Distinguish the Roles and Responsibilities of a Nurse in the Selected Specialty Practice Area

NOTE: This assignment is based on medical/surgical ward, as I am working or doing placement in medical/surgical ward

Online Module One

Online Module 1

Distinguish the roles and responsibilities of a nurse in the selected specialty practice area. [LO 1]

In this module you will explore the role of the specialist nurse.

You will be asked identify some of the physical and emotional safety issues related to the specialty and determine some strategies you can use to keep yourself (and your patient) safe.

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The module will conclude with an examination of the legal aspects associated with the specialty, both in terms of your responsibilities and the responsibilities of the employer.

In Australia, specialist nursing usually requires a post-graduate qualification (Jokiniemi, Pietilä, Kylmä & Haatainen, 2012). However, as registered Nurses you can work in any area of nursing, so what defines specialty practice?  What is the difference between a nurse practitioner and an advanced practice nurse as opposed to someone who has worked in same clinical area for 10 years or someone who has a postgraduate certificate or Diploma in specialty area?

To get you started, the following article may address some of these questions for you:

Jokiniemi, K., Pietilä, A., Kylmä, J., & Haatainen, K. (2012). Advanced nursing roles: A systematic review. Nursing & Health Sciences, 14(3), 421-431.

Roles and Responsibility of Registered Nurse

The roles and the responsibilities (scope of practice) of the registered nurse are defined by the Nursing & Midwifery Board of Australia (NMBA) in consultation with industry and other governing nursing bodies.  The NMBA also have definitions pertaining to nurse practitioners and advanced practice nurses.

The following will help you establish a basis for your reflection and enable you to complete the activity:

Fact Sheet: Advanced nursing practice and specialty areas within nursing 

Shields (2013) discusses the role of the nurse in a reflective personal essay that makes for interesting reading on how nursing is viewed and where Australian nursing fits in the global scene. It makes for a good introduction to the elective and to the module. Please read this article:  Shields, L. (2013). A personal essay on the role of the nurseContemporary Nurse: A Journal for the Australian Nursing Profession, 43(2), 213-218.

Having read the above resources  it is time to explore what you know and understand about the role of the specialty nurse within your clinical practice area. Consider what you already know in relation to the NMBA standards of practice for registered nurses (2016).  If all registered nurses need to meet these standards then what more is expected of someone with specialty experience?

To explore the role of the specialist nurse in the area of your elected specialty:

  • Locate, read and reflect on the standards that guide the practice of nurses in your specialty area (these can often be found on the relevant specialty association webpage)  – this is important!!
  • Find the job description for a clinical nurse in your specialty area and read it.
  • Identify the characteristics of the role that are beyond the generic description of the role of a registered nurse, that is, identify what makes the person a specialist in the area.
  • What is the difference between a clinical nurse specialist (CNS), advanced nursing practice and advanced practice nursing?
  • If possible speak to a nurse who currently practices in a specialty area. Ask him/her how they acquired the knowledge and skills that makes a specialist in the area. You might ask them about what facilitators and barriers they dealt with in the course of developing their specialty knowledge.
  • Write down some key messages you learned from these activities.

 

 

Physical and emotional safety

Staying safe physically is important and discussed frequently. Nurses are very aware of issues such as manual handling competencies and workplace health and safety issues, but perhaps not as aware of emotional safety issues. We will explore both in this section, but place it in the local context, by examining the environment you are working in.

To get you thinking, explore the Australian Nursing & Midwifery Federation website on Workplace Health & Safety and Workers Compensation.

The next reading is an systematic review looking at stress in the Australian nursing workforce.

Lim, J., Bogossian, F., & Ahern, K. (2010). Stress and coping in Australian nurses: a systematic review. International Nursing Review57(1), 22-31. doi:10.1111/j.1466-7657.2009.00765.x

Next, compare the findings of the more recent study, to those of the systematic review by Lim, Bogossian and Ahern (2010):

Gifkins, J., Loudoun, R., & Johnston, A. (2017). Comping strategies and social support needs of experienced and inexperienced nurses performing shiftwork. Journal of Advanced Nursing, 73(12), 3079-3089. 10.1111/jan.13374

This final link discusses the concept of ‘burnout‘, and although the focus is on medical burnout, the author makes some important and relevant points that can be applied to nursing (updated 2015).

Exploring safety issues in your specialty area:

  • If you can, talk to a nurse/ medical practitioner from your chosen specialty and ask them what safety issue, whether physical or emotional, concerns them the most. If you are not on placement yet, engage with some of your tutors/ lecturers who may have experience teaching or practicing in these areas;
  • Find one primary researcharticle from the past 5 years that examines this issue in an Australian nursing context (if possible), read it and document a brief summary of the findings;
  • In your summary mention one strategy identified from your reading that will help you to keep yourself safe from this risk.

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Legal Obligations

As you will be well aware by now, nursing is subject to a number of legal and ethical imperatives. We operate under a nursing code of conduct and a specific act of parliament. These codes and laws are designed to protect patients and clients, but also nurses. The profession of the nurse is protected by law, and the title of nurse cannot be used without proper qualification and registration by an accredited authority.

But nurses also operate under other legal requirements: mandatory reporting of suspected child or elder abuse.

Here is a link to the mandatory reporting requirements for suspected child abuse in the different states and as you can see it is not consistent across states either. http://www.aifs.gov.au/cfca/pubs/factsheets/a141787/

And here is another link to an article exploring issues of financial abuse of older adults in residential aged care.

Tilse, C., & Wilson, J. (2013). Recognising and responding to financial abuse in residential aged care. The Journal of Adult Protection, 15(3), 141-152. doi:http://dx.doi.org/10.1108/JAP-11-2012-0025

There may be specific legal obligations associated with your specialty area of practice.

  • Talk to experienced nursing staff, lecturers or tutors about legal obligations specifically related to your chosen specialty. It may not necessarily be mandatory reporting issues, but be related to other issues. Areas to explore may be confidentiality issues when a person is cognitively impaired or underage, has a positive HIV status and is sexually active, and so on. For this section you can think outside the square about legalities of what nurses can and cannot do.
  • Identify one aspect of your legal obligations related to your specialty and write a short paragraph on how you would ensure you honour your legal obligations while working in this area.

 

 

Online Module Two

Assessment task 3

Module two looks specifically at the rights of patients/clients and in more depth the rights of carers in the process of treatment and recovery. It raises some questions about how the nursing profession views and deals with the rights of the carers and their need for information, particularly in the context of patients/clients who may lack insight in their care needs.

For your assessment: Write 600 words on your understanding of the dilemma of providing information to carers while considering the confidentiality concerns relating to the patient/client.  Don’t forget to consider the ethical implications in your consideration of the issues (ethical vs. legal dilemma for nurses). Ensure it is specifically related to the specialty area that you are/will be completing your placement in.

Submission – Part A: Your written answer should be clearly labelled with module 2 and placed in a single document (that will include module 1 written answer) and uploaded in the relevant drop box in assessment block (Assessment 3: Part A includes answers to module 1 AND 2).

 

Online Module Two

Online Module 2 – Activities and Readings

Where do carers stand in healthcare law and ethics?  It is important to understand that while the holistic approach to healthcare is preferred it is hard to balance the rights of all parties.  What is the nurse’s role in ensuring carers and patients/clients have a say and that all opinions are respected?  Sharing of information is fundamental to this consideration.  The carers play an important role in providing information to health care professionals but do they have any rights to be considered in the decision making of care if there is no legal directive?  The patient/client has rights but do the carers have rights as well?  Further to this ethical dilemma, theories are often at the foundation of nurse’s approach to care.  Ethics of Care theory claims that moral agents (carers, clients, health care professionals and institutions) are not separate entities and that the application of universal ethics is not inappropriate.  This theory is based on consensus ethics which incorporates the views of all involved in care (Buchanan, Cooper & Fielding et. al, 2012).

Read the following articles as a starting point, there are many similar articles out there that you can source for further reading.  It might be good idea to bring out your ethics text book again and revise the ethical theories related to this matter.  Once you have completed the readings undertake the activities to find information on how the institution you are working views these issues, then complete the component of the assessment task.

READINGS

Gold, M., Philip, J., McIver, S., & Komesaroff, P. A. (2009). Between a rock and a hard place: exploring the conflict between respecting the privacy of patients and informing their carers. Internal Medicine Journal39(9), 582-587. doi:10.1111/j.1445-5994.2009.02020.x

Now, taking into consideration what you have read, explore the Australian Government policies and strategies for carers.

Some other useful documents to explore (be sure that these are relevant to your home state or territory):

  • Guardianship and Administration Act (Victoria, 1986);
  • Guardianship Act (NSW, 1987);
  • Guardianship and Administration Act (Brisbane, 2000);
  • Australian Charter of Healthcare Rights;
  • International Council of Nurses Code of ethics for nurses (2012)
  • NMBA Code of Conduct for Nurses (2018);
  • NMBA Registered Nurse Standards for Practice for Nurses (2016).

Please note that this list is far from extensive. You will be expected to research much more broadly to do well in the assessment component for this module (Module 2).

ACTIVITY

Most health care organisations have a patient charter or similar document that is given to patients or clients in the care of the organisation, to explain their rights.

  • If you know your placement allocation, go to the organisation website, find the document for your specialty area and read it.
  • If you don’t know where you are going, explore the page of a major public or private healthcare organisation in your area to find this document.
  • Consider, who is it aimed at and does it include the rights of the carers as well?
  • Is the organisational charter prescriptive in nature allowing no room for flexibility based on ethical considerations?

It would also be worth finding out if the healthcare organisation has specific policies to cover the rights of patients/clients and their carers. If you are able:

  • Go to the organisation’s policies and procedures manual or web page, and find out what the relevant policies are.
  • Are there policy for each party or just a general policy that is inclusive, again is there flexibility in the policy

Jot down some note to these points as they will assist you in completing the assessment component for this module (Module 2). Take note also what evidence or parliamentary acts these policies/ charters are informed by, as these may prove useful too!

Online Module Three

Readings and Activites

For this module you are asked to explore some of the writings in the public domain on how people have made meaning of their health related issues.

Exploring how people perceive a variety of issues in health, illness and dying may help us make meaning of it, both in terms of our own views on these concepts, and in terms of how the people in our care or people related to those in our care, may respond to alterations in health and experience illness.

Reflection is not a new concept, the ancient Greek philosopher Plato insisted that reflection and ultimately change was important component of our humanity.  Reflection is not an artificial technique it is inherently human and reflection and action are the impetus for change and personal improvement (Daly, Speedy & Jackson, 2014).  This being said in order to reflect fully we must know ourselves well, our drive, ambition and prejudices if we are going to understand others fully.

WATCH

Here are some examples to get you started.

READING

The following article relates to informal carer, while the article is based in Europe there is relevance to Australian Health care system with increasing number of community and home services

Plank, A., Mazzoni, V., & Cavada, L. (2012). Becoming a caregiver: new family carers’ experience during the transition from hospital to home. Journal Of Clinical Nursing21(13/14), 2072-2082. doi:10.1111/j.1365-2702.2011.04025.x

http://ezproxy.acu.edu.au/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=2011567962&site=ehost-live

ACTIVITY

Find three articles from magazines, journals, blogs, online postings (most numerous), where the person writes about the meaning an illness has had for them.  Preferably this will be from your area of specialty practice however this may prove difficult for some specialties in this case pick a specialty area that interests you where there is information available.  Choose one article each from the following perspectives or points of view.

  • From the perspective of the person being cared for
  • From the perspective of the person closest to them (partner, parent, child, etc)
  • From the perspective of a health professional caring for such a person

Choose one of these readings and write a reflection on how it has changed your perspective or given you some insight into the meaning illness has for a particular person.

When writing your reflection make sure you consider your own perceptions, morals and ethics.

 

Assessment task 3: Online Modules

 

Students are required to complete and submit the three (3) online modules. The online modules cover a range of content, which should be related to the clinical specialty practice of your choice. Each module is designed to help you achieve learning outcomes set for the unit, or to enhance your learning related to your placement. Each module has an activity attached which the students are required to complete.

 

 

Module 1

 

Module one looked at the specific rights and responsibilities of the registered nurse in a specialty clinical area, from the perspective of keeping the nurse and her/his patients/clients physically and emotionally safe. It also raised the issue of legal responsibilities and identified issues specific to the specialty area.

 

For your assessment: Write 600 words on an issue of safety or of legal responsibility that you explored in some depth, ensuring it is specifically related to the specialty area.

 

 

 

 

Module 2

 

Module two looks specifically at the rights of clients and in more depth the rights of carers in the process of treatment and recovery. It raises some questions about how the nursing profession views and deals with the rights of the carers and their need for information, particularly in the context of patients/clients who may lack insight in their care needs.

 

For your assessment: Write 600 words on your understanding of the dilemma of providing

 

information to carers while considering the confidentiality concerns relating to the

 

patient/client. Don’t forget to consider the ethical implications in your consideration of the issues.

 

Ensure it is specifically related to the specialty area.

 

Submission: This paragraph should be clearly labelled and with module 1 written components placed in

 

single document and uploaded in the relevant drop box in assessment block (Assessment 3: Part A).

 

 

 

 

 

Module 3

 

For this module, you are asked to explore some of the writings in the public domain on how people have made meaning of their health-related issues. In the module activity, you are asked to choose one of your readings (from one of the three perspectives listed) and write a reflection on how that has changed your

 

 

 

 

 

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perspective or given you some insight into the meaning illness has for a particular person. When writing your reflection make sure you consider your own perceptions, morals and ethics.

 

Preferably this will be from your area of specialty practice however this may prove difficult for some specialties in this case pick a specialty area that interests you where there is information available.

 

For your assessment:

 

Review and refine your reflection from the activity (on ONE of the readings) for this module to a 500 word submission using the 5 R’s of reflection (Bain, Ballantyne, Packer & Mills, 1999).

 

Your reflection should consider:

 

  • How that has changed your perspective or given you some insight into the meaning illness has for that person;

 

  • How you relate to this and make meaning of your own experiences;

 

  • Your own perceptions, morals and ethics.

 

 

NOTE: For this assessment, it is not appropriate for you to reflect on a personal experience you have had relating to death, dying or illness, rather you MUST select an article from the prescribed list provided in

LEO.

 

Submission: This paragraph should be clearly labelled Module 3 and uploaded in the relevant drop box in

 

assessment block on LEO (Assessment 3: Part B).

 

Assessment criteria: Further information pertaining to the case study can be found in
the assessment block on LEO. Please also refer to the criterion
reference rubric below.

 

 

 

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APPENDIX D

 

Criterion Referenced Rubric: Assessment Task 3, Part A – Online Modules 1 & 2

 

Criteria for High Distinction High Distinction Distinction Credit Pass Unsatisfactory Unsatisfactory
Marking (95-100%) (85-94%) (75-84%) (65-74%) (50-64%) (31-49%) (0-30%)
Discussions Cohesive and logical Cohesive and logical Cohesive and logical Cohesive and A logical discussion is Minimal cohesion to No cohesion to flow
discussions. discussions. discussions. logical discussions. presented with limited flow of discussions. of discussions.
60% Comprehensive and Thorough and Well-developed Some attempt at consideration of Broad generalisations Broad generalisations
insightful analyses insightful analyses analyses and analysis and alternative are made. are made.
which presents a which presents a critiques from a critique from a viewpoints. Discussions consist Discussions consist
diverse range of diverse range of diverse range of range of largely of personal largely of personal
perspectives. perspectives. perspectives. perspectives opinion, and/or the opinion and/or the
evident. discussion lacks selected topic is
alignment to the inappropriate
required topic
Evidence to Relevant, high quality Relevant, high quality Relevant, quality Relevant literature Some relevant Minimal/irrelevant use No use of the
support the literature utilised with literature utilised with literature utilised with used with erratic but literature used with of the literature literature
analysis sophisticated detailed interpretation consistent appropriate some attempt to
30% interpretation and and analysis. appropriate interpretation & interpret & apply the
analysis. interpretation & application. literature.
application.
Organisation, Flawless Excellent standard of High standard of Effective written Adequate written Marginal, written Poor, written
Presentation and presentation. written written communication with communication presentation and presentation and
Referencing communication with communication with few errors of although a number of referencing, not at an referencing, not at an
Flawless use of APA few errors of spelling few errors of spelling spelling and spelling and
academic/professional academic/profession
referencing style in all and grammar. and grammar. grammar grammatical errors.
10% standard. al standard.
instances. A range of
in-text citations has Consistent accurate Accurate use of APA Accurate use of APA referencing style There are inaccuracies There are several
been used. use of APA referencing style on APA referencing is demonstrated
with the APA inaccuracies with the
referencing style in all most occasions. A style on most inconsistently. There
instances. A range of range of in-text occasions. There is is no variation of in- referencing style. APA referencing
in-text citations has citations has been limited use of a text citation format. style.
been used. used. range of in-text
citation formats.

 

 

 

 

 

 

 

APPENDIX E

 

Criterion Referenced Rubric: Assessment Task 3, Part B – Online Modules 3

 

Criteria for Marking High Distinction High Distinction Distinction Credit Pass Unsatisfactory Unsatisfactory
(95-100%) (85-94%) (75-84%) (65-74%) (50-64%) (31-49%) (0-30%)
Reporting and Student has explicitly Student has identified Student has identified Student has identified Student has identified Student has identified Student hasn’t
Responding identified an an appropriate critical an appropriate critical an appropriate critical an appropriate critical an appropriate critical identified an
5% appropriate critical incident or issue, and incident or issue, and incident or issue, and incident or issue, and incident or issue, but appropriate critical
incident or issue, and has: has: has: has: has not explained incident or issue.
has: – Reported what – Reported what – Reported what – Reported what what was involved.
– Reported what happened or what the happened or what the happened or what the happened or what the
happened or what the issue or incident issue or incident issue or incident issue or incident
issue or incident involved. involved. involved. involved.
involved. – Explained why it is – Explained why it is – Explained why it is
– Explained why it is relevant relevant relevant
relevant – Responded to the – Responded to the
– Responded to the incident or issue by incident or issue by
incident or issue by making observations making observations
making observations and expressing an and expressing an
and expressing an informed (referenced) informed (referenced)
informed (referenced) opinion opinion
opinion – Posed questions to
– Posed questions to address as a result of
address as a result of the incident
the incident
Relating Student has explicitly: Student has: Student has: Student has: Student has: Student has The student has not
15% – Related or made a – Related or made a – Related or made a – Related or made a – Related or made a unsuccessfully made an effort to
connection between connection between connection between connection between connection between attempted to relate relate (connect) the
the incident or issue the incident or issue the incident or issue the incident or issue the incident or issue (connect) the incident incident or issue to
and own skills, and own skills, and own skills, and own skills, and own skills, or issue to their own their own skills,
professional professional professional professional professional skills, professional professional
experience, or experience, or experience, or experience, or experience, or experience or experience or
discipline knowledge discipline knowledge discipline knowledge discipline knowledge discipline knowledge discipline knowledge discipline knowledge
– Commented on – Commented on – Commented on – Commented on
aspects that they aspects that they aspects that they aspects that they
have or have not have or have not have or have not have or have not
experienced before experienced before experienced before experienced before
– Analysed the – Analysed the – Analysed the
similarities and similarities and similarities and
differences between differences between differences between

 

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the conditions of this the conditions of this the conditions of this
environment and the environment and the environment and the
conditions of other conditions of other conditions of other
environments they environments they environments they
have encountered have encountered have encountered
– Explained the extent – Explained the extent
to which their skills or to which their skills or
knowledge will knowledge will
enable them to deal enable them to deal
with the incident or with the incident or
issue issue
Reasoning Student has explicitly: Student has: Student has: Student has: Student has: Student has: Student has:
25% – Highlighted in detail – Highlighted in detail – Highlighted in detail – Highlighted in detail – Identified significant Limited
significant factors significant factors significant factors significant factors – Highlighted in detail factors underlying the understanding of the
underlying the underlying the underlying the underlying the significant factors incident or issue, but incident or issue and
incident or issue incident or issue incident or issue incident or issue underlying the has not provided its significance to
– Explained and – Explained and – Explained and – Explained and incident or issue details their discipline
analysed their analysed their analysed their shown why they are
importance importance importance important
– Referred to relevant – Referred to relevant – Referred to relevant
theory and literature theory and literature theory and literature
to support their to support their to support their
reasoning reasoning reasoning
– Considered different – Considered different
perspectives – (eg perspectives – (eg
theoretical or ethical) theoretical or ethical)
in relation to this in relation to this
issue issue
Restructuring Student has explicitly: Student has: Student has: Student has: Student has: Student has: Student has:
15% – Explained how and – Explained how and – Explained how and – Explained how – Explained how – Provided an – Not explained how
why future practice or why future practice or why future practice or future practice or future practice or Unsatisfactory future practice or
professional professional professional professional professional attempt at reframing professional
understanding has understanding has understanding has understanding has understanding could or reconstructing understanding could
been reconstructed been reconstructed been reconstructed been reconstructed be reconstructed future practice or be reconstructed.
– Described how they – Described how they – Described how they – Described how they – Described how they professional
would deal with this would deal with this would deal with this would deal with this would deal with this understanding.
next time next time next time next time next time
– Elaborated on what – Elaborated on what – Elaborated on what – Explained how
might work and why might work and why might work and why relevant literature
– Identified different – Identified different – Explained how supports their ideas
options and/or options and/or theories or relevant
scenarios and scenarios and literature support
their ideas

 

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hypothesised hypothesised
possible outcomes possible outcomes
– Explained how – Explained how
theories or relevant theories or relevant
literature support literature support
their ideas their ideas
– Explored whether – Explored whether
changes could be changes could be
made to benefit other made to benefit other
stakeholders stakeholders
Integration of The student has The student has The student has The student has The student has The student has The student has not
Reflective explicitly successfully successfully integrated all of the integrated some but unsatisfactorily made an attempt to
Components and successfully integrated each of the integrated each of the elements (reporting not all of the attempted to integrate the
30% integrated each of the elements (reporting elements (reporting and responding, elements (reporting integrate the elements (reporting
elements (reporting and responding, and responding, relating, reasoning, and responding, elements (reporting and responding,
and responding, relating, reasoning, relating, reasoning, and reconstructing) relating, reasoning, and responding, relating, reasoning,
relating, reasoning, and reconstructing) of and reconstructing) of into a cohesive and reconstructing) relating, reasoning, and reconstructing) of
and reconstructing) of the reflection. the reflection. reflection. into a cohesive and reconstructing) of the reflection.
the reflection. There is evidence There is evidence reflection. the reflection.
There is evidence that the that the
that the reconstruction builds reconstruction builds
reconstruction builds on each of the other on each of the other
on each of the other elements. elements.
elements. The four elements
The four elements are linked clearly,
are linked clearly, cohesively, and
cohesively, and logically.
logically.
Organisation, Flawless Excellent standard of High standard of Effective written Adequate written Marginal, written Poor, written
Presentation and presentation. written written communication with communication presentation and presentation and
Referencing communication with communication with few errors of spelling although a number of referencing, not at an referencing, not at an
Flawless use of APA few errors of spelling few errors of spelling and grammar spelling and
academic/profession academic/profession
referencing style in all and grammar. and grammar. grammatical errors.
al standard. al standard.
10% instances. A range of Accurate use of APA
in-text citations has Consistent accurate Accurate use of APA referencing style on APA referencing style There are There are several
been used. use of APA referencing style on most occasions. is demonstrated
inaccuracies with the inaccuracies with the
referencing style in all most occasions. A There is limited use inconsistently. There
instances. A range of range of in-text of a range of in-text is no variation of in- APA referencing APA referencing
in-text citations has citations has been citation formats. text citation format. style. style.
been used. used.

 

 

 

 

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