The connection between the education of BSN-prepared nurses and improved patient outcomes can be explained not only by the advanced writing skills and critical thinking of professionals but also by the long-term effects of their activity. In the first place, they are related to lower readmission rates in the facilities where they work and shorter hospital stays for the people admitted to these hospitals (O’Brien et al., 2018). These scores are complemented by the decrease in mortality within 30 days from the moment of admission regardless of the conditions, which are to be treated by these nurses (O’Brien et al., 2018). As a result, patient satisfaction is higher, the probability of complications is much lower, and the quality of rendered services is unaffected by any external circumstances (O’Brien et al., 2018). Hence, the presence of these specialists in medical facilities is advantageous for all the aspects of their functioning, and the performed operations are more efficient.
In turn, the differences in the patient population are better addressed by BSN nurses in contrast to the outcomes of employees of lower qualifications. The former is characterized by improved cultural competence, which is especially essential in critical situations, such as the provision of end-of-life care. The diversity of their patients does not prevent these workers from considering their desires in a timely manner (Cheshire & Strickland, 2018). Moreover, BSN-prepared nursing personnel possesses better skills in the area of cultural assessment, which allow them to anticipate the needs of people stemming from the traditions of their population group (Cheshire & Strickland, 2018). Thus, the involvement of these specialists in the operations of hospitals contributes to the promotion of an individualized approach to providing healthcare services.
References
Cheshire, M. H., & Strickland, H. P. (2018). Distance learning teaching strategies in registered nurse to baccalaureate nurse programs: Advancing cultural competence of registered nurses in providing end-of-life care. Teaching and Learning in Nursing, 13(3), 153-155. Web.
Geraghty, S., & Oliver, K. (2018). In the shadow of the ivory tower: Experiences of midwives and nurses undertaking PhDs. Nurse Education Today, 65, 36-40. Web.
McCauley, L. A., Broome, M. E., Frazier, L., Hayes, R., Kurth, A., Musil, C. M.,… & Villarruel, A. M. (2020). Doctor of nursing practice (DNP) degree in the United States: Reflecting, readjusting, and getting back on track. Nursing Outlook, 68(4), 494-503. Web.
O’Brien, D., Knowlton, M., & Whichello, R. (2018). Attention health care leaders: Literature review deems baccalaureate nurses improve patient outcomes. Nursing Education Perspectives, 39(4), E2-E6. Web.
Nathanial Hawthorne’s “Young Goodman Brown”
It is Nathanial Hawthorne’s Young Goodman Brown that still makes students’ minds and imaginations work hard after reading the short story. The plot is marvelous as per both theological and moral issues. Undeniable, the short story is one that makes one rethink the ideas and values of own life due to the controversial and at the same time sharp plot. So, in this paper, the following issue will be discussed: if Brown’s conflict was an imaginary one, or if he actually fought the Devil in this theological Heart of Darkness.
As such, the image of a character due to whom Brown was being torn to pieces during the entire story is essential. This is Faith – his beloved wife – who is vitally important to him as a person, as well as the major theological strength giver. The overall story is unveiling quite a challenge that Goodman Brown meets as a Puritan leader. This is a feature that extra emphasis should be given. A protagonist is a person living in soul quests about God and faith. When Goodman is ultimately challenged by the Devil, he says ‘Faith kept me back awhile’ (p. 1290). This statement has a double meaning since there was his beloved wife, Faith, who physically kept him from going on an ‘errand’ and his actual faith in God that delayed his meeting with the Devil. However, it has to be noticed here that Goodman himself went on this journey resolutely and implicitly. The reason for that might be a mere interest, which explicitly correlates with the story of Adam and Eve when they were led by the snake to the Tree of Knowledge. It has to be said that the trip through the forest was a desired and deliberate one. Hence, the meeting with the Devil was the presupposed and ultimately longed-for affair. Goodman Brown consciously left his wife and made his way to the Sabbath: “My journey needst be done twixt now and sunrise” (p. 1289)
Hawthorne explicitly and brilliantly showed how Goodman tortured himself with the thought of his wife being at Sabbath, too. This was probably the most awful fact for him as after he returned home his life became gloomy for the rest of the days. Here, the main question arises: was the meeting for real since it spoiled Goodman’s entire life and attitude towards his wife? In order to answer this question, it has to be mentioned that the story has many symbols and overall plot ideas connected with Bible. Thus, according to the Bible, a person is whatever he/she thinks about. Therefore, Goodman was the one who wanted to meet the Devil himself, though was totally afraid of the circumstances. Also, the creepy fact is that Goodman found out that his forefathers belonged to the Heart of Darkness, too. Therefore, it is evident that he was completely devastated by the facts that came to the surface during the conversation with the Devil, though the devastation was an inevitable outcome of the conversation since Goodman knew that there would be nothing nice after he meets the Devil at Sabbath. Therefore, although it is hard to define if he fought the devil for real or not, it is undeniable that he definitely fought his own devil, the ‘old man’ depicted by Hawthorne resembled the ‘young man’ so much.
Works Cited
Hawthorne, Nathaniel. Young Goodman Brown. New York: Dover Publications, February 5, 1992. Print.
Ethical Arguments In The “AMA Journal Of Ethics Case”
End-of-life controversies exist in modern American society because not all people are ready to accept their beloved ones’ deaths, relying on their cultural and religious beliefs. In the case under analysis, NK is a 32-year-old patient who remains comatose with no brain activity during the next 24 hours after losing consciousness due to a severe headache (Weiner & Sheer, 2020). His wife, SK, is an Orthodox Jew, and she does not believe in her husband’s death until his heart stops beating. Although computed tomography proved subarachnoid hemorrhage and hydrocephalus, there is a need for additional confirmative testing to prove brain death.
Still, the wife expects to continue keeping the patient on the machines anyway. Regarding the evident cultural and religious impact on health care in this case, my ethical position is to treat the patient with respect, kindness, and understanding and provide time to demonstrate my reasonable restraint and objectivity.
In nursing practice, there are many cases related to brain death debates. Sometimes, families of patients with no brain activity are ready to let their beloved ones go and stop machine life support. However, some people are not able to cope with the shock of losing and search for solutions in their cultures, traditions, and religions. This scenario impacts me, as a nurse practitioner, in several ways, provoking doubts, regret, and a feeling of inevitability. On the one hand, I cannot reject the wife’s request to keep the patient on the machines. She has to trust me and my intentions to help and support. On the other hand, I should be honest in this situation, which makes me say about zero chances for her husband to come back. To avoid personal disagreements, I must stay objective and rely on the results of all brain death diagnostic tests.
At this moment, I have several sources to rely on and defend the chosen position. First, there is the Uniform Determination of Death Act, according to which a person is defined as dead due to irreversible cessation of all brain functions (Pope, 2018). Secondly, Jewish law also permits withholding life-prolonging interventions when rabbis support the idea of not taking new steps, causing the heart to stop with time (Weiner & Sheer, 2020).
Still, one of the ethical principles of justice underlines the importance of distributing resources and services equitably (Weiner & Sheer, 2020). Such a statement provokes new debates because health equity means to care for patients when they need it. In this case, it is hard to define this necessity. From a professional perspective, I would pay attention to the patient’s opinion on life-prolonging service (many Americans are obliged to choose if they want to be supported by machines or not).
Addressing the issue of religious and professional opinions about brain death, the only solution I see at the moment is to wait and provide the wife with enough time to grieve. The establishment of positive trustful relationships with a family is an important task for nurse practitioners. It is a chance to learn their interests and beliefs and help them accept and understand the situation. Collaboration and communication should explain the importance of additional tests to prove death by neurological criteria. However, even after obtaining the results, the health and nursing care team must be ready for additional ethical issues like the conflict between science and spirituality or between truth and hope.
In general, it is never easy to advise people who have to get prepared for losing their beloved ones to make final decisions. Brain death is a complex health and spiritual issue that does not have one clear explanation. Nurse practitioners have to cooperate with families and demonstrate their support and respect even if they are confident in the absurdity of their decisions. To reduce misunderstandings, it is better to choose correct words, never give vain hope, and remember about the uniqueness of each case.
References
Pope, T. (2018). Brain death and the law: Hard cases and legal challenges. Hastings Center Report, 48, 46–48. Web.
Weiner, R. J., & Sheer, C. (2020). How should clinicians respond when patients’ loved ones do not see “brain death” as death? AMA Journal of Ethics, 22, 995-1003. Web.