Ethical Frameworks for Advanced Nursing Practice of Psychiatric Care

Phenomenon of interest

The selected phenomenon of interest (POI) is managing anxiety among adults. The excessive anxiety that leads to distress or interferes with the daily activities is not part of normal aging and can lead to decreased functioning in everyday life and a variety of health problems. The most common anxiety disorders include panic disorder, obsessive-compulsive disorder, social phobia, and post-traumatic stress disorder (PTSD). In older adults, anxiety may be linked to several important risk factors including stressful life events, chronic medical conditions, stressful life events, sleep disturbance, negative or difficult events in childhood and overall feelings of poor health. Individuals with anxiety disorders experience poor physical health outcomes such reduced average life expectancy of 25 years or less as opposed to the rest of the population.

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One of the major barriers to accessing mental healthcare services among this population is social stigma. Healthy equity involves the provision of equal opportunity for all people to benefit from optimal health. The World Health Organization and the U.S government provide support in promoting mental health while recognizing the possible barriers which prelude healthy equity. The Healthy People 2020 incorporated the elements of social determinants during its launch of four overarching goals. One of the overarching goals is to improve the health of all groups, eliminate disparities and achieve equity in accessing health care services (Satcher & Rachel, 2017).
The most common and effective treatment for anxiety among adult population involves a combination of medication and therapy. However, some people may benefit from one form of treatment. It is advisable for any individuals experiencing any form of anxiety to seek professional help. Meeting the goals of enhanced mental health status and equity in accessing health services has a significant impact on both eliminating and reducing healthcare disparities and promoting quality of life including increased life expectancy. These approaches are aimed at closing the 25-year mortality risk gap in the population with psychiatric disorders. Integrated care models serve as tools for healthcare providers to identify and respond to anxiety disorders and concerns that impact patients’ physical values (Satcher & Rachel, 2017). Understanding patient’s health status with a holistic context that includes patient’s social determinants and culture will often impact a person’s opportunity to access behavioral and mental health and substance use treatment services.
Ethical principles
Nursing actions are regarded as statements of moral beliefs. Ethical principles provide criteria on which nurses and other health professionals base judgments about ethical theories. Health professionals are required to practice in an ethically sound professional manner to balance professional values with ethical considerations and relevant legislation. Advanced nursing practice as a higher level of practice requires health practitioners to demonstrate expertise and high professional skills. The significance of ethical practice at all healthcare settings involves a health professional identifying what professional, ethical, and legal standards required is and how they can be compassionately applied to the challenges of the clinical practice (Preshaw et al. 2016).
This principle advocates that each has unrestricted freedom to make choices for themselves and has worth in their own right. Besides, the principle of autonomy is at the center of the consent procedure (Preshaw et al. 2016). Based on this principle, individuals with mental health disorders have the unrestricted freedom to make an informed decision regarding access to health care services. Patient autonomy directs my advanced nursing practice through demonstrating expertise and professional skills about ethical and legal issues. Non-maleficence
This ethical principle requires the patient to be protected from harm. The patient has the right to anticipate that the healthcare being provided to them won’t do any harm (Preshaw et al. 2016). The effects of harm and its considerations are part of the decision making in the provision of healthcare. However, the principle of non-maleficence provides little useful guidance since beneficial therapies may have adverse effects. The relevant issue is whether the benefits overshadow the side effects. Physicians should provide not provide ineffective treatment which has risks or has no possible benefits and hence have a chance of harming the patient. Non-maleficence directs my advanced nursing practice through demonstrating expertise and professional skills to avoid any possible occurrences which can happen to the patient.
According to Preshaw et al. (2016), the principle of justice holds that all care services should be distributed in fair and equitable manner. Any healthcare practice which violates this ethical principle can be a potential ethical issue which calls for intervention. Advanced nurse practice addresses the potential ethical issue related to the unequal distribution of healthcare services. Justice directs my advanced nursing practice through demonstrating expertise and professional skills in the provision of equitable and accessible healthcare services.
Ethical Framework
As nursing practices and knowledge increase, questions about the scope of practice begin to arise and present a quandary for nurses who want to upgrade their knowledge and skills but are held by boundaries of regulation. The American Nurse Association, the National League for Nurses (NLN) and the American Organization of Nurse Executives (AONE) developed a scope of practice that helps nurses and employers in the decision-making process (Ballard et al. 2016, p.20). This tool helps nurses to determine whether specific roles, interventions or activities are allowed under a nurse’s level of competence, licensure, and education. This decision-making framework is relevant to me because it serves to provide standardized decisions for nurses within all healthcare settings concerning their accountability, function, role, and education within the scope of nursing practice.


1. Ballard, K., et al. (2016). Scope of nursing practice decision-making framework. Journal of Nursing Regulation, 7(3), 19-21. Preshaw, D. H., Brazil, K., McLaughlin, D., & Frolic, A. (2016). Ethical issues experienced by healthcare workers in nursing homes: Literature review. Nursing ethics, 23(5), 490-506. 2. Satcher, D., & Rachel, S. A. (2017). Promoting mental health equity: The role of integrated care. Journal of clinical psychology in medical settings, 24(3-4), 182-186.

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