Overview Create a 15-minute oral presentation (3–4 pages) that examines the moral and ethical issues related to triaging patients in an emergency room. By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria: · Competency 1: Explain the effect of health care policies, legislation, and legal issues on health care delivery and patient outcomes.  . Explain the health care policies that can affect emergency care. . Recommend evidence-based decision-making strategies nurses can use during triage. · Competency 3: Apply professional nursing ethical standards and principles to the decision-making process.  . Describe the moral and ethical challenges nurses can face when following hospital policies and protocols. . Explain how health care disparities impact treatment decisions. · Competency 4: Communicate in a manner that is consistent with expectations of nursing professionals.  . Write content clearly and logically, with correct use of grammar, punctuation, and mechanics. . Correctly format citations and references using APA style. Context Working in an emergency room gives rise to ethical dilemmas. Due to time restraints and the patient's cognitive impairment and lack of medical history, complications can and do occur. The nurse has very little time to get detailed patient information. He or she must make a quick assessment and take action based on hospital protocol. The organized chaos of the emergency room presents unique ethical challenge, which is why nurses are required to have knowledge of ethical concepts and principles. Questions to consider To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. · How does a triage nurse decide which patient gets seen first? · How does health disparity affect the triage nurse's decision making? · What ethical and moral issues does the triage nurse take into account when making a decision? · What are triage-level designations? Resources Suggested Resources The following optional resources are provided to support you in completing the assessment or to provide a helpful context. For additional resources, refer to the Research Resources and Supplemental Resources in the left navigation menu of your courseroom. Capella Resources · APA Paper Template. · APA Paper Tutorial. Library Resources The following e-books or articles from the Capella University Library are linked directly in this course: · Tingle, J., & Cribb, A. (Eds.). (2014). Nursing law and ethics (4th ed.). Somerset, NJ: John Wiley & Sons. · Cranmer, P., & Nhemachena, J. (2013). Ethics for nurses: Theory and practice. Maidenhead, UK: Open University Press. · Aacharya, R. P., Gastmans, C., & Denier, Y. (2011). Emergency department triage: An ethical analysis. B MC Emergency Medicine, 11(1), 16–29. · Guidet, B., H.

1. Overview
Create a 15-minute oral presentation (3–4 pages) that examines
the moral and ethical issues related to triaging patients in an
emergency room.
By successfully completing this assessment, you will
demonstrate your proficiency in the following course
competencies and assessment criteria:
· Competency 1: Explain the effect of health care policies,
legislation, and legal issues on health care delivery and patient
outcomes.
. Explain the health care policies that can affect emergency
care.
. Recommend evidence-based decision-making strategies nurses
can use during triage.
· Competency 3: Apply professional nursing ethical standards
and principles to the decision-making process.
. Describe the moral and ethical challenges nurses can face
when following hospital policies and protocols.
. Explain how health care disparities impact treatment
decisions.
· Competency 4: Communicate in a manner that is consistent
with expectations of nursing professionals.
. Write content clearly and logically, with correct use of
grammar, punctuation, and mechanics.
. Correctly format citations and references using APA style.
Context
Working in an emergency room gives rise to ethical dilemmas.
Due to time restraints and the patient's cognitive impairment
and lack of medical history, complications can and do occur.
The nurse has very little time to get detailed patient
information. He or she must make a quick assessment and take

2. action based on hospital protocol. The organized chaos of the
emergency room presents unique ethical challenge, which is
why nurses are required to have knowledge of ethical concepts
and principles.
Questions to consider
To deepen your understanding, you are encouraged to consider
the questions below and discuss them with a fellow learner, a
work associate, an interested friend, or a member of your
professional community.
· How does a triage nurse decide which patient gets seen first?
· How does health disparity affect the triage nurse's decision
making?
· What ethical and moral issues does the triage nurse take into
account when making a decision?
· What are triage-level designations?
Resources
Suggested Resources
The following optional resources are provided to support you in
completing the assessment or to provide a helpful context. For
additional resources, refer to the Research Resources and
Supplemental Resources in the left navigation menu of your
courseroom.
Capella Resources
· APA Paper Template.
· APA Paper Tutorial.
Library Resources
The following e-books or articles from the Capella University
Library are linked directly in this course:
· Tingle, J., & Cribb, A. (Eds.). (2014). Nursing law and
ethics (4th ed.). Somerset, NJ: John Wiley & Sons.
· Cranmer, P., & Nhemachena, J. (2013). Ethics for nurses:
Theory and practice. Maidenhead, UK: Open University Press.

3. · Aacharya, R. P., Gastmans, C., & Denier, Y.
(2011). Emergency department triage: An ethical analysis.
B MC Emergency Medicine, 11(1), 16–29.
· Guidet, B., Hejblum, G., & Joynt, G. (2013). Triage: What can
we do to improve our practice?Intensive Care Medicine, 39(11),
2044–2046.
· Kangasniemi, M., & Haho, A. (2012). Human love – The inner
essence of nursing ethics according to Estrid Rodhe. A study
using the approach of history of ideas. Scandinavian Journal of
Caring Sciences, 26(4), 803–810.
· Gastmans, C. (2013). Dignity-enhancing nursing care: A
foundational ethical framework. Nursing Ethics, 20(2), 142–
149.
· Domagala, S. E., & Vets, J. (2015). Emergency nursing triage:
Keeping it safe. Journal of Emergency Nursing, 41(4), 313–316.
Course Library Guide
A Capella University library guide has been created specifically
for your use in this course. You are encouraged to refer to the
resources in the BSN-FP4006 – Policy, Law, Ethics, and
Regulations Library Guide to help direct your research.
Internet Resources
Access the following resources by clicking the links provided.
Please note that URLs change frequently. Permissions for the
following links have been either granted or deemed appropriate
for educational use at the time of course publication.
· American Nurses Association. (2015). Ethics and Human
Rights. Retrieved from https://www.nursingworld.org/practice-
policy/nursing-excellence/ethics/
· American Nurses Association. (2016). Position statement: The
nurse's role in ethics and human rights: Protecting and
promoting individual worth, dignity, and human rights in
practice settings. Retrieved from
https://www.nursingworld.org/practice-policy/nursing-
excellence/official-position-statements/id/the-nurses-role-in-
ethics-and-human-rights/
· Vigil, J. M., Alcock, J., Coulombe, P., McPherson, L.,

4. Parshall, M., Murata, A., & Brislen, H. (2015). Ethnic
disparities in emergency severity index scores among U.S.
veteran's affairs emergency department patients. PLoS One,
10(5). Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/26024515
Assessment instructions
Your supervisor has asked you to do a 15-minute oral
presentation at a staff meeting about a recent issue that occurred
at another hospital in town. Following an industrial accident,
two patients arrived at the emergency room of that hospital at
the same time, presenting with very similar inhalation injuries.
The hospital received a great deal of negative press due to how
the patients were triaged in the ER. Your supervisor would like
you to use the specifics of this case to review triage procedures
and best practices at your facility. Here are the details:
· One is a 32-year-old firefighter, Frank Jeffers, who is
presenting with respiratory difficulties that he obtained while
evacuating victims of an industrial accident. He is a married
homeowner and father of two young boys. He has lived in the
community all his life. He has full and comprehensive health
insurance through his employer.
· The other is Brent Damascus, a 58-year-old man. Brent is
presenting with respiratory difficulties with the same intensity
as Mr. Jeffers above. He is well known at the hospital
emergency room, as he is a frequent visitor with various
complaints, including asthma, headaches, and tremors. He is
homeless, unemployed, and uninsured. He stays many nights at
the YMCA and eats lunch at the soup kitchen. He has lived in
the community for over 10 years and has been arrested several
times for petty theft.
Preparation
Search the Capella library and the Internet for scholarly and
professional peer-reviewed articles on best practices in triage
nursing. You will need at least three articles to use as support

5. for your work on this assessment.
Directions
Create a 15-minute presentation (3–4 pages) that examines the
moral and ethical issues that occurred when triaging these two
patients and the best practices for managing this in the future.
Divide your draft into a number of talking points that you can
summarize neatly. Keep in mind that an oral presentation
requires slightly different language than an essay. The aim is to
communicate your message so keep sentences simple and focus
on the key points you want to deliver. Address the following in
your presentation:
· Explain the health care policies and protocols that are in place
that direct triage care in an emergency situation.
· Explain how health care disparities impact treatment
decisions.
· Identify the health care policies that are in place that direct
care for uninsured individuals. Is there a difference in how
these individuals are triaged?
· Describe the moral and ethical challenges nurses can face
when following hospital policies and protocols. Is there a
conflict when a severely injured person is also uninsured?
· Recommend evidence-based strategies that should be applied
for managing the care of uninsured and indigent population.
·
Additional Requirements
Your presentation should meet the following requirements:
· Written communication: Written communication should be
free of errors that detract from the overall message.
· References: Include a reference section with a minimum of
three references; a majority of these should be peer-reviewed
sources. All resources should have been published within the
last 5 years.
· APA format: Resources and citations should be formatted
according to current APA style and formatting.
· Length: 3–4 typed, double-spaced pages, excluding title page
and reference page. Use Microsoft Word to complete the

6. assessment.
· Font and font size: Times New Roman, 12-point.
Overview
Write an article for a community newsletter for a local
retirement village that explains the laws, policies, and choices
surrounding end-of-life health care decisions.
By successfully completing this assessment, you will
demonstrate your proficiency in the following course
competencies and assessment criteria:
· Competency 1: Explain the effect of health care policies,
legislation, and legal issues on health care delivery and patient
outcomes.
. Identify the primary policies that define current health care
practices in regard to end-of-life health care decisions.
. Explain the legislation that generated end-of-life health care
policies.
· Competency 2: Explain the effect of regulatory environments
and controls on health care delivery and patient outcomes.
. Explain the effect of end-of-life regulations and controls on
patient outcomes.
· Competency 3: Apply professional nursing ethical standards
and principles to the decision-making process.
. Describe the role of the nurse in end-of-life decision making
with patients and their families.
. Describe the ethical considerations that have influenced policy
decisions in regard to end-of-life decisions.
· Competency 4: Communicate in a manner that is consistent
with expectations of nursing professionals.
. Write content clearly and logically, with correct use of
grammar, punctuation, and mechanics.
. Correctly format citations and references using APA style.

7. Context
Nurses are at the bedside during the dying process; they spend
entire shifts with patients and families; they develop trusting
relationships; and they are competent to assess patient and
family needs. Nurses gain a unique perspective that allows them
to become aware when a patient is not responding to treatment.
This perspective places nurses in a position to facilitate end-of-
life decision making. (Adams, Bailey. Anderson, & Docherty,
2011, para. 4)
Reference
Adams, J. A., Bailey, D. E., Jr., Anderson, R. A., & Docherty,
S. L. (2011). Nursing roles and strategies in end-of-life decision
making in acute care: A systematic review of the
literature. Nursing Research and Practice, 2011.
Questions to consider
To deepen your understanding, you are encouraged to consider
the questions below and discuss them with a fellow learner, a
work associate, an interested friend, or a member of your
professional community.
· How should nurses manage patients whose end-of-life
decisions may run contrary to their personal beliefs and values?
· How can nurses influence new policies, laws, or legislation
regarding end-of life decisions?
· What are some of the most difficult decisions patients and
families have to make at the end of the patient's life?
Suggested Resources
The following optional resources are provided to support you in
completing the assessment or to provide a helpful context. For
additional resources, refer to the Research Resources and
Supplemental Resources in the left navigation menu of your
courseroom.Capella Resources
· APA Paper Template.
· APA Paper Tutorial.Library Resources

8. The following e-books or articles from the Capella University
Library are linked directly in this course:
· Norlander, L. (2014). To comfort always: A nurse's guide to
end-of-life care (2nd ed.). Indianapolis, IN: Sigma Theta Tau
International.
· Hebert, K., Moore, H., & Rooney, J. (2011). The nurse
advocate in end-of-life care. The Ochsner Journal, 11(4), 325–
329.
· Lewis, K. (2013). How nurses can help ease patient transitions
to end of life care. Nursing Older People, 25(8), 22–26.
· Lund, S., Richardson, A., & May, C. (2015). Barriers to
advance care planning at the end of life: An explanatory
systematic review of implementation studies. PLoS One, 10(2).
· Aoun, S., O'Connor, M., Skett, K., Deas, K., & Smith, J.
(2012). Do models of care designed for terminally ill 'home
alone' people improve their end-of-life experience? A patient
perspective. Health & Social Care in the Community, 20(6),
599–606.
· Nakano, K., Sato, K., Katayama, H., & Miyashita, M.
(2013). Living with pleasure in daily life at the end of life:
Recommended care strategy for cancer patients from the
perspective of physicians and nurses. Palliative & Supportive
Care, 11(5), 405–413.
· Adams, J. A., Bailey, D. E., Jr., Anderson, R. A., & Docherty,
S. L. (2011). Nursing roles and strategies in end-of-life decision
making in acute care: A systematic review of the
literature. Nursing Research and Practice, 2011.Course Library
Guide
A Capella University library guide has been created specifically
for your use in this course. You are encouraged to refer to the
resources in the BSN-FP4006 – Policy, Law, Ethics, and
Regulations Library Guide to help direct your research.Internet
Resources
Access the following resources by clicking the links provided.
Please note that URLs change frequently. Permissions for the
following links have been either granted or deemed appropriate

9. for educational use at the time of course publication.
· American Nurses Association. (2016). Position statement:
Nurses' Roles and Responsibilities in Providing Care and
Support at the End of Life. Retrieved from
https://www.nursingworld.org/~4adf1c/globalassets/docs/ana/en
doflife-positionstatement.pdf
Assessment instructions
Your manager asked you to prepare an article for a community
newsletter for a local retirement village. The editor wants you
to talk about the laws, policies, and choices surrounding end-of-
life health care decisionsPreparation
Search the Capella library and the Internet for scholarly and
professional peer-reviewed articles on end-of-life care. You will
need at least three articles to use as support for your work on
this assessment.Directions
Write an article of 750–1,000 words (3–4 pages) that discusses
the laws, policies, and choices surrounding end-of-life health
care decisions. Address the following in your article:
· Describe the role of the nurse in end-of-life decision making
with patients and their families.
· Explain the legislation that generated end-of-life health care
policies. Was the legislation an outcome of a specific medical
case?
· Identify the primary policies regarding current health care
practices related to end-of-life health care decisions. How to
these policies affect treatment decisions?
· Explain the effect of end-of-life regulations and controls on
patient outcomes. What effect does this have on the nurse-
patient relationship?
· Describe the ethical considerations that have influenced policy
decisions in regard to end-of-life decisions.Additional
Requirements
Your article should meet the following requirements:
· Written communication: Written communication should be

10. free of errors that detract from the overall message.
· References: Cite a minimum of three resources; a majority of
these should be peer-reviewed sources. Your reference list
should be appropriate to the body of literature available on this
topic that has been published in the past 5 years.
· APA format: Resources and citations should be formatted
according to current APA style and formatting.
· Length: 750–1,000 words or 3–4 typed, double-spaced pages,
excluding title page and reference page. Use Microsoft Word to
complete the assessment.
· Font and font size: Times New Roman, 12-point.