Academic Master


Ethical Frameworks for Advanced Nursing Practice of Psychiatric Care

Phenomenon of interest

The selected phenomenon of interest (POI) is promoting mental health equity. Individuals with psychiatric disorders experience poor physical health outcomes such reduced average life expectancy of 25 years or less as opposed to the rest of the population. One of the major barriers in accessing mental healthcare services among this population is social stigma. Healthy equity involves 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).

Realizing the goals of enhanced mental health status and equity in accessing health services has 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 population with psychiatric disorders. Integrated care models serve as tools for healthcare providers to identify and respond to psychiatrist disorders and concerns that impact patients’ physical values (Satcher & Rachel, 2017). Understanding patient’s health status with 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 in relation to 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 is professional, ethical, and legal standards required and how they can be compassionately applied to the challenges of the clinical practice (Preshaw et al. 2016). The ethical principles include:


This principle advocates that each individual 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 informed decision regarding access to health care services. Patient autonomy directs my advanced nursing practice through demonstrating expertise and professional skills in relation to ethical and legal issues.


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 provision of health care. However, this principle offers little useful guidance since beneficial therapies may have adverse effects. The pertinent issue is whether the benefits outweigh the side effects. Physicians should provide not provide ineffective treatment which have 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 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 call for intervention. Advanced nurse practice addresses potential ethical issue related to unequal distribution of healthcare services. Justice directs my advanced nursing practice through demonstrating expertise and professional skills in 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 help nurses and employers in 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 frame work is relevant to me because it serves to provide standardized decisions for nurses within all healthcare settings with respect to their accountability, function, role, and education within the scope of nursing practice.

Cross post 1

Healthy equity is about every person in the community having the necessary resources, skills, and knowledge to achieve and maintain good health. It is also about having the essential services provided in the right places and in right measures to support wellbeing and promote health. Health equity ensures that the social determinants of health do not create barriers to people and communities seeking in promoting their health and wellbeing (Neutens, 2015).

Post 2

Qualitative prevention approaches can be effective in supporting treatment of mental disorders and reducing the severity associated with the treatment (Purnell et al. 2016). Common mental disorders affecting the general population include post-traumatic stress disorder, anxiety, and depression. Strategies that create thriving communities foster mental health and wellbeing for everyone. Therefore, there is a significant reason to reduce health inequities.


Ballard, K., et al. (2016). Scope of nursing practice decision-making framework. Journal of Nursing Regulation, 7(3), 19-21.

Neutens, T. (2015). Accessibility, equity and health care: review and research directions for transport geographers. Journal of Transport Geography, 43, 14-27.

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.

Purnell, T. et al. (2016). Achieving health equity: closing the gaps in health care disparities, interventions, and research. Health Affairs, 35(8), 1410-1415.

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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