1371/journal.pone.0129688

McGinley, S., Zhang, L., Mattila, A., & O’Neill, J. (2015). Attraction to Hospitality Companies: How Processing Fluency Moderates Value Fit. Journal of Human Resources in Hospitality & Tourism, 14(1), 25-44. doi:10.1080/15332845.2014.904171

Mitteness, C. R., DeJordy, R., Ahuja, M. K., & Sudek, R. (2016). Extending the Role of Similarity Attraction in Friendship and Advice Networks in Angel Groups. Entrepreneurship: Theory & Practice40(3), 627-655. doi:10.1111/etap.12135

Sprecher, S., Treger, S., Fisher, A., Hilaire, N., & Grzybowski, M. (2015). Associations Between Self-Expansion and Actual and Perceived (Dis) Similarity and Their Joint Effects on Attraction in Initial Interactions. Self & Identity14(4), 369-389. doi:10.1080/15298868.2014.1003592

Talamas, S. N., Mavor, K. I., & Perrett, D. I. (2016). Blinded by Beauty: Attractiveness Bias and Accurate Perceptions of Academic Performance. Plos ONE11(2), 1-18. doi:10.1371/journal.pone.0148284

Vacker, B., & Key, W. R. (2013). Beauty and the beholder: The pursuit of beauty through commodities. Psychology & Marketing (1986-1998), 10(6), 471. Retrieved from

Weidenfeld, A., & Leask, A. (2013). Exploring the relationship between visitor attractions and events: definitions and management factors. Current Issues In Tourism16(6), 552-569. doi:10.1080/13683500.2012.702736

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Unethical behaviors in the Workplace: Case Study

Unethical behaviors in the Workplace
Unethical behaviors in the Workplace

Unethical behaviors in the Workplace

Human Resources and Staffing Crisis at Blumberg’s Nursing Home

            Ethics goes a long way in ensuring the organization achieves good public relations and good image as a means of acquiring public confidence. In the case of Blumberg Nursing Home, the actions of three employees were detrimental to its reputation and government regulations, requiring a change of tact by the administration in approaching future crises. It is requisite to formulate an effective way of replacing the erring staff, while setting policies and incorporating residents and staff views in the future running of the nursing home.

Staffing needs

            There is an immediate need for a Director of Nursing, dietician, and a receptionist at Blumberg Nursing Home. A DON is important since she manages nursing activities, controls patient care, makes nursing policies and institutes short-term and long-term future nursing plans that ensure that the hospital meets stringent government standards (Bisk, 2016).

The DON also does financial and nursing budget needs, involves the hospital management in nursing care, evaluates nursing activities to ensure it is patient-centered, meets regularly with other members of the executive, and communicates with them regarding the nursing department. The hospital dietician also does several important tasks in the hospital such as teaching patients about nutrition, addressing patients’ healthcare needs, partially gets involved as a multidisciplinary team, and coordinates dietary changes among the patient.

            Additionally, the medical receptionist is important for coordinating patient arrival and plan for care, gives patients information concerning their problems, organizes clerical and administrative activities and keeps inventory of office and medical equipments (Hicks, 2016). The receptionist also answers phone calls, registers new patients’ and coordinates their next treatment plan by notifying other members of the medical team.

Therefore, the DON, dietitian and the receptionist all are important for the general welfare of the hospital. However, due to the large administrative responsibility of the DON, the hospital should fill this position first. The nursing care is a very important part of hospital activities and requires a leader to coordinate all its activities effectively, including hiring a receptionist and dietitian, important in nursing care.

            In addition, the receptionist should come second to aid the nursing staff in coordinating the activities of receiving patients and informing them of their treatment requirements. Since the receptionist helps in keeping office records and inventory of all the required equipments for administrative work in the hospital, it is imperative to have this staff member (Hicks, 2016). On the other hand, the hospital can outsource a temporary self-employed dietitian to coordinate dietary needs of the patients. Most dieticians have their own clinics and can always schedule hospital visits, as the plan of acquiring a permanent dietician is underway.

Policies for addressing unethical behaviors in the workplace

            Unethical behaviors in the work place can be detrimental to the overall running of the organization and can really hurt the organizations reputation. Each employee in the organization acts as an agent of the company, and whatever they do may be beneficial of disadvantageous to other employees. To avert future crisis and staff misdemeanor, a good policy ought to be in place. The first step is to have a robust human resource manager, either internal or hired externally, to provide trainings, procedures, and policies for tackling ethical issues (Goldfield, 2015).

Having a robust human resource manager is requisite for effective reporting of unethical behavior, and for company to have and maintain proper policies. The task of the HR manager shall involve communicating to employees the organization’s expectations and making clear to them how their bad demeanors can affect the entire organization.

            An effective way of combating unethical behavior is creation of codes of ethics. The codes of ethics aids in communicating the organization’s values, and establishing means of creating boundaries for what is appropriate (Goldfield, 2015). These codes of ethics are simple and succinct, contained in the mission statement, value statement, and employee handbooks. The codes of ethics for Blumberg hospital shall have a protocol where employees can report unethical behaviors to the human resource manager or a senior manager far removed from the role.

This aids in bringing seriousness to the issue and creating trust in employees (Goldfield, 2015). A dedicated anonymous hotline is also useful in reporting such cases. Additionally, the protocol shall ensure no victimization to any employee who reports such cases. The policy shall also entail empowering the employees through training, yearly bonuses and public acknowledgement, in order to ensure the code becomes effective (Goldfield, 2015). The hospital shall have to review the code on a yearly basis y having the employees read and sign over a form, to encourage adherence to the standards.

            The organization can have punishment procedures for unethical employees who may not adhere to ethical standards. These may include demotions, suspension, denying leaves, or firing them, but as a last resort whenever warnings and summons do not work (Mack, 2016). The organization can also fight ethical misdemeanors through protection of whistleblowers, rewarding ethical employees, and having a dedicated panel or person who shall offer unbiased approach to enforcing ethical standards in the organization.

Leadership roles

            The aftermath of an unethical crisis within a business offers an opportunity for the administrator of the organization to exercise decisions that aid in boosting staff morale and that of the residents. According to Lisa Quast (2011), the administrator of an organization ought to lead by example. By incorporating good ethics in one’s behaviors makes the employees avoid unethical situations at work.

The administrator can constantly echo the need to act ethically within the organization, by encouraging employees to follow the codes of ethics every time. Quast (2011) adds that reinforcing ethical behavior and punishing unethical behaviors aids in warning employees, and coercing them towards adhering to code of ethics.

            The administrator can further show good leadership skills by listening to the unethical employees’ explanation of their action. Having good listening skills helps in getting valuable feedback from the erring employee. This can also provide an opportunity to remind and enforce codes of ethics to an employee who may err because of being overconfident (Quast, 2011). The administrator can also bring back confidence among his juniors by showing calmness and confidence that makes other employees increase in morale.

The confidence shows that the decision taken was appropriate and the administrator is in charge. The administrator can also use his character and competence as part of good leadership skills to encourage the employees and inspire them (Trevino & Brown, 2004). Instead of punishing erroneous employees, the administrator can re-inspire confidence in them by reminding them of their value to the organization, and its expectation of them. The unethical employees have new challenges to spur their recovery and show support to them.

            The administrator of Blumberg hospital can show management skills by exercising his authority effectively. The administrator can demonstrate his integrity by ensuring adherence to the codes of ethics by all employees (Quast, 2011). A high integrity leadership communicates straightforwardness to the employees. The administration should be consistent in rewarding ethical employees and punishing the unethical ones, but at the same time taking time to encourage employees adhere to codes of conduct (Kurucz & Wheeler, 2013).

However, despite the need to warn and lead unethical employees into recovery, it is imperative that the employees understand the severity of their actions. In the case of Blumberg hospital, a drunk DON, who also happens to be a senior member of the executive, sends a wrong leadership message to the entire nursing fraternity. This communicates to the other nurses that they too can behave unethically without undergoing any punishment. A drunken receptionist can give wrong information to patients and may talk inappropriately to the hospital clientele.

            According to Goldfield (2015), it is imperative to inculcate good communication framework within the organization to ensure employees grow satisfactory with the management decision. The administrator can do this by often calling for meetings to highlight to the employees the recent happenings, the reasons for taking such decisions, and the expectation of the management to the employees in assisting to averting a future crisis.

This helps to communicate the urgency, and the dire need of the employees to maintain high work standards and ethics for the benefit of the organization. Additionally, Trevino and Brown (2004) suggests that the administration can train and encourage the lower leadership levels who interact with the employees on a higher levels, to show high levels of integrity and support for other employees. By maintaining a culture of professionalism and high work standards, the hospital can avoid future crises occurring from employees acting unethically.

How to use the Quality Indicator Survey

            The Quality Indicator Survey is a computer-generated survey meant for assessment of long-term care to ensure nursing homes licensed by the Medicare and Medicaid meet the federal guidelines (Lin & Kramer, 2013). The survey entails two processes meant to assess certain regulations within nursing homes to ensure they follow the federal laid standards. Factors such as deficiencies, current complaints, and adherence to standards can undergo review to assess the suitability of a nursing home to its intended purpose.

The surveyors does this, while at the same time ensuring the federal set guidelines are followed to the later. The first stage of the survey involves interviewing residents, reviewing clinical records and observing the residents (Lin & Kramer, 2013). The data gathered goes into a computer system, which analyses it using special software and gives a feedback. The second stage of the survey entails using investigative tools to do an in-depth analysis and systematic review of the causes of certain discrepancies and the completion of essential and non-essential tasks.

            According to Lin and Kramer (2013), the QIS can help a hospital to gather information concerning the perception of the residents towards it and their expectations in terms of the type and quality of services offered. Therefore, the administration of the Blumberg hospital can use the QIS survey to learn of the perception, requirements and recommendations that the residents deems imperative for the efficient running of the institution.

The actions of the DON, the dietitian and the receptionist might be an opportunity for the hospital administration, to check whether the breaching of the hospital codes of conduct has been persistent, and whether some of the employees have offered poor services. The employee staff can take the survey to echo to the administration their recommendations and desired mode of treatment in case of future crises. It is vital to ensure training of the codes of ethics to the employees during its implementation.


            The Blumberg nursing home staff crisis is solvable by hiring a new Director of Nursing as a more urgent plan, so that the DON can assist in hiring the best receptionist and dietitian who are instrumental in the activities of the nursing care. The hospital administrator requires good leadership and management skills such as listening, integrity, and understanding the employees. Good procedures should exist to ensure unethical behaviors undergo punishment, while at the same time rewarding those acting well. The Quality Indicator survey is useful for the hospital administrator to assess and implement changes that shall ensure future adherence to the hospital’s codes of ethics.


Bisk. (2016). RN Management Careers for Master’s Degree Graduates: Nurse Director. Retrieved from: (Accessed December 5, 2016).

Goldfield, B. (2015). A Proactive Approach to Addressing Unethical Behavior in the Workplace. (Updated 20 January 2015). Retrieved from: (Accessed 5 December 2016).

Hicks,J. (2016). Medical Office Receptionist: Job Duties and Requirements for a Medical Office Receptionist. (Updated 20 November 2016). Retrieved from: (Accessed 5 December 2016).

Kurucz, E. C., Colbert, B. A., & Wheeler, D. (2013). Reconstructing value: Leadership skills for a sustainable world. University of Toronto Press.

Lin, M. K., & Kramer, A. M. (2013). The quality indicator survey: background, implementation, and widespread change. Journal of aging & social policy, 25(1), 10-29.

Mack, S. (2016). How to Enforce Ethical Behavior in the Workplace. Retrieved from: (Accessed 5 December 2016).

Quast, L. (2011). How To Prevent Poor Ethical Decision-Making. (Updated 19 December 2011). Retrieved from: (Accessed 5 December 2016).

Treviño, L. K., & Brown, M. E. (2005). The role of leaders in influencing unethical behavior in the workplace. Managing organizational deviance, 69-87.

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Ethical Dilemma in Advanced Nursing Practice

Ethical Dilemma
Ethical Dilemma

Ethical Dilemma in Advanced Nursing Practice

Physicians may be confronted with an ethical dilemma where they must decide whether or not provide treatment for themselves, family members, or others close to them(CPSO, 2016). Whereas it may be the physician’s best intentions to provide treatment in this context, there is a growing body of literature indicating that personal or close relationships have the potential of compromising the emotional and clinical objectivity of the physician. This paper examines the process of using ethical principles in decision-making and meeting the Nursing Practice Core Ethics Competencies.

The first step in approaching ethical decision-making is to state the ethical dilemma. It is important for the physician to identify the components of the situation presenting a potential ethical dilemma. In the case scenario, Mrs. ABC’s mother should have first identified the ethical dilemma presented by her undertaking to treat Mrs. ABC. The physician should be able to identify the issue objectively without the influence of subjective perceptions, values or attitudes specific to the issue.

Upon identification of the ethical dilemma, the physician needs to connect ethical theory to the dilemma in practice. Beauchamp and Childress’s ethical theory is often regarded as one of the basic foundations for discussions of this nature. This theory is grounded in four major principles: justice, beneficence, non-maleficence, and autonomy. Justice involves appropriate, equitable, and fair treatment of patients.

Beneficence supports the use of positive steps for benefitting others, which involves the balancing of benefit, risk and costs. Non-maleficence encompasses the intent not to inflict harm. Lastly, autonomy is a principle which requires a professional or client to have the capacity to self-determination in his/her engagement in decision-making (Nagy, 2015).

Exploring an ethical dilemma requires a physician to examine the issue and see the manner in which each of the principles relate to it. In some cases, this examination alone clarifies the issue enough that the resolution of the dilemma becomes obvious to the physician (Forester-Miller & Davis, 1995).


CPSO. (2016). Physician Treatment of Self, Family Members, or Others Close to Them. Retrieved from:

Forester-Miller, H., & Davis, T. E. (1995). A practitioner’s guide to ethical decision making. Alexandria, VA: American Counseling Association. Nagy, T. F. (2015). Approaches to ethical decision making. Journal of the Academy of Nutrition and Dietetics. Retrieved from:

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DNP Essentials

DNP Essentials
DNP Essentials

DNP Essentials Pertinent To Health Care Leadership and Inter-Professional Collaboration


            The push for one to acquire a doctoral level before practicing nursing is a matter of contention. Some people argue that there are simply inadequate reasons amounting to forced matriculation of the present and future nurse practitioners to attain a doctoral-grade. On the contrary, some health care experts consider DNP as an essential tool in developing an efficient system of administering health care services (Chism, 2013).

The introduction of DNP Essentials (AACN, 2006) recommended several measures geared towards developing clinically skilled and competent educators with the ability to administer skills and evidence-based practice knowledge using innovative methods. In this reflective essay, I will focus on the learning practices, which are designed to meet the DNP Essentials (AACN, 2006) pertinent to healthcare leadership and inter-professional collaboration.

Reflection on DNP Essentials for enhancing Health Care Leadership and Interprofessional Collaborations
DNP essentials associated with enhancing inter-professional collaboration and health care leadership include,

  1. Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking
  2. Essential VI- Interprofessional Collaboration for Improving Patient and Population Health Outcomes (DeCapua, 2016).

Essential II consists of a description of procedures of organizational and system leadership, which subsequently affects healthcare service delivery and the outcomes of patients’ care. According to AACN, (2012) preparation facilitates DNP graduates with the necessary expertise in evaluating organizational structure, identification of system challenges and enhancing organization-wide changes in discharging their service. Under this essential, the graduate is prepared to take leadership roles at different levels. This involves advancement from informal leadership at a clinical stage to formal leadership at an executive level (Chism, 2013).

On the other hand, Essential VI helps the graduates to understand the significance of inter-professional collaboration in the health care environment. Since nurses collaborate with other health practitioners in carrying out their duties, Essential VI focuses on enhancing the collaboration by equipping the graduates with leadership skills necessary to enhance cohesion amongst themselves and other team members. In some cases, graduates assume the roles of consultants.

In an attempt to evaluate the relevance of DNP essentials, the following are reflection examples demonstrating how we can relate our active learning to achieving competencies of DNP essentials. The main courses in this study provide an understanding of practice management principles, strategies of productivity assessment and quality care. For instance, the ability to evaluate current procedures and practice policies is facilitated by the development and implementation of an algorithm, which describes the protocols in health care personnel management.

This is in consistency with the procedures provided by the US Public Health Services (2013). According to Thompson and Alexandroy (2013), DNP courses promote one’s ability in strategies of improving quality both at the organizational and policy stages. Some of the main courses that enhance proficiency in quality improvement include, Application of Best Practises, where assignments are protocol and accompanied by a citation of levels of evidence. Another course is in healthy policy and politics, which involves assignments on healthy policy analysis and field project in an organization. Attending conferences are also significant in attaining the requirements of an independent study.

Similarly, Advanced Practice Registered Nurses (APRN) must adjust to collaborate with other health care practitioners to assess the impact of nursing on the health of the individuals and populations. For instance, American Association of Colleges of Nursing, (2012)  states that the restructuring of the current health system in America promotes collaboration among different teams to provide a comprehensive, cost-effective and risk-free health care for persons with chronic conditions.

Similarly, attending the UAB DNP conferences creates a wider awareness on inter-professional collaboration. In addition, Thompson and Alexandroy, (2013) states that there exists a working gratitude amongst physicians, assistants and the nursing practitioners within her work environment.                 

Complex health situations are resolved by sharing abilities, skills, and knowledge among team members. This was facilitated Population Health in Advanced Practice course accompanied by a project assignment in Community of Interest. In addition, Interdisciplinary Leadership and Role Development for Practice is another course promotes leadership and inter-personal   According to DeCapua (2016), students at the University of South Florida were provided with a direct care cognate option for ARNPs in direct clinical care or indirect cognate care for education and leadership. For a person who has practiced teaching, it easier to take indirect cognate care in nursing education.


In conclusion, DNP Essentials are significant implementing effective health care policy. In accordance with the Essential II and VI of the DNP Essentials, health care leadership and inter-professional collaboration can be achieved by developing courses, which will promote a better understanding of management practice principles, productivity evaluation techniques and quality health care delivery (DeCapu, 2016).

According to Thompson and Alexandrov (2013), DNP courses develop one’s ability in developing strategies for improving quality care both at the organizational and policy stages. Essential II involves a description of procedures of organizational and system leadership, which affects healthcare service delivery and the outcomes of patient care. On the other hand, Essential VI equips graduates with knowledge on the significance of inter-professional collaboration in the health care environment (Chism, 2013). 


American Association of Colleges of Nursing, (2012). The Essentials of Doctoral Education         for Advanced Nursing Practice. Retrieved on January 3RD, 2017 from

Chism A, (2013).   Essentials of the Doctor of Nursing Practice: A Philosophical Perspective. Jones & Bartlett Learning,

DeCapua. M, (2016). The Essentials of the DNP Program. Retrieved on January 3rd, 2017 from

Thompson, J., & Alexandrov, A., (2013). Reflective Summary Retrieved on January 3rd, 2017 from

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Leadership Command Philosophy Interview Essay

Leadership Command Philosophy
Leadership Command Philosophy

Leadership Command Philosophy

Being the CEO of the organization named Drugs and Co., I find myself competent enough to lead the organization diligently. There are many traits of the leader which need to be inculcated in one’s personality so that one can hold this position confidently. The leadership quality is based on various types of leadership theories. These theories depict the importance of behavior, nature and demeanor which play significant role in shaping the overall personality of a leader. The point of argument is that as far as my personality is concerned, I feel that my leadership abilities are the combination of charisma, democratic spirit and motivational leadership.

My organization demands that I provide sufficient moral and physical support to the employees so that they may feel comfortable at the workplace. In order to ensure that the employees feel relaxed, I would employ the use of motivational leadership at the first place. For this purpose, I would arrange regular informal meetings to get the point of view of the employees.

This type of leadership is called the participatory type of leadership. It is the useful technique which helps the employees to find the way and solution regarding the problem at hand. It also keeps the employees involved in the organization so that they intend to own the organization. This would enable me to get any idea about their feelings, apprehensions and issues. The reason is that, the organization which I own is based on the very tough routine and it requires the rigorous research and exploration.

The laboratory technicians are the experts who need peaceful environment to find out the chemical formulas of new drugs. These drugs are then required to be transferred to the medical stores. In order to enable the employees to make the good quality drugs I would invite their expertise (Müller, Geraldi & Turner, 2012). In addition to that, I would also make the use of my physical charisma and the authoritative decision making. I have the great quality of eloquence with the help of which I can motivate them to take risky decisions.

I conducted the interview of the CEO of an international company who has an experience of working for two years in that organization. While answering the question related to the most challenging issue he faced during his leadership tenure, he said that the most difficult task was to carry out the conflict resolution among the employees. There are many instances in which the compromise seems not to be reached among the team due to the difference of opinion.

He told that he used to manage this situation by taking the individual opinion of the contesting parties. After getting the views, he used to decide the case in the light of the best possible options. After giving the final verdict, the CEO used to arrange the joint meeting of the employees to tell them about his decision.

          While replying to the question regarding the best possible solution to the problem of leadership, the CEO said that it is best to observe patience and tolerance in the conflicting situation. Instead of getting into the head on collision with the employees and harassing them, it is rational that the employees are asked to calm down and leave the place. They must be given the relaxed environment to ponder over the situation more critically. It is the possibility that they would realize their mistake and become able to take rational decision.

He also told that in majority of the cases, this strategy worked for him. However, as an alternative he used to use his authoritative approach in those cases in which the employees exhibited the egoistic behavior. In those situation, it was necessary to bring their steadfastness under control. Had he not employed this tactics, the situation would have gone out of controls.

          The analysis of this interview shows that there is not a single leadership type or skill which can be employed in the practical life. The best approach is to use multiple types of leaderships to tackle the employees. The reason is that the employees vary from one another as far as their nature and temperament is concerned. Moreover, the leaders are required to make a rational decision about the type of leadership.

Had I been involved in the similar situation, I would have also gone for the same strategy of using the combination of different types of leadership. The reason is that the position of a leader is very dynamic and he needs to be very receptive to this fact (Zhu, Kraut & Kittur, 2012). In addition to that, I would have tried to keep my emotions under control so that my weaknesses were not evident in front of the employees.

          I would have also gone for the option of getting the grip on the rules and regulations of the organization. This would help me in making the decisions according to the rules of law. As a result, there would be the rare chances of any objections raised on my credibility. I would also try to win the confidence of the employees through my friendly behavior with them. Risk taking strategy should also be used to keep the employees attentive and ready to take new initiatives (Miner, 2015).

I would also use my charisma and eloquence so that the employees may focus the attention on my views. This type of leadership is called charismatic leadership. It is the sort of leadership which helps a lot in those situations in which no other strategy works and the employees are not ready to work unanimously. Sometimes, the conflict needs to be mediated through the presence of some compromising personalities who may lead the team through their holistic approach.

In order to ensure that, I would keep a committee of some of the competent people who can accompany me during the conduction of the meetings (Goleman, Boyatzis & McKee, 2013). The decision making needs to be very much tactical to avoid the unfair situations.

          Keeping in view the critical analysis and summary of the interview, it is concluded that the leadership modalities need to be employed through the deliberation. The competent leaders are those who keep the team bound together in the hour of both distress and happiness. They are the people with exemplary capabilities and have high level of self-esteem.

As far as their role in the organization is concerned, it is pertinent to mention that the leaders are not required to stay stubborn and rigid. Instead of that, the leaders need to be very much tolerant and accommodating so that they can control the situation and turn the tide of events. Keeping in view all these comments, I find myself to be in a better position to lead the team in a better way.


Goleman, D., Boyatzis, R., & McKee, A. (2013). Primal leadership: Unleashing the power of emotional intelligence. Harvard Business Press.

Miner, J. B. (2015). Organizational behavior 1: Essential theories of motivation and leadership. Routledge.

Müller, R., Geraldi, J., & Turner, J. R. (2012). Relationships between leadership and success in different types of project complexities. IEEE Transactions on Engineering Management, 59(1), 77-90.

Zhu, H., Kraut, R., & Kittur, A. (2012, February). Effectiveness of shared leadership in online communities. In Proceedings of the ACM 2012 conference on Computer Supported Cooperative Work (pp. 407-416). ACM.

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Nursing Practice: Evaluation of course competencies

Nursing Practice
Nursing Practice

Nursing Practice:

Evaluation of course competencies

The historical evolution of advance nurse practice indicates the importance of Advance practice nurses are in delivering of quality and cost effective care.  This class outlined the theoretical foundation of nursing practice which has enabled me gain credibility and develops the necessary practice skills and core competencies in this dynamic and complex nursing environment.

It has empowered me with appropriate skills to navigate the complex healthcare systems and to promote evidence based practice and knowledge. The course provides an opportunity to evaluate the traditional and current nursing practice by exploring nursing theories and theories in other discipline. This has provided an opportunity to understand the various theories, and to explore the best framework that reflects my role as a Family nurse practitioner (Shearer and Adams, 2012).

Reflecting on this course outcomes, I recognize several outcomes that I can relate with to develop my professionalism. The course has enabled me to integrate knowledge gathered from previous courses to deliver quality care. I have developed critical thinking skills that are essential in developing differential diagnoses; and competences that will help one to relate and address the health dilemmas encountered in my discipline.

The unit course on facilitates the development and interdisciplinary leadership provided; thereby  providing an opportunity to interact collaboratively with other professions, and their role in delivering cost effective and quality care. The course outcome provides an opportunity to exhibit advanced communication skills, thereby ensuring that I can appropriately and confidently engage as a team member and collaborator and simultaneously functioning as part of the multi-disciplinary team (Zanetti, 2015).

The Advance nurse practitioner functions in various role territories including the family nurse practitioners, nurse specialists, certified nurse anesthetists, administrators and nurse researchers.  Through this course, one can differentiate the distinct role territories; for instance, nurse specialist focus on illness management in acute care, during consultation, education and research.  

Nurse administrators work as clinical leaders within the field or expertise. On the other hand, the Family nurse practitioner focus on primary care where they provide care plan, comfort, educate and in promotion of health and wellness strategies.  As a family nurse practitioner, my core role as primary care clinician is to coordinate the healthcare team, educate/instruct patient and to work as care managers (Fitzgerald et al., 2012).

The advance nurses (family nurse practitioners) are patient’s advocates and must deliver this role actively to ensure that patient’s rights and dignity are protected.  The course is structured in such a way that one can synthesize knowledge from ethics, regulatory statutes and theory, to develop personal philosophy in my career.

This includes development of cultural competence so as to champion as a social and culture ambassador and to ensure that care is available, accessible, and delivered equitably without any bias.  I have explored the ethical and legal principles in my State, and as required as a professional member of the nursing community (Shearer and Adams, 2012).

 This course outcome provides an opportunity to utilize research so as to identify health promotion strategies, diseases prevention and to deliver cost effective and quality care as evidence based, while respecting sensitivity towards population or patient’s unique attributes.

The introduction to scholarly project development helped me in gaining skills on the importance of consulting with preceptors, identifying problems in clinical practice, explore on evidence of achievements and to disseminate findings.  I find these skills to be very useful even upon graduation, and also when pursuing professional advancement (Morgan, Barry, & Barnes, 2012).

As a future advance nurse practitioner, I now understand that learning is not just an act of momentary acquisition of skills and knowledge, but a process where skills and knowledge become honed so that they can manifest in every aspect of clinical practice. Looking at my future career, it is my hope that I will apply the core competencies gained to develop critical awareness in all the different role functions. Thank you for your immense guidance and support throughout the course.


Fitzgerald, C., Kantrowitz-Gordon, I., Katz, J., & Hirsch, A. (2012). Advanced Practice Nursing Education: Challenges and Strategies. Nursing Research and Practice, 2012, 854918.

Morgan, C., Barry, C., & Barnes, K. (2012). Master’s programs in advanced nursing practice: new strategies to enhance course design for subspecialty training in neonatology and pediatrics. Advances in Medical Education and Practice, 3, 129–137.

Shearer, D., and Adams, J. (2012). Evaluating an advanced nursing practice course: student perceptions, nursing standard 26(21):35-41. DOI:10.7748/ns2012.

Zanetti, M. L. (2015). Advanced nursing practice: strategies for training and knowledge building. Revista Latino-Americana de Enfermagem, 23(5), 779–780.

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Spiritual Discipline

Spiritual discipline
Spiritual discipline

Spiritual discipline

Spiritual Growth Plan 2

            Spiritual discipline is imperative for any Christian with a strong quest to live a fulfilling godly lifestyle and achieve the optimum outcome from his faith. It has been part of my weekly practice to adhere to a spiritual discipline plan for the aim of inculcating a consistent godly lifestyle and avoiding all manner of temptations. This study provides a brief evaluation of the achievements I attained while implementing the plan, how I overcame temptations and the plan I shall use for the next twelve months.

Spiritual Discipline Evaluation 

            In the entire week while implementing the spiritual discipline plan, I came to realize the importance of having a consistent personal relationship with God. Spiritual discipline highlighted to me the beauty of staying attached to the creator of all and learning many things that the Holy Spirit has to offer to all that are thirsty for Him. My spiritual discipline plan entailed two activities, which were journaling and a scripture taking. Each day I allocated an hour of prayer and reading the Word every morning and evening with a quest of making it my personal habit. It was difficult to adhere to the schedule as I was used to the normal routine of waking up and preparing for other activities.

            Putting God first ahead of my daily activities has made me realize that I achieve more because He goes ahead of me. In scripture taking, I came across a verse granting the ownership of day and night to Him;[1] therefore, His importance in leading us every day is unquestionable.

I allowed the Holy Spirit to lead me through scripture taking, which enabled me to have a satisfying devotion every day. Although I managed to accomplish the devotions almost daily, some days I slept late and woke up very late making it difficult to have a conducive session. I was able to achieve covering up to nine chapters of the scriptures per day, only skipping devotion on average twice a week.

I spent a considerable amount of time, sharing the scripture with my neighbors and friends during the weekend and in our cell group, which exposed me to more revelations from other brethren. I would make it clear that it was not smooth sailing as exhaustion sometimes made it difficult to attain these goals but God enabled me to achieve them.

            I also managed to do journaling every day. Journaling is an activity I personally saw as important since it allowed me to quickly capture insights developed whenever I read the scripture or reflected on the doings of the Lord in my life. Personal reflections and meditations especially after my devotions helped me to grow a deep understanding of the purposes of God in my life.

Every day I sought to record at least five things that I consider a blessing in my life. This helped me to identify what I had taken for granted in my life that God was doing. It is surely surprising to know what the Lord has done by counting one’s blessings one by one. Implementing the first plan was difficult because of lack of personal training into being consistent in implementing the plan.

However, it became easier to implement the plan on a daily basis by developing some discipline in avoiding distractions that would rob me time in the evenings and morning. Some of these activities included staying out late, sleeping late, oversleeping, and watching television until late.

Battle Strategy

            The ability to overcome temptations is an important step in achieving long-term goals in life, whether spiritually, academically, economically, or socially.[2] Lack of self-control is a major setback in establishing a thriving spiritual life that is both fulfilling and successful in the pursuit of godliness. The Bible is clear that temptations that come upon people are due to the evil that are accustomed to them.[3]

It is however important to undergo trials as it helps to build perseverance in the life of a Christian. The main temptations I identified before the beginning of my plan was the use of electronics and the social media. I realized I was spending a considerable amount of time watching television and chatting on social media sites. This was detrimental to my spiritual walk and especially being consistent in my devotions and prayer.

            During the implementation of my plan, I learnt how to allocate time for my evening and morning devotions by, reducing the time I was using to watch television and accessing social media sites. I placed a lot of priority on my devotions especially in the evening by deciding to do my devotions early before doing other things. Social media can also provide a lot of temptation to a Christian, so I limited the time taken to use the sites. Additionally, I decided to use the sites to promote spiritual matters by sharing Bible verses and evangelism.

            I developed the need to draw satisfaction from the social media by interacting with friends and catching up with people I have not met for a long time. Using sites like facebook, whatsapp, and twitter provides a window into getting information concerning what is happening in the society and people’s views concerning them.

However, the devotion plan helped in making me understand the importance of allocating time to build a relationship with God. Although there was some great tendency to veer off the quest to remain spiritual, adhering to the spiritual discipline plan made it easier to overcome temptations.

However, I can also say that the Holy Spirit helped me a lot in realizing this goal as it is not by my strength that I was able to accomplish this. I also drew a lesson from the Bible, which states that we should draw closer to God in order to overcome the temptations that the devil throws at us.[4]

Spiritual Discipline Plan

            Reading the scriptures and prayers constitute a very important part of personal devotion. In my devotions, I have learnt to create notes on what I have learnt, and this has helped me in developing personal insight on what the Spirit communicates to me on a daily basis.  In my new plan for the next six-month or so, I would like to share with people more about these insights in order to spread the word of God. I have desired to be active in evangelism so that I may lead other people to Christ and help them change their lives.

            In order to undertake this new plan, I would like to get involved with some brethren in the church who are consistent in evangelism and become part of them. I believe by surrounding myself with people who have the heart for the lost will enable me reach out to more people with the message of truth and helping them in their daily struggle through sharing of a message of hope. I also need to study the Bible more and my plan shall not rely on my daily devotions but by taking part in Bible studies with my church’s cell group members.

            In the next month going forward, I shall aim to lead at least one person to Christ every month, while taking part in church activities that optimally capitalizes on my faith and ability. Having a great intimacy with God can overflow into a personal action and lead to someone reaching out to others as an expression of this intimacy.[5] I believe by putting action into my faith, I shall not only be alive to the working of God in my life but also to hearing from Him even more.


Bible, Holy. “King James Version.” Texas: National Publishing Company(2000).

Campolo, Tony. The God of Intimacy and Action: Reconnecting ancient spiritual practices, evangelism and justice. SPCK, 2013.

Fishbach, Ayelet, and Luxi Shen. “The explicit and implicit ways of overcoming temptation.” Dual process theories in the social mind (2014): 454-467.

[1] Holy Bible. Psalms 74:16

[2] Fishbach, Ayelet, and Luxi Shen. “The explicit and implicit ways of overcoming temptation.” Pp. 02.

[3] Holy Bible. James 1:14.

[4] Holy Bible. James 4:7

[5] Campolo, Tony. The God of Intimacy and Action: Reconnecting ancient spiritual practices, evangelism and justice.pp. 17.

Quantitative Research Critique

Quantitative Research Critique
Quantitative Research Critique

Quantitative Research Critique

To deliver quality care for patients, it is essential for nurses to apply the best current practice.  However, the old adage “all that glitter is not gold” is also applicable in research.  This is because not all nursing research is of high standard, which implies that nurses should not just take research based on the fact that it is being published.  Critiquing of quantitative study follows a systematic approach to appraise the strengths and weakness of the piece of research, with the aim of determining their applicability or credibility to practice.

In this context, this paper will critically analyze this study: – Dobson, R., Whittaker, R., Jiang, Y., Shepherd, M., Maddison, R., Carter, K., Cutfield, R., McNamara, C., Khanolkar, M., and Murphy, R. (2016). Text message-based diabetes self management support (SMS4BG): Study protocol for a randomized controlled trial. Trials 17: 179. doi: 10.1186/s13063-016-1305-5

Background of study

 The title is the first thing observed in this article. An appropriate title should be about 10-15 word long.  Too short or long title can be confusing as well as misleading. In this context, the title clearly identifies the purpose of study, which is randomized controlled study on the impact of text message based diabetes support program.

The study’s abstract provides a succinct overview of the study research, including the aim of the study, sample size, study method, findings and conclusion. Reading the abstract, one is able to determine the relevance of the study to the researchers interest, and to whether continue or not continue reading the article (Melnyk and Fineout-Overholt, 2015).

The research problem is well presented in the back ground if the study. The statement in this section broadly informs a reader about the purpose of the study. For instance, the study highlights that the prevalence of diabetes is increasing internationally, and the burden of this disease is reported among the minority groups, especially those from low income household.

The quantitative research critique reports that effective self management strategies should include frequent monitoring of diabetic patient, empowering the patient with healthy behaviors, and appropriate dosages insulin administration in order to enhance improvement in glyceamic control.  In this section, the significance of the issue in nursing is also explored.

The study proposes that use of text message services to deliver health services and vital information is effective in supporting healthy behaviors and appropriate disease management.  The increasing ownership of mobile phones makes it possible to reach populations that would otherwise be difficult to reach (Hinshaw & Basu, 2015).

The research question is thorough and is well elaborated using substantial yet relevant details as well as the explanation process.  The study aims, research question and hypothesis helps the researcher to form a link between stated purpose and research problem. In this study, these concepts are clearly.

The aim of this quantitative research critique is to evaluate the effectiveness of mobile health diabetes in supporting program (SMS4BG) in patients diagnosed with diabetes type1 and type 2. The specific objectives includes a) enhancing self management processes to improve glycosylated  haemoglobin (HbA1c) and b) to assess its ability to improve diabetes management in remote populations (Dobson et al., 2016).

Methods of study

Methodology can be compared to nuts and bolts of a research study.  The study followed the Standards Protocol Items Recommendation for Interventional Trials (SPIRIT) 2013. The study intervention was done based to the Consolidated Standards of Reporting Trials (CONSORT)-EHEALTH checklist. The research method used in this study is quantitative research method.

There are various research method including experimental, non- experiment and quasi experimental design. In context, the study applied randomized controlled design to determine cause and affect relationship of the study variables. This type of research design is appropriate because it reduces potential sources of bias. This research method is easier to blind mask the participants because the treatment are identified clearly (Melnyk and Fineout-Overholt, 2015).

The sample size used was 1000 participants (500 per arm).  The stratification was done per health district with the urban and remote areas. This sample size was adequate and provided 90% power and 5% significance level to detect changes in 0.5% HbA1c within baseline of 9 months.  Randomization and blinding was done in a ratio of 1:1. The stratification was done according to health district categories i.e. high urban or remote and status of diabetes.

To enhance vigor, the randomization process was done using computer program based on block sizes of 2 or 4. The nature of intervention made it difficult to conceal treatment allocation to participants and the research staff. To improve study outcome validity, the primary patient outcome such as HbA1c, hospital emergency visits and admissions were the objective assessors of the intervention (Dobson et al., 2016).

 The next element is method of data collection. There are many strategies that can be adopted when collecting data in quantitative research including interviews, observational tools and attitude scales. This study used tailor made questionnaires that consisted of closed questions that had fixed answers. The paper outlines the process of data collection in clear and logical processes (Melnyk and Fineout-Overholt, 2015).

The last phase is analysis of data collected, which is often identified as the most daunting tasks. This is because it is associated with complex statistical tests. The study clearly identifies the statistical tests that were undertaken including descriptive and inferential statistics in order to identify the causal and effect relationship between the variables. In this context, the demographics attributes were summarized using descriptive statistics. The study’s continuous variables was summarized using mean, standard deviation, and mean (Dobson et al., 2016).

Results of study

            The discussion of the study findings flow logically and have been associated with literature review. However, the researcher does not indicate if the hypothesis supports the findings or not. The study discussions do not indicate if the findings relate to conceptual framework or not. However, the interpretations as well as the inferences met are clearly associated with study results.  The significance of study findings is stated. The researcher also explores clinical significance and its clinical implication of the study (Polit and Beck, 2006; Jackson et al., 2014).

In this context, the paper explains the protocol for the proposed intervention which is use of SMS4BG trial to explore its impact on diabetes self management program. According to the study findings, this kind of intervention provides tailored support for people with poorly controlled diabetes, especially those living in remote areas. The study develops a protocol that builds on previous evidence on the impact of technology in people with diabetes. The researcher states that the pilot study indicates that the intervention is applicable and is perceived and important in patients diagnosed with diabetes across the country (Dobson et al., 2016).

Ethical considerations

There are four fundamental ethical principles including justice, non-maleficence, autonomy and beneficence.  The principle of autonomy implies that participants have the right to decide whether or not they want to participate in research without any coercion or have fear of what the research is investigating. The Non-maleficence principle implies that the participants are protected from any kind of physical or psychological harm.

Beneficence principle in this context implies that the research should have positive impact to the patient and the society. Justice in case implies that the research should ensure that all participants are treated equally. In addition, moral rules connected with these ethical principles include fidelity, veracity, privacy and confidentiality (Melnyk and Fineout-Overholt, 2015).

To ensure that these ethical considerations are observed is by ensuring that the institutional review boards approve research before it takes place. This is to ensure that the principles and moral rules are adhered to. In this context, the research team sought ethical approval from Health and Disability Ethics Committee (14/STH/162), and that each participant signed an informed consent (Dobson et al., 2016).


The paper concludes by discussing the significance of the study findings. The study makes generalization but indicates that caution should be taken when implementing the recommendations depending on the study purpose and design. The paper does not make any meaningful recommendations for further investigations (Polit and Beck, 2006).


Dobson, R., Whittaker, R., Jiang, Y., Shepherd, M., Maddison, R., Carter, K., Cutfield, R., McNamara, C., Khanolkar, M., and Murphy, R. (2016). Text message-based diabetes self management support  (SMS4BG): Study protocol for a randomized controlled trial. Trials 17: 179. doi: 10.1186/s13063-016-1305-5.

Hinshaw, L., & Basu, A. (2015). Technology Use for Problem Solving in Adolescent Type 1 Diabetes. Diabetes Technology & Therapeutics, 17(7), 443–444.

Jackson, I. L., Adibe, M. O., Okonta, M. J., & Ukwe, C. V. (2014). Knowledge of self-care among type 2 diabetes patients in two states of Nigeria. Pharmacy Practice, 12(3), 404.

Melnyk, B. M., and Fineout-Overholt, E. (2015). Evidence-Based Practice in Nursing and healthcare; a guidance to practice, 3rd Edition.

Polit, D. and Beck. C. (2006). Essentials of Nursing Care: Methods, Appraisal and Utilization. 6th edn. Lippincott Williams and Wilkins, Philadelphia

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