1. Discuss types of suffering. 2. Address the role of nursing in situations of suffering. 3. Introduce quaternary prevention as it relates to nursing practice. 4. Apply the Code of Ethics for Nurses with Interpretive Statements in situations of suffering. 5. Consider informed risk, autonomy, beneficence, and nonmaleficence in difficult situations

No need generalize answer ok. Module Eight: Suffering, Quaternary Prevention, Ethics in Chronic Illness Situations This module introduces quaternary prevention and addresses the role of nurses in situations where individuals and families may be suffering. Principles of ethics are revisited as related to suffering and the nursing role. Module Objectives 1. Discuss types of suffering. 2. Address the role of nursing in situations of suffering. 3. Introduce quaternary prevention as it relates to nursing practice. 4. Apply the Code of Ethics for Nurses with Interpretive Statements in situations of suffering. 5. Consider informed risk, autonomy, beneficence, and nonmaleficence in difficult situations. Resources and readings (you have seen some of these before in this course): Required videos linked into this module American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). (available free through the SMSU McFarland Library e-books: https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nlebk &AN=2935865&scope=site Focus on Standard 8 Nagano, H., Chida, K., & Ozawa, T. (2022). Can We Be at Peace With Unsolvable Suffering? A Qualitative Study Exploring the Effectiveness of Supportive Communication and Resilience Building. Journal of Hospice & Palliative Nursing, 24(3), E76–E82. https://doi- org.ssuproxy.mnpals.net/10.1097/NJH.0000000000000852 Palliative and Supportive Care at the End of Life: Reducing Suffering, Enhancing Meaning, and Improving the Quality of Life. (2021). Journal of Oncology Navigation & Survivorship, 12(10), 360–361. https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm& AN=153038018&scope=site Potter, M.L., & Wynne, B.P. (2015). Loss, Suffering, Bereavement, and Grief. In M. Matzo & D.W. Sherman (Eds.), Palliative care nursing: Quality care to the end of life (4th ed., pp. 205 - 234). Springer Publishing Company. https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=e680s ww&AN=801728&lang=en%2cen&scope=site Seng Beng, T., Ting Ting, T., Karupiah, M., Xin Ni, C., Li Li, H., Chong Guan, N., Ee Chin, L., Chee Loong, L., & Maw Pin, T. (2021). Patterns of Suffering in Palliative Care: A Descriptive Study. Omega: Journal of Death & Dying, 84(2), 512–524. https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=cul&A N=153934673&scope=site Tarzian, A.J., & Schwarz, J.K. (2015). Ethical Aspects of Palliative Care. In M. Matzo & D.W. Sherman (Eds.), Palliative care nursing: Quality care to the end of life (4th ed., pp. 33-60). https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=e680s ww&AN=801728&lang=en%2cen&scope=site Varkey, B. (2021). Principles of Clinical Ethics and Their Application to Practice. Medical Principles & Practice, 30(1), 17–28. https://doi-org.ssuproxy.mnpals.net/10.1159/000509119 Optional readings Alber, K., Kuehlein, T., Schedlbauer, A., & Schaffer, S. (2017). Medical overuse and quaternary prevention in primary care -- A qualitative study with general practitioners. BMC Family Practice, 18, 1–13. https://doi-org.ssuproxy.mnpals.net/10.1186/s12875-017-0667-4 American Nurses Association (2015). Code of ethics for nurses: With interpretive statements. Silver Spring, MD: ANA. http://ssuproxy.mnpals.net/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=nlebk& AN=1021757&scope=site Bolton, L. E., Seymour, J., & Gardiner, C. (2022). Existential suffering in the day to day lives of those living with palliative care needs arising from chronic obstructive pulmonary disease (COPD): A systematic integrative literature review. Palliative Medicine, 36(4), 567–580. https://doi- org.ssuproxy.mnpals.net/10.1177/02692163221074539 Martins, C., Godycki-Cwirko, M., Heleno, B., & Brodersen, J. (2019). Quaternary prevention: an evidence- based concept aiming to protect patients from medical harm. British Journal of General Practice, 69(689), 614–615. https://doi-org.ssuproxy.mnpals.net/10.3399/bjgp19x706913 Martins, C., Godycki-Cwirko, M., Heleno, B., & Brodersen, J. (2018). Quaternary prevention: reviewing the concept. European Journal of General Practice, 24(1), 106–111. https://www.tandfonline.com/doi/full/10.1080/13814788.2017.1422177 Norman, A. H., & Tesser, C. D. (2019). Quaternary prevention: a balanced approach to demedicalisation. British Journal of General Practice, 69(678), 28–29. https://doi-org.ssuproxy.mnpals.net/10.3399/bjgp19X700517 Takla, A., Savulescu, J., & Wilkinson, D. J. C. (2021). A conscious choice: Is it ethical to aim for unconsciousness at the end of life? Bioethics, 35(3), 284–291. https://doi- org.ssuproxy.mnpals.net/10.1111/bioe.12838. 1) Reflect on what individual nurses can do when individuals and families are living with suffering. Include a minimum of two citation/reference pairs in your response. 2) Review Standard 8 in the ANA: Nursing Scope and Standards of Practice. How does the role of advocacy fit with Quaternary Prevention? 3) How do 'informed risk', autonomy, and quaternary prevention 'fit' with decision making in situations of chronic illness? For the future Dr. Atul Gwande is a prominent neurosurgeon whose perspective on death and dying changed when his own father was diagnosed with cancer. Dr. Gwande’s work has been very well received and recognized over the last few years. When you have a bit of free time (maybe between semesters), I strongly recommend reading his book titled Being Mortal: Medicine and What Matters in the End - well worth your time! Appendix C: Focused Reflections Rubric Please refer to the Focused Reflections folder for a more detail. Note: Reflections should demonstrate that the assigned content was appropriately reviewed, understood, and synthesized. Additionally, integrate additional professional healthcare and nursing journal articles and references (see page six in the syllabus) with your own thought Criterion Excellent Competent Not satisfactory Question # 1 Question #1 addressed in a clear, focused manner. Response demonstrates the assigned content was appropriately and synthesized. Supported with evidence. Clarity and focus lacking or does not demonstrate synthesis of assigned content or not supported with evidence. Responses do not demonstrate synthesis of assigned readings Question # 2 Question #2 addressed in a clear, focused manner. Response demonstrates the assigned content was appropriately and synthesized. Supported with evidence. Clarity and focus lacking or does not demonstrate synthesis of assigned content or not supported with evidence. Responses do not demonstrate synthesis of assigned readings Question # 3 Question #3 addressed in a clear, focused manner. Response demonstrates the assigned content was Clarity and focus lacking or does not demonstrate synthesis of assigned content or not supported with evidence. Responses do not demonstrate synthesis of assigned readings . appropriately and synthesized. Supported with evidence. Evidence based At least two professional resources support reflections. Evidence must be integrated, cited, and referenced per APA style. See criteria for professional references in syllabus. Minimal direct quotations. Fewer than four APA style errors Supported by fewer than two professional resources. Or evidence based sources included, but not integrated into post. Or provides evidence-based, scholarly references using incorrect APA format. Or provides non-scholarly references Provides no professional reference to support position/ideas in postings/discussion and /or uses no APA format Writing quality Fewer than four punctuation, spelling, spacing, capitalization, and writing mechanics errors. Easy to understand main ideas. Fewer than eight total writing mechanics Challenging to understand mai Six or more writing mechanics errors; run-on sentences. Writing lacks organization or focus