Impact of Ethical Behaviour on Nursing Practice

Discuss about the Nursing and Midwifery Council System.

Nursing can be considered a profession that offers job satisfaction and the opportunity to care and support the sick and ailing of the society to gradually revert to normal health (D’amour et al., 2012). Nursing care has been one of the integral elements of the health services without which providing adequate and patient centred care to the sick and ailing would become impossible. There has been a significant crisis for recognition for the nursing workforce. The health care industry now recognises the crucial role of the nursing workforce in the care delivery scenario, and hence nursing is regarded as a highly noble and sought after profession in the present day scenario which provides honour and respect along with job satisfaction and financial security (Lowe et al., 2012).

The nursing profession has undergone significant reform in the past few decades in order to implement holistic; patient centred care practices. There is a profound role played by the guidelines and nursing codes of practice standards in facilitating the reform. There have been many transformations in the nursing practice standards in an attempt to streamline the practice scope of the nursing profession as optimally effective, safe and patient centred as possible (Kleinpell et al., 2014). This assignment will attempt to explore the impact of different nursing practice standards and codes on defining and guiding the graduating nursing professionals in the clinical practice.

In case of nursing practice, the element that imparts a profound effect on the practice is the ethical behaviour. According to the D’amour et al. (2012), nursing is a public service that has to deal with a variety of different individuals, patients and their family members; their demands and grievances. In nursing care, the conflict of compassion and beneficence is crucial. Often the requirements of the patients or their family members contradict the medical need or justified intervention. Hence, the only option for the nursing care professionals when facing such dilemma is adhering to the nursing code of ethics.

Ethical behaviour is one of the fundamental necessities of nursing practice that refers to a well-founded set of standards of right and wrong while making crucial and conflicting clinical decisions. One of most significant resources for maintaining ethical behaviour for the nurses is the code of ethics for the nurses developed by the international council of nursing (Nursingandmidwiferycouncil.nsw.gov.au., 2018). Four elements discuss the requirement for ethical behaviour among the nurses. The first element, “Nurses and people” explains that protecting the human rights, values, and spiritual or cultural beliefs are the necessities while planning and delivering nursing care to the different individuals. This code of ethics also guides the nursing professional to disseminate accurate and sufficient information to the patient and their family members promptly as a part of ethical behaviour. However, there is discretion in sharing confidential information regarding the patient. Another document that discusses the construct of ethical conduct in nursing practice is the standard one of registered nurses standard for practice; standard 1.5 discusses the registered nurses to use to ethical frameworks when making any key clinical decisions (Nursingmidwiferyboard.gov.au., 2018).

Impact of Scope of Practice and Competency on Nursing Practice

When considering the scope of practice and competency, it is essential for the nurses to understand their scope of practice and their competency and only perform within the permissible limits. Here the Registered nurses practice standards can be discussed, according to the standard 6 “Provides safe, effective and responsible quality nursing practice”, it has to be mentioned 6.2 discusses that the registered nurses should practice within their scope of practice. They should also delegate the scope of practice of the subordinate enrolled nurses as well (Nursingmidwiferyboard.gov.au. 2018). Masters (2015) has stated that the scope of practice is the educational and competency levels that they have learned in their nursing degree or during their professional development. According to the code of professional conduct for nurses in Australia, the conduct statement one discusses that the nurses will have to maintain nursing competence by participating in ongoing professional development practices to continue to enhance their scope of practice (Nursingmidwiferyboard.gov.au. 2018). These standard guidelines help the nursing professionals to not only adhere to the specific practice tasks that they are legally competent to perform but also provide an opportunity to enhance their competencies legally.

Effective communication and cultural diversity are another very important element of nursing practice. According to Gardner et al. (2013), nursing is a profession where the entire responsibility of assessing the patient situation, patient assessment and care planning, effective communication with the patient is a key element. In case of Australian demographics, the patient population is highly culturally diverse. Hence to attend culturally diverse patient population, it is essential for the nursing guidelines to emphasize on the culturally competent effective communication. The first element of the nursing code of ethics guides the nurses to plan care activities, disseminate patient information and implement care activities in a culturally appropriate manner (Nursingandmidwiferycouncil.nsw.gov.au, 2018). The second element of nursing code of ethics discusses “Nurses and practice”, where the nurses are directed to providing care ensuring that the technological use and use of other devices are suitable for the construct of cultural safety. According to the registered nurse standards for practice, the standard 1.3 discusses that registered nurse must respect all the different cultures and experiences, communicates and plans the care with utmost cultural safety and with attention to the inclusion of the culturally diverse indigenous individual and their traditional healing concepts (Nursingmidwiferyboard.gov.au. 2018). On the other hand, considering the communication part of the nursing practice, the registered nursing practice standards are a compatible guidelines as well. According to standard 2, “Engages in therapeutic and professional relationships”, the communication of the nurses with the patient or their family members needs to be effective and respectful of their culture, dignity, principles and values (Nursingmidwiferyboard.gov.au. 2018). Hence, for any graduating registered nurse, these standards and guidelines direct their practice to be culturally appropriate and safe. They must communicate efficiently and practise inclusion at every step of care planning and implementation.

Impact of Effective Communication and Cultural Diversity on Nursing Practice

Justice and legality are essential elements of care delivery as well, it has to be mentioned in this context, that the importance of careful planning with social justice is a critical aspect of care. According to the nursing code of ethics, nurses and people element guides the nursing professionals to maintain utmost social justice in allotment of resource and access to different health care services as well. When concerned with legal issues pertinent to the nursing code of practice, the A nurse’s guide to professional boundaries, (2018) provides a few key considerations. According to the conduct statement 5, the nursing professionals have the legal obligations regarding the protection of the privacy of the patients requiring and receiving care. The misconduct of confidential or private information is regarded as a breach of the legal frameworks and legislation A nurse’s guide to professional boundaries (2018) states that the legal issues can arise within the working environment organizational relationship as well. Primarily, the legal issues are vital in case of any harassment or sexual misconduct. A nursing professional is given the responsibility to maintain the safety of the patient receiving care from the healthcare facility. Hence, if a nursing professional is faced with a situation where the patient has faced sexual misconduct the nurse needs to inform the governing authority with necessary documentation.

Patient advocacy is a very important aspect of nursing practice, as the nursing professionals are the point of contact between the care facility and the patients receiving care. Hence the needs and requirements of the patents are the best understood by the nursing professionals. Hence, the nurses can advocate the needs and choices of the patients better than any other allied health professionals associated with the care procedure. Consequently, the nursing individuals practising need to invest honest efforts to perform adequate and justifiable patient advocacy. There are a few guidelines that assist in understanding the patient advocacy needs in the nation and the legal frameworks to practice the same. As per the nursing code of ethics, the nurse is responsible for advocating safe and healthy environment for the patients. Along with that, the nursing codes of ethics also state that the nurse needs to advocate for equity and social justice for the patient as well (Nursingandmidwiferycouncil.nsw.gov.au, 2018). According to the nursingandmidwiferycouncil.nsw.gov.au, 2018, the standard 2.5 states that the registered nurse has to advocate on behalf of the patient all the while respecting the autonomy of the patient and legal capacity of the patient. The advocacy practiced by the registered nurses need to be effective but also needs to be mindful of not disturbing the autonomy of the patient, which is an elemental construct of nursing practice.

Impact of Justice and Legality on Nursing Practice

Coming to the concept of accountability, the element 2: “Nurses and practice” of nursing code of ethics state that the nurses will have to maintain personal responsibility and accountability for the nursing practice. On a more elaborative note, Nursingmidwiferyboard.gov.au., (2018), state that nurses are also accountable for providing safe and competent nursing care for the patient which addresses every care requirement of the patient as well. Moreover, according to the conduct statement 2, the nurses are also accountable for maintaining health documentation, proper information management and adverse incident report maintenance as well. A very similar explanation is provided by the third standard of the registered nurse practice standards as well, stating that registered nurses are accountable for providing safe and effective care to the patients (Nursingmidwiferyboard.gov.au. 2018). Furthermore, registered nurses are accountable for decisions, actions, behaviors and responsibilities. They are also accountable for the actions other healthcare professionals take, to whom they have delegated responsibilities.

Lastly, the nursing professionals are also accountable for the different social media uses as well. The Social Media Policy (2014) developed by the APHRA and NMBA is directed towards maintaining and directing the care practices that relate to the social media usage. This guideline applies the patient to remember that the nursing profession must comply with professional obligations at all times, the nursing professionals must also comply with confidentiality and privacy obligations, no private information or pictures can be shared in the social media by the nurse.  Posting pictures of procedures, case studies, patients, or sensitive material is considered to be a breach of this policy (Nursing and Midwifery Board of Australia – Social media policy, 2018).

Conclusion:

On a concluding note, it has to be mentioned that there are various codes of conducts applicable to the nursing practice in Australia and there are multiple elements of nursing practice that can be severe concerns when considering different practice guidelines. The five legal and legislative documents guide the nursing professionals to understand the various aspects of care planning and delivery and help the graduating nurses to understand better their care directives and how to enhance their competence while providing safe and effective care to the patients.

References:

A nurse’s guide to professional boundaries. (2018). Nursing and midwifery board of Australia. Retrieved from https://file:///C:/Users/absas/Downloads/Nursing-and-Midwifery-Board—Codes-and-Guidelines—Professional-boundaries-for-nurses—February-2010%20(2).PDF

Alligood, M. R. (2017). Nursing Theorists and Their Work-E-Book. Elsevier Health Sciences. Retrieved from https://books.google.co.in/books?hl=en&lr=&id=l7stDwAAQBAJ&oi=fnd&pg=PP1&dq=nursing+practice+&ots=yVrI_RIOfa&sig=QLey9tNpI9xJxfW4IsM3bUc9yM4#v=onepage&q=nursing%20practice&f=false

D’amour, D., Dubois, C. A., Déry, J., Clarke, S., Tchouaket, É., Blais, R., & Rivard, M. (2012). Measuring actual scope of nursing practice: a new tool for nurse leaders. Journal of Nursing Administration, 42(5), 248-255. doi: 10.1097/NNA.0b013e31824337f4

Gardner, G., Chang, A. M., Duffield, C., & Doubrovsky, A. (2013). Delineating the practice profile of advanced practice nursing: a cross?sectional survey using the modified strong model of advanced practice. Journal of Advanced Nursing, 69(9), 1931-1942. Doi: 10.1111/jan.12054

International Codes of Ethics to be adopted from 1 March 2018 | Nursing and Midwifery Council of New South Wales. Retrieved from https://www.nursingandmidwiferycouncil.nsw.gov.au/international-codes-ethics-be-adopted-1-march-2018

Kleinpell, R., Scanlon, A., Hibbert, D., Ganz, F., East, L., Fraser, D., … & Beauchesne, M. (2014). Addressing issues impacting advanced nursing practice worldwide. Online journal of issues in nursing, 19(1). Retrieved from https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-19-2014/No2-May-2014/Advanced-Nursing-Practice-Worldwide.html

Lowe, G., Plummer, V., O’Brien, A. P., & Boyd, L. (2012). Time to clarify–the value of advanced practice nursing roles in health care. Journal of advanced nursing, 68(3), 677-685. Doi: 10.1111/j.1365-2648.2011.05790.x

Masters, K. (2015). Role development in professional nursing practice. Jones & Bartlett Publishers. Retrieved from https://books.google.co.in/books?hl=en&lr=&id=ftkBCwAAQBAJ&oi=fnd&pg=PR1&dq=nursing+scope+of+practice+australia+&ots=nhSgHU-kFv&sig=PzjpLogSGc9ixqc0uzkhZFs6O60&redir_esc=y#v=onepage&q=nursing%20scope%20of%20practice%20australia&f=false

Morton, P. G., Fontaine, D., Hudak, C. M., & Gallo, B. M. (2017). Critical care nursing: a holistic approach (p. 1056). Lippincott Williams & Wilkins.

Nettina, S. M., Msn, A. B., & Nettina, S. M. (2013). Lippincott manual of nursing practice. Lippincott Williams & Wilkins. Retrieved from https://books.google.co.in/books?hl=en&lr=&id=yW8DhPxxUR0C&oi=fnd&pg=PR1&dq=nursing+practice+&ots=9O4VxcBjCq&sig=CVJo2E19pfpm23BZ3NdcaqLX254#v=onepage&q=nursing%20practice&f=false

Nursing and Midwifery Board of Australia – Home. (2018). Nursingmidwiferyboard.gov.au. Retrieved 13 April 2018, from https://www.nursingmidwiferyboard.gov.au/

Nursing and Midwifery Board of Australia – Professional standards. (2018). Nursingmidwiferyboard.gov.au. Retrieved 13 April 2018, from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

Nursing and Midwifery Board of Australia – Social media policy (2018). Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Policies/Social-media-policy.aspx

Russell, K. A. (2012). Nurse practice acts guide and govern nursing practice. Journal of Nursing Regulation, 3(3), 36-42. Doi: 10.1016/S2155-8256(15)30197-6