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Ethics Analysis Paper Sample

Title: The Belmont Report and the Social Contract of Nursing in the Context of the Story of Henrietta Lacks.

Thesis statement: Certainly, Rebecca Skloot has immensely succeeded in bringing out the bioethical violations that occurred in a racist backdrop during the advent of biomedical research.

1st Main Point                             2nd Main Point                     3rd Main Point              

Ethical issue (Autonomy)          The Belmont Report             Social Contract

Supporting details                      Supporting details                Supporting details

Autonomy violated                    Moral autonomy                  Expectation of honesty


The book by Rebecca Skloot on the trials and tribulations of Henrietta Lacks in the mid 1900s is a stark reminder of how many moral and ethical violations were committed on the road to the biomedical successes we know today. Henrietta had her cells taken without her consent and used in research. Since then the Belmont Report has made it clear that moral autonomy to consent must be granted to all human subjects.


Title: The Belmont Report and the Social Contract of Nursing in the Context of the Story of Henrietta Lacks. Ethics Analysis Paper Sample

Thesis statement: Certainly, Rebecca Skloot has immensely succeeded in bringing out the bioethical violations that occurred in a racist backdrop during the advent of biomedical research.

1st Main Point                             2nd Main Point                     3rd Main Point              

Ethical issue (Autonomy)          The Belmont Report             Social Contract

Supporting details                      Supporting details                Supporting details

Autonomy violated                    Moral autonomy                  Expectation of honesty


The book by Rebecca Skloot on the trials and tribulations of Henrietta Lacks in the mid 1900s is a stark reminder of how many moral and ethical violations were committed on the road to the biomedical successes we know today. Henrietta had her cells taken without her consent and used in research. Since then the Belmont Report has made it clear that moral autonomy to consent must be granted to all human subjects.



Ethics Analysis Paper Sample

Trends or challenges of Nursing Education

Nursing leaders such as Dr. Jean Watson (1995) have envisioned a future in which nurses play a predominant role in leading the delivery of health care instead of responding to the demands of others. Discuss at least three issues, trends, or challenges that you believe will impact the future of nursing education the most. As you identify and discuss the 3 trends, include the following area for each trend: Why do you believe it will impact nursing education? Provide evidence to support your contention- at least 2 reasons for each trend. Based on the evidence supply at least 1 example for each trend of how nursing curriculum can support nursing students to provide the optimal care in meeting this trend. Two articles have been provided in the readings folder that will help with this assignment. The first is “Are Nurses Ready for Health Care Reform”, the second is “Healthcare Transformation and Changing Roles for Nursing”. Remember that you must use at three to five scholarly references. Include the required text book and the powerpoint presentation, the listed articles, and any other scholarly reference you utilize. Also remember that APA matters. Please review the APA document I have uploaded into Blackboard and use the URL addresses for examples if you are having difficulties with APA. Try to keep these reflective questions to 4 pages; they are not meant to be a thesis but a synopsis of what you are learning. The Grading Rubric for this document is included at the end of this document Trends or challenges of Nursing Education

The demand of nurses in a healthcare setting continues to escalate to greater heights, a trend that has made nursing one of the most promising careers in the future. This increase in demand also parallels with a rise in changing trend that demand for more enhanced knowledge within the nursing field. Nevertheless, the health care arena has changed with the global trend and what nursing demanded a decade ago is a bit different today and thus will even be different heading into the future (Susan & Mercedes, 2017). Demand for enhanced quality of care, quality of the workplace environment, staffing and healthcare facility policies, as well as health reforms are some of the major influencers that have impacted the nursing profession in a big way and pushed for changes in the nursing education for future sustainability (Susan & Mercedes, 2017).


The rising demand for quality care, changing social and diseases demographics and reduction in costs, have led to the need for change, especially on the nursing education. The future nursing seems to be a teamwork career for the best care coordination for better results. This trend will therefore demand a nurse who is knowledgeable in areas of informatics, equipment use, team coordination, as well as communication (Buerhaus et al., 2012). These enhancements will only be achieved through applying reforms in the nursing education to cater for these trends. This essay will focus on the trends or challenges that will impact the future of nursing education, suggest curriculum change and justify why these trends will be the future determinants of the nursing education demand.

Emerging Trends

Nursing education is demanding for more enhanced education curriculum going into the future due to emerging trends and challenges within the field, which demand for more knowledge and different approach in nursing operations. The three major trends that are bound to change the nursing education include; technological change, rising trend in non-communicable diseases, and nursing informatics.

  1. Technological Change

Change is inevitable and so is the technology. With globalization trend, technological innovations are being discovered and spread quickly across the globe. With the rise in this trend, the healthcare world and more so the nursing field has not been left behind. The nursing field acting as the center nerve for health care has seen a growing demand in Improved patient outcomes, which can be enhanced by application of technology in the care giving (Dowding, 2013). This trend has called for nurses who are knowledgeable with the technological trend be it in the areas of equipment use, diagnostic procedures, research, as well as information management. Future nurses are therefore expected to be tech savvy and advance in technology trends through familiarizing themselves with the emerging technology through furthering their learning in this area to equip them with the necessary knowledge that will enable them to cope with the technological environment that they are faced with (Sanko, 2017).

Secondly, the future patient handling is becoming more personalized and the quality of service and a number of patients to be served in a given period can therefore be enhanced through technology. In nearly every hospital setting, technological equipment ranging from the computers to monitoring equipment, require advanced knowledge in operating and interpreting data (Susan & Mercedes, 2017). As such, this demands for more technology inclusion and familiarization with the technology trend through continued learning (Dowding, 2013). The future nursing education curriculum should therefore strive to incorporate more technology-based units that will enhance the nursing students with the future technology skills. This will enable them to cope with the technology demands and emerging trends in this area, as well as improve the service quality in their place of work. Trends or challenges of Nursing Education

  1. The Rising Trend in Noncommunicable Diseases

Noncommunicable diseases are those diseases that cannot be transmitted from one individual to the other. The past disease trend was that the most patients were affected by communicable diseases a fact which saw a vigorous research and interventions for treatment of these diseases. However, in the recent past, there has been a notable challenge across the globe with the rise of non-communicable diseases such as hypertension, diabetes, heart related complications, kidney failure, mental illnesses as well as obesity (Susan & Mercedes, 2017). This has seen this group of diseases contributing up to 70% of all recorded deaths worldwide (NCD Countdown 2030, 2018). This is a shocking figure and a wake up call, especially in the nursing field where most learning was concentrated on communicable diseases.

Most of the non-communicable diseases demand close attention and monitoring, with some requiring specialized treatment. This requires the nurse on duty to be knowledgeable on the diagnostics, emerging treatment and management trends as well as other related risks with a certain medical condition. To achieve this objective, nursing education must incorporate the current treatment, modern equipment uses, as well as patient handling in relation to the non-communicable diseases and conditions (Susan & Mercedes, 2017). Secondly, most of these diseases require great self-care and family involvement to record a success in their treatment (Hearn, et al., 2019). On that note, communication skills coupled with knowledge in patient psychology will be of great importance. Therefore, the nursing student curriculum must also incorporate these learning elements to equip the nurses with the necessary skills to handle such situations effectively. This will assist the patient, as well as the family members to work in collaboration to respond to the experiences and walk together in the journey to recovery (Senitan, Alhaiti & Gillespie, 2019).

  1. Nursing Informatics

Nursing informatics is a trend which has become popular in the recent past, due to the increased need for patient information management. This trend involves documentation, management, generation and processing of medical data concerning patients, which its aim is to provide a comprehensive support to the nurse, other health care providers, as well as the patient (Kaur & Rawat, 2015). Nursing informatics is an emerging trend and therefore most of the nursing education curriculum had not incorporated this learning aspect. Nurses within a facility are in need of a timely information that can assist them either in administering care, patient history or during patient identification (Murphy, 2010). Sometimes this data requires to be handled by a specialist who can avail it when needed.


As such, the nurse must be well versed with the type of information that is required and at the same time have the knowledge of how to collaborate with the specific nurse informatics specialist (Susan & Mercedes, 2017). This will enhance the service delivery by saving the cost and time and increasing efficiency in the service delivery. Nevertheless, it is important for the nursing education curriculum to incorporate informatics basics for the nurses to be aware of how, when and why they may be required to get the assistance of a nurse informatics and how to pass information, including the policies in regard to the handled information (Rajalahti, Heinonen & Saranto, 2014). When nurses are equipped with such knowledge, the work of informatics becomes easier and this improves the smooth running of operations within the facility. Trends or challenges of Nursing Education


Nursing education should be a continuous process as there is so much in trend every day and nurses require to update themselves with the emerging trends to cope with the challenges associated with these changes. Technological advancement, a rise in non-communicable diseases, as well as emerging trends in nursing informatics are the most common trends that will require an update of teaching curriculum and change in approach when it comes to nursing education. These three areas form a crucial determinant of the level and quality of care now and into the future and thus the emphasis and necessary resources should be committed to new learning about these trends in order to realize a positive change in the world of nursing, as well as the patient care.


Buerhaus, P. I., Desroches, C., Applebaum, S., Hess, R., Norman, L. D., & Donelan, K. (2012).

Are Nurses Ready for Health Care Reform? A Decade of Survey Research. Nursing Economic$, 30(6), 318–330.

Dowding, D. (2013). Are nurses expected to have information technology skills? Nursing

Management – UK, 20(5), 31–37.

Hearn, J., Ssinabulya, I., Schwartz, J. I., Akiteng, A. R., Ross, H. J., & Cafazzo, J. A. (2019).

Self-management of non-communicable diseases in low- and middle-income countries: A scoping review. PLoS ONE, 14(7), 1–14.

Kaur, S., & Rawat, H. C. L. (2015). Importance of Nursing Informatics in Nursing Curriculum

for Utilization of Information Technology in Nursing Profession. Baba Farid University Nursing Journal, 9(2), 1–5.

Murphy, J. (2010). Nursing Informatics: The Intersection of Nursing, Computer, And

Information Sciences. Nursing Economic$, 28(3), 204–207.

NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress

towards Sustainable Development Goal target 3.4. (2018). Lancet, 392(10152), 1072–1088.

Rajalahti, E., Heinonen, J., & Saranto, K. (2014). Developing nurse educators’ computer skills

towards proficiency in nursing informatics. Informatics for Health & Social Care, 39(1), 47–66.

Sanko, J. S. (2017). SIMULATION AS A TEACHING TECHNOLOGY: A Brief History of Its

Use in Nursing Education. Quarterly Review of Distance Education, 18(2), 77–85.

Senitan, M., Alhaiti, A. H., & Gillespie, J. (2019). Improving integrated care for chronic non-

communicable diseases: A focus on quality referral factors. International Journal of Healthcare Management, 12(2), 106–115.

Susan, W. & Mercedes, E. (2017). Healthcare Transformation and Changing Roles for Nursing.

Orthopaedic Nursing. 36(1). 12-25.




Trends or challenges of Nursing Education


African Missionary Healthcare Worker Case Study

Question 1

Mastication-chewing and swallowing of food that occurs in the mouth African Missionary Healthcare Worker Case Study

Peristalsis-propulsion of food from the mouth to the stomach occurs in the esophagus

Digestion and absorption- occurs in the stomach where food mixes with gastric juices

Segmentation- absorption of food which occurs in the small intestines

Defecation-undigested materials are excreted from the body as feces

Question 2

The coastal African village that Jenny visited to do missionary work was less developed and members not only had poor sanitation but also no refrigeration. Therefore, due to the lack of safe and proper resources to store and handle food, the risks of contamination were very high.  Similarly, the signs and symptoms that the child presented with were very similar to those Jenny experienced in college following a case of food poisoning.

Question 3

Patients with vomiting and diarrhea become dehydrated and lose a lot of electrolytes. Therefore, electrolyte solutions containing glucose are administered to correct electrolyte imbalance since glucose increases the absorption of sodium to ensure the maintenance of an osmotic balance between the intestinal tissue and fluids in the bowel thus preventing any additional complications that may result from dehydration (Anigilaje, 2018). Similarly, since the patient was unable to eat, an electrolyte containing glucose provided an alternative energy source to promote cellular metabolism.


Question 4

An increased respiratory and pulse rate with decreased blood pressure is common in dehydrated patients. Vomiting and diarrhea influenced the depletion of the child’s body fluids resulting in a significant blood pressure drop. The immediate compensatory mechanism that occurs is an increase in the respiratory and pulse rate (Radlović et al., 2015).African Missionary Healthcare Worker Case Study

Question 5

Since the children experienced diarrhea and vomiting that led to the depletion of body fluids, they lost a lot of bicarbonates in stool and had excessive ketone production following starvation (Chogle et al., 2016). The perfusion of tissues was also reduced increasing the production of lactic acid which resulted in metabolic acidosis.

Question 6

Muscle cramping and excessive thirst were symptoms of potassium deficiency following electrolyte loss due to excessive vomiting, diarrhea, and starvation.

Question 7

The cholera toxin usually prevents the creation of a sodium gradient in the sodium active transport which is essential for transporting glucose from the lumen to the epithelial cells. The inability to absorb glucose leads to high levels of glucose than normal in the lumen with an increased osmotic potential (Gurney et al., 2017). As a result, the absorption of fluids in the intestines is decreased, resulting in diarrhea. Similarly, the inability to absorb glucose tends to limit the sources of energy available for cellular metabolism. This increases the production of lactic acid giving rise to metabolic acidosis.


Anigilaje, E. A. (2018). Management of diarrhoeal dehydration in childhood: A review for clinicians in developing countries. Frontiers in pediatrics6, 28.

Chogle, A., Velasco-Benitez, C. A., Koppen, I. J., Moreno, J. E., Hernández, C. R. R., & Saps, M. (2016). A population-based study on the epidemiology of functional gastrointestinal disorders in young children. The Journal of pediatrics179, 139-143.

Gurney, M. A., Laubitz, D., Ghishan, F. K., & Kiela, P. R. (2017). Pathophysiology of intestinal Na+/H+ exchange. Cellular and molecular gastroenterology and hepatology3(1), 27-40.

Radlović, N., Leković, Z., Vuletić, B., Radlović, V., & Simić, D. (2015). Acute diarrhea in children. Srp Arh Celok Lek143(11-12), 755-762. African Missionary Healthcare Worker Case Study


Ramona Mercer’s Theory on Maternal Role Attainment

My theory is by Ramona Mercer’s maternal role of attainment. And all sources need to be the following and I have attached my rubric for this assignment and also article that can be used as a source too. Please do not select research articles that test the theory, theory construction, a concept analysis or review of the literature articles. When you choose an article it may be quantitative or qualitative. See rubric for those specific details. for the theorist find the original work or as close as possible to the original work of the theorist. Why use a secondary source when you have an original source? Your textbook will not be accepted as source or any other nursing text. Noone & Young clearly state how they used a theory in guiding their qualitative study. Since some theories have only been used to guide qualitative work…..students have found this article helpful. QUALITATIVE Noone & Young 2009.pdf Please refer to the rubric on how to write about your research article depending on if they are quantitative or qualitative. – N5327 Exploration of Science and Theories for Nursing Theory Description and Evaluation Paper


Criteria Identify a theory that uses a concept of interest that might be applied in research and nursing practice (clinical, education, or administration). The purpose of this paper is for you to describe and evaluate the theory using the following criteria. This is a professional paper in which headings, full sentences, paragraphs, correct grammar and punctuation, and correct citation of sources are required. Introduction. Identify your concept of interest and briefly discuss why you chose that concept (explain whether it was observed in clinical practice, identified from relevant literature, or some other reason.) Identify the theory (that utilizes your concept of interest) which will be described and evaluated in this paper. Give the reader a sense of what to expect in this paper. The introduction should be one very short paragraph, and there should not be a heading for the introduction. Ramona Mercer’s Theory on Maternal Role Attainment   Theory Description. Provide a brief description of the theory using an original source or as close to the original source as possible. Include a brief discussion of the origins of the theory and the scope/level (grand, middle range, practice/situation specific) of the theory. Identify the major concepts of the theory and discuss how they are related (propositions). Pick two of the concepts, including your concept of interest, and state the theoretical definitions of these concepts. (30 points) Application of Theory to Research. Find two published, original sourcE es in which researchers used the theory as a framework to support their research. Briefly discuss how those researchers utilized the theory to support their research. Include in the discussion of each study the purpose of the study, how the researchers used the theory in their study, how the concept of interest was used in their study, and how the researchers operationally defined the concept of interest. (20 points) Application of Theory to Practice. Briefly discuss how the theory might be used to support nursing practice (clinical, education, or administration). Include in the discussion the purpose of the practice application and how the concept of interest might be operationally defined in practice. Provide an example of how you might use the theoretical and operational definitions of your concept of interest in your future practice or research. Include a potential practice question based on the propositions of your theory. (20 points) Theory Evaluation. Briefly discuss whether/how the theory appears to be accurate/valid (based on empirical testing of the theory as discussed above). Discuss generalizability of the theory. Summarize the strengths and weaknesses of the theory. Briefly discuss whether/how the theory is congruent with current nursing standards and current nursing interventions or therapeutics. Explain whether/how the theory is relevant socially and cross-culturally. Describe briefly how the theory might contribute to the discipline of nursing. (20 points) Style & Format. The paper will include a title page (using specified format), 7-8 pages of text, and a reference list. It will be double-spaced, written in 12-point Times New Roman font, and have 1-inch margins. Professional and orderly presentation of ideas (precision, clarity, format, headings, grammar, spelling, & punctuation) with appropriate citation of sources in text and reference list is required. Up to 0.5 points will be deducted for each type of grammar, spelling, punctuation, or format error. (10 points) Please see attached for a description of the theory paper that is due on Wednesday. Please note that it is up to 7 pages in length, not including the cover page. For the text, please double space as per APA formatting. You will be uploading your paper here. The following is the APA format for the paper. You are provided here with a sample.



Ramona Mercer’s Theory on Maternal Role Attainment

Ramona Mercer’s on Skin to Skin Theory

Theory Paper with Ramona Mercer’s on Skin to Skin

  1. State the theory that can be applied for this intervention and give a very brief description of the theory

The theory that can be used in this intervention is Ramona Mercer’s maternal role attainment. The theory was developed to advocate for early skin-to-skin contact between the mother and her newborn, breastfeeding, and minimum separation between the two. According to Husmillo (2013), maternal identity is established through one’s commitment to and involvement in a child’s life.
2. Discuss the nursing intervention (very brief 2 -3 sentences) Ramona Mercer’s on Skin to Skin Theory

Nursing intervention is guided by Ramona Mercer’s theory of maternal role attainment. Nurse use this theory to educate mothers on the importance of bonding with their children at their early stages (Kordi et al, 2017). The bond established at the early stages of a child’s life is strong and long-lasting.


3. Explain why you chose this theory and how it applies to nurse intervention and application.

I selected maternal role attainment theory since it is applicable in daily nursing practices particularly those working in the maternity. Ramona Mercer came up with this theory to enhance strong bonding between infants and their mothers (Husmillo, 2013). This theory has four stages, which apply to nursing intervention. Anticipatory is the first phase in which the mother anticipates the infant. Nurses use this theory to prepare mothers for the rival of their infants. Formal that lasts from birth through six months is the second stage in which the nurses advocate mothers to maintain close contact with their children for bonding. Informal is the third stage in which the child becomes a member of the family. The last stage is personal where the child becomes independent from other family members.


Husmillo, M. (2013). Maternal Role Attainment Theory. International Journal of Childbirth Education, 28(2).

Kordi, M., Fasanghari, M., Asgharipour, N., & Esmaily, H. (2017). The effect of the maternal role training program on role attainment and maternal role satisfaction in nulliparous women with an unplanned pregnancy. Journal of education and health promotion6. Ramona Mercer’s on Skin to Skin Theory


The Doctor of Nursing Practice Essay

Implications that Doctor of Nursing Practice will have on the regulation of APRNs

The implications that the DNP  will have on the regulation of APRNs will majorly relate to the educational requirement for APRNs. As Lubkin and Larsen (2015) indicate, due to recognition that additional skills set and knowledge is needed for APRNs, a majority of whom can practice autonomously, a clinical terminal degree that will focus on practice expertise, the DNP will be an entry-level for all APRNs. Dissimilar to the Doctor of Philosophy (PhD) degree, the DNP will not prepare nurse graduates to undertake original research.  Instead the DNP will be a practice-focused doctorate aimed at preparing APRNs for highest degree of nursing practice. Lubkin and Larsen (2015) claim that DNP will be established as the educational requirement for national certification in all roles of advanced practice nursing as well as for issuance of APRN licensure at the state level. Having a DNP will be the only scheme of guaranteeing high-quality and safe care. providing accreditation to APRNs at the DNP level will offer a better uniformity in educational requirements as well as titling. The Doctor of Nursing Practice Essay


Questions that APRNs seeking the DNP should have with regard to their practice setting and scope of practice

The questions that APRNs seeking the DNP should have is how their new roles might change due to the DNP program and the way the courses they will take will contribute to changes in role development. According to Dreher and Glasgow (2014), the major positive outcome of the DNP degree is the recognition that with the intricacy of the health care nowadays, there is a curricular content along with specialized knowledge past the MSN to offer DNP graduates extra enhanced skills. There will be resistance, nevertheless, to claims that there exists a domain of skill set and practice beyond and above basic advanced practice. Another question will be whether the DNP degree will eventually alter the APRN scope of practice. It is rather irrational to require extra competencies and skills for APN and then presume that there will not be a change in scope of practice.


Dreher, H., & Glasgow, M.  (2014). Role Development for Doctoral Advanced Nursing Practice. New York: Springer Publishing Company.

Lubkin, M. & Larsen, P.  (2015). Chronic Illness: Impact and Intervention. Burlington, MA: Jones & Bartlett Publishers.


The Doctor of Nursing Practice Essay


APRN Credentialing Assignment Paper

Two current issues that are important for APRNs in regard to credentialing

The current issues that I believe to be most significant for APRNs with regard to their credentialing is inconsistency in legal regulation and lack of a uniform model for credentialing. The legal regulation of APRNs is varying and lacks consistent definitions. Some states certify APRNs as advanced practice nurses but do not provide them with a separate license, while other states state identify a licensing level for them but they utilize different titles. States differ in regard to legal scopes of practice, the recognized APRNs roles, as well as the criteria for entry into advanced nursing practice, entailing the way competency is determined (Catalano, 2017). These issues are important when an APRN relocates to another state, his or her scope of practice might be dissimilar and there is also a likelihood that even the credentialing process and till may be different. APRN Credentialing Assignment Paper


Strategies that an individual APRN and the nursing profession should take to address the issues

A strategy that an individual APRN and the nursing profession as a whole should take to address issues regarding APRN credentialing and strengthen the advanced nursing practice is to recommend for the implementation of the APRN Consensus Model. Tracy (2014) claims that the consensus model was created by principal stakeholders and has received scrutiny from regulatory and legal experts. The model addresses accreditation, APRNs’ scope of practice and education, offering standardization across United States’ state boards of nursing so as lo less state by state disparity in regulation, practice, education, and licensure of APRNs.   This model will promote uniformity on the credentialing of APRNs and can be foundational to enabling APRNs to offer care across states. APRNs and the nursing profession should also advocate for regulatory bodies to collaborate to develop a comprehensive model and continuously communicate with the objective of increasing the standardization and clarity of APRN regulation.


Catalano, J. (2017).  Nursing Now! Today’s Issues, Tomorrow’s Trends.  Philadelphia: F. A. Davis.

Tracy, M. (2014). America Academy of Nursing: Improving health and health care systems with advanced practice registered nurse practice in acute and critical care settings. Nursing Outlook, 62(5): 366-370.


APRN Credentialing Assignment Paper


NRS 490 Assignment Discussion

The significance of adequate nurse staffing in providing quality care is a major finding that has also been highlighted in a report by the Institute of Medicine. Nurse staffing is an essential aspect of care that determines the nature of patient health outcomes and the quality of care in clinical settings. Currently exiting literature highlights that, inadequate nurse staffing that is primarily characterized by a decreased nurse/patient ratio is strongly associated with poor health outcomes (Cho et al., 2015). Similarly, in a hospital setting with a decreased nurse-patient ratio, a high turnover of patients and nurses and increased life-sustaining procedures, death is likely to occur. A decreased ratio between nurses and patients is a major issue in the American healthcare system that results from a shortage of nursing staff. As noted by Needleman (2015), the shortage in nursing staff has been influenced by a high nursing turnover, an increase in the aging population and an inadequate supply of nurses. NRS 490 Assignment Discussion


Nurse staffing issues that result in a decreased ratio between nurses and patients are a major concern that affects healthcare organizations. It is linked to adverse health outcomes and mortalities. After recognizing this issue, healthcare organizations often implement appropriate measures to improve are quality care and maintain the safety of patients. Numerous factors contribute to the shortage of nursing and ultimately a decreased nurse-to-patient ratio. They include: high nursing turnover, a shortage of qualified nursing professionals and an aging population that is rapidly increasing (He et al., 2016). Since nurses have a preference for working in environments where their efforts are recognized, acknowledged and rewarded, the shortage of nursing staff is still an issue of significance. NRS 490 Assignment Discussion



Problems in nurse-patient ratios are observable in clinical settings when providing care to patients in either inpatient or outpatient units. According to Falk & Wallin (2016), quality indicators are the best tools to assess how a decreased nurse-patient ratio affects patient safety, care quality and health outcomes.

High-Level Description of the Problem

            Significant declines in financial nursing resources alongside the effects brought about by a gradually increasing shortage of nurses have contributed to a decrease in the nurse-to-patient ratio with nurses working longer than expected taking care of patients. According to Griffiths et al., (2014), this does not only compromise the safety and quality of care but also adds to the current shortage through the creation of a working environment that pushes nurses away from he patient’s bedside.

Impact of The Issue

            With the current reforms in the American health sector that are linked to cost- reductions, the least staffing levels are vital to safeguard the safety of nurses’ and patients. However, adequate staffing of nurses is mandatory for improved patient care and retaining nurses. Driscoll et al., (2018) notes that poor nurse staffing does not only endanger the patient safety and  care quality but also drives nurses away from the nursing profession. As the demands for health services continue to grow, it is expected that issues in the staffing of nurses will continue to worsen, making it a priority issue for patients, policymakers’ researchers, healthcare administrators, and nurses.  Noted by

Significance Of The Problem

Inadequate nurse staffing characterized by a decreased nurse-patient ratio increases patients fall risks, preventable medical and medication errors, healthcare-related complications, readmissions, prolonged admissions, and additional healthcare-related costs. Besides, empirical studies have revealed that inadequate nurse staffing (a decreased nurse-to-patient ratio) has a strong association with nurse burnout, emotional exhaustion, job dissatisfaction, and high nursing turnover. Thus, it negatively impacts care quality and compromises the patient safety. NRS 490 Assignment Discussion

Proposed Solution

Implementing a nurse retention program is the best strategy to address this issue since it was identified that a high nursing turnover rate is the major cause of a decreased nurse-patient ratio in the selected organization. Evidence suggests that an effective retention program should ensure a favorable working environment that is primarily characterized by a formal plan for staffing, a staffing committee, opportunities for professional development, shared governance, reduced turnover time, rewards for longevity and excellence and programs for nursing residency (Van Camp & Chappy, 2017). A nurse retention program would also increase the levels of job satisfaction, reduce burnout and promote flexible work schedules amongst nurses, hence reducing the rate of nurse turnover to achieve an adequate nurse-patient ratio.


Cho, E., Sloane, D. M., Kim, E. Y., Kim, S., Choi, M., Yoo, I. Y.,  & Aiken, L. H. (2015). Effects of nurse staffing, work environments, and education on patient mortality: an observational study. International journal of nursing studies52(2), 535-542.

Cho, E., Lee, N. J., Kim, E. Y., Kim, S., Lee, K., Park, K. O., & Sung, Y. H. (2016). Nurse staffing level and overtime associated with patient safety, quality of care, and care left undone in hospitals: a cross-sectional study. International journal of nursing studies60, 263-271.

Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis. European Journal of Cardiovascular Nursing17(1), 6-22.

Falk, A. C., & Wallin, E. M. (2016). Quality of patient care in the critical care unit in relation to the nurse-patient ratio: A descriptive study. Intensive and Critical Care Nursing35, 74-79.

Griffiths, P., Ball, J., Drennan, J., James, L., Jones, J., Recio, A., & Simon, M. (2014). The association between patient safety outcomes and nurse/healthcare assistant skill mix and staffing levels and factors that may influence staffing requirements.

Griffiths, P., Ball, J., Drennan, J., Dall’Ora, C., Jones, J., Mariotti, A., … & Simon, M. (2016). Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the National Institute for Health and Care Excellence Safe Staffing guideline development. International journal of nursing studies63, 213-225.

He, J., Staggs, V. S., Bergquist-Beringer, S., & Dunton, N. (2016). Nurse staffing and patient outcomes: a longitudinal study on trend and seasonality. BMC nursing15(1), 60.

Needleman, J. (2015). Nurse staffing: knowns and unknowns. Nurs Econ33(1), 5-7.

Van Camp, J., & Chappy, S. (2017). The effectiveness of nurse residency programs on retention: a systematic review. AORN Journal106(2), 128-144.NRS 490 Assignment Discussion


Discussion: Strategies for Academic Portfolios

Strategies for academic portfolios

An academic portfolio is a marketing tool that allows individuals to present themselves as competent persons with the right complement of skills and knowledge. In fact, it is a folder that presents the individual as a unique brand based on past activities and practical experiences, offering proof of being the right person based on past activities and experiences while demonstrating the qualities being sought. As such, it helps in maximizing career opportunities (Smith, 2011).

There are two distinct strategies that students can apply for including academic activities and accomplishments into their professional portfolios. The first strategy is to organize the portfolio based on the skills that the job market expects or requires. This is grounded on the awareness that each job will require a particular complement of skills. This implies that the student only needs to focus on presenting the skills that are relevant to the job or position, rather than presenting all the skills, some of which may be irrelevant or even detrimental to being considered for the job. It highlights the relevant learning activities that the individual has undertaken and how the learning informed and influenced professional practice as reflected in the acquired skills, projects and practice. In addition, it presents the individual as an organized, professional and creative person. This strategy involves applying a three-step approach. The first step is to determine the skills that are required for the program or position that the individual is interviewing for. The second step is to select the professional materials and documents that act as proof that the individual has the required skills. The final step is to group the information into sections and label the sections to ease efforts by persons reviewing the information to find the required information (Casey & Egan, 2010). Discussion: Strategies for Academic Portfolios


 The second strategy is to prepare an electronic portfolio rather than a printed version. It involves creating an online presentation of professional experiences and academic achievements. It recognizes the fact that although traditional paper-based portfolios are still in use, ICT advances and the fast paced technological growth are phasing these paper-based systems out and replacing them with electronic portfolios. Given this awareness, it is only logical for individuals to anticipate the change and prepare electronic portfolios to show initiative. This strategy allows for the development of a more comprehensive portfolio with additional documentation that may not be apparent at first glance. It enables the individual to present a simple portfolio front page along with active links to proofs of academic activities and accomplishments. The links to the proofs could be offered in the form of online materials (such as animations and graphics), professional networking websites, school program website, e-mail addresses, video clips of practical activities, and audio clips. Besides that, this strategy allows the individual to create a digital identity and leave a footprint that demonstrates technical experiences and skills, offering an online presence and links to any other relevant discoverable online content. In addition, it allows the individual to create a positive digital identify that articulates professional experiences and goals while highlighting the unique set of marketable achievements and skills, as well as linking the individual to other individuals with the same professional interests who may offer links to new opportunities (Hannah’s & Oliyo, 2017).


Casey, D. & Egan, D. (2010). The use of professional portfolios for career enhancement. British Journal of Nursing, 15(11), 547–552.

Hannans, J. & Olivo, Y. (2017). Craft a positive nursing digital identity with an ePortfolio. American Nurse Today, 12(11), 48–49.

Smith, L. S. (2011). Showcase your talents with a career portfolio. Nursing, 41(7), 54–56. Discussion: Strategies for Academic Portfolios


Neonatal Nurse Practitioner Paper

Neonatal nurse practitioner practice involves the care of newborns particularly in the first 28 days of their lives (Lavoie-Tremblay et al., 2016). As a Neonatal Nurse Practitioner, I would like to specialize in neonatal intensive care practice as a Level III nursing practitioner that entails multiple intensive responsibilities. I have always loved to practice in the NICU and monitor premature and seriously ill newborns as well as provide education to the parents on the proper care for the delicate little humans.

Level III nursing practice is on high demand considering the need for NICU services for the infants born prematurely and with the increased serious illnesses affecting the contemporary society. Many children are born with less than 32 weeks gestational age which necessitates the need for incubation in order to help them mature to the right age and in a health manner. I love infants and their tenderness and hence believe I can contribute to their wellbeing and improve their chances of survival by specializing in the level 3 NICU nursing practice. Neonatal Nurse Practitioner Paper


Another reason as to why I choose this specialty is because; the future of neonatal nursing presents an increased demand of socialized acute care services and therefore would guarantee me an employment with less competition. According to the US Bureau of Labor Statistics reports (2019), the Neonatal nursing demand presents a higher than the average demand of 19% for the period between 2012 and 2022. Moreover, the specialty is well paying with an average salary of $93,122 annually which is higher than that of other registered nurses in the NICU. A good salary is a significant motivation to work, increased productivity and job satisfaction to me and thus, I believe that level 3 neonatal intensive care unit is my best choice of specialty for my career.


Lavoie-Tremblay, M., Feeley, N., Lavigne, G. L., Genest, C., Robins, S., & Fréchette, J. (2016). Neonatal intensive care unit nurses working in an open ward: Stress and work satisfaction. The health care manager35(3), 205-216.

U.S. Bureau of Labor Statistics . (2019). Retrieved from

Neonatal Nurse Practitioner Paper