Ethical Case Studies for Advanced Practice Nurses: Solving Dilemmas in Everyday Practice

We are excited to provide a book that increases advanced practice registered nurses' knowledge and agility in resolving ethical dilemmas encountered in the clinical setting, healthcare organizations, and academic institutions. Goals for this book are:

• Provide an educational tool to increase APRN students' abilities to identify ethical concerns and work through them to find a solution.
• Inform and expand current ethical pedagogy for APRN students. Faculty teaching in doctor of nursing practice, master of science in nursing, and certified nurse anesthetist pro- grams; their students; and practicing APRNs will benefit from working through the case studies to identify and solve ethical dilemmas.
• Provide classroom and clinical teaching in the form of case studies to foster critical thinking, judgment, and the skills needed to resolve ethical dilemmas. As healthcare increases in complexity, APRNs will continue to experience ethical conflicts and dilemmas. Providing guidance to APRNs in identifying and resolving ethical dilemmas can increase effective patient outcomes, and we can continue to be the most honest and ethical profession now and into the future.

Consideration for ethics in advanced nursing practice can be taxing, regardless of where one is in their career. As an APRN with many responsibilities when caring for patients, applying ethical consideration to each decision can be a daunting task. Not that every situation needs an in-depth ethical analysis; however, certain circumstances require more thought and attention. Applying a framework can help the APRN by providing a set of criteria for working through an ethical dilemma. It does not provide an answer to the dilemma, but it helps to guide the APRN to use critical thinking to come to an ethically sound decision.

Amber L. Vermeesch, PhD, MSN, RN, FNP-C, FACSM, FNAP, has been a practicing family nurse practitioner since 2006. She has spent most of her practice serving underinsured and vulnerable populations. She completed her master's in nursing at Vanderbilt University School of Nursing. She earned her PhD in nursing science from the University of Miami in 2011, where she focused on reducing healthcare disparities among Latino populations using multiple methodologies, including participatory photography. She joined the University of Portland as an Associate Professor in 2014, teaching in both graduate and undergraduate programs and served as the Director of Research and Scholarship. She became a certified nurse educator in 2017. In 2020, Vermeesch became a Fellow in the American College of Sports Medicine as well as Distinguished Practitioner and Fellow in the National Academies of Practice. Her overall area of expertise is wellness, both physical and emotional. In 2022, she became the Department Chair for Family and Community Nursing at the University of North Carolina at Greensboro. Her investigations have concentrated on physical activity and integrated health among vulnerable populations.

Patricia H. Cox, DNP, MPH, MN, BSN, RN, recently retired as the Director of Doctoral Nursing Education & Practice at the School of Nursing at the University of Portland. Her long career in nursing took her from the bedside as an Army nurse to working as a public health nurse with migrant farmworkers and then Lao refugees in Thailand. Along the way, she advanced her education while caringfor HIV/AIDS patients as a nurse practitioner in the early days of the epidemic. Later she provided primary care to Native American and Hispanic populations in a community clinic in Los Angeles. Always supportive of nursing education, Cox served as adjunct faculty in several nursing programs prior to relocating to Portland to teach full time and prepare the next generation of nurse practitioners in the DNP Program at the University of Portland.

Inga M. Giske, DNP, MSN, RN, PMHNP-BC, PMH-BC, NE-BC, serves as a psychiatric nurse practitioner on the Psychiatric Consult-Liaison service at Providence St. Vincent Medical Center. She provides psychiatric evaluation and treatment recommendations for patients during their medical admission while also providing education and support to professional staff, nursing, and ancillary care team members. In addition, she serves as a preceptor to nurse practitioner students, medical students, and internal medicine residents. Her nursing career has spanned from bedside nursing to regional leadership in acute inpatient psychiatric units and psychiatric emergency departments. She implemented evidence-based practice changes in both acute inpatient and psychiatric settings to reduce falls and violence and improve patient and caregiver satisfaction. Giske works to improve knowledge regarding mental health conditions and reduce stigma through education of nurses, other healthcare providers, and her community. She has been adjunct faculty at the University of Portland, teaching undergraduate psychiatric nursing. She provides competency-based suicide assessment training to nurses both locally and nationally. Lastly, she has served as a trainer to local law enforcement in her community, educating both new recruits and experienced officers on mental health, crisis intervention, and de-escalation for the past six years.