Advanced Practing Nurse

Advanced Practice Nurses (APNs) provide care in a variety of multicultural settings. So, they must be aware of the various ethnic backgrounds and needs of their patients. There are barriers that pose challenges that require the APN to know different approaches that will help provide the best care and at the same time respect their needs or views. For example, the APN in a pediatric setting is challenged with a cultural belief of a parent that does not want their child to be immunized, because it is against their religious beliefs. The APN would like to respect the patient’s preferences; however the patient’s safety and best interest is still a concern. In challenging cases such as the one above the APN should consult with ethic consultants to come up with culturally sensitive options that can preserve the patient’s rights and dignity (Hamric & Delgado, 2009). There are also patients who are not able to speak for themselves and do not have an advanced directive that can carry out the patient’s wishes. This is another major barrier that could mean life or death for a patient. An advanced directive is a legal document of the person who is to make the decisions for the patient’s end of life care. If there is no advanced directive, the decisions are made according to the state statue. The closest relative available may be appointed to make these decisions. As an APN we must encourage the patients and their families to prepare before these emergency situations occur (Hamric & Delgado, 2009). Noncompliance is a common problem in many clinical settings. This barrier may be very frustrating for the APN. The patient may choose not to adhere to the recommendations of their primary care providers. Some reasons for noncompliance may not be the patient’s choice such as literacy issues, lack of funds, lack of resources, or inadequate communications. These are issues that may be addressed by the case manager or social worker who are involved in the

References: Hamric, A. & Delgado, S. (2009). Ethical Decision Making. In A. Hamric, C. Hanson, & J. Spross (Eds.), Advanced Practice Nursing: An integrative approach (4th ed., pp. 380-402). St. Louis, MO: Saunders Elsevier Kawi, J., & Xu, Y. (2009). Facilitators and barriers to adjustment of international nurses: an integrative review. International Nursing Review, 56(2), 174-183. doi:10.1111/j.1466-7657.2008.00705.x