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Professional Nursing Concepts

Scope of practice involves the task and responsibility that a nurse needs to perform and it also tells about the limitations of the nursing practice. Scope of practice in nursing in Australia has been set by various bodies such as by Nursing and Midwifery Board of Australia (NMBA), Australian College of Nursing (ACN) and Australian Nursing and Midwifery Federation (ANMF). This is important so that nurses would know their role and will work according to it (Birks et al., 2016). Hence, this is a significant approach for the nurses to know so that they can help the community and the patients. Therefore, in this essay, I will be explaining about the scope of practice and why will I choose my field of expertise after my nursing degree. I will also be explaining my reflection on the chosen area of practice.

Scope of practice in nursing has expanded and evolved during the last decade. International Council of Nurses has stated that the scope of practice highlights the boundaries and parameters within which nurses could practice and can perform their tasks and responsibility (International Council of Nursing, 2020). These boundaries are important because they protect the public and as well as the nurses. It also provides identity to the practice of nursing. It also describes what the role of nurses is and what they are competent to do. Scope of practice makes clear that what practices are safe and secure in the nursing profession and how to implement the practices adequately as per the requirements and needs of the society (Murray, Sundin& Cope, 2018; van Pelt et al., 2020). Nurses are one of the main pillars of healthcare services. They have a range of responsibilities concerning the health of the patients. Including them in most of the tasks that are performed is an approach which is cost-effective and it could also meet with the increasingly complicated demands of the healthcare. Scope of practice is crucial as it forms the base for all the standards of practice under which a nurse should work. It also mentioned about the job description and helps in protecting nurses via a legal framework highlighting who is authorized and qualified to give specific interventions and services (Murray, Sundin& Cope, 2018; Lindberg et al., 2020; Saunders et al., 2018).

Nursing scope of practice in Australia has been set by the Nursing and Midwifery Board of Australia, the Australian College of Nursing and Australian Nursing and Midwifery Federation. These guidelines and standards pay attention to the role description of the nurses, their role and responsibility and on their competencies. They do this to provide guidance to registered nurses and enrolled nurses for determining the professional and legal boundaries of their nursing practice. If the roles and responsibilities are not outlined than new nurses and the experienced registered nurse would altogether be confused about their position and function and thus it would create ambiguity in practice (Birks et al., 2016; MacLeod et al., 2019; Tie, Birks & Francis, 2019). According to NMBA standards, nurses have to think critically and also analyze the best available material in their practices. They should also engage in professional and therapeutic relationships with the patient and his family. Nurses also need to preserve the capability of practice. They need to develop a therapeutic plan for the patient and have to provide safe and secure practice which is appropriate for the diseased individual. Moreover, they need to evaluate the results of their practice on the patient (Nursing and Midwifery Board of Australia, 2020). These are some of the roles that nurses need to perform while working under the legislation and legal obligations.

After the completion of my nursing degree, I want to pursue my clinical practice in aged care and will especially focus on medication error. I want to take aged care as my topic because caring for older adults is very complicated. They are in need of physical and as well as mental help from the nurse. By providing those, both types of care their quality of life could be increased. Nurses can help in their relocation to the hospital or nursing home setting. They can also educate them about their condition or situation and therefore can provide support to them for the physical and mental wellbeing. Nurses could also give them person-centred care which will enhance their living condition and also their families(Ellis & Rawson, 2015; Yoon, 2018; Fitzpatrick &Tzouvara, 2019). Many older people have several conditions which require multiple medications. Unfortunately, medication error or use of various medicines could result in adverse events in the case of older people and thus, complicate their condition (Naples et al., 2016; Paliwal et al., 2019; Toffoletto et al., 2018). Therefore, it is necessary to control the incorrect administration of the medicines and this could be done by gaining more information on this topic. So, for this, I would like to increase my knowledge and therefore wants to help the community.

I have chosen this practice because in my clinical placement I have seen a case where a nurse administered wrong medication to one of the old patients who was admitted to the ward. The patient had complained about stomach ache since the morning and on that day the ward was filled with the patient. Instead of giving him pain relief medicine, the nurse provided him with a sleeping pill. This medication was for another patient who was on the next bed to the old patient. Because of this, the patient starts to feel sleepy but his pain was not gone. The nurse realized her mistake but now she could not do anything about the pill which already has been taken by the patient. This shows that because of even minor medication error the safety and quality care of the patient is compromised.

In conclusion, it can be said that the nurse needs to work under their scope of practice. The scope of practice describes their job and outlines the margin for their tasks so that no confusion will be there. The guidelines and standards have been set already so that there will be no confusion. It is also helpful to prevent nurses and the public from legal boundaries. I would, therefore, like to practice my expertise in aged care and will especially focus on medication error because it can lead to various implications on the health of the patient. A medication error can be avoided if more information and knowledge gained on this subject. It will thus, help in providing quality care to the older patient and will increase their quality of life.

References for Scope of Practice

Birks, M., Davis, J., Smithson, J., & Cant, R. (2016). Registered nurse scope of practice in Australia: An integrative review of the literature. Contemporary Nurse52(5), 522-543. https://doi.org/10.1080/10376178.2016.1238773

Ellis, J. M., & Rawson, H. (2015).Nurses' and personal care assistants' role in improving the relocation of older people into nursing homes. Journal of Clinical Nursing24(13-14), 2005-2013.https://doi.org/10.1111/jocn.12798

Fitzpatrick, J. M., &Tzouvara, V. (2019). Facilitators and inhibitors of transition for older people who have relocated to a long‐term care facility: A systematic review. Health & Social Care in the Community27(3), e57-e81.https://doi.org/10.1111/hsc.12647

International Council of Nursing. (2020). Nursing Policy. Available at https://www.icn.ch/nursing-policy

Lindberg, M., Carlsson, M., Engström, M., Kristofferzon, M. L., &Skytt, B. (2020). Nursing student's expectations for their future profession and motivating factors–A longitudinal descriptive study from Sweden. Nurse Education Today84, 104218.https://doi.org/10.1016/j.nedt.2019.104218

MacLeod, M. L., Stewart, N. J., Kosteniuk, J. G., Penz, K. L., Olynick, J., Karunanayake, C. P., ... & Zimmer, L. V. (2019). Rural and remote registered nurses’ perceptions of working beyond their legislated scope of practice. Canadian Journal of Nursing Leadership32(1), 20-29. 10.12927/cjnl.2019.25851 

Murray, M., Sundin, D., & Cope, V. (2018). New graduate registered nurses’ knowledge of patient safety and practice: A literature review. Journal of Clinical Nursing27(1-2), 31-47. https://doi.org/10.1016/j.ijans.2018.04.001

Naples, J. G., Hanlon, J. T., Schmader, K. E., &Semla, T. P. (2016).Recent literature on medication errors and adverse drug events in older adults. Journal of the American Geriatrics Society64(2), 401–408. https://doi.org/10.1111/jgs.13922

Nursing and Midwifery Board of Australia. (2020). Registered nurse standards for practice. Available at https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx

Paliwal, Y., Gendron, T. L., Jones, R. M., Moczygemba, L., Nadpara, P. A., &Slattum, P. W. (2019).A qualitative study to understand over-the-counter medication use and decision-making among residents of senior-living communities. Research in Social and Administrative Pharmacy15(6), 730-737. https://doi.org/10.1016/j.sapharm.2018.09.004

Saunders, D. R., Arnold, E., Seaman, K., Green, A., &Gullick, K. (2018). Graduate registered nurses’ reflections on implementing safety and quality improvement projects. Reflective Practice19(5), 678-689. https://doi.org/10.1080/14623943.2018.1538958

Tie, Y. C., Birks, M., & Francis, K. (2019). Playing the game: A grounded theory of the integration of international nurses. Collegian26(4), 470-476.https://doi.org/10.1016/j.colegn.2018.12.006

Toffoletto, M. C., de Oliveira, E. M., Andolhe, R., Barbosa, R. L., &Padilha, K. G. (2018).Comparison between patient severity and nursing workload before and after the occurrence of adverse events in elderly in critical care. Texto & Contexto - Enfermagem27(1), e3780016. https://dx.doi.org/10.1590/0104-070720180003780016

van Pelt, S., Massar, K., van der Eem, L., Shields-Zeeman, L., de Wit, J. B., &Ruiter, R. A. (2020). “If you don’t have enough equipment, you’re not going to provide quality services”: Healthcare workers’ perceptions on improving the quality of antenatal care in rural Tanzania. International Journal of Africa Nursing Sciences, 100232.https://doi.org/10.1016/j.ijans.2020.100232

Yoon, J. Y. (2018). Relationships among person-centered care, nursing home adjustment, and life satisfaction: A cross-sectional survey study. International Psychogeriatrics30(10), 1519-1530. https://doi.org/10.1017/S1041610218000194

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