Legal and Professional issues in nursing

Legal and Professional issues in nursing 1
Legal and Professional issues in nursing
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Legal and Professional issues in nursing 2
Case study 1
Introduction
The nursing profession is one of the most prestigious professions. This is not only due to
the association with the care of human lives but also the efficiency with which its members
perform. This performance, though individually attained, is guided by strict codes of conduct and
core competencies that ensure the nurses are adequately skilled and capable of managing the
health of people. Failure to adhere to the core competencies may cause the de-registering or
suspension of the named person.
The profession is client-centered and, like many other client-centered professions, its
major focus is to the ‘clients’, who are the community (Gostin, 2010). Thus, its actions are
subject to scrutiny by the clients and therefore it should prioritize them first. Failure to honor the
professional code of ethics and conduct is irreverent to the profession (Milton, 2017).
The case study illustrates the enrolled nurse’s failure to adhere to several core
competencies that resulted in her suspension. Moreover, she treated the patient without
supervision from a Registered Nurse (RN). The nurse operated outside her scope of practice,
hence, failed to meet certain core competencies and generic skills of Enrolled Nurses.
Question 1
Core competencies and generic skills.
Core competencies illustrate the understanding of nursing practice and act as a guide for the
nurses. These core competencies are categorized into domains and include; professional, legal

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and ethical nursing practice; management of care; and professional development (Singapore
Nursing Board, 2018).
Professional, legal and ethical nursing
This domain illustrates an understanding of practices and knowledge in nursing,
accountability, and responsibility of legal obligations in nursing practice. Moreover, it also
involves the demonstration of an understanding and maintenance of ethical nursing practice such
as complacency with the Code for Nurses and Midwives.
This competence domain also recognizes the differences in accountability and roles of the
registered nurse and the enrolled nurse, thus, ensuring both the nurses understand their respective
scope of operation. It also demonstrates the responsibility and accountability of care within their
scope of practice and competence. This allows the nurses to deliver the best possible care to the
patient. Thus, they act true with the vision of care in the best interest of the patient.
The nurse operated independently without supervision or consent from a registered nurse.
It showed that the nurse did not recognize her role in delegated care nor did she respect the
legislative policies and procedural guidelines for nursing practice. The treatment of the patient
outside a health facility not only hindered effective monitoring, but also the maintenance of
proper records. It was very unethical (O’Connell, 2004)
Enrolled Nurses (EN) are guided by regulations put in place by the Singapore Nursing
Board. Understanding their roles and maximally performing to their best creates efficiency in the
system. It also creates accountability since everyone’s role is clear. It ensures that the enrolled
nurses understand the chain of management thus creating a respectful and cohesive working
environment.

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These regulations also consist of measures taken in the event that an enrolled nurse does
not comply. The nurse did not demonstrate an understanding of ethical nursing practices nor did
he comply with the Code for Nurses and Midwives. The Nurses and Midwives Act (1999-2012)
contains the parameters required for a nurse to practice including the institution they are to work
in (Singapore Nursing Board, 2018). However, a patient’s home is not included in the list. It
indicates the nurse failed to adhere to the guidelines put forth by the Board warranting
disciplinary action.
Management of Care
The domain of Management of Care consists of a variety of competency standards that
include but not limited to maintaining a safe environment for the patient such as implementing
infection control procedures. The nurse's treatment of the patient at home might have
unnecessarily exposed the patient to more pathogens than at a health center. The home setting
also could not allow for effective monitoring of the patient’s condition unlike at a health facility
with extensive resources on standby including doctors and RNs available for consultations.
Generic skills
These are skills taught to Enrolled Nurses to enable them to practice and perform
accordingly. Generic skills combined with core competencies are the basis of registration as an
EN. These skills are a prerequisite for registration by the Board, hence, form part of the course
study prior to the completion of the nursing course. They are, therefore essentials and should be
performed competently.
The levels of independence in practice vary and are indicated in each skill. There are
three levels; performing the skills independently; performing the skills independently though