Distinguish the roles and responsibilities of a nurse in the selected specialty practice area. [LO 1.]
In this module we will explore the role of the specialist nurse, including identifying the special skill set of the specialist nurse in your elective area. We will identify some of the physical and emotional safety issues related to the specialty and determine some strategies you can use to keep yourself safe. We will conclude the module with examining the legal aspects associated with the specialty, both in terms of your responsibilities and the responsibilities of the employer.
In Australia specialty nursing practice is a post graduate qualification. As registered Nurses you can work in any area of nursing, so what defines specialty practice? What is the difference between a nurse practitioner and an advanced practice nurse as opposed to someone who has worked in same clinical area for 10yrs or someone who has a postgraduate certificate or Diploma in specialty area.
Roles and Responsibility
The roles and the responsibility (scope of practice) of the registered nurse are defined by the Nursing & Midwifery Board of Australia (NMBA) in consultation with industry and other governing nursing bodies. The NNMBA also have definitions pertaining to nurse practitioners and advanced practice nurses.
The following will help you establish a basis for your reflection and enable you to complete the activity
Shields (2013) discusses the role of the nurse in a reflective personal essay that makes for interesting reading on how nursing is viewed and where Australian nursing fits in the global scene. It makes for a good introduction to the elective and to the module. Please read this article: Shields, L. (2013). A personal essay on the role of the nurse. Contemporary Nurse: A Journal for the Australian Nursing Profession, 43(2), 213-218
Having read the above articles it is time to explore what you know and understand about the role of the specialty nurse within your clinical practice area. consider what you already know is relation to the NMBA standards of practice for registered nurses. If all registered nurses need to meet these standards then what more is expected of someone with specialty experience?
To explore the role of the specialist nurse in the area of your elected specialty:
• Find the job description for a clinical nurse in your specialty area and read it.
• Identify the characteristics of the role that is beyond the generic description of the role of a registered nurse, that is, identify what makes the person a specialist in the area.
• Speak to one of the clinical nurses and ask him/her how they acquired the knowledge and skills that makes a specialist in the area. You might ask them about what facilitators and barriers they dealt with in the course of developing their specialty knowledge.
Write down some key messages you learned from these conversations.
Physical and emotional safety
Staying safe physically is important and discussed frequently. Nurses are very aware of issues such as manual handling competencies and workplace health and safety issues, but perhaps not as aware of emotional safety issues. We will explore both in this section, but place it in the local context, by examining the environment you are working in.
To get you thinking, here is a link to a book chapter on Personal Safety for Nurses (Trinkoff et al., 2008), in Hughes(2008) Patient Safety and Quality: an Evidence-Based Handbook for Nurses, AHPRO publication from the U.S. Department of Health and Human Services, on safety. Admittedly it is from an American perspective, but useful nonetheless,:
The next reading is an systematic review looking at stress in the Australian nursing workforce. Lim, J., Bogossian, F., & Ahern, K. (2010). Stress and coping in Australian nurses: a systematic review. International Nursing Review, 57(1), 22-31. doi:10.1111/j.1466-7657.2009.00765.x
As a way of exploring safety issues in your specialty area:
• Take some time to talk to the staff in your chosen specialty and ask them what safety issue, whether physical or emotional, concerns them the most.
• Ask them to identify some of the stressors in their current environment
• Find one primary research article that examines this issue, read it and document a brief summary of the findings.
In your summary mention one strategy identified from your reading that will help you to keep yourself safe from this risk.
As you will be well aware by now, nursing is subject to a number of legal and ethical imperatives. We operate under a nursing code of conduct and a specific act of parliament. These codes and laws are designed to protect patients and clients, but also nurses. The profession of the nurse is protected by law, and the title of nurse cannot be used without proper qualification and registration by an accredited authority.
But nurses also operate under other legal requirements: mandatory reporting of suspected child or elder abuse.
Here is a link to the mandatory reporting requirements for suspected child abuse in the different states and as you can see it is not consistent across states either. http://www.aifs.gov.au/cfca/pubs/factsheets/a141787/
And here is another link to an article exploring issues of financial abuse of older adults in residential aged care.
Tilse, C., & Wilson, J. (2013). Recognising and responding to financial abuse in residential aged care. The Journal of Adult Protection, 15(3), 141-152. doi:http://dx.doi.org/10.1108/JAP-11-2012-0025
There may be specific legal obligations associated with your specialty elective.
• Talk to the senior staff (unit manager or clinical nurses) about legal obligations specifically related to your chosen specialty. It may not necessarily be mandatory reporting issues, but be related to other issues. Areas to explore may be confidentiality issues when a person is cognitively impaired or underage, has a positive HIV status and is sexually active, and so on. For this section you can think outside the square about legalities of what nurses can and cannot do.
Identify one aspect of your legal obligations related to your specialty and write a short paragraph on how you would ensure you honour your legal obligations while working in this area.
Module one looked at the specific rights and responsibilities of the registered nurse in a specialty clinical area, including from the perspective of keeping the nurse and her/his patients/clients physically and emotionally safe. It also raised the issue of legal responsibilities and identified issues specific to the specialty area
For your assessment: write a 350 word paragraph on an issue of safety or of legal responsibility that you explored in some depth, ensuring it is specifically related to the specialty area.
Online Module Two
Promote the rights of clients and carers and their role in treamtent planning and recovery [LO6]
Herring (2007) asks this question: ‘where are the carers in healthcare law and ethics?’ This is a thought provoking question. Herring makes the point that the role of carers is often devalued and their opinion is not considered, because our healthcare is too focused on the individual only. Modern healthcare promotes partnerships with patient/clients and their carers, encouraging them to take responsibility for their health. The question for us as nurses, therefore, is: ‘how do we support that partnership?’
Activities and Readings
‘Where are the carers in the healthcare law and ethics’. It is important to understand that while the holistic approach to health care is preferred it is hard to balance the rights of all parties. What is the nurse’s role in ensuring carers and patients/clients have a say and that all opinions are respected. Sharing of information is fundamental to this consideration. The carers play an important role in providing information to health care professionals but do they have any rights to be consider in the decision making of care if there is no legal directive. The patient/client has rights but do the carers have rights as well. Further to this ethical theorie are often at the foundation of nurse’s approach to care. Ethics of Care theory claims that moral agents (carers, clients, health care professionals and institutions) are not separate entities and that the application of universal ethics is not in appropriate. This theory is based on consensus ethics which incorporates the views of all involved in care (Freegard & Isted, 2012).
Read the following articles as a starting point, there are many similar articles out there that you can source for further reading. It might be good idea to bring out the ethics text book again and revise the ethical theories related to this matter. Once you have completed the readings undertake the activities to find information on how the institution you are working views these issues, then complete the component of the assessment task.
Herring, J. (2007). Where are the carers in healthcare law and ethics? Legal Studies, 27(1), 51-73. doi: 10.1111/j.1748-121X.2006.00037.x
Gold, M., Philip, J., McIver, S., & Komesaroff, P. A. (2009). Between a rock and a hard place: exploring the conflict between respecting the privacy of patients and informing their carers. Internal Medicine Journal, 39(9), 582-587. doi:10.1111/j.1445-5994.2009.02020.x
Most health care organisations have a patient charter or similar document that is given to patients or clients in the care of the organisation, to explain their rights.
• Find this document for your specialty area and read it.
• Consider, who is it aimed at and does it include the rights of the carers as well?
• Is the organisational charter proscriptive in nature allowing no room for flexibility based on ethical considerations
It would also be worth finding out if the health care organisation has specific policies to cover the rights of patients/clients and their carers.
• Go to the organisation’s policies and procedures manual or web page, and find out what the relevant policies are.
• Are there policy for each party or just a general policy that is inclusive, again is there flexibility in the policy
Jot down some answers to these points as they will assist you in completing the assessment task 3 component for this module
Module two looks specifically at the rights of clients and in more depth the rights of their carers in the process of treatment and recovery. It raises some questions about how the nursing profession views and deals with the rights of the carers and their need for information, particularly in the context of patients/clients who may lack insight in their care needs.
For your assessment: write a paragraph of 400 words on your understanding of the dilemma of providing information to carers while considering the confidentiality concerns relating to the patient/client. Don’t forget to consider the ethical implications in your consideration of the issues.
Online Module Three
Reflect on the personal perceptions and meaning of health, illness, dying and death as appropriate in the specialty practice area. [LO7]
The perspectives on and understanding of health, illness, dying and the experience of someone’s death is a very personal matter and the meaning a persona ascribes to it varies from person to person. As nurses it is important for us to understand that different people view these concepts and experiences in a variety of ways, and some of those ways may surprise or even dismay us.
Readings and Activities
For this module you are asked to explore some of the writings in the public domain on how people have made meaning of their health related issues.
Exploring how people perceive a variety of issues in health, illness and dying may help us make meaning of it, both in terms of our own views on these concepts, and in terms of how the people in our care or people related to those in our care, may respond to alterations in health and experience illness.
Reflection is not a new concept, the ancient Greek philosopher Plato insisted that reflection and ultimately change was important component of our humanity. Reflection is not an artificial technique it is inherently human and reflection and action are the impetus for change and personal improvement (Daly, Speedy & Jackson, 2014). This being said in order to reflect fully we must know ourselves well, our drive, ambition and prejudices if we are going to understand others fully.
Here are some examples to get you started.
The following article relates to informal carer, while the article is based in Europe there is relevance to Australian Health care system with increasing number of community and home services
Plank, A., Mazzoni, V., & Cavada, L. (2012). Becoming a caregiver: new family carers’ experience during the transition from hospital to home. Journal Of Clinical Nursing, 21(13/14), 2072-2082. doi:10.1111/j.1365-2702.2011.04025.x
Find three articles from magazines, journals, blogs, online postings (most numerous), where the person writes about the meaning an illness has had for them. Preferably this will be from your area of specialty practice however this may prove difficult for some specialties in this case pick a specialty area that interests you where there is information available. Choose one article each from the following perspectives or points of view.
• From the perspective of the person being cared for
• From the perspective of the person closest to them (partner, parent, child, etc)
• From the perspective of a health professional caring for such a person
Choose one of your readings and write a reflection on how that has changed your perspective or given you some insight into the meaning illness has for a particular person.
When writing your reflection make sure you consider your own perceptions, morals and ethics.
Module three gave you the opportunity to explore how the various people we interact with in the health care environment make meaning of their illness and of their situation. It has also given you the opportunity to reflect on how you relate to that and to make meaning of your own experiences.
For your assessment:
Review and refine your reflection from the activity for this module to a 350 word paragraph.
350 word paragraph: Issue of safety or of legal responsibility specifically on a surgical ward
400 word paragraph: understanding of the dilemma of providing information to carers while considering the confidentiality concerns relating to the patient/client. Consider ethical implications in consideration of the issues.
Reflection from the activity. Refer to Online module three above.
Reference: years 2010 and above only. 1-2 references per paragraph
Reference list in APA format