• Internal Code :
  • Subject Code : NUR120
  • University : Charles Darwin University
  • Subject Name : Nursing

Registered Nurse Standards for Practice and Code of Conduct

Part A

1. Standards of Practice

Registered nurses are highly competent and are professionally strong enough to describe the standards of care to the patients. The main objective of a registered nurse is to maintain and direct safety and nursing practices that are clinically competent. There are seven well defined standards that are laid by the Nursing and Midwifery Board of Australia (NMBA) that are highly specific of the nursing profession with an aim of promoting and guiding the clinical practice. A registered nurse has to think beyond her scope of work and should engage in critical thinking and reasoning so that she would work independently and could make effective decisions for the betterment of the patient. They are supposed to maintain constructive relationships along with supporting the professional development.

Based on the given scenario wherein the registered nurse has to do a set of vital signs, standard of practice no. 4 needs to be applied that focuses on comprehensively conducting the assessments and in a systematic manner. This standard of practice ensures that the registered nurse should conduct all kinds of clinical assessment is a holistic manner and those should be culturally appropriate. The relevant data should be collected in a systematic manner with the use of wide range of verified technics of assessment in order to collect accurate clinical data for assessment so that the treatment plan can be developed in the most effective manner. The treatment planning would be based on these data and information and it would also help in enabling smooth partnership with other people and departments involved.

2. Standards of Practice

Ethical dilemma is quite common in nursing profession, but the registered nurse should be capable enough to take right type of decision depending on the criticality of the situation. The most important and the primary objective of a registered nurse is to provide the best quality care to the patient so that it can help in early recovery and good health (Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Cox, D., ... & Fisher, M. (2017). This can only be possible if a registered nurse performs her roles and responsibilities in the most effective manner.

In this case where the registered nurse could clearly locate a fluctuation in the blood pressure of the patient, she should have acted appropriately. Although she has notified the buddy nurse regarding the blood pressure going out of the normal range but the response, she got was neither ethical nor acceptable. Here standard practice no. 6 of the Registered nurse standards for practice should be applied that clearly signifies that the registered nurse needs to act in an appropriate manner so that she can provide safe, appropriate and highly responsive quality of nursing to the patient.

Therefore, when the buddy nurse did not do her job appropriately or ethically, the same should have been informed to the authorized individuals along with taking adequate steps that would help in bringing back the blood pressure of the patient to normal. Registered nurse standards for practice no. 6 ensures that the registered nurse should provide and delegate the nursling responsibilities in a qualitative manner and that should be highly ethical and goal oriented. It also provides scope and freedom to the registered nurses to practice the nursing within their own scope and should act in a responsive manner to supervise, promote and advice as per the authorized standards, policies, guidelines, legislation and regulations.

3. Standards of Practice

Maintaining professionalism along with working in an ethical manner is very important for a registered nurse. Standard of practice no. 2 of the Registered nurse standards focuses on the fact that the registered nurse should engage in the professional and therapeutic relationships to add value to the treatment process. They should show generosity and respect for developing and maintaining professional relationships along with supporting mutual trust. This signifies that the registered nurses are supposed to establish, sustains and conclude relationships above the boundaries of personal and professional context. They should have the ability and interest to connect with patients and try to gain their trust so that they could be able to open up about their concerns and issues so that the nursing plans could be developed accordingly.

In this situation, the patients was showing interest to build a relationship which was a good start and thus it is the responsibility of the registered nurse to develop and maintain the trust so that a professional and personal relationship could be built which would help in supporting the care and treatment plan (Wilson, N. J., Lewis, P., O’Reilly, K., Wiese, M., Lin, Z., Devine, L., ... & Goddard, L. (2019). The registered nurse should recognize the experiences of the life of the patients along with the cultural background so that it could support in sustaining the trust and effective communication that would help in optimizing the health-related decisions. Nursing profession is a collaborative process and it should support person-entered care that could be only possible through building relationships and effective communication. All personal activities and that of the other health professionals should be under the code of nursing conduct.

4. Standards of Practice

Criticality in the condition of patient can arise at any point of time but the registered nurse should be capable and skilled enough to take appropriate decisions based on the versality of the situation and condition of the patient so that it could add the best to the patient care. A registered nurse has to think beyond her scope of work and should engage in critical thinking and reasoning so that she would work independently and could make effective decisions for the betterment of the patient. They are supposed to maintain constructive relationships along with supporting the professional development. The registered nurse should hold the ability not just to collect and analyse the patient assessment but should change the nursing plan whenever required for the betterment of the patient.

In this case, there was a sudden change in the patient condition. He was supposed to be discharged tomorrow but now based on the clinical assessments, he was taken to the ICU. Here a combination of standard of practice of the Registered nurse standards can be applied i.e. standard of practice no. 1 and no. 7. Standard of practice no. 1 emphasizes on the ability of critical thinking and analysis power of the nursing profession while standard of practice no. 7 focuses on evaluating the patient outcome to inform or support the nursing practice. The care should be based on patient centric, but the nursing plan should be based on the evidence-based practice. This will help in meeting the competency of the registered nurses along with providing the best quality healthcare to the patients.

Part B

Code of conduct is very important in the healthcare profession and the registered nurses needs to follow the defined code of conduct which is consistent with the national law. This law was defined by the Australian Health Practitioner Regulation Agency which is responsible for implementing the national scheme or the national Registration and Accreditation scheme across Australia for ensuring that the healthcare professionals acts in a regulated and ethical manner (Wilson, N. J., Lewis, P., O’Reilly, K., Wiese, M., Lin, Z., Devine, L., ... & Goddard, L. (2019). Everyone has their one values and beliefs and the same needs to be respected. Code of conduct values these beliefs along with respect people and are obliged to perform their duties with care and dedication.

In nursing profession, duty of care is highly values and is referred to be one of the codes of conduct where obligations are placed on people for acting towards others in an ethical manner in accordance with the established standards. This is critical for voiding any kind of omissions or acts that could lead to injury or harming others (Wilson, N. J., Lewis, P., O’Reilly, K., Wiese, M., Lin, Z., Devine, L., ... & Goddard, L. (2019). The code of conduct also helps in supporting the nursing profession with added knowledge, technical expertise, decision making process, developing leadership attributes, adhereing to the clinical governance, taking up advisory roles, managing and taking part in the administration along with regulating development of policies.

Code of conduct for nurses are set in align with the legal requirements along with the professional behaviour and conducting expectation for all the nursing professionals under the nursing practice (Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Cox, D., ... & Fisher, M. (2017). These Code of conduct for nurses helps in guiding the nurses as per the defined responsibilities in an ethical and legal manner so that they could be able to render their duties in an effective manner. Some of the importance of using the code of conduct in the nursing profession include,

  • Protecting the behaviour, roles and responsibilities of the nurses and directing them in an ethical manner

  • It will help in enhancing the culture and professionalism of nursing profession and aligning it with the objectives of the Australian healthcare system for supporting health and well-being of its people (Wilson, N. J., Lewis, P., O’Reilly, K., Wiese, M., Lin, Z., Devine, L., ... & Goddard, L. (2019)

  • Help the nurses in delivering safe clinical care practice and fulfilling their roles as nursing professions

  • Helps in safeguarding the rights and values of the patients to get good care without compromising the quality

Nursing code of conduct includes four domains and seven principles which are guided by ethical and legal values. Those include,

Domain – Practise legally

Principle 1. Legal compliance

Domain – Practise safely, effectively and collaboratively

Principle 2. Person-centred practice

Principle 3. Cultural practice and respectful relationships

Domain – Act with professional integrity

Principle 4. Professional behaviour

Principle 5. Teaching, supervising and assessing

Principle 6. Research in health

Domain – Promote health and wellbeing

Principle 7. Health and wellbeing

Notifiable conduct is a part of the code of conduct which demands for notification where there is any act of intoxication either by drugs or alcohol or any kind of engagement in sexual misconduct. It also includes any action that would cause social or public harm or practice of impairment (Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Cox, D., ... & Fisher, M. (2017). Four mandatory reporting requirements as per the Australian Health Practitioner Regulation Agency about the registered health practitioner are, intoxication, impairment, not following the established professional standards and any kind of sexual misconduct. This encourage to notify the breach of code of conduct of the buddy nurse who was under the influence of drugs during commencing duty.

The most important and the primary objective of a registered nurse is to provide the best quality care to the patient so that it can help in early recovery and good health. This can only be possible if a registered nurse performs her roles and responsibilities in the most effective manner (Wilson, N. J., Lewis, P., O’Reilly, K., Wiese, M., Lin, Z., Devine, L., ... & Goddard, L. (2019). The registered nurse should recognize the experiences of the life of the patients along with the cultural background so that it could support in sustaining the trust and effective communication that would help in optimizing the health-related decisions. Nursing profession is a collaborative process and it should support person-entered care that could be only possible through building relationships and effective communication.

References

Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Cox, D., ... & Fisher, M. (2017). Standards for practice for registered nurses in Australia. Collegian, 24(3), 255-266.

Harrison, H., Birks, M., Franklin, R., & Mills, J. (2019). An assessment continuum: How healthcare professionals define and determine practice readiness of newly graduated registered nurses. Collegian.

Gower, S., Duggan, R., Dantas, J. A., & Boldy, D. (2019). One year on: Cultural competence of Australian nursing students following international service-learning. Journal of Nursing Education, 58(1), 17-26.

McKenna, L., Wood, P., Williams, A., O’Connor, M., Moss, C., Griffiths, D., ... & Cross, W. (2019). Scope of practice and workforce issues confronting Australian Enrolled Nurses: A qualitative analysis. Collegian, 26(1), 80-85.

Ossenberg, C., Mitchell, M., & Henderson, A. (2019). Adoption of new practice standards in nursing: Revalidation of a tool to measure performance using the Australian registered nurse standards for practice. Collegian.

Pryor, W., Newar, P., Retis, C., & Urseau, I. (2019). Compliance with standards of practice for health-related rehabilitation in low and middle-income settings: development and implementation of a novel scoring method. Disability and rehabilitation, 41(19), 2264-2271.

Takashima, M., Burmeister, E., Ossenberg, C., & Henderson, A. (2019). Assessment of the clinical performance of nursing students in the workplace: Exploring the role of benchmarking using the Australian Nursing Standards Assessment Tool (ANSAT). Collegian, 26(4), 502-506.

Thompson, M. J., Watt, M. E., & Ostaszkiewicz, J. (2017). Dr Bart O'Brien (Continence Nurse Adviser) with the help of flagrant from Australian Nurses for Continence.

Wilson, N. J., Lewis, P., O’Reilly, K., Wiese, M., Lin, Z., Devine, L., ... & Goddard, L. (2019). Reframing the role, identity and standards for practice for registered nurses working in the specialty area of intellectual and developmental disability in Australia: The NDIS and beyond. Collegian, 26(1), 132-139.

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