Education of Enrolled Nurses in Western Australia - Research Paper Example

 Table of Content 1.0 Introduction 1 1.2 Education of Enrolled Nurses 3 1.3 Objectives and Policy statement 4 1.3.1 Objectives; 5 Identify the proficiency of enrolled nurses and guarantee that they are manageable among similar health care facilities. Guarantees that the nursing board in Western Australia executes and enforces decision making structure in all public health care services. Eliminate artificial restrictions positioned on the scope of practice of ENs 5 1.3.2 Policy Statement 5 1.4 Roles and responsibility 5 1.4.1 Work force for Enrolled nurses 5 1.4.2 Roles 6 1.5 Standards for Enrolled Nurses 10 1.6 Conclusion  12 1.7 References 12 1.0 Introduction Western Australia is one of the states in the Federation of Australia that comprises of six states and two territories. Western Australia has a populace of 2.02 million.Generrally; in Western Australia health care encompasses diverse arrangements including planning financial aid and delivery of quality health care services to all its residents in both private and public hospitals. In addition it is the leading country in health research and health care are provided at all levels such as primary preventative, secondary and tertiary, Armstrong, F. (2001). Public Medicare which covers all the common Australia is sustained by the NHIS (National Health Insurance Scheme) whereas private health care is supported by individuals paying for treatment or private public health insurance which is approximately preferred by a third of Australians. According to the Nursing board in Western Australia an enrolled nurse is a medical practitioner capable of practicing nursing in Division 2 under the supervision of a professional who is registered in Division 1. In Australia there are two main levels of nursing namely, the enrolled nurse (EN) and the registered nurse (RN).A registered nurse is a first division nurse who has attained a degree or higher qualification in a university and are allowed to practice nursing without guidance whereas an enrolled nurse is a second level nurse providing his or her service under the supervision of RN. This group of nurses in Australia usually has to accomplish an advanced certificate or associate diploma. In 1992 Western Australia established an ANMC (Australian Nursing and Midwifery Council) in collaboration with NMRAs (Nursing and Midwifery regulatory authorities) and the ANMC (Australian National Midwifery Council is the body responsible for the nursing care instituted by the Australian nurse regulatory authorities with the objective of developing national concepts to assist enrolled nurses (EN) to ensure they deliver quality services, comply to the set out code of conducts and ethics. These concepts have been regularly reviewed and amended by experts in Medicare to reflect the shifting roles of the EN within modern health sector, Armstrong, F. (2001). Primarily the EN work closely under the direction and command of registered nurses, who in turn are normalized by the individual nurse registration authorities’ through the adherence of educational system and dogmatic standards; moreover, the Nursing council of Australia has launched standards and guidelines for enrolled nurses. Currently the council is conducting a study on the roles and function of Enrolled Nurses in the changing global village. In Western Australia the nursing board launched scope of nursing practice. The scope involved well informed decision making frame to assist in the consultation with other nursing experts to offer guidance for individual ENs, nursing profession and other health providers. As stipulated by the nursing board the structure should be applied in concurrence with tools and standards including competency, policies convention and legislations. Execution of the decision making structure will help the enrolled nurses and employers to agree on nursing practice such as advancement and scope, Armstrong, F. (2001). There exists an independent body for the Enrolled Nurses popularly called the ENPA (Enrolled Nursing Professional Association) established in 1994 to hunt for their professional, career and educational aspirations. Today, ENPA stands out as an organization that aims at diffusing appropriate topics and seeking out to accomplish more professional acknowledgement of proficiency, propensity and learning through review methods. Furthermore, the organization ensures there is an open communication among the nurses in Australia, Armstrong, F. (2001). 1.2 Education of Enrolled Nurses In Australia, enrolled nursing has to undergo eighteen month training in TAFE. Majority of ENs go for further education in university to attain the status if the registered nurses and a few remain in the both private and public hospitals, and nursing homes. A trainee ENs (TEN) becomes employed only after getting experience from the hospital. As a result of changes in the recent years the government of Australia acknowledges the duties of ENs and they are given support to further their education by applying for post graduate education in areas such as mental health and pediatrics. Customarily, in Western Australia, the education and training of EN has been the duty by hospitals approved by the nurse registration authorities. In the 1990s training and education of EN was the responsibility of VET (Vocational Education and Training) which comprised of government funded Technical and further education (TAFE).World wide, Australia is the only state that provides EN education through VET, Lockwood, A. & Maguire, F. (2000). Possibly the persistent shortage of nurses is the main reason that the field of nursing is making several distinction in degree process. Simultaneous shortage of nurses creates problems to any county’s health care needs. In most cases nurse shortage is attributed to slow growth in the number of enrolled nurses, enrollment rate in nursing schools is slow to meet the demand of the increase in population, inadequate faculties and frustrations nurses go through that make them to leave their professions. Regardless of recommendations by the nursing policy and planning unit to transfer ENs in VET, in Victoria Enrolled Nurses education and training is hospital oriented whereas in the northern territory of Australia there was no enrolled nurse education. It is always essential that ENs engage in areas that they are competent in. Competency can be attained either formally or informally. The ANMC and the Nurses Board of Western Australia governs the competency and also allows ENs to be registered. Policies in health care also guide the provisions for competency among the ENs and further allows for the negotiations for nursing practice including previous competencies, and advancement of individual ENs scale of practice. The previous competency of ENs should be acknowledged. It is eminent that nursing proficiency is a permutation of talent, knowledge, attitudes, principles, and aptitude that fortify efficient and valuable performance in a professional manner. For that reason enrolled nursing proficiency gained in a given health care facility should be convenient to related health care facility. 1.3 Objectives and Policy statement The primary objective and policy statement in enrolled nursing is to ensure the following. 1.3.1 Objectives; Identify the proficiency of enrolled nurses and guarantee that they are manageable among similar health care facilities. Guarantees that the nursing board in Western Australia executes and enforces decision making structure in all public health care services. Eliminate artificial restrictions positioned on the scope of practice of ENs 1.3.2 Policy Statement All the health care facilities and providers to adopt scope of nursing practice as stipulated by the Western Australia nursing. All health services to enforce decision making practice for ENs. Execution of the framework helps in the eradication of artificial obstructions that hinder the full advancement of ENs with the framework of legal regulatory margins. Employers to acknowledge proficiency gained by enrolled nurses either through formal or informal education, Lockwood, A. & Maguire, F. (2000). Enrolled nurses to have knowledge of the essential checks to manage correct medication including the right dosage, indicators among others. An EN may accept to administer medication according to education level, period of practice and of all supervision. 1.4 Roles and responsibility 1.4.1 Work force for Enrolled nurses Enrolled nurses are charged with the duty of ensuring and maintaining professionalism that entails competence, professional advancement and learning portfolios. According to the labor force study of 2001 approximately 22,500 out of 248,500 people which translates to 9.1 percent of enrolled nurses were employed, Department of health (2005).For instance, in Western Australia ENs were allowed to administer medication for schedules 4 and 8 however, under the supervision of the registered nurses(RNs). Across various states in Australia ENs workforce vary, like in Queensland, Southern Australia and Western Australia the number of enrolled nurses is higher compared to other states. However, in the recent years the number has been reducing due to the reforms in the nursing sector, hardships in the remote areas of South Australia and closure of nursing schools in the state of Victoria, Lockwood, A. & Maguire, F. (2000). 1.4.2 Roles As a result of the increased pressure in health care demands, the redeployment of health care funding and deficiency in nursing workforce accessibility and knowledge intermingle. In Australia nurses form the keystone of health care provision. In the recent years the roles of enrolled nurses has greatly improved due to the reduced number of registered nurses in Australian public health care system, Armstrong, F. (2001). In 2004, a prescription approval certificate was established, allowing EN's to manage some oral prescription. The certification also allows the enrolled nurses to administer IV (intravenous), IVT (intravenous therapy), Blood transfusion, IM (Intramuscular) and SC (subcutaneous injections). In addition, Enrolled Nurses can also minor check-ups and give S4D and schedule 8 prescriptions under the directions of the registered nurses. The Enrolled Nurses employed in public health facilities are allowed to carry out ECG’s, assemble specimens from the pathology and regularly take a patient’s consignment with either indirect or direct supervision of a registered nurse depending on the state or territory of their service with Australia, Lockwood, A. & Maguire, F. (2000). Enrolled nurses also take part in the decisive and philosophical thinking skills that contribute to the decision making, report health changes in respective nursing territories, health and health care intrusions.Morerover, EN also form part of health care team to campaign for and allow the participation of individuals and families in health care planning and evaluation, Lockwood, A. & Maguire, F. (2000). Enrolled nurses are highly skilled health care experts who have the ability to substitute the responsibilities that are met for a general practitioner. EN can offer high quality health care services and generally they have a significant on the overall scope of practice in nursing. This group of medical practitioners assists in the time management and reduces costs in nursing sector. Integrating ENs in teams can greatly improve patient outcomes. By the fact that EN is proficient and able to provide an array of duties they are not allowed carrying out health services solely because these would be considered as working outside the scope of practice, Department of health (2005). In Western Australia, ENs assists the General Practitioner in the delivery of medical assistance to their patients. In addition, they should be registered by the nursing board, be well conversant with the nursing community, able to visit patients in their own homes and above all conversant with the nurses’ code of conduct. However, a general practitioner cannot manage or direct the enrolled nurses. But the registered nurse should come up with guidelines and policies to supervise and direct the ENs. The policies should entail how supervision should transpire, supporting of the ENs system and communication between the registered nurses and enrolled nurses. Therefore, all enrolled nurses have the duty of continuous improvement in sustain their knowledge and skills base to perform their general roles, Nurses Board of Western Australia (2004). Carry out their duties to ensure the safety of patients by identifying and reporting of any dangers including; clarifying harmful situations in the stipulation of health to reduce dangers on self and on others; seek for approval from individuals and families before diagnosing them; in the case of precarious incidents during practice, enrolled nurses are supposed to report immediately to the registered nurses and in most cases look for ways to avoid their re-occurrence, Armstrong, F. (2001). In fact, enrolled nurses are not only to communicate efficiently with patients and other health care professionals; they also should have extensive know-how as care givers, designer, administrator and coordinator of health care. Such duties require planning and incorporating treatment for patients as they obtain care across various settings. As such, an enrolled nurse can incorporate all the duties efficiently. Enrolled nursing should also carry out nursing practice in an ethical manner. This will ensure that all the enrolled nurses abide to the stipulated codes of conduct in all the responsibilities they undertake, Nurses Board of Western Australia (2004) Unlike the registered nurses, the enrolled nurse is geared up to perform in all health care settings such as critical care, outpatient, public health and mental health. Consequently, an enrolled nurse is well-qualified to provide and deliver health care services in private homes, outpatient centers and other health centers, even in businesses such as book publishers, pharmaceutical firms, insurance companies and law firms where their demand is high, Lockwood, A. & Maguire, F. (2000). Precisely gather information related to the health and practical status of individuals patients .The enrolled nurses are required to use a range of the available technologies in health services to precisely gather the patients health history in addition, their health records should also be kept securely in accordance with the hospital policies and confidentiality of the patients, Lockwood, A. & Maguire, F. (2000). In collaboration with the registered nurses and the patients the enrolled nurses should be able to determine the expected patients’ results after diagnosis and participate in the launch of the patient recovery plans. Take part in the assessment of the registered nurses by collecting data of individual patient reaction to certain medication and preparation of health care plans under the guidance of the Registered nurse and even participate in the evaluation of those plans. Enrolled nurses also put into action nursing care to accomplish the identified goals and objectives within the scope of nursing practice. In line with this, they also attend to urgent health care needs, encourage independence and identify the duties of other members of the health teams, Armstrong, F. (2001). They are also charged with the responsibility of reporting changes in health sector of individuals to registered nurses. In accordance to this the ENs are also in charge of scrutinizing adjustments in nursing scope, and document appropriate information to the Registered nurses regarding various patients, Nurses Board of Western Australia (2004). Enrolled nurses have the duty of ensuring open communication and precise reporting. The ENs is responsible to ensure that information conveyed when in duty should be accurate and done on time in accordance with the health policies, elucidate written orders for nursing practice with the registered nurse when ambiguous and, documents nursing scope as requested by their area of nursing or practice, Lockwood, A. & Maguire, F. (2000). They also participate in promotion of security, personal safety and integrity. The Enrolled Nurses should perform their duties to improve the safety of all patients always, clarify the prospective threats within the environs of the health facilities within their area of operations, act in their own level to ensure proficiency in services delivered and conform to the hospital policies to ensure security, Lockwood, A. & Maguire, F. (2000). Act aptly to ensure and encourage self esteem, dignity and integrity among individual patients. The enrolled nurses are required by the nursing policy to respect the privacy, community milieu and veracity of their patients. Institute and sustain mutual interaction with various members of the health teams through provision of assistance to one another and promote positive working relationship amongst each other. Also they have to provide essential information to help in the overall decision making within the nursing practice, Nurses Board of Western Australia (2004). In nut shell, the Western Australia nurse board that clearly stipulates the roles of the ENs. It has formulated that: An enrolled nurse should not be directed or supervised by the general practitioner. Enrolled nurses should be supervised by the registered nurses to ensure proficiency and quality health care is provided to the patients. When the enrolled nurse is on duty the registered nurse, in charge of him or her should be reachable. In the course of duty the EN is responsible for all the actions, standards and policies put in place, Nurses, Board of Western Australia (2004). 1.5 Standards for Enrolled Nurses There have been increased demands in health care provisions. In response to these, adjustments in policies have been made in health sector that call for approaches in the development of community health care services. Health care providers have been prompted by the need for understanding the social framework of illness, as such; health care has been preconceived to be culturally insightful in the sense that services are available to those in need, Lockwood, A. & Maguire, F. (2000). These are the proficiency standards that are useful in determining the performance of nurses in Australia. The guidelines provide structures for evaluating EN competence and nurses involved in certified conduct matters,  Lockwood, A. & Maguire, F. (2000). 1.5.1 Some of these standards include: All the Enrolled Nurses should perform their duties in harmony with the health policies, legislations and regulations. This standard exhibit that all the EN should comprehend knowledge of legislation and common law. Recognize that all Enrolled Nurses conform to the health care policies and regulations. Illustrates the common law necessities in enrolled nursing practice. The standards also advocates for enrolled nurses to have knowledge of hospital policy which entails: classify policies and bureaucratic guiding principles impacting on enrolled nursing practice; offer nursing care in accordance with the hospital policies and guidelines and lastly categorize hospital policies and measures pertinent to other health experts who work in partnership enrolled nurses, Nurses Board of Western Australia (2004). 1.6 Conclusion  It is evident that the nursing fraternity is going thorough a paradigm shift. This is also true about the Enrolled Nurses in addition to the wide ranging nursing curriculum. In this case it could appear embryonic to erect a vivid conclusion regarding the tremendous changes that are being witnessed in Australia especially at Perth. Conversely, a comprehensive reprisal indicates that much more needs to be done than meet the eye. The leadership should play a monumental role in instituting health reforms in bid to meeting the needs of the clientele. Hands on experiential line of attack should be emphasized in lines of duty, where competency is employed as the specifications through which nurses are evaluated and when the professional ethics are suspect. Nursing informatics replica is a prerequisite in our contemporary society and should therefore be entrenched in the nursing curriculum. In conclusion the guiding principles should be harmonized by the ruling elite to accommodate all the variables necessary in keeping the nursing domain upbeat, Armstrong, F. (2001). 1.7 References Department of health (2005) scope of enrolled Nursing practice policy including: Recognition of enrolled nurse Competencies, Western Australia. Nurses Board of Western Australia (2004). Scope of Nursing Practice Decision-Making Framework. Learning Guide.Perth, Australia. Armstrong, F. (2001). Expanding the role: Nurses in general practice. Australian Nursing Journal, 9, 6, 28-30. Lockwood, A. & Maguire, F. (2000). General practitioners and Nurses collaborating in general practice, Fremantle Regional Division of General Practice, Australian Journal of Primary Health, 6, 2, 19-29.   Read More