A nurse follows through with a promised pain management plan. Which ethical principle does this action reflect?

A. Seeking social support from friends and family: This is a characteristic of healthy, uncomplicated grief where the individual utilizes their social network to process the loss. Engaging with others for emotional support is a protective factor that helps facilitate the transition through the mourning process. It indicates that the person is actively employing adaptive coping mechanisms to manage their distress.

B. Crying during anniversaries or holidays: These are known as "anniversary reactions" and are considered a normal part of the grief experience for many years following a loss. Significant dates often trigger temporary upsurges in grief that do not necessarily indicate a pathological disorder. Normal grief includes these intermittent periods of sadness interspersed with productive daily functioning.

C. Persistent yearning and impaired daily functioning 14 months after a loss: Prolonged grief disorder is diagnosed when intense longing and emotional distress continue beyond 12 months for adults and interfere with daily life. The persistence of these symptoms past the one-year mark suggests the mourning process has become "stuck" or maladaptive. This requires specialized clinical intervention to help the individual reintegrate into their social and occupational roles.

D. Sadness and fatigue two months after a loss: These symptoms are typical manifestations of the early stages of normal, uncomplicated grief. During the first few months, it is expected for individuals to experience somatic complaints and significant emotional pain as they begin to navigate life without the deceased. A diagnosis of PGD cannot be made this early in the bereavement process.

A. Replace facility policies: Facility policies are internal rules that must operate within the boundaries of the law but cannot supersede state legislation. While policies provide specific operational instructions, the Nurse Practice Act serves as the superior legal authority. Nurses must comply with both, but the legal scope of practice is defined by the state.

B. Are optional practice recommendations: These acts are statutory laws enacted by state legislatures and are mandatory for all nurses practicing within that jurisdiction. Failure to adhere to the provisions of the Nurse Practice Act can lead to legal action or loss of licensure. They are not mere suggestions but are the legal foundation for professional accountability.

C. Establish legal guidelines for nursing practice within each state: These acts define the scope of practice, educational requirements, and title protection for nurses to ensure public safety. Each state has the authority to regulate nursing to protect its citizens from unskilled or unsafe practitioners. This legal framework outlines what a nurse can and cannot do in their professional role.

D. Provide national competency standards: While there are similarities across states, Nurse Practice Acts are state-specific laws rather than a single national standard. Organizations like the American Nurses Association provide professional standards, but the legal authority remains with the individual states. Nurses must be familiar with the specific act in the state where they are licensed.