5. Nursing Practices

a) Describe three main differences between historical and current nursing practice.

Answer: a) During pre-historic times, there were no written documents to validate the practice. The medical practice was a combination of miracles and medicine. Unhygienic conditions contribute to high mortality and morbidity. (Beevi, 2008)

Current nursing practice has changed since the 19^th century. Intervention is planned to achieve the desired outcome. The expected outcomes are projected clinical conditions that occur as a result of nursing activities. Nursing interventions are specific directives for nursing care to help the patient recover from illness to the expected outcome. Factors that are considered by the patient’s family and nurses are:

• knowledge, skills, and abilities of a child and family
• Cultural and religious background
• Access to resources or the needs of people
• Financial resources and
• Coping methods

If these factors are not met, then nursing care won’t be unique and won’t serve the needs of the clients. A nursing intervention should be selected based on direct observation and medical diagnosis.

b) Provide a brief description of the roles of the following professional bodies: AHPRA, ANMC, ANF, and the Royal College of Nursing.

b) AHPRA (Australian Health Practitioner Regulation Agency): supports the National Board for the protection of the public. They publish national registers of practitioners available to the public, manage registrations and renewals of health practitioners and students in Australia, have offices all across Australia where the public can complain against any doctor or student, and conduct investigations into any health-related issues.

ANMC (Australian Nursing and Midwifery Council) operates under National Accreditation Guidelines, develops accreditation guidelines and standards for midwifery and nursing programs, registers and endorses programs, accredits nursing institutes, assesses international midwives and nurses who want to study and practice in Australia, and develops, reviews, and frames policies on accreditation and skilled migration of nurses and midwives.

ANF (Australian Nursing Federation) is the union of nurses, midwives, and assistant nurses and one of the largest federations in Australia. Their core business is the political, industrial, and professional representation of nurses. They advocate for nurses, midwives, and assistant nurses if they face problems in the health system: underpaid, underfunded hospitals; not enough nurses and workload; insufficient nurses or midwives; insufficient beds; no time to spend with patients and with their families.

The Royal College of Nursing promotes nursing, health care facilities, shapes health care policies, and provides nursing courses.

2. a) Choose two competencies from the competency guidelines and explain your understanding of what they mean. You may use an example to reflect your understanding.
3. b) Explain what “scope of practice” means in relation to your nursing practice.
4. a) Laws and rulebooks support the minimum standard for practice. For instance, licensing laws defend patients from any kind of harm or injury, but professionals are not responsible as their skills promote quality.

Think proactive. Suppose that when a new competency is presented, nurses must examine the real and possible ethical inferences. For instance, some questions could be thought of regarding new technical competencies: What is the possible harm that this new technology could cause? What new skills are needed to achieve the competency level? What skills are tested?

1. b) The nursing practices act defines three categories of nurses: LPNs, RNs, and APNs. LPNs are licensed to practice work under the supervision of registered nurses. (Robert L. McCarthy, 2011) APNs are advanced practice nurses who require additional education above and beyond licensure as RNs. RN is the most advanced form of nursing, and the scope of practice is broader than LPN. RN nurses have the opportunity for advanced practice roles. (Clark, 2009)
2. Define and discuss the following:
3. a) Code of Conduct: The Codes and Guidelines provide some good management to nurses regarding their professional responsibilities, but sometimes they are ignored by employers or practitioners and are not relevant to the conduct of the employer.

The National Boards emphasize to employers the importance and significance of professional standards, codes, and guidelines in health services and in the practice of individual health consultants. The lawful status of professional standards and the codes and guidelines are developed to conform to national law. Such clarification can be found in Section 136 of the National Law, which charges penalties if the employer does not comply, or inspires a physician not to comply, with a professional standard, code, or guideline.

1. b) Code of Ethics (http://www.ahpra.gov.au/n.d.)
2. Nurses should provide quality nursing care for all people.
3. Nurses should have high self-esteem and kindness toward others.
4. Nurses should appreciate the diversity of societies.
5. Nurses should ensure the availability of quality nursing and health care for all individuals.
6. Nurses should maintain an informed decision-making process.
7. Nurses should nurture safety in the practice of nursing and health care.
8. Nurses shall ensure ethical supervision of evidence.
9. Nurses shall contribute to a socially, economically, and ecologically justifiable atmosphere endorsing fitness and health.
10. c) Professional boundaries: (http://www.ahpra.gov.au/, n.d.)
11. Care is optimized, and nurses must not engage in dual relationships with patients.
12. If dual relationships are unavoidable in therapeutic care, nurses must minimize the risks of any harm or injury.
13. Nurses must maintain professional relationships with patients and communicate with that person where necessary.
14. Nurses must consider the setting, community effects, and needs of the patient, as well as the type of care required to demarcate the boundaries.
15. Nurses must understand the complications of personal relationships if they develop and end professional relationships as the individual needs extra care and support.
16. Nurses must scrutinize boundary crossings, be aware of their implications, and not repeat crossings.
17. Nurses must pursue the advice and guidance of professional leaders, especially when they have trepidations concerning boundaries in therapeutic intervention.
18. Nurses must treat personal information acquired during professional practice as confidential and must not use that confidential information for any advantage.
19. Nurses must be judicious in their reasons for revealing private information. Self-disclosure should be limited to information that may have importance in providing medical care and only occur within the boundaries of a well-known health care relationship.
20. It shall be a priority for nurses to plan care in such a way as to meet the therapeutic and care requirements of individuals assigned to them.
21. Nurses shall not refuse care to a person as a reprimand and realize that an intention to inflict pain or anguish as a reciprocal reaction to the behavior of a patient in their care is inappropriate and unethical.
22. Nurses should analyze their own desires, conduct, principles, attitudes, and philosophies and be aware of their likely effect on therapeutic and skilled decision-making for patients in their care.
23. Nurses should be informed about the intrinsic inequity in patient care relations, being aware that forcing a patient’s acquiescence may be an abuse of power.
24. Nurses should be knowledgeable and have the aptitude to authenticate the therapeutic objective of their decisions and also consider the patient’s choices and reactions to them.
25. Nurses should be well versed about the capacity for individual uneasiness for both the person getting the care and themselves when care includes a personal contact of a private nature or an invasion of personal space and respond suitably.
26. Nurses should know that involvement in business dealings (other than in a contract for the delivery of amenities) and receiving anything other than ‘symbolic presents’ in professional associations with patients in their care may put undue strain on the professional relationship.
27. d) Professional Conduct: The Council The Council (22006) states nursing is practiced in a safe and compoetent environment.
28. Nursing must be practiced in accordance with professional standards and the health system.
29. Nursing must be practiced in accordance with the laws of nursing.
30. Nurses must respect the faith, belief, ethnicity, values, and dignity of people receiving care and treatment and of their colleagues.
31. Nurses must maintain the confidentiality of information received at the time of practice.
32. Nurses must provide exact and impartial information about health care and its products.
33. Nurses must support the health, well-being, and decisions of the people receiving care.
34. Nurses must cultivate and nurture the art of being the patients’ confidantes and must learn to respect and keep the secrets entrusted to them by the patient.
35. Nurses must also earn the faith of the community, thereby enhancing the trust that society puts in them.
36. Nurses must ensure that their practice strictly follows the code of ethics, encompassing their own moral responsibilities.
37. e) Decision-Making Framework:

The purpose of the DMF is to adopt constancy across authorities by:

• Recognizing principles for decision-making tools
• representing the application of philosophies and notions in the two professions

Occupations are controlled in the public interest. Regulation leads to public safety because those who are authorized to make decisions, have adequate professional knowledge and experience, and are competent enough to meet the requirements. Therefore, the use of national principles for evaluation of decision-making will lead to safety and quality practice in nursing.

1. f) Confidentiality: Nurses must treat personal information acquired during professional practice as confidential and must not use that confidential information for any advantage. Nurses must be judicious in their reasons for revealing private information. Self-disclosure should be limited to information that may have importance in providing medical care and should only occur within the boundaries of a well-known health care relationship.
2. Briefly discuss the following areas in relation to the Australian Health Care System: 1.

Structure (levels of government) and function

• Common Wealth takes responsibility for the management of the health and elderly care systems, its community funding, and the Australian people’s health system.
• State takes responsibility: States are accountable for planning, appointing, funding, local health regulation, and elderly care services.
• Joint Commonwealth-State Health Commission: This option involves the Commonwealth and the states working together to establish a third-party health expert to plan and command health services in the state. Commonwealth and state funds for health and elderly care are shared and assigned to the Health Commission.
• Renovate With this choice, the current Commonwealth and state health authorities are not changed.

-Funding issues The National Board provides funds for the Nursing and Midwifery Health Program Victoria (NMHPV), a self-governing organization health care program for nurses and midwives with disabilities in Victoria.

Government and non-government services The role of private hospitals is to provide care for community patients or to respond to tightening chances to deliver a wider choice of care.

Commonwealth funding—inhabited and some public elderly care, MBS, PBS, DVA, state grants, Indigenous PHC, 30% discount on health coverage

State-public infirmaries, community health, ambulances, public oral care services, accident coverage, and incapacity care.

Private sector/NGO- health coverage, accident coverage

(Eagar, 2008). There are enormous non-government organizations providing health care services, from large church-oriented infirmaries to indigenous infirmaries, for those with a particular complaint. Their parts are not altered by the choices but are more effective in appointing, and the clarity of funds will improve their chance to take part and contribute to local health providers concerning new care models. Better offering and agreement management have the potential to recover both competence and reaction to the care delivered by NGOs.

-Governing health care bodies, e.g., AHMAC

—Medicare (Eagar, 2008). The Australian health care system is supported by Medicare, which provides all medical and pharmaceutical benefits to Australians. As per the Commission’s terms of reference, Australia’s national Medicare system requires support. Medicare Australia acts as the deal agent for MBS and PBS services, along with any extra amount the Commonwealth may assign. Medicare Australia is the financier and settles claims on behalf of the states.

Alternative medicine (complimentary therapies): Alternative andComplementary Therapies delivers the most effective, proven, and practical information for assimilating alternative therapies and methods into private practice or hospital integrative medicine programs.

5.a) Discuss a health policy in relation to a current health issue relating to Aboriginal people.

1. b) Describe five health risk factors for aboriginal people.

Answer a) Mortality, morbidity, asthma, emotional or behavioral difficulties, and diabetes are the recent diseases Aboriginal people suffer from. In 2014–15, they have a budget of $920 million to be spent on health care programs for Aboriginal people. This includes Medicare and access to medicines through the Pharmaceutical Benefits Scheme (PBS). The Indigenous Australians’ Health Programme combined four Indigenous health fund disciplines: primary health care fund; child and maternal health events; Strong Futures in the Northern Territory (Health); and the Aboriginal and Torres Strait Islander Chronic Disease Fund.

6. Access the search website. Choose one employment opportunity for an EN. Explain the skills that your future employer might be searching for in your curriculum vitae (CV). Include the advertisement when submitting your assignment. If you were successful in getting the job, explain three ways you could show evidence of professional development.

The Role of an EN (Enrolled Nurse)

Aspen Medical is providing an excellent opportunity for a civilian-endorsed enrolled nurse (EEN) to join our medical care group. This is a temporary opening for the desired applicant, established at the Robertson Health Center in Darwin.

• The best number of patients, working environments, and times are comfortable.
• Attractive compensation, above prevailing market rates
• Excellent work setting
• Compassionate team situation

As an Aspen Medical-endorsed enrolled nurse, you will be accountable for supporting and sustaining the health of defense personnel. A person has to provide health care services to the public who have an interest in maintaining their fitness and health.

Eligibility Criteria

• A minimum of 2 years’ of full-time or equivalent experience as an EEN in a critical background
• Enrolled Nurse Certificate or Certificate IV in Health
• Present, unobstructed APHRA registered as an EEN
• The capability to meet ‘baseline’ safety screening needs

The reason for joining Aspen Medical

Aspen Medical has been delegated by Medibank Health Solutions to deliver base health care services to the ADF. Aspen Medical provides its team with good compensation and flexible working conditions. Full-time employees receive Professional Development (PD) support and brilliant leave prerogatives, including paid maternity, long service, career, and defense leave.

Professional Development of Nurses

(Deborah Dolan Hunt, 2014). Professional portfolios are different from academic portfolios. The structure and presentation of the portfolio differ according to preferences, experiences, educational background, and career goals. Some common guidelines are given below.

• Biographical information
• Educational qualification
• Experience and a brief description of previous jobs, roles, and responsibilities
• Professional qualification certificates (Casey & Egan, 2010, p. 547)

The professional portfolio must state your development as a professional nurse. Oermann (2002) defined a plan for professional development as follows:

• Complete self-learning needs assessment.
• Developing a plan to meet the learning needs of Step 1
• Implementing the plan
• Evaluation of the plan and validation of the completion of goals and objectives

Oermann (2002) stated that this nursing process involves assessment, planning, interference, evaluation, and review of the plans needed. This method helps in achieving commitment to professional development.

References

Beevi, 2008. Textbook of Paediatric Nursing. s.l. : Elsevier India.

Clark, C., 2009. Creative Nursing Leadership and Management. s.l. : Jones & Bartlett Learning.

Council, A. N. a. M., 2006. www.nursingmidwiferyboard.gov.au [Online]
Available at: http://www.nursingmidwiferyboard.gov.au/

Deborah Dolan Hunt, H., 2014. The Nurse Professional: Leveraging Your Education for Transition Into Practice. s.l.:Springer Publishing Company,.

Eagar, J. D. a. K., 2008. A paper commissioned by the National Health and Hospitals Reform Commission. s.l.:s.n.

http://www.ahpra.gov.au/Search.aspx?q=MEDICARE, n.d. http://www.ahpra.gov.au/Search.aspx?q=MEDICARE. [Online]
Available at: http://www.ahpra.gov.au/Search.aspx?q=MEDICARE

Robert L. McCarthy, K. W. S., K. S. P., 2011. Introduction to Health Care Delivery. s.l.: Jones & Bartlett Publishers.