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Individuals who become ill as a result of personal lifestyle choices often shift the monetary costs of their healthcare needs to the taxpaying public or to fellow members of a private insurance pool. Some argue that policies permitting such cost shifting are unfair. Arguments for this view may seem to draw support from luck egalitarian accounts of distributive justice. This essay argues that the luck egalitarian framework provides no such support. To allocate healthcare costs on the basis of personal responsibility would arbitrarily and publicly burden socially detectable risk-takers while undetectable risk-takers continue to get a free ride. That problem is unavoidable even on the assumption that distributive institutions outside the healthcare sector are fully just. In actual, farfrom-just societies, imposing personal liability for the costs of voluntary risk taking would be wrong for an additional reason. Doing so would tend to magnify existing distributive injustices. These conclusions draw attention to two common 'moral fallacies of the second best' that can arise when applying ideal normative theory to matters of institutional design and in real-world policy contexts. © 2011 Springer Science+Business Media B.V.

Abstract: In the past, major scientific and technological revolutions, like the Copernican Revolution and the Industrial Revolution, have had profound effects, not only upon society in general, but also upon Philosophy. Today's Information Revolution is no exception. Already it has had significant impacts upon our understanding of human nature, the nature of society, even the nature of the universe. Given these developments, this essay considers some of the philosophical contributions of two “philosophers of the Information Age”—Norbert Wiener and Luciano Floridi—with regard to the nature of the universe, human nature, the nature of society, and the nature of “artificial agents” such as robots, softbots, and cyborgs.

This paper defends the thesis that privacy as a right is derived from fundamental rights to life, liberty, and property and does not permit restricting the commodification of bodily material; however, privacy as life, liberty, property does require conventions that ensure a robust and just market in bodily material. The analysis proceeds by defending a general commitment to liberty and markets, but not in the manner one might expect from a 'doctrinaire' libertarian. Ethical concerns about commodification are legitimate in the context of new medical and information technologies, but these concerns are not sufficiently well defined to justify political conclusions, since not every ethical concern is in itself a political concern, and the best way to resolve certain ethical difficulties is to draw up political boundaries that facilitate the discovery and testing of various solutions to our ethical puzzles. To illustrate the point, I will indicate how privacy as life, liberty, property defines such a dynamic solution to the problems of commodification of human bodily material and slippery information in insurance markets.

The information ethics (IE) of Floridi and Sanders is evaluated here in the light of an alternative in virtue ethics that is antifoundationalist, particularist, and relativist in contrast to Floridi's foundationalist, impartialist, and universalist commitments. Drawing from disparate traditional sources like Aristotle, Nietzsche, and Emerson, as well as contemporary advocates of virtue ethics like Nussbaum, Foot, and Williams, the essay shows that the central contentions of IE, including especially the principle of ontological equality, must either express commitments grounded in the particular perspectives we already inhabit, or be without rational or ethical force for us. © 2010 Metaphilosophy LLC and Blackwell Publishing Ltd.

This article describes the development process for creating a digital educational mini game prototype designed to provide practice opportunities for learning fundamental principles of arterial blood gases. Mini games generally take less than an hour to play and focus on specific subject matter. An interdisciplinary team of faculty from two universities mentored student game developers to design a digital educational mini game prototype. Sixteen accelerated bachelor of science in nursing students collaborated with game development students and playtested the game prototype during the last semester of their senior year in nursing school. Playtesting is a form of feedback that supports an iterative design process that is critical to game development. A 10-question survey was coupled with group discussions addressing five broad themes of an archetypical digital educational mini game to yield feedback on game design, play, and content. Four rounds of playtesting and incorporating feedback supported the iterative process. Accelerated bachelor of science in nursing student playtester feedback suggests that the digital educational mini game prototype has potential for offering an engaging, playful game experience that will support securing the fundamental principles of arterial blood gases. Next steps are to test the digital educational mini game for teaching and learning effectiveness. (C) 2016 Elsevier Inc. All rights reserved.

Error disclosure and apology are evolving concerns for advanced practice nurses who have increased exposure to liability. Error disclosure is required by regulatory agencies and the American Nurses Association Code of Ethics for Nurses, yet barriers to disclosure exist and nurse practitioners may not be aware of state apology laws that protect some statements from use in civil lawsuits for negligence or malpractice. Two law cases that apply apology laws are reviewed to illustrate these protections. Best practices for error disclosure are presented, and nurse educators are urged to include error disclosure content in nurse practitioner curricula as part of safety and quality education.

Health disparities, especially among minorities, persist; obesity is a national concern; and the combined effect can be significant for families and populations. In an effort to address obesity at an early age, the National Association of Hispanic Nurses (NAHN), developed the Muevete USA project. Muevete USA (from the Spanish verb for to move) features five lesson plans on healthy lifestyles for children and their families. This article describes Muevete USA, the partnership with a local school of nursing, the implementation of the program at the local level and the emerging program and student outcomes of a successful partnership.

The shortage of school nurses, school nurses covering multiple buildings, and the expanded role of the school nurse has called for innovative ideas to meet the growing health care needs of youth. Partnering with local schools of nursing may be a welcomed strategy. This brief article will share the benefits of hosting student nurses as well as identify ways to begin these partnerships. © 2016 The Author(s).

This study identified the types of caregiver stress and the caregiver and care management characteristics that are associated with this stress. 169 caregivers were recruited from a variety of community settings that cater to caregivers in a New England metropolitan area. They completed the Zarit Burden Interview (ZBI) and a questionnaire concerning their care recipient and caregiving arrangements. Principal Components Analysis on the ZBI resulted in five factors: personal strain/loss, uncertainty/inadequacy, social strain/embarrassment, anger, and dependency. The average age of the caregiver was 59.95 years (SD = 11.75) and the average age of the CR was 83.44 years (SD = 7.88). Of the 169 caregivers, 82% were women, 61.5% daughters/in-law or wives (12.9%), 34.3% were solo caregivers; 16.8% little or no burden, 39.9% reported mild to moderate burden, 35% moderate to severe burden, and 8.4% had severe burden. Dependency (22.4%) and personal strain/loss (13.7%) had the highest proportions reported as “often” to “nearly always.” The ZBI was predicted by only two caregiver characteristics, indicating that it is not sensitive to the experiences of different types of caregivers. Caregivers experience different types of burden depending on their gender, kinship roles, and levels of involvement in the care of their older relative. Solo caregiver status and age (younger) significantly predicted most if not all 5 burden types. Solo and young caregivers experienced the highest levels of caregiver burden. Social work practice must identify the caregiver’s life stage and other and self-expectations in relation to dependency, personal loss, embarrassment, anger, or uncertainty. © 2016 Taylor & Francis.

Novice nurses are often inadequately prepared to respond to complex, patient care situations where patients' conditions deteriorate. Exposure to a video-taped intervention that role-models and reinforces expected behavior of an expert nurse before participation in a simulation may improve student nurse performance in a cost-effective manner. The primary purpose of this quasi-experimental pre-test, post-test study was to assess the preliminary effectiveness of a theory based role-modeling intervention on enhancing student nurse competency in responding to a simulated response to rescue event. Performance was measured by a previously validated Heart Failure Simulation Competency Evaluation Tool (c) (HFSCET). Total mean scores on the HFSCET for the pre-test (59.08) and post-test (87.08) were significantly different (p = .000); students performed better on the post-test after exposure to the role-modeling intervention. A power analysis indicated a large effect size (effect size = .926; alpha = 0.50; power = 0.991). Students who had a greater number of days between the intervention and the post-test had a lower score. This innovative intervention based on established learning theory may change the way educators prepare novice students to achieve expected clinical competencies in graded simulation performance assessments. (c) 2013 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved.

Background: Reliable and valid instruments are needed to assess patient safety competencies, specifically nursing students' ability to appropriately respond to simulated rescue events. Methods: This was an instrument development study conducted with 152 senior nursing students in 2 phases. Results: Student groups performed poorly during the simulation scenario, with mean scores on the Heart Failure Simulation Competency Evaluation Tool ranging from 46% to 56%. Interrater reliability increased to .839 after item revision during Phase 2 of the study. Discussion: This simulation competency assessment package is ready to be tested with more diverse student groups and novice nurses in the practice setting. © 2012 International Nursing Association for Clinical Simulation and Learning.

Nurse practitioners are playing an increasingly visible role in home care. The Institute of Medicine in collaboration with the Robert Wood Johnson Foundation recommends wider use of Advanced Practice Registered Nurses and there has been growing interest in using the role in home care.1 However, the physician remains the provider who must sign home health agency paperwork and orders. The "Home Health Care Planning Improvement Act" would allow nurse practitioners to certify Medicare-sponsored treatment plans.2 This article will discuss the status of the nurse practitioner role in home care, the impact of reimbursement on home care services, how the passage of the new act would change current practice, and a vision for the future role of the nurse practitioner in home health care. © 2012 SAGE Publications.

PURPOSE: To examine the worklife experiences of physicians, to further the exploration of the worklife experiences of nurses with disabilities, and to discover how the two healthcare professions compare with each other with regard to these experiences., METHODS: This study employed the research tradition of interpretive naturalistic inquiry and used constant comparative analysis to collect and analyze the data., FINDINGS: Despite the cultural and educational differences between physicians and RNs, their experiences as healthcare professionals with self-identified permanent physical and/or sensory disabilities were very similar. The research team identified five core themes., CONCLUSIONS: Healthcare professionals, including staff and administrators, need to make an effort to retain employees as turnover and predicted shortages are likely to jeopardize the current healthcare system., CLINICAL RELEVANCE: Modifications can be made within both professions to support people with disabilities and to enable them to contribute to their professions using their abilities to think critically, solve problems, and care for patients safely. Copyright © 2012 Association of Rehabilitation Nurses.

PURPOSE: The authors sought to generate insights and hypotheses about the professional experiences of registered nurses and physicians with self-identified disabilities to inform local and national policy conversations on supporting a diverse health care workforce., METHOD: In 2009-2010, the authors conducted in-depth interviews in person and over the telephone with a sample of licensed registered nurses and physicians across the country who self-identified as having a permanent disability. They coded the interview transcripts to identify key themes across the participants' responses., RESULTS: The authors interviewed 10 registered nurses and 10 physicians. Five novel and consistent themes emerged from the data analysis: (1) Living and working with a physical/sensory disability narrows the career choices and trajectories of nurses and physicians, (2) nurses and physicians struggle with decisions regarding whether to disclose and discuss their disabilities at work, (3) nurses and physicians rarely seek legally guaranteed workplace accommodations, instead viewing patient safety as a personal responsibility, (4) interpersonal interactions often reflect the institutional climate and set the tone for how welcome nurses and physicians feel at work, and (5) reactions to workplace disability-related challenges run an emotional spectrum from anger and grief to resilience and optimism., CONCLUSIONS: The responses revealed several missed opportunities for supporting health care professionals with disabilities in the workplace. These findings should inform the continuing debate regarding what defines "reasonable accommodation" and how to create a workplace that is welcoming for nurses and physicians with disabilities.

A qualitative study was done to explore the perceptions of volunteering among retired registered nurses (RNs) in Kansas. Participants were volunteers in formal nursing roles or were using their nursing knowledge and experience in non-nursing roles, such as church work. Regardless of the type of volunteer position, retired RNs reported that they use what they have learned as nurses when they volunteer. Volunteering benefits include enhanced self-worth, intellectual stimulation, reduced social isolation, and opportunities to help others. Increased paperwork, new technology, difficulty finding nursing-specific volunteer opportunities, resistance from health care organizations, and a lack of respect for what these nurses know are challenges and barriers to volunteering. Retired RNs have accumulated years of clinical nursing experience and can be helpful to employed nurses. Health care organizations should launch targeted efforts to recruit and utilize retired RN volunteers. Health care professionals who care for older adults should recommend volunteering as a healthful endeavor. (Geriatr Nurs 2011;32:96-105)

A survey design was used to explore the perceptions and characteristics of registered nurses (RNs) with sensory disabilities and their risk for leaving their jobs. An earlier study found that nurses with disabilities are leaving nursing and that employers do not appear to support these nurses. Work instability and the mismatch between a nurse's perceptions of his or her ability and the demands of their work increase risk for job retention problems. This study's convenience sample of U.S. RNs had hearing, vision, or communication disabilities. Participants completed a demographic form, three U.S. Census questions, and the Nurse-Work Instability Survey. Hospital nurses were three times more likely to be at risk for retention problems. Nurses with hearing disabilities were frustrated at work. Hearing difficulties increased with years spent working as a nurse. Many nurses with sensory disabilities have left nursing. Early intervention may prevent work instability and increase retention, and rehabilitation nurses are ideally positioned to lead early intervention programs.