Professional Practice Revision
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School
University of Tasmania *
*We aren’t endorsed by this school
Course
NUR131
Subject
Philosophy
Date
Jan 9, 2024
Type
Pages
8
Uploaded by ColonelUniverse12642
†Professional Practice Semester 1 Revision
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15 multiple choice
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15 t/f
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6 short answers
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3 topics to choose one page to write, in response 4 criterias
5. Regulatory authorities that impact on nursing (1)
Regulatory authorities in Nursing
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Australian Health Practitioner Regulation Agency (AHPRA)
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Nursing and Midwifery Board of Australia (NMBA)
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Health Professional Councils Authority (HPCA)
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Nursing and Midwifery Council of NSW (NMC)
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Health Care Complaints Commission (HCCC)
AHPRA
What they do. Functions they have. How they are involved with each other.
All health professionals are registered with their relevant board under the Australian health
practitioner regulation agency (APHRA) n Nurses and midwives are registered with the Nursing
and Midwifery Board of Australia (NMBA)
Nursing and Midwifery Board Australia (NMBA)
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Maintains the register of nurses n Criminal record checks
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Registers and imposes restrictions with AHPRA
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Approves accreditation standards, codes and guidelines
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Assesses English language and education requirements
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Monitors continuing professional development (CPD)
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Assess notifications referred from AHPRA
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Publish accountability guidelines for nursing practice decisions
Health Professional Councils Authority (HPCA)
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An administrative body of the Health Administration Corporation
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Can receive notifications in NSW
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Provides administrative support to Health Councils in NSW including the NMC (see next
slides)
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Director reports to the NSW Ministry of Health
Nursing and Midwifery Council of NSW (NMC)
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The aims of the NMC are n Protection of the public
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Educate the nurse on how to an effective and safe practitioner n Seeks to prevent
negative incidents before they occur n Work to assist the nurse to continue in their role n
Rehabilitate the nurse where possible n Refer for further intervention if required
Health Care Complaints Commission (HCCC) n Regulates health care professionals n Can
receives notifications in NSW n Accepts referred notifications from AHPRA n Investigates and
prosecutes notifications about nurses in NSW n Refers notifications for management by NMC
The NSW Civil and Administrative Tribunal (NCAT)
A notification is referred to the Occupational Division of the NCAT if, were it proved, it would
result in suspension or cancellation of a nurse or student's registration (except in the case of
impairment) n NCAT also considers repeals and reviews of lower decisions
6. Critical thinking (1)
The two types of reasoning
Reasoning: inductive re: generalis
Observations based on evidence(scientific)
Deductive reasoning: decisions based on opinions
Divergent thinking: is used to evalua
Clinical judge: concerns the ability
Critical in this context, means “capable of judging carefully and accurately”
Accessing
Diagnosing
Skills required for critical thinking n Reflection – enables the nurse to process an experience
and evaluate their performance n Creativity – Creativity in problem solving and decision making
is the ability to develop and implement new and better solutions n Critical analysis – allows the
nurse to distinguish between relevant and irrelevant information n Reasoning (more on next
slides) n Divergent thinking and clarification
7. Research models (1)
Research model: some models used
Hypothet: hypothesis
Pattern recog: pattern recog
8. Decision Making (3: have an idea about it)
Decision making is the ability
Influences: the problem
Nmba decison: a national framework
9. Clinical reasoning cycle and SMART goals (clinical reasoning cycle is not on the exam)
(1)
Nursing goals: SMART
SMART n S - specific n M - measurable n A - achievable n R - realistic n T - timely
10
. Reflective and reflective practice (1)
Types of reflection(technical: structured method, prac: focuses on interpret, emanci: manage th
taken for granted)
The reflective process: very often a negative
Timing of the reflective: however posta(2007)
The relefective:
Critical releflect: critical reflection comes next
13. Nursing roles and the multidisciplinary team (1)
Registered nursing roles
Enrolled nurse
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The enrolled nurse is an associate to the registered nurse who demonstrates
competence in the provision of patientcentred care as specified by the registering
authority’s licence to practise, educational preparation and context of care n Core as
opposed to minimum enrolled nursing practice requires the enrolled nurse to work under
the direction and supervision of the registered nurse n At all times, the enrolled nurse
retains responsibility for his/her actions and remains accountable in providing delegated
nursing care
Assistant in nursing n Provide direct patient care n Support the nursing team in the delivery of
nursing care under guidance of the RN n Assist RN or EN with patient care activities under
supervision n Patient assessment and documentation n Therapeutic patient and interdisciplinary
communication n The AIN remains responsible for own actions at all times
Medical roles
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Intern
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Resident
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Registrar
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Consultant
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Allied health role pg 68 Occupational:, Social worker: Getting ppl housing, dole , speech patho:
speaking and swallowing, dietician: nutrition, diversional: playing gamed keeping ppl occupied
Physiotherapist n Occupational therapist n Social worker n Speech pathologist n Dietician n
Diversional therapist
HERE>>
The aims of the NMC are n Protection of the public n Educate the nurse on how to an effective
and safe practitioner n Seeks to prevent negative incidents before they occur n Work to assist
the nurse to continue in their role n Rehabilitate the nurse where possible
Need to know the 4 bioethical principles 47:35
Silo
pg 69: one of several,
One of several definitions is: to isolate a system, department, etc. from another or others
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The health care system is complex and each professional group has their own culture,
rules and autonomy; forming their own ‘silo’
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Breaking down these silos is important to create a system that focuses on the patient
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Doing so allows for effective patient centred care
The multi pg 70, 71, 73, 75
The multidisciplinary team n The multidisciplinary team comprises members from different
disciplines in healthcare n Each member performs duties and tasks towards goals associated
with their individual discipline n Team disciplines may change based on individual patient
requirements n The patient is involved in and central to all care initiatives
The multidisciplinary team n Each member acts as a member of the team so decisions to do so
are made at a team level n Interdisciplinary care is a single team working towards a common
goal n So there is an interdisciplinary element to the multidisciplinary team n An example of a
common goal of the multidisciplinary team is to see the patient back to the best possible health
Why is the team important? n The multidisciplinary team is important because n Some individual
have highly technical skills and knowledge n Some individuals have information about the
patients values and wishes n Others know how the patient is coping day to day n Resources
can be combined n Overlaps in care duties can be minimised n Each team member is important
Patient centered care n Patients are usually told about their diagnosis and then how they will be
managed and by whom n For all the rhetoric, patients are ‘not really’ expected to make
decisions other than whether they will have the treatment or not n Patients however, do better
when they are included in their care and treated as part of the team
14 Open disclosure and patient advocacy (3)
Pg 77, 78, 79, 80, 82
3. Ethics
Code of ethics
Bioethics human tissues
Pg 85, 87, 89, 90*, 91**, 92**, 94, 95***, 97, 98, 99, 100, 102(how is the expe), 103
The four biomedical principles n Autonomy – the right of persons to make their own decisions,
free of interference n Non-maleficence – the practitioner’s imperative to do no harm (a negative,
requires one to not act to cause harm) n Beneficence – the imperative to remove harm, to do
good (requires a positive action) n Justice – the imperative to ensure a fair and equitable
distribution of goods or services based on individual need
51:30< The four biomedical principles n In isolation and when viewed together no one principle
carries greater weight than another. n However, where two (2) or more principles apply to a
given set of facts they may conflict. n Where there is a conflict the principles must be weighed or
balanced against each other . n The principle judged to have the greatest weight in this
particular set of facts is the one that will apply (achieving balance).
Duty of care is a duty to take reasonable steps to prevent reasonably foreseeable harm
Duty of care for the registered nurse n A duty to take reasonable care to ensure that a nurse’s
acts or omissions do not cause reasonably foreseeable harm to others n The nursing codes and
competencies require nurses to meet a minimum expected standard of practice n Thus, in
meeting a duty of care the nurse must also provide the minimum expected standard of a
registered nurse n Why do you think it is minimum, and not the “best possible standard?”
How does a duty of care arise in nursing? n A duty of care arises in nursing where a relationship
can be shown to exist between the parties (nurses and patient/family)
To whom do I as a nurse owe a duty of care? n Persons who are so closely and directly affected
by my act or omission that I ought reasonably have had them in contemplation as being so
affected when I was directing my mind to the acts or omissions which are called in question
When does the my duty of care as a nurse commence? n The duty can commence before the
treatment starts. For example when a patient presents to ED but leaves before being seen
How is the expected standard of care measured?(know a few of these)
n By expert evidence of peers n Statutory/legal/regulatory provisions n Professional standards
of practice n Guidelines and policies n Academic texts and literature
Negligence n “The core idea of negligence is that people should exercise reasonable care when
they act by taking account of the potential that they might foreseeably cause harm to other
people”
3. 19.
Consent pg 106/8,109(the three elements, consent must be), 110, 114, 115, 116
1:02:05 The three elements of a valid consent n Consent must be given freely and voluntarily –
without lies or coercion n Consent must be fully informed and for a specific procedure/treatment
n The person giving consent must have legal capacity – they must be competent to make their
own decisions
By what means can consent be given? n Implied – for simple procedures within the patient’s
knowledge base. For example, the nurse requests to do a blood pressure and the patient
silently extends their arm n Verbal – through speech by explicit verbal agreement. This is
important for non-invasive or very simple procedures to ensure patient understands n Written –
Consent given through signing. This is important for invasive procedures or those that may have
serious sideeffects or risk of an adverse outcome
Legal capacity: able to make their own decision
Cant: children, disabled, unconcious,
Why is informed consent necessary? n Consent also protects the practitioner n Consent proves
that the patient has given permission for the contact n No consent equals a Trespass to the
Person and may result in legal action for assault, battery or even false imprisonment
cultural(30% of paper)
Lectures 5 and 6
Culture: A dynamic concept which identifies systems of rules, beliefs, attitudes, values and
behaviours, shared by a group, taught across generations, relatively stable but capable of
change across
NOTE pg 119, 120
Know the definitions
Cultural diversity: the differences between people based on a shared ideology and valued set of
beliefs, norms, customs, and meanings evidenced in a way of life.
Cultural sensitivity: a process of recognising the attitudes, values, beliefs and practices within
your own culture so that you can have an insight into your effect on others
Describe the concept of culture
Cultural awareness in communication with CALD
Cultural awareness in communication with refugee persons vs
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Statistics of migrants in australia
Know the trends
Characteristics of culture
Culture is learned, shared, integrated • Culture is based on symbols (material items: artifacts,
objects, dress etc) • The most symbolic aspect of culture is language • Cultures change
Barriers to health care seeking – CALD individual … Lack of knowledge about the health care
system, primary health care and support available Language difficulties Lack of trust Cultural
differences
Definitions know what they
CALD Culturally and linguistically diverse
Migrant A person who has chosen to migrate to a country
Refugee An individual who has fled their home country due to fear of being persecuted for
reasons of race, religion, nationality, membership of a particular social group, or political opinion
Asylum Seeker Person who has fled their own country and applied for legal protection and
material assistance in another country
Cultural compentence: the awareness, knowledge, skills, practices and processes needed by
individuals, professions, organizations and systems to function effectively and appropriately in
situations characterised by cultural diversity in general and, in particular, in interactions with
people from different cultures
Difference between ethnicity and culture
Issues that refugees face/ help considerations for refugees
3 questions on culture
1.
Interpreter(8 criteria), (Risks of using family to interpret), cultural awareness
Risks of using family to interpret Inaccurate interpretation of information Withholding or
distorting messages Breach of patient confidentiality Incomplete medical history obtained
Inappropriate responsibilities placed upon the family members Invalid consent to surgery or
treatment Difficult for health care provider to build rapport with patient.
8 criteria dealing with CALD
(1) Working with interpreters
Plan session
Brief the inter before
Sit facing the person triangle form
Plan the session. Avoid asking a family member, especially a child or spouse Be aware of
gender and age differences Avoid interpreter who is politically or socially incompatible e.g.
Bosnian Serb interpreting for a Muslim Brief the interpreter before the session. Arrange a place
where the session can be conducted in private Allow for extra time Arrange seating in a circle
or triangle
Need to know Giger and Davidhizar Transculutral assessment model (2003). 1.
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Six cultural phenomena that vary with aplication and use yet are evident in all cultural
groups:
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These include communication, space, social organisation,
Giger and Davidhizar Transcultural Assessment Model (2003)
Culturally diverse nursing care must take into account six cultural phenomena that vary with
application and use, yet are evident in all cultural groups These include: Communication
Space Social organization Time Environmental control Biological variations
Simple communication tips
DON’T Shout, mumble or speak too quickly Use jokes, irony or sarcasm Use long complicated
sentences Use slang, colloquialisms or health jargon Simple communication tips DO Speak
slowly and deliberately Use short sentences with pauses Use simple sentence structure
Explain things simply Demonstrate when giving explanations Give instructions in the order that
they should be carried out Try to get feedback so you know whether you have been understood
Strategies to improve cultural competence: being culturally aware
Initiating therapeutic relationships with CALD patient/clients
Hypothetico-deductive reasoning
1. Use your experience: Consider the problem and try to make sense of it. Gather data and look
for previous explanations. If this is a new problem to you, then move to step 2.
Form a conjecture (hypothesis): When nothing else is yet known, try to state an explanation, to
someone else, or to your notebook.
Deduce predictions from the hypothesis: if you assume step 2 (the explanation for your
hypothesis) is true; then what consequences follow?
Test (or Experiment): Look for evidence (observations) that conflict with these predictions in
order to disprove step 2 (your hypothesis). It is a logical error to seek step 3 (your assumption
that your explanation is true) directly as proof of step 2. This formal fallacy is called affirming the
consequent.
Pattern recognition Pattern recognition can lead to n Making a clinical judgment on the basis of
a few critical pieces of information n Making a clinical decision based on patients or situations
that we have previously seen n Categorising new cases based on a similarity to a patient seen
earlier n Expert novice differences n Conscious level n Intuition