Professional Nursing Practice Issues - Essay Example

Running Head Professional Practice Issues Nursing Professional Practice Issues Nursing Recent years, there is lack of professional nursing staff in Australia. Unregulated care providers 'replace' professional nurses performing formal duties and secondary care fro wide number of patients. In considering the limits of authority, an obvious limitation is that action must conform with the policies and programs of healthcare. In many cases, specific limitations are made (e.g. not to take on more staff without the approval of a superior). Registered nurses pay a special attention to delegation and collaboration with unregulated care providers and their role in healthcare. In general, delegation is the process whereby an individual (nurse) transfers to some other individual (unregulated care providers) the duty of carrying out some particular action and, at the same time, taking some particular decision. It means, in effect, entrusting some part of the work of management to subordinates. Responsibility is not, though, surrendered, as no nurse avoids ultimate responsibility by delegating. The work is delegated and the superior holds the subordinate accountable. "Delegation within the context of nursing is the action by which an RN/Midwife delegates aspects of client care to another care provider who has the appropriate education, knowledge and skills to undertake the activity safely" (Scope of Nursing Practice Decision-Making Framework 2001). A set of pre-established rules and expectations directs the course of client-nurse or client-unregulated care provider interactions. There may be some overlap in these interactions with those involving friends and family, but one factor in particular differentiates helping relationships from social relationships. A helping relationship is established for the benefit of the client, whereas kinship and friendship relationships are designed to meet mutual needs. In particular, this relationship is established to help the client achieve and maintain optimal health. These relationships are entered for the benefit of the client, but such a relationship is more effective if it is mutually satisfying. Clients are satisfied when their health care needs have been met and they sense that they have been cared for. Nurses feel a sense of accomplishment when their interventions have had a positive influence on their clients' health status and when their conduct has been competent and caring. Client-nurse relationships may be a mutual learning experience, but in general the goals of therapeutic relationships are directed toward the growth of clients. "Delegating to an unregulated care provider occurs when the required task is performed primarily by registered nurses and is outside the role description and training of the unregulated care provider" (Assigning and Delegating to Unregulated 2007). Clients and nurses alike come to the relationship with unique cognitive, affective, and psychomotor abilities that they use in their joint endeavor of enhancing the clients' well-being. Nurses are responsible for encouraging this interchange of ideas, values, and skills. In an effective helping relationship there is a definite and guaranteed interchange between clients and nurses in all three dimensions (Guarding Principles of Delegation among Nurses 2003). Registered nurse delegate only tasks. The main implications of delegation are: (1) "the responsibility for the practice of nursing cannot be delegated; (2) under certain conditions, a registered nurse may delegate selected tasks for a specific client; (3) the best interest of the client must be embedded in all aspects of delegation decisions; (4) the unregulated care provider must have sufficient training, supervision and support to perform the delegated task safely" (Assigning and Delegating to Unregulated 2007). In all cases, the responsibility of a registered nurse is to ensure that a thorough assessment is made of clients' health concerns, that suitable nursing actions are chosen and implemented to help clients, and that an evaluation of the results is carried out. Assuming this leadership does not mean that a registered nurse takes over and do for, or to, clients (Nurses Board of South Australia 2002). In Australia, delegation of tasks to unregulated care providers is stipulated and regulated by Guidelines on Delegation and Supervision for Nurses. The purpose of these guidelines is to assist nurses to make decisions in relation to delegation and supervision within a nursing context in a variety of settings" (Nurses Board of South Australia 2002). The quality of nursing care and delegation is determined by the completeness of the interchange of knowledge, attitudes, and skills between a nurse and clients. A registered nurse must act responsibly to achieve nursing goals. A registered nurse needs to collect pertinent information from clients and make an accurate assessment on which a registered nurse will base nursing care. Using these standards, nurses will be an assertive and responsible nurse helper. "Teaching and competence assessment is necessary to prepare for delegation of situation specific activities to unregulated care providers. Examples of such activities are showering a person and providing other hygiene and grooming activities" (Scope of Nursing Practice Decision-Making Framework 2001). Also, the helping relationship uses this information to deliver nursing care that focuses on this person in this moment, a person with a desire to live fully as a human being with his own hopes and dreams and vision of himself. Unregulated care providers are responsible for doing the job; it is the nurse's responsibility to see the job is done. When authority is delegated, all it means is that someone has been grantee permission to do something; the nurse must ensure that the unregulated care providers have sufficient authority to do the job and that the unregulated care providers have been told the kind of authority is to be used (Alexander et al 2006). Delegation can therefore be briefly stated to be a process whereby a nurse assigns duties to unregulated care providers; grants them authority to make commitments to the extent thought necessary to enable those duties to be carried out; creates an obligation on the part of each unregulated care provider for the satisfactory performance of the job. In 1998, the Queensland Nursing Council (QNC) endorsed its Scope of Nursing Practice and included Guiding Principles for Delegation to Unregulated Care Providers. According to these principles responsibilities should be clearly defined at all levels before work can be delegated. "The delegation is legally permissible under the statute and common law and is based on appropriate consultation and planning" (Nurses Board of South Australia 2002). Ensuring that clients understand and agree with each step of the nursing process increases the probability that they will do their part to comply with treatment. Unregulated care providers should have a clear understanding of health problems, as well as what they and nurses can do about them, will expend less energy worrying and more energy doing something constructive (Standards for the Scope of Professional Nursing 2006). Clearly understanding their nursing diagnoses and having a say in how best to handle them gives clients a sense of control. Nursing embraced the technology, acquired the skills, and assumed the task of teaching new nurses critical care content. While other groups concentrated on one system or focus, the nurse assume total responsibility for round-the-clock care of the patient and all equipment that appeared at the bedside. In modern healthcare environment, the role and function of delegation has been transformed from merely a management function to a tool which helps to optimize resources and organizational structure. Delegation provides the channels through which work is made to flow while planning determines the volume of the work passing through those channels. It endeavors to put the form of organization to its maximal use. Nurses are concerned in the arrangement of duties between the individuals affected, so that the methods existing for the delegation may operate smoothly and economically (Alexander et al 2006). In sum, delegation of tasks to unregulated care providers proposes great opportunities for healthcare system decreasing shortage of nursing professionals. In Australia, delegation of tasks is regulated by healthcare organizations in order to ensure high service quality and minimal risks. Unregulated care providers depend on the nurse to call them to the patient's bedside when they are needed. As far as delegation is concerned, a nurse should have a clear idea of a unregulated care providers' time-span of discretion and his level of responsibility, a nurse may feel she can delegate more freely. References 1. Alexander, M.F., Fawcett, J., Runciman, P.J. (2006). Nursing Practice: Hospital and Home. Churchill Livingstone; 3 edition 2. Assigning and Delegating to Unregulated Care Providers. (2007). Retrieved 06 September 2007, from www.crnbc.ca/downloads/98.pdf 3. Guarding Principles of Delegation among Nurses (2003). Retrieved 06 September 2007, from www.nursesboard.sa.gov.au/pdf/nbsa_Inquiry_into_the_Role_of_Unregulated_Care_Workers_June_2003.pdf 4. Nurses Board of South Australia: Discussion Board (2002). Retrieved 06 September 2007, from www.nursesboard.sa.gov.au/pdf/nbsa_Discussion_Paper_UHCW_June_2002.pdf 5. Scope of Nursing Practice Decision-Making Framework (2001). Retrieved 06 September 2007, from www.nbwa.org.au/cproot/450/2227/Pocket%20Guide.pdf 6. Standards for the Scope of Professional Nursing Practice for Nurses and Midwives (2006). Retrieved 06 September 2007, from http://www.nursingboardtas.org.au/nbtonline.nsf/attachment/NursesMidwivesScope2006/$File/Standards%20for%20the%20Scope%20of%20Professional%20Nursing%20Practice%20for%20Nurses%20and%20Midwives%20June%202006%20-%20web%20version.pdf Read More