Why is advanced education important? Many nurses question why their employer wants or requires them to return to school for a BSN or – if in a leadership position – an MSN. It is simple: advancing your education will change the way you practice. It will change the way you make decisions. Associate and diploma nursing programs help nurses prepare for initial practice, but a BSN can help nurses prepare for higher-level competencies.
Here we will explore some key areas that are impacted by advanced nursing education, including:
- Enhanced ethical responsibility to patients
- Patient safety and liability
- Ethical guidelines
- Health policy involvement
- Informatics and technology
Ethical Responsibility to Patients
Nurses are held accountable and are liable for the care they provide, including handling of personal patient information. Accountability refers to the acceptance of responsibility for one’s actions, and in nursing, it is “a sense of duty in performing nursing tasks and activities.”1
Accepting the responsibility to care for a patient implies a legally binding responsibility for the welfare of the patient to the best of the nurse’s ability. Liability refers to the legalities of the professional nurse-patient relationship. When a patient is harmed under a nurse’s care, and the cause is related to the care or lack of care given, then that nurse is held legally responsible.
Position of Trust
Nurses have access to sensitive information about their clients. This trusted position requires that nurses have high ethical standards. The framework of ethical guidelines that direct nurses' practices cannot cover all possible situations; therefore, when nurses must make decisions on their own without clear directions from an authority figure, they should base their decision on these ethical guidelines. Nurses must be aware of the ethical and legal guidelines of nursing because their actions have the potential to improve or have a devastating impact on the lives of their clients.
The bioethical dilemmas of today’s nursing practice are often the indirect result of rapid technology growth. Due to technology that can prolong life and create the possibility of life where there was none before, the previously clear lines of life and death have become vaguer. When machines force oxygen into lungs that can no longer work on their own, the quality of that person's life must be considered. Nowadays, nurses must speak with clients and family members about the implications of technology to prepare for the end-of-life situations they may face.
When assisting clients and their family members with these and other value-laden decisions, nurses are challenged to set aside their own values and beliefs to provide nonjudgmental processing with the clients. Some key principles that nurses must keep in mind in these situations are the following:2
- Autonomy (self-direction)
- Beneficence (do good and prevent harm)
- Nonmaleficence (do no harm)
- Veracity (truthfulness)
- Paternalism (thinking one knows better and acting protectively)
It is important that nurses evaluate their own principles to be more aware of their behaviors that might overstep their roles as advocates. In addition, these principles can guide nurses through their own ethical decision making.
From a legal standpoint, nursing actions are guided by statutory and common law. A statutory law refers to those laws written and enacted by a legislative body, such as Congress. These laws mandate the standard of care provided in facilities that receive reimbursement from Medicare, Medicaid, and any other federal funding programs.1 Because ignorance of the law is not a defense, it is imperative for nurses to become familiar with the relevant laws and be accountable for their behavior.
Nurses can also be held liable for the mishandling of personal patient information because it can cause harm to patients. In 1996, the Health Insurance Portability and Accountability Act (HIPAA) was enacted to protect the vast amount of personal information that can be accessed through electronic transmissions.3 HIPAA went well beyond those original intentions to include all personal information about patients: written, oral, or electronic. Nurses must be aware of the details of HIPAA restrictions to protect the client, the health care organization, and themselves. For instance, when patients’ family members call the hospital to get information about their loved ones, nurses cannot release the patient's information unless there is written consent in the patient's chart allowing health care personnel to share information with that particular person. A code word must be established and written in the chart to identify callers as the people on the written information consent list.
Although technology appears to weaken the security of patient information, computerized information is actually more easily secured than paper records.4 Electronic health records (EHRs) are not only more secure than paper records but also can include a broader amount of information that is more easily accessible to those who have the right to (and need for) access. For example, a patient arriving in the emergency department can provide health care workers with their personal health information on a portable memory drive. This provides more information in a more accessible format than information in medical records located in the patient's doctor’s office, pharmacies, and hospitals. This portable data can even be on something as small as a credit card.
Grow Your Nursing Skillset
Basic nursing knowledge can be expanded upon with advanced education. Through pursuing additional education, nurses may have the opportunity to study leadership principles, evidence-based practice, population or community health, informatics, and critical reasoning. The more education that nurses have, the better equipped they are to make informed decisions.
Colorado Technical University offers online nursing programs including a Bachelor of Science in Nursing (BSN), a Master of Science in Nursing (MSN), and a Doctor of Nursing Practice (DNP). Learn more about CTU’s nursing programs.