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NU500 discussion 1- Megan
As I currently work in the PACU and surgical services, I found that the comfort theory by Katharine Kolcaba. Within this theory, Kolcaba explains comfort in three forms. These forms are, relief, ease, and transcendence (Nursing Theory, 2019). Within the PACU, I feel that this theory is a large factor. As we mostly handle post-operative pain. For example, within the post-operative setting, when a patient receives pain medication this is receiving relief comfort. As a PACU nurse, as I give pain medication or deliver non-pharmacological therapies that induce comfort this is considered a relief. For instance, as a PACU nurse, if pain management was not met then the patient will not feel relief, ease, or transcendence.
The comfort theory was developed in the 1990s as a middle range nursing theory that was designed for nursing practice, education, and research (Nursing Theory, n.d.). In the article by Berntzen et al. (2019), it covers how patients within the intensive care unit (ICU) experience a great about of physical and psychological discomfort. “Pain, as one type of discomfort, is regarded as multidimensional, comprising nociception, perception of pain, suffering and pain behavior patterns” (p. 2442). As nurses, it is our duty to ensure that our patients pain both physically and psychologically are being cared for. “Nurses in intensive care may be assisted in diminishing the identified comfort gap in their patients by keeping in mind the three types of comfort explained by Kolcaba, relief, ease, and transcendence” (p.2442). Overall, with the comfort theory, it is about reaching the goals of relief, ease, and transcendence.
NU 500 discussion 2 Jaclyn
According to Chinn et al. (2018), “personal knowing is the basis for the expression of an authentic or genuine self.” Personal knowing is developed deliberately over time based on your interactions with ones self and others. One must be in touch with themselves in order to understand that who you are as a person will in turn reflect on ones own behaviors, attitudes and values. To have personal knowledge one is always reflecting on themselves and their behaviors to cultivate self wholeness. This is an on-going process that leads you to your genuine self. Personal knowing affects professional development because one must always be aware of their strengths and weaknesses in order to further themselves.
One professional strength that I have would be knowledge in my particular field. I am always participating in education to gain more knowledge to be able to provide my patients with the best care I can. I frequently ask questions to understand why we are doing things rather than just because the doctor order it. Another professional strength I have would be that of leadership. Being in charge of an emergency department I need to know everything that is going on at all times and I need to be able to guide my coworkers when something arises. My coworkers need to feel they can count on me and come to me with any issues they may be having whether it personal or professional. One professional weakness I have would be that I need a better work life balance. I frequently work too much and drain myself mentally and physically. This in turn leads to another weakness I have acquired which is lacking empathy. When I am tired and burnt out it is very hard for me to empathize with a parent in the emergency room that caused an injury to their own child whether purposeful or non-purposeful.
To address my weaknesses I would apply Orem’s theory of self care to my practice. One must first care for themselves in order to then be able to care for others. By having self-care I would then be more physically and mentally rested to be able to care for others’ physical and mental ailments. This would allow me to gain more patience and understanding and be more empathic to others. This would further my strengths by giving me more drive to gain knowledge and lead others in the work place.
NU560 discussion 1 Amy
Study Topic
I chose a research study regarding the prevalence of non-AIDS neoplasms in patients living with HIV (PLWH). The study is aimed at identifying if prevalence decreases in this population when enhanced screening is utilized. Masia et al. (2021) indicate that nearly one in three PLWH will die due to non-AIDS

malignant neoplasms.
Participant Protection
In 1974 the Nation Research Act was signed into law, creating the Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. This commission was tasked with putting ethical standards into place to protect study subjects (The Belmont Report, 2019). The participants in the study I read were protected by the utilization of informed consent and education regarding risk and benefits (Masia et al., 2021).
Harm, Discomfort, Vulnerability, and Distress
The study functioned with a respectable level of beneficence. One arm was receiving standard of care and the other was receiving a higher level of screening than the standard. The risk of harm was minimal if any. No participant received less than the standard of care. There were confidentiality measures in place as well, to ensure that the subject’s privacy had a high level of protection, only appropriate investigators had access to the database in REDcap (Masia, 2019). It was recognized that with the level of testing involved in this study that reminders and monitoring of appointment adherence were necessary, which was a way to ensure study adherence and would likely ease the distress of the participants. The vulnerability of these patients was minimal, they were not coerced, they were able to decide on their own and their care was not jeopardized dependent upon their decision.
Participant Selection
In this study, bias was eliminated as subjects were randomized, by entering them into a database called REDcap, which assigned each subject a number that was randomly assigned to each arm (Masia et al., 2021). Patients were enrolled by their physician who was already treating the PLWH with the standard of care medical protocols (Masia et al., 2021). They offered the study to the patients of their free will of agreeing to join or not. The one ethical risk I can think of in this study is a physician may or may not offer to all patients based on details known about their patients, such as non-compliance, socially disturbing behavior, and more. This would mean that study selection would jeopardize individual justice, as the study would not be offered to all, but selected for the physician’s benefit, not the study’s benefit (The Belmont Report, 2019).
NU 560 discussion 2 Amy
I would consider myself a fair person, sometimes to a fault. With that said, I believe that the ethics in educational research and clinical research should be treated equally. This takes out confusion and eliminates the need for someone to play judge and jury. I believe a good rule of thumb is if there is a human factor related, it should be protected. Sullivan (2011) explains that medical education research requires IRB approval if there are interventions or interactions of research of human subjects. I agree this is a good practice.
One reason in medical educational research for protection is related to the perception of power (Sullivan, 2011). For example, is a student is involved as a research subject, they may act according to their perception of what others would expect of them, therefore, not being true to themselves or the topic of research at hand. Also, there would be potential of fear of retaliation if their information was not subject to privacy or knowing that they were being researched.
Some educational research has been exempted from ethical research regulations if the research is conducted in educational setting, utilizing standard educational practices research on instructional strategies or effectiveness of instructional strategies (Sullivan, 2011). However, this research must not be identifiable. This is a good concept to me as well, to keep people’s privacy at the forefront.
I believe in HIPAA standards for research subjects, whether the intent is educational or clinical. I believe this provides the maximum level of protection for those involved. It helps to maintain dignity and prevent any harm to a reputation when there are privacy regulations in place. I think this is a good gold standard to maintain. I did not investigate FERPA a whole lot as I focused my aim in this post on clinical and collegiate medical educational research. However, I will say as a parent with children in school, I am glad that there are privacy protections in place for the kiddo’s academic records.