All nursing professionals should abide by the rules and minimum standards when performing their tasks. It helps to ensure that they apply their necessary skills and expertise to practice best practices within the scope of their operations. Registered nurses have the responsibility of saving lives thus their behaviour in the healthcare sector must be controlled and managed effectively (Chiarella et al, 2008). As a result, Nursing and Midwifery Board of Australia develops the policies to follow. Besides, quality of healthcare services provided by the health professionals is checked by Australian Commission on Quality Healthcare Standards. The purpose of this paper is to discuss the minimum standards guiding registered nurse in Australia.
a). Scope of practise and what it means to the nursing discipline
The scope of practise is defined as the aspect comprising of different professional regulations that nurses use while performing their duties. It explains the processes and actions that healthcare practitioners use in order to provide quality health services (Halcomb et al, 2008). For instance, an individual scope of practise is determined by the ability and variety of factors that empower them to make decisions and conduct certain tasks. The professional bodies in Australia develop professional behaviour and the minimum standards followed by nurses.
NMBA is the organisation that has a responsibility of developing qualifications for nurses as well as the experience they require in their practise. All nurses are expected to follow the laid down procedures so that they can meet the health standards (Queensland Nursing Council, 2012). Moreover, when practising their skills as Registered Nurses, they must follow the Safety and Quality Framework and this helps to deliver quality healthcare standards that meet the needs and expectations of the clients. From the video case study, the nursing professionals are showing ethical standards by communicating with the patients well. For instance, Colleen the registered nurse with competent skills greets all the patients and introduces her partners and this shows courtesy and ethics.
Also, it is crucial to note that the scope of practise for nurses is changing regularly because of the changes and developments in technology. For instance, the standards activities of the nurses are changing because they can incorporate technology into their operations thus approved responsibilities can quickly become out-dated (Queensland Nursing Council, 2012). As a result, the board empowers professionals to reflect on their own scope so that they can catch up with evolving roles in the healthcare sector.
Moreover, the practise of an individual midwife or nurse is affected by many factors. The first factor is the environment where they exercise their skills. It is because different contexts have differentiated needs (Lin et al, 2010). Other factors include the healthcare requirements of the client and education level as well as the qualifications of the professional (Queensland Nursing Council, 2012). In this regard, the board has developed flexible policies to adapt the flexibility in the medical sector.
The scope of practise means a lot to the nursing discipline. Firstly, the clients and nurses must understand that the industry is a safe environment. It is because the policies and regulations developed aim at safeguarding the rights of all stakeholders including nurses and the clients. For any nurse to be registered, they must undergo required guidelines including the academic qualifications as well as experience to ensure they provide quality services to the people. In addition, it helps to make sure that nursing as a discipline is well respected because one must be willing and be patient to complete the entire process of certification (Chiarella et al, 2008). It is not only academic qualification that enables individuals to be registered but many factors are considered including experience and professionalism. Therefore, nursing discipline is a well-structured sector that does not leave anything to chance because it deals with human life.
b). Roles of different types of nurses
Before one becomes a registered nurse, they must have undergone through the entire process and possess relevant skills. A newly graduated registered nurse must meet the required experience. The roles of a registered nurse differ with roles of other professionals. The newly registered nurses have a limited scope as compared to registered nurses and have been in the field for more than three years. As a result, they follow the guideline of Nursing and Midwifery Board of Australia. Their first role is to work in shifts and replace other professionals (Queensland Nursing Council, 2012). For instance, the case study shows that registered nurses exchange changes. It means that they administer medication and routine check to patients. Furthermore, the newly registered nurses have the responsibility of taking medical records of the patients. In the video, the newly registered nurse is following the instructions of the registered nurse. Besides, they practise accountability and courtesy as depicted in the video. They must talk to patients politely and make friendship with their clients. Furthermore, the newly registered female nurse has slightly different role from the registered nurse. From the video an individual can determine that most of the diagnosis work is done by experienced and registered nurse assisted by the newly introduced nurse and the endorsed enrolled nurse so that they can gain required experience.
The roles of the newly registered nurses are slightly different from those of the Enrolled Nurse. The first difference in terms of scope is that EN is second level nurses. They work directly under a Registered Nurse. As a result, they perform duties as stated by in the code of practise as developed by NMBA (Nursing and Midwifery Board of Australia, 2008). In this regard, their duties include maintaining the healthcare of patients by conducting routine measures. This includes checking blood pressure as well as the levels of blood sugar. Other roles include providing support to patients like dressing and hygiene and comfort. From the video case study, the Registered Nurse who is experienced conducts patient diagnosis to determine what the patient is suffering from. She introduces the day shift nurses to the patients and hands over necessary patient information. The other role is orienting the nurses to the different wards especially to enrolled nurse who is new in the Australian wards. Therefore, she supervises the newly registered nurses as well as the enrolled nurse.
On the other hand, newly registered nurses who have just graduated differ with Endorsed Enrolled nurses. For an individual to become Endorsed Enrolled Nurse, they must complete an endorsement medication program. Their roles include administering different schedules of medication like 2, 3 and 4. They also have the duty of changing therapy alternatives that suit the needs of the patient. However, the EEN are not supposed to provide medication such as implanted devices and via CVC and Femoral lines (Stanley, 2011). Therefore, they do not perform duties that newly graduated nurses perform. In the video case study, it is clear that the facility is missing many important services like the services of EEN. They will help the patients with therapy. Also from the video, the role of newly registered female nurse is to take instructions from the experienced registered nurse. She takes notes and instructions and performs duties as explained by the night shift and experienced nurse. Besides, the enrolled nurse supports the registered nurse in administering medication as depicted in the video. He takes notes about the patients and general. One can easily identify that the male endorsed enrolled nurse is keen on checking therapy issues which are not associated with any medications.
Finally, the other type of nurses who have a different scope and roles from newly graduated registered nurse is Assistant In Nursing. It is a professional who works directly under the supervision of the Registered Nurse. The main duty is to assist the nurse to provide standardised healthcare services to the patients. Other duties include supporting patients in their daily activities and promoting personal hygiene for patients who cannot support self (Nursing and midwifery board of Australia, 2012). They also check as well as maintaining the hospital equipment to make sure they are in good condition. In the video provided, the Registered Nurse has a AIN who takes charge in the day shift and will work together with the Enrolled Nurse in the daytime shift. One can identify from the video that the newly registered nurse acts as an assistant to the registered nurse and that is why she is getting briefing from the registered nurse with experience about the condition of the patients. She assists the registered nurse in administering treatment and checking the progress of the patients.
c). Nursing minimum standards
The nurses and midwives in Australia are guided by set standards so that they can give quality healthcare services to the people (Harrington & Smith, 2008). The board has come up with regulations discussed below that guide the general practise of medical practitioners;
Standard 1: Thinking correctly and analysing the exercises of nurses
It is the first standard that is applied in the nursing sector. It helps to ensure that the practitioner make rational decisions that can help to achieve consumer requirements. They must think critically about the approaches to practise like person-centred approach (Lee et al, 2014). In this regard, registered nurses should use the available information and evidence to make quality decisions. Further, they should understand the cultural beliefs of the people before commencing their services as this helps to determine the behaviour of the receivers of the services. They need to understand the role played by the community in the medical sector (Margaret, 2013). Most importantly, they must follow the laid down procedures and regulations when providing their services to the patients. They must also use the available frameworks when making decisions regarding the healthcare sector.
The same case applies to Enrolled Nurses. It guides them to adhere with the principles of healthcare. As a result, they put the interests of the people at forefront before their personal needs. They must understand the priorities of the national government so that they can conflict with their personal interests. In the case study provided, the registered are seen taking notes properly meaning that they are following set standards by the board. Before a practitioner takes over a shift, he or she must take notes regarding the patients to serve (Rhian et al, 2009). The data is taken by the registered nurse accurately to avoid providing wrong medication or untimely dosage. In this context, it helps to apply self-centred approach to medication. However, the standards limit the practise of administering services because professionals are limited to the set regulations. They are not allowed to be innovative to develop the services they provided. Consequently, the standard should be flexible so that the nurses can incorporate what they think is best for the practise.
Relation to the case study
From the case study, the registered nurse with experience explains to the newly graduated registered nurse and endorsed enrolled nurse about the condition of the patients. The aim is to ensure that they provide required medication. Also, the registered nurse explains the conditions of each patient differently implying that they apply person-centred approach to medication.
Standard 2: Building therapeutic relationship as well as professional engagement
It is another important standard guiding the working relationship of the medical practitioners. Primary healthcare services are achieved when there is good relationship between the users and the providers of the services. However, the relationship should be based on professionalism. Most importantly, respect and mutual trust should be built (Lee, 2008). In this regard, the health practitioners must develop relationship that builds trust but clearly defines the boundaries. It means that personal pleasure should not be mixed with professional engagement.
Moreover, the nurses must communicate effectively with their clients so that they do not infringe their rights and dignity. It is important to consider individual cultural beliefs so that active communication can take place. If the needs and expectations of the clients are not considered, it will be difficult to develop a policy that can promote good communication (Rhian et al, 2009). They need to realise that people understand the dynamics of their own life and that is why they are included in the decision making process. It is crucial to build good relationship with other nurses and this helps to build partnership working towards administering quality healthcare services to the clients. They can do this by networking.
Relation to the case study
In the case study provided, the registered nurse as well as the enrolled nurse is building good relationship with the patients. The first thing they do when visiting the patient is greetings and asking how they are doing. It clearly shows that the nurse is greatly concerned about the welfare of the client. Also, the enrolled nurse and the other registered nurse communicate with the patients politely applying courtesy and this helps to build good relationship thus partnership approach to primary healthcare (Lee, 2008). However, this standard is criticised because sometimes it leads to unethical relationship where the patients and the professional engage in a relationship beyond the required limits and this can eventually affect the working effectiveness. Therefore, it is important to employ ethical issues when engaging in relationship to avoid overstepping the boundaries.
Standard 3: Maintaining capability practise
There are changing dynamics in the health sector and this requires regular training and development to meet the dynamics in the department. The RNs have the responsibility of determining their development needs and techniques employed to achieve them. They all have opportunity to attend seminars and forums aimed at developing their skills (NMBA, 2006). They need to come up with updated skills in order to provide information to their clients so that they make informed decisions regarding their well-being.
The RNs can do this by disseminating relevant information to their clients about good health. The clients can also use this information to determine the future relating to health (Nursing and Midwifery Board of Australia, 2016). However, this can be achieved by employing lifelong learning ad always providing updated information to the patients. Most importantly, the medical officers should accept responsibility for their own actions. It means that they will be held accountable for their decisions.
Relation to the case study
In the case study, the enrolled and registered nurses are taking updates from the night shift nurse. The aim is to share information adequately and it is communicated to the patients thus improving the control of their own health status (Australian Nursing and Midwifery Federation, 2014). Even if the endorsed enrolled nurse is certified and competent, he had worked outside Australia hence he needs to understand the dynamics in the Australian health department through the update. However, the standard is criticised because it gives he nurses opportunity to develop their skills and they might have little interest in the needs of the patients. In this regard, they should be controlled so that they can consider the needs of the clients when developing their skills.
d). 3 National Standards (ACSQHC, 2012)
The Australian Commission on Safety and Quality in Health Care introduced standards guiding general behaviour of the nursing practitioners. The aim of the standards is to ensure secure and better medical services (Australian Commission on Safety and Quality in Health Care, 2012). It helps in upholding rights of both users and the providers of the nursing services. The following are the primary policies;
Standard one: Leadership in healthcare organisation
The commission has developed standard followed by the health and social care organisations. The leaders of the organisations must develop leadership systems and programs aiming to offer better health and social care support. It improves the client experience because their needs are met. The primary aim of this standard is to apply organisational management skills that improve health and wellbeing of the people (Australian Commission on Safety and Quality in Health Care, 2012). The measures executed to improve the services include quality management systems that monitors the quality of services provided. The other system put in place is clinical practise and the nursing practitioners apply this standard by following the best practises developed and professionalism in their services. Other systems include skills management and managing customer complaints. The suggestion boxes are encouraged in any healthcare organisation so that the leadership can collect feedback from the clients regarding approaches to develop services provided.
However, the standard limits innovation and creativity among the stakeholders. For instance, there are no standard issues in the organisation. There is dynamism in the sector that requires innovation. In this regard, organisations require flexibility so that they can develop better internal measures aiming to improve the quality healthcare services (Coiera et al, 2002).
Relation to the case study
In the video provided, the governance and quality standard is depicted by the registered nurse and enrolled nurses. In the first place, the registered nurse enquires from the patients what they think should be improved in the facility (Coiera et al, 2002). Besides, the organisation is well organised and look neat. The enrolled nurse requests patients to press the bell whenever there is an issue that requires professional attention. In this context, the safety of the patients is taken care of.
Standard 2: Partnership with stakeholders
Furthermore, the Australian commission advocates for partnership working. Leaders of an organisation must implement programs and policies encouraging partnership working. Through teamwork, it is possible to improve quality of healthcare services provided. The consumers in the health department are the clients and patients. The aim of the partnership standard is to design a healthcare service that takes the needs of the stakeholders into account (Libby et al, 2013). In the process, the management of the organisation develops a responsive service program that holds the management accountable for their deeds. Other consumers engaged include relationship between different organisation as well as consumers and practitioners.
The criteria applied to ensure partnership with consumers include employing partnership approach when designing organisational policies and plans. This helps to incorporate the needs and ideas of different stakeholders. The same case applies when creating a service care program. It helps to improve customer experience since their specific needs are taken into account (Gosbee, 2002). The carers and care givers are included in organisational governance as a way of providing partnership working. Moreover, organisational leadership should develop training to the consumers so that they can understand their rights and obligations. It also helps to build their roles in the partnership. Finally, partnership approach is required when monitoring and evaluating the services. When evaluating the service, the consumer feedback is crucial because it helps to identify the success of the program.
However, the standard is criticised to some extent because informal partnership hinders quality of healthcare services provided. It is because partners become familiar with one another affecting the professional relationship. For effective partnership to take place there is division of duties. As a result, it hinders diversity in individual skills because every individual focuses on his or her roles (Charmel & Frampton, 2008).
Relation to the case study
In the video case study, there is clear partnership working. There is good communication between the enrolled nurse, registered nurses and the patients. Colleen the experienced registered nurse starts by greeting the patients and inquiring how they feel (Charmel & Frampton, 2008). On the other hand, the newly graduated female nurse talks to patients nicely after the introduction that she will take care of them during the day. As a result, they work as a team towards improving quality of health and social care services provided.
Standard 3: Preventing infections associated with healthcare
It is another necessary element in controlling the medical ministry. Organisational leaders and managers in a healthcare institution must put in place measures to prevent infectious diseases. The measures must be communicated to the stakeholders so that appropriate outcomes will be achieved. Adequate control systems are required to improve the overall healthcare system (Duguid, & Cruickshank, 2011). The primary aim is to prevent patients in the service organisation from contracting infectious diseases. Creative strategies are employed to protect the patients.
The strategies employed to implement the standard include conducting surveillance of infectious diseases. It helps to understand the dynamics of the infections and developing appropriate systems to protect patients. The other criterion is prevention strategy (Duguid, & Cruickshank, 2011). It includes vaccination against identified diseases. There is also patient management strategy. Patients with the diseases are identified and treated before it infects other patients.
However, the standard is criticised because it promotes laxity in the national government in taking measures to protect people from infectious diseases (Charmel & Frampton, 2008). It assumes that it is the responsibility of the services organisations to protect its patients and this is wrong. Required outcomes cannot be achieved because of the resource constraint.
Relation to the case study
In the video case study, the patients are kept in isolated rooms indicating that the infectious diseases will not spread implying that the needs of the patients are taken care of efficiently. Furthermore, the beddings are changed regularly to keep the service organisation hygiene. In this regard, the patients are protected from infectious diseases (Charmel & Frampton, 2008). Furthermore, the newly registered nurse says that she is coming back shortly to conduct routine check-ups. It shows that she is applying professionalism to protect the patients from any infectious diseases while they are treated.
Nursing is a crucial segment in government departments. It influences the economy of a country because a healthy nation is a wealthy country. Nurses operate within a scope. The Nursing and Midwifery Board of Australia has a mandate of developing policies and framework for nurses. They must work within specified framework to meet the needs of the patients. For instance, professionalism and courtesy are encouraged. On the other hand, there are various nurses and they include Enrolled nurses, registered nurses and assistant in nursing. The competency standards set by NMBA (2006) include analysing nursing practises and creating therapeutic relationship.Finally, the National Standards are applied by nurses to improve quality of services they provide. They include appropriate governance, prevention of infectious diseases and creating a partnership working environment.
Australian Nursing and Midwifery Federation. (2014). National Practise Standards for Nurses In the General Practise. Australian Nursing and Midwifery Federation.
Australian Commission on Safety and Quality in Health Care. (2012). National Safety and Quality Health Service Standards. Australian Commission on Safety and Quality in Health Care.
Coiera, E.W, Jayasuriya, R.A, Hardy, J, Bannan, A, Thorpe, M.E.C. (2002). Communication loads on clinical staff in the emergency department. Medical Journal of Australia 176(9): 415-418.
Charmel, P & Frampton, S. (2008). Building the business case for patient-centred care. Healthcare
Financial Management, 62 (3):80-85.
Chiarella, M. Thomas, D. Lau, C & Mclnnes, E. (2008). An overview of the competency movement in nursing and midwifery. Collegian, 15 (2): 45-53.
Duguid, M & Cruickshank, M. (2011). Antimicrobial Stewardship in Australian Hospitals. Sydney:ACSHQC.
Gosbee, J. (2002). Human factors engineering and patient safety. Quality and Safety in Health Care, 11(4): 352-354.
Halcomb, E. Davidson, P & Brown, N. (2008). Nurses in Australian general practice: implications for chronic disease management. Journal of Nursing & Healthcare of Chronic Illnesses, 17 (5A): p. 6-15.
Harrington, L.C & Smith, M. (2008). Nursing Peer Review: A Practical Approach to Promoting Professional Nursing Accountability, Sydney.
Lee T. (2008). Submission to the National Health and Hospitals Reform Commission, Australian Nursing Federation.
Lee, A. Nicole, J & Pamela, B. (2014). The Power of Nursing Peer Review, The Journal of Nursing and Administration,
Lin, C. Hsu, C. Li, T, Mathers, N & Huang, Y. (2010). Measuring professional competency of public health nurses: development of a scale and psychometric evaluation. Journal of Clinical Nursing, 19 (21-22): p. 3161-3170.
, Sydney. Literature Review: Medication Safety in Australia
Libby, R., Susan, S & Ellie, R. (2013).
Margaret, O. (2013). End-of-Life care in Australia: Issues and trends, Oita University of Nursing and Health Sciences.
Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practise, Nursing and Midwifery Board of Australia.
Nursing and Midwifery Board of Australia. (2006). National competency standards for the registered nurse, Melbourne, Victoria.
Nursing and Midwifery Board of Australia. (2008). Code Of Ethics For Nurses In Australia. 1st ed. Melbourne: Nursing and Midwifery Board of Australia.
Nursing and midwifery board of Australia. (2012). A Nurses Guide To Professional Boundaries. Melbourne: Nursing and Midwifery Board of Australia.
Rhian, M. Helen, K, Karen, F & Omar, A. (2009). Practice nursing in Australia: A review of education and career pathways, BMC Nursing
Stanley, D. (2011). Clinical Leadership. South Yarra: Palgrave Macmillan.
Queensland Nursing Council. (2012). Scope of Practise-framework for nurses and midwives, Queensland Nursing Council.