The term scopes of practice in nursing profession seem to be utilized very much but not well defined that increase the chances of the breach of the scope of practice. The term helps to identify the professional role and responsibility of the registered nurses that are needed to be justified to deliver quality care to the patient but it is considered to be the difficult concept. The scope of practises demands from the nurses that they should utilize their skills and education in an authorized way to deliver the care to the patient. Different barriers are associated with the adherence to the scope of practice which directly leads to poor health care results (Birks et al., 2018). Scope of practice is considered to be the law and action that are framed by the committees as per the specific qualification of the nurse and registered nurses are expected to use their full potential in the care. The scope of the practice helps the nurses to understand their accountability toward the patient health and their responsibility to deliver quality care. The lack of knowledge or carelessness can lead to the breach of the scope of practice that leads to legal complication due to increased risk for the patient (Lubbe & Roets, 2013).
In Australia, the scope of practice has been defined in different aspect like code of conduct, practise standards that are expected to form a professional boundary. The scope of practice is directly influenced by the clinical and organizational facto which directly hamper the clinical practise that is not ethical as per the professional role of the registered nurse. The blurred boundaries of the professional role increase the chances of the unaddressed issue of the patient which can lead to a negative impact over the health of the patient. The scope of practises state that nurses are expected to use their knowledge and surrounding resources to justify their professional role by delivering quality care to the patient (Birks et al., 2016). The HCCC case indicates that Ms. Cristobal not only able to justify the professional role but also increased the risk for the patient for deteriorated health which leads to unsatisfactory professional conduct. The careless of Ms. Cristobal toward the post-operative care of the patient can increase the complication for the patient that is the first complaint against the registered nurse. The breach of maintaining patient confidentiality is another complaint that leads to the unethical professional role.
Misconduct of the professional role of the nurses directly impacts the patient that directly indicates the breach of law due to increased risk for the patient. The reason for the misconduct of the professional role can occur due the inappropriate clinical care which increases the susceptibility of the patient to acquire the right care. The illegal and unethical practises of the nurse also lead to the misconduct of the professional role which has a deteriorating impact over the patient and can increase the risk for mortality (Millbank, 2019). Post-operative care is considered to be an important aspect after the surgery as the patient is more susceptible to acquire different complication that leads to deteriorated health. The registered nurses are expected to actively engage in patient assessment and care planning to deliver quality care to the patient. The assessment helps to identify the issue that increased complication for the patient which can be addressed by the accurate intervention (Nilsson et al., 2020). The evidence indicates that Ms. Cristobal doesn’t actively engage in the care of the patient A moreover she also not followed the instruction of the seniors when she explained that drug can be harmful to the non-ventilated patient. She also states that due to heavy workload there was misbalance in her daily routine that is increasing her complication thus she opted for the easiest option and also forget to take the medical order for the drug administration.
The article presented by Beltran-Aroca et al. (2016) discussed that medical professional is expected to maintain the confidentiality of the patient documents to work ethically. Different reasons lead to the breach of confidentiality in the clinical setting that includes carelessness of the staff or sometimes intentional that leads to serious action from the medical department. Different aspects need to be considered while taking action against the breach that includes type, severity, area and personnel. The evidence indicates that Ms. Cristobal was not able to maintain the confidentiality and mailed the patient documentation with the consent of the patient. The complaint charges that Ms. Cristobal accessed the medical records of the patient followed by saving them in the personal USB which can help her to transfer it into her personal computer. Ms. Cristobal has no authority from the hospital management team and there was no consent of the patient.
The nurses are expected to work as per the two forms to improve the practise which helps to deliver the quality care that includes statutory regulation and self-regulation. The registered nurses are expected to follow the Nursing and Midwifery Board of Australia professional standard, National minimum standard of competency that comes under the statutory regulation. On the other hand, self-regulated standards are not set by the legislation but they are the personal understanding concerning the professional role. These two regulations help the registered nurse to avoid the chances of misconduct to deliver quality care (Foley, 2014). The legal obligation of the registered nurse during the misconduct includes a different aspect that covers the individual as well as the patient perspective. The registered nurse should be aware of the Nurse Practise Act that helps to justify the professional role by following the guidelines for professional practice. Advocacy toward the patient is also important to decrease the chances of misconduct and delivering accurate care. The right administration of the medication to address the issue of the patient is by improving the clinical practise. The consent form is also important to decrease the chances of any legal complication faced by the patient (Kumar et al., 2013).
The Nursing and Midwifery Board (2017) state that professional standards that are necessary for maintaining the professional obligation of the registered nurses. The professional standard of the registered nurse includes the code of conduct, standards for practise and code of ethics. Codes of conduct are important to understand the registered nurse clinical role of the nurse and code of ethics are important to guideline the ethical working of the nursing. Standard of practice is important in the care as they sum up the professional role of the nurses that are important to deliver the quality care to the patient. The study presented by Zahedi et al. (2013) discussing the ethical obligation of the nurse by indicating that the code of ethics is important for the registered nurse to maintain professional role compatibility. The nurses are expected to follow all the ethical principle in the care to improve the clinical practice by considering the individual as well as patient views. The ethical principle includes beneficence, autonomy, non-maleficence and justice to include human rights in the care. The ethical principle considering in the care help the nurses to work ethically and legally which decrease the chances of the legal complication in the care of the patient.
Beltran-Aroca, C. M., Girela-Lopez, E., Collazo-Chao, E., Montero-Pérez-Barquero, M. & Muñoz-Villanueva, M. C. (2016). Confidentiality breaches in clinical practice: What happens in hospitals? BMC Medical Ethics, 17(1), 52. DOI: 10.1186/s12910-016-0136-y
Birks, M., Davis, J., Smithson, J. & Cant, R. (2016). Registered nurse scope of practice in Australia: An integrative review of the literature. Contemporary Nurse, 52(5), 522–543. DOI:10.1080/10376178.2016.1238773
Birks, M., Smithson, J., Lindsay, D. & Davis, J. (2018). How registered nurses determine their scope of practice: A cross-sectional study. Contemporary Nurse, 1–14. DOI:10.1080/10376178.2018.1520605
Foley, E. (2014). By whose standard? Australian Nursing and Midwifery Federation. Retrieved from: https://anmf.org.au/pages/professional-july-2013.
Kumar, H., Gokhale, Jain, K. & Mathur, D. R. (2013). Legal awareness and responsibilities of nursing staff in administration of patient care in a trust hospital. Journal of Clinical and Diagnostic Research: JCDR, 7(12), 2814–2817. DOI: 10.7860/JCDR/2013/7737.3886
Lubbe, J. C. I. & Roets, L. (2013). Nurses’ scope of practice and the implication for quality nursing care. Journal of Nursing Scholarship, 46(1), 58–64. DOI: 10.1111/jnu.12058
Millbank, J. (2019). Serious misconduct of health professionals in disciplinary tribunals under the National Law 2010–17. Australian Health Review. DOI: 10.1071/ah18239
Nilsson, U., Gruen, R. & Myles, P. S. (2020). Postoperative recovery: The importance of the team. Anaesthesia, 75(S1), 158-164. DOI:10.1111/anae.14869
Zahedi, F., Sanjari, M., Aala, M., Peymani, M., Aramesh, K., Parsapour, A., Maddah, S. B., Cheraghi, M., Mirzabeigi, G., Larijani, B. & Dastgerdi, M. V. (2013). The code of ethics for nurses. Iranian Journal of Public Health, 42(Supple1), 1–8.
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