1 Assessment Task 2: Short Answer Questions Q1. The 5 main functions of the Nursing and Midwifery Board of Australia are: I.
Overseeing practitioner registration
II.
Developing professional standards, codes, and guidelines
III.
Handling notifications and complaints about the profession
IV.
Assessing overseas-trained practitioners who wish to practice in Australia
V.
Approving accreditation standards and courses of study.
Q2. Part 1 The NMBA needs to know where a nurse practices to make informed regulatory decisions. It also helps the board in monitoring compliance (Australian Health Practitioner Regulation Agency, 2018). Part 2 The three effective ways that could assist in identifying relevant areas for your further professional development include assessing job market needs, the need to comply with e NMBA’s registration standard on Continuing Professional Development, and the need to enhance professional competence. Q3. Locate and review the current Code of Professional Conduct for Nurses from the Part 1 I can maintain professional boundaries when working with clients by observing the following in line with NMBA standard practice and code of professional conduct: I.
Be respectful.
II.
Be truthful
2 III.
Be open
IV.
Adhere to confidentiality (Nursing and Midwifery Board of Australia, 2023).
V.
Seek consent where necessary
Part 2 The 3 responsibilities all nurses have concerning bullying and harassment are:
Never engage in bullying
Not to ignore bullying
Never excuse bullying.
Part 3 The 4 ways in which to maintain client privacy and confidentiality are: a) Conversing with the client away from eavesdropping. b) Keep client information away from other people’s eyesight, particularly when documenting or after documenting it (Nursing and Midwifery Board of Australia, 2023). c) Encrypting client information stored on computers. d) Locking rooms or computers in which client information is stored. e) Avoid discussing information about the client with unauthorized persons. Q4. Part 1 If you do not comply with health care legislation, what is a potential implication for: ● Your clients? The client is likely to get compromised care services and be harmed. ● Your organisation? The organization is likely to face lawsuits and suffer a damaged reputation as clients complain about compromised services.
3 ● You? I am likely to face disciplinary actions from the regulator, face lawsuits from harmed clients, and even lose a job. Part 2 While giving evidence to the coroner as an expert witness during a coronial inquest, I must only share facts to the best of my knowledge. Secondly, I should answer all questions raised professionally (Nursing and Midwifery Board of Australia, 2023). Lastly, I ought only to stick to relevant information. Part 3 ● Defendant A defendant is simply the accused person in a case or issue. ● Plaintiff The plaintiff is simply the complainant in a case, a person who is allegedly harmed. ● Coroner A coroner is a person authorized by the government to conduct an inquest into the death based on the coroner's jurisdiction. ● Expert witness An expert witness is an individual with a certain specialization who is called to provide an opinion on a case before a court of law. Q5. Part 1 Forcing treatment to a client who has validly refused treatment may constitute an assault or battery offense. The act would also constitute a legal offense of violating the client's autonomy (Hobart Community Legal Service, 2022). Part 2
4 Veracity refers to telling the truth while interacting with the patient. The principle of veracity conflicts with non-maleficence in this case because the latter requires that a nurse avoid harm to the client while implementing veracity would mean harm to the client (Hobart Community Legal Service, 2022). Q6. Part 1 In this case, my duty of care is to first ensure that the boy gets necessary healthcare and is protected from any possible abuse. Part 2 The 2 main protections given to people who report incidents under mandatory reporting legislation are confidentiality of information and immunity against civil, criminal, or administrative action in relation to the report. Part 3 Apart from child abuse, the other 3 situations where mandatory reporting is required include neglect, sexual violation, and physical injury. Part 4 The other registration I would be required to have when working with children include being registered with the National Council Licensing Examination (NCLEX-RN) and the Paediatric Nurse Certification Board Q7. Part 1 Vicarious liability refers to implied liability. It does not protect the nurse from legal action, particularly in scenarios where the nurse caused harm while performing duties or was present when the harm was committed (Beuermann, Christine, 2022). Part 2
5 Enrolled nurses are required to hold professional indemnity insurance to protect themselves against claims for harm, damage, or loss by clients due to the effect of negligent services offered (Australian College of Nursing, 2022). The policy covers possible claims by clients to insulate nurses against the burden of lawsuits and fines to pay harmed clients. Part 3 An enrolled nurse has a legal responsibility to refuse to perform an activity if there is reasonable ground to believe it is religious or morally unacceptable and if it is illegal. Q8. Part 1 The language can be considered defamatory if it is proven that the statement is based on falsehoods because the statement discredits the nurse’s character and reputation. The said nurse is thought to be unprofessional; a person who does not know what should be done in caring for clients, which borders on character assassination when proven to be falsehood (Hobart Community Legal Service, 2022). Part 2 Equal Employment Opportunity (EEO) implies that everyone employed by a healthcare provider has equal access to employment opportunities and is hired based on merit (Hobart Community Legal Service, 2022). In essence, all nurses should be equally competent. Q9. Part 1 It is important to gain consent from ALL clients before undertaking ALL procedures involving physical contact to avoid misunderstanding and possible accusations of assault or breach of privacy. Consent also helps the nurse to prepare the client for contact to avoid upsets (Hobart Community Legal Service, 2022).
6 Part 2 Expressed consent is done verbally or in writing, where a client agrees to a particular procedure or action for instance, a patient signing a consent form to undergo surgery is expressed consent. On the other hand, implied consent is the approval given by a person through implied action or inaction; for instance, a patient can pull off a bra to allow a healthcare service provider to examine her breast to imply consent to the procedure (Hobart Community Legal Service, 2022). Part 3 The 3 elements of valid consent are disclosure of information, the competency of the consenting party to make a decision, and voluntariness of the decision. Part 4 Consent is obtained through implied actions for an unconscious person in a non-emergency situation as against to a life-threatening situation. Also, the consent can also be obtained from a surrogate or guardian (Hobart Community Legal Service, 2022). Q10. Part 1 The nurse was negligent because she owed the patient the duty of care based on the vulnerability. The nurse breached the duty of care by prioritizing the message over the patient's safety (Hobart Community Legal Service, 2022). The patient was hurt because of her act of negligence. If she had acted with utmost care, the patient would not have slipped and hurt. Part 2 False imprisonment False imprisonment is restricting a person's movement without legal authority or justification. Trespass
7 Trespass is illegal direct or intentional interference with another person's body or freedom. Q11. Part 1 A policy framework such as this can improve the quality of healthcare provided in Tasmania by providing a framework for best practices in healthcare and standard practices that healthcare practitioners should observe in performing their duties. Part 2 Power of Attorney Power of Attorney authority, mainly in the form of a signed document, gives a person the power to make decisions for another person in incapacity to make decisions or death. Living will A living will refers to a legal document that defines the type of healthcare one wishes to get, including preferences in case of terminal illness, pain management, and donation of body organs after death. Guardianship Guardianship is the state of being appointed to take care of and make decisions for an adult with a compromised ability to make decisions. Q12. Part 1 Ethics Ethics are simply moral principles that govern what is deemed acceptable and unacceptable. Nursing ethics Nursing ethics refers to the philosophy that guides what is good and bad for a nurse as a professional. Bioethics
8 Bioethics is the rules and norms that govern biomedicine. Part 2 Nurses should identify and analyse ethical issues to stay within acceptable acts and behaviours in nursing. Analysing ethical issues also helps nurses avoid potential public backlash and lawsuits, hence critical to nurses (Australian Government Department of Health and Aged Care, 2023). Part 3 The embryonic stem cells donated from IVF procedures research is a controversial bioethical issue because it entails destroying embryos. The different arguments about when life begins, where some people, such as religious leaders argue that life begins at conception, make the issue of donating embryonic stem cells more controversial (Hobart Community Legal Service, 2022). Moreover, the process also has a potential for human cloning that has attracted divergent views. Q13. Part 1 To show beneficence to the mother, I would try to comfort her and also ensure that the child dies a dignified death. The death should not be violent and dehumanizing (Ahpra.gov, 2023). Part 2 In this case, beneficence differs from non-maleficence in the sense that the nurse wants to promote the good of another patient while at the same time doing so means the organ donor should not be harmed before dying (Ahpra.gov, 2023). Beneficence is promoting good, while non-maleficence is to avoid causing harm, but only in this case, two patients are involved, potential organ donor and recipient (Nursingworld.org, 2023). Part 3
9 The main steps in an ethical decision-making model that could be used in a scenario are the definition of ethical issues, identifying principles to guide the decisions, identifying ethical options, and making the decision. Q14. Part 1 The scenario is an ethical dilemma in the sense that a terminally ill patient has a right to request euthanasia; however, the request should be made by a person of sound mind. In this case, the nurse has doubts about the patient's mental stability, hence partially justified not to comply with the request (Nursingworld.org, 2023). The dilemma can be resolved by ascertaining the mental health of the patient. Part 2 Client autonomy influences the decisions a patient makes and their implementation. Healthcare service providers are required to respect the independence of the patient to make decisions about the type of care or treatment to receive, including requests for assisted termination of life (Pacfa.org, 2023). Client autonomy also requires that healthcare practitioners acknowledge and respect patient's capacity to make decisions. Q15. In the scenario at hand, the patient has lost the capacity to make decisions and she did not have an Advance Care Directive in place, in which she would have stated her preferred future treatment or care, including the plan for ending her life (Australian Government Department of Health and Aged Care, 2022). The nurse can invoke a lack of advance directive care to persuade the family to give the patient more time for treatment. Q16. Part 1
10 Yes, this is a conflict of interest because the nurse wants to advance and protect her cultural and religious beliefs against the woman's wish to terminate the pregnancy. Part 2 A nurse can invoke conscientious objection when there is a conflict of interest that touches on the deeply held religious and cultural beliefs. The nurse is justified to refuse participation in abortion if it violates deeply held religious and philosophical beliefs (Australian Medical Association, 2019). Q17. Part 1 Yes, discrimination is evident in the case scenario. The Aboriginal man is denied timely healthcare services based on his race (Fedele, 2021). This is direct discrimination against the Aboriginal man in a healthcare facility. Part 2 The client may be restrained if he is violent, or threatens the safety of the healthcare practitioner and other patients. Restraint was inappropriate in the scenario because it was not the patient was not violent (Safetyandquality.gov.au, n.d). It was the doctor who was unnecessarily rough on the client. I conducted triage on the patient without any incident, underlining his calmness and cooperation. Restraint should only be used as a last resort in managing a dangerous patient (Teece et al., 2021). Part 3 The right to health is linked to nurse practice in the sense that nurses should not deny anyone in need of treatment healthcare. Nurses should ensure that patients get quality healthcare, without discrimination (Australian Government Department of Health and Aged Care, 2023). The concept of justice relates to treating patients equally and fairly. In essence,
11 nurses should be impartial and objective in handling patients as part of promoting justice in healthcare. Part 4 Apart from human rights, the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) would ensure this Aboriginal man’s right to health care (The Australian Human Rights Commission, n.d.).
12 Reference list Ahpra.gov. 2023. The ICN Code of Ethics for Nurses - Ahpra. https://www.ahpra.gov.au/documents/default.aspx? record=WD21%2f31394&dbid=AP&chksum=%2fYe7Wsutxzjzs4cCDgR %2bEA%3d%3d. Australian College of Nursing 2022. Professional Indemnity Insurance. Australian College of Nursing. https://www.acn.edu.au/membership/indemnity-insurance. Australian Government Department of Health and Aged Care 2022. Advance care directive. https://www.health.gov.au/topics/palliative-care/planning-your-palliative-care/ advance-care-directive Australian Government Department of Health and Aged Care 2023. About nurses and midwives. https://www.health.gov.au/topics/nurses-and-midwives/about. Australian Health Practitioner Regulation Agency 2018. Informing a National Board about where you practice: Responsibilities of registered health practitioners under section 132 of the National Law. www.ahpra.gov.au. Australian Medical Association 2019. Conscientious objection. https://www.ama.com.au/position-statement/conscientious-objection-2019. Beuermann, Christine 2022. Vicarious Liability in Australia In Vicarious Liability in the Common Law World. DOI: 10.5040/9781509939107.ch-004. Fedele, R. 2021. Black African nurses battle racism in rural Australian workplaces, study finds. ANMJ. https://anmj.org.au/black-african-nurses-battle-racism-in-ruralaustralian-workplaces-study-finds/. Hobart Community Legal Service 2022. Abortion/Termination of Pregnancy. https://www.hobartlegal.org.au/handbook/medical-treatment-and-medical-products/ medical-treatment/abortion-termination-of-pregnancy/.
13 Hobart Community Legal Service 2022. Consent. https://www.hobartlegal.org.au/handbook/medical-treatment-and-medical-products/ medical-treatment/consent/. Nursing and Midwifery Board of Australia 2023. Professional Codes & Guidelines“. Nursing and Midwifery Board of Australia. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements.aspx. Nursingworld.org 2023. Why ethics in nursing matters: Ethical principles in nursing. ANA. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/why-ethicsin-nursing-matters/. Pacfa.org 2023. Code of ethics - PACFA. https://www.pacfa.org.au/common/Uploaded %20files/PCFA/Documents/Documents%20and%20Forms/PACFA-Code-of-Ethics2017.pdf Safetyandquality.gov.au. n.d. Australian Commission on Safety and Quality in Health Care. https://www.safetyandquality.gov.au/standards/nsqhs-standards/comprehensive-carestandard/minimising-patient-harm/action-535. Tasmania Government n.d. Palliative care policy framework. https://www.health.tas.gov.au/sites/default/files/2022-11/doh8653_palliative_care_pol icy_framework_web38.pdf. Teece, A., Baker, J. & Smith, H. 2021. ‘Understanding the decision‐making of critical care nurses when restraining a patient with psychomotor agitation secondary to hyperactive delirium: A ‘think aloud’ study.’ Journal of Clinical Nursing, 31(1–2), S. 121–133, DOI: 10.1111/jocn.15889. The Australian Human Rights Commission n.d. UN Declaration on the rights of indigenous peoples. The Australian Human Rights Commission. https://humanrights.gov.au/ourwork/un-declaration-rights-indigenous-peoples-1.