401007 Approaches To Professional Nursing Practice Assignment 2022
Added on 2022-11-21
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401007 Approaches to Professional Nursing Practice
Module 3 : NMBA Documents
Ethics, health ethics and bioethics (pp. 10–16) from Chapter 1: Introduction: Why
study philosophy, ethics, and legal issues
Ethics is about words, and often very emotive and value-laden considerations must be
articulated. Professionals usually try to adopt a rational, scientific approach to problem solving;
they may feel a need to distance themselves from emotional issues and can do so by using
jargon and their position of ‘power’ to promote their point of view.
Bioethics is the study of ethics as the field relates to health care. Bioethicists specialise in
translating and relating the theories of health to the theories guiding moral behaviour in health
care. Bioethicists address health and health research controversies and raise awareness of
these controversies. Some authors have devised strategies to examine problems or have
developed codes of ethical practice to ensure professionals know the behaviour expected in real
life when competing interests arise.
Bioethics is ‘applied’ ethics. The focus tends to be on determining the most suitable ethical
solution to a specific health issue. Bioethics is less concerned with the theories and social or
religious moral systems that underpin values, or with emotions, opinions or personal belief; rather
it identifies agreed ways of investigating issues, establishing ways to analyse problems that have
a moral dimension and achieving an objective assessment in order to make an ethical decision.
Codes of professional ethics and codes for ethical research give direction to and policies for
health professionals to adhere to satisfy expected standards. Some are very precise as to what
is expected while others are less specific.
Summary
Nursing practice draws on many science and humanities subjects and the demand for nurses to
be able to identify their legal and moral obligations is high. Nursing occurs in many environments
and care is provided to people with varying needs, abilities, and expectations. Holistic
approaches require us to consider the needs of the client across many dimensions so it will be
inevitable that dilemmas will arise and a desire to have a ‘one size fits all rule’ is understandable
but not possible. As professionals there is an expectation that we have the knowledge and skills
to assess not only the needs of the client but the context within which those needs arise. We
need to be alert to the fact the boundaries of our practice, the decisions we take and the actions
we implement are always context bound. What is reasonable in one time and place will not
necessarily be reasonable in another circumstance. Professional reasoning, professional
assessment and professional documentation that considers the context, and which gives a
rationale for our work, is a communication skill we need to develop. Clear and unambiguous
facts, lucid and accurate reports and evaluation of our actions will give anyone who questions or
reviews our work and behaviour valuable and reliable information. Gaps will only raise doubts
about the accuracy or integrity of the author of notes and poor explanations or limited
engagement with our clients can lead to loss of trust and it is the clients’ perceptions of us as
professionals we need to meet. By satisfying these obligations the risk of legal and professional
investigations is minimised.
Module 3 : NMBA Documents
Ethics, health ethics and bioethics (pp. 10–16) from Chapter 1: Introduction: Why
study philosophy, ethics, and legal issues
Ethics is about words, and often very emotive and value-laden considerations must be
articulated. Professionals usually try to adopt a rational, scientific approach to problem solving;
they may feel a need to distance themselves from emotional issues and can do so by using
jargon and their position of ‘power’ to promote their point of view.
Bioethics is the study of ethics as the field relates to health care. Bioethicists specialise in
translating and relating the theories of health to the theories guiding moral behaviour in health
care. Bioethicists address health and health research controversies and raise awareness of
these controversies. Some authors have devised strategies to examine problems or have
developed codes of ethical practice to ensure professionals know the behaviour expected in real
life when competing interests arise.
Bioethics is ‘applied’ ethics. The focus tends to be on determining the most suitable ethical
solution to a specific health issue. Bioethics is less concerned with the theories and social or
religious moral systems that underpin values, or with emotions, opinions or personal belief; rather
it identifies agreed ways of investigating issues, establishing ways to analyse problems that have
a moral dimension and achieving an objective assessment in order to make an ethical decision.
Codes of professional ethics and codes for ethical research give direction to and policies for
health professionals to adhere to satisfy expected standards. Some are very precise as to what
is expected while others are less specific.
Summary
Nursing practice draws on many science and humanities subjects and the demand for nurses to
be able to identify their legal and moral obligations is high. Nursing occurs in many environments
and care is provided to people with varying needs, abilities, and expectations. Holistic
approaches require us to consider the needs of the client across many dimensions so it will be
inevitable that dilemmas will arise and a desire to have a ‘one size fits all rule’ is understandable
but not possible. As professionals there is an expectation that we have the knowledge and skills
to assess not only the needs of the client but the context within which those needs arise. We
need to be alert to the fact the boundaries of our practice, the decisions we take and the actions
we implement are always context bound. What is reasonable in one time and place will not
necessarily be reasonable in another circumstance. Professional reasoning, professional
assessment and professional documentation that considers the context, and which gives a
rationale for our work, is a communication skill we need to develop. Clear and unambiguous
facts, lucid and accurate reports and evaluation of our actions will give anyone who questions or
reviews our work and behaviour valuable and reliable information. Gaps will only raise doubts
about the accuracy or integrity of the author of notes and poor explanations or limited
engagement with our clients can lead to loss of trust and it is the clients’ perceptions of us as
professionals we need to meet. By satisfying these obligations the risk of legal and professional
investigations is minimised.
401007 Approaches to Professional Nursing Practice
Confidentiality (pp. 50–54) from Chapter 3: Common law
Confidentiality is not a tort. However, with a little thought you should see that the issues of
privacy and confidentiality link to the concept of defamation and emotional distress. There is
legislation that gives direction to practice for the protection of individual right to privacy.
The Privacy Act 1988 (Cth) does not regulate the handling of personal information by individuals
for the purposes of, or in connection with, their personal, family or household affairs. This means
that an individual acting in a personal capacity, for example, an individual who posts personal
information about others on a personal ‘blog’ is not regulated by the Privacy Act.
Privacy law the right to privacy and the absolute expectation that personal data, medical records,
financial data, and credit information is kept secure and protected is the focus of extensive
legislation. There is Commonwealth legislation that covers public entities. Ongoing reforms in this
area have broadened the range of obligations and responsibilities as well as including private
entities. The Privacy Act 1988 regulates the handling of personal information about individuals.
This includes the collection, use, storage and disclosure of personal information, and access to
and correction of that information. There have been many amendments to the Act and since
2014 the inclusion of 13 Australian Privacy Principles replaced the former Information Privacy
Principles.
In New South Wales the Privacy and Personal Information Protection Act 1998(NSW) covers the
public sector and has established an Office of the New South Wales Privacy Commissioner.
Major government agencies, such as the police, are exempt from some or all the privacy
principles. All state-owned corporations, courts, tribunals, and royal commissions are fully
exempt.
The Health Records and Information Privacy Act 2002 deals with medical records. Other relevant
legislation: Privacy and Personal Information Protection Act 1998, Health Records and
Information Privacy Act 2002 (NSW), Freedom of Information Act 1989 (NSW)
Chapter 4: Consent: Legal principles and practice considerations (pp. 59–79).
Assault is when someone deliberately creates a fear or apprehension of harmful contact.
Battery is when the threat is carried out.
o The standard expected was to be determined with careful consideration of several
factors: The nature of the information to be disclosed.
o The nature of the treatment.
o The desire of the patient for information.
o The temperament and health of the patient.
o The general surrounding circumstances.
Information that a responsible doctor should disclose depends on five factors including:
‘the nature of the matter to be disclosed.
the nature of the treatment.
the desire of the patient for information.
the temperament and Application to practice health of the patient.
and the general surrounding circumstances.
Confidentiality (pp. 50–54) from Chapter 3: Common law
Confidentiality is not a tort. However, with a little thought you should see that the issues of
privacy and confidentiality link to the concept of defamation and emotional distress. There is
legislation that gives direction to practice for the protection of individual right to privacy.
The Privacy Act 1988 (Cth) does not regulate the handling of personal information by individuals
for the purposes of, or in connection with, their personal, family or household affairs. This means
that an individual acting in a personal capacity, for example, an individual who posts personal
information about others on a personal ‘blog’ is not regulated by the Privacy Act.
Privacy law the right to privacy and the absolute expectation that personal data, medical records,
financial data, and credit information is kept secure and protected is the focus of extensive
legislation. There is Commonwealth legislation that covers public entities. Ongoing reforms in this
area have broadened the range of obligations and responsibilities as well as including private
entities. The Privacy Act 1988 regulates the handling of personal information about individuals.
This includes the collection, use, storage and disclosure of personal information, and access to
and correction of that information. There have been many amendments to the Act and since
2014 the inclusion of 13 Australian Privacy Principles replaced the former Information Privacy
Principles.
In New South Wales the Privacy and Personal Information Protection Act 1998(NSW) covers the
public sector and has established an Office of the New South Wales Privacy Commissioner.
Major government agencies, such as the police, are exempt from some or all the privacy
principles. All state-owned corporations, courts, tribunals, and royal commissions are fully
exempt.
The Health Records and Information Privacy Act 2002 deals with medical records. Other relevant
legislation: Privacy and Personal Information Protection Act 1998, Health Records and
Information Privacy Act 2002 (NSW), Freedom of Information Act 1989 (NSW)
Chapter 4: Consent: Legal principles and practice considerations (pp. 59–79).
Assault is when someone deliberately creates a fear or apprehension of harmful contact.
Battery is when the threat is carried out.
o The standard expected was to be determined with careful consideration of several
factors: The nature of the information to be disclosed.
o The nature of the treatment.
o The desire of the patient for information.
o The temperament and health of the patient.
o The general surrounding circumstances.
Information that a responsible doctor should disclose depends on five factors including:
‘the nature of the matter to be disclosed.
the nature of the treatment.
the desire of the patient for information.
the temperament and Application to practice health of the patient.
and the general surrounding circumstances.
401007 Approaches to Professional Nursing Practice
Summary
The existence of policies and protocols as well as codes of practice for obtaining consent should
mean that there would be no risk that a client could feel their right to consent has been
overridden. The routine nature of pre-procedure consent may in fact be a cause of problems as
health professionals may fail to treat clients as individuals and be so focused upon the task that
they forget the patients. Recognising that some clients may refuse or withhold consent and
others may lack the capacity to consent does not mean health professionals are helpless or freed
of professional responsibility. If a client decides that health staff members believe is based on
unsound judgment or one that puts the client at risk, where treatment has benefits, there are
procedures to follow. If the rights of the patient, not the preference of the service provider, take
precedence it is unlikely to be an issue. There are regular media reports about cases exploring
the right of client or family to refuse treatments or to withdraw life-saving technology. Sometimes
these cases get to court to clarify the law and to protect all parties from a fear of consequences;
often they are ethical dilemmas. It is not just one nurse’s responsibility to deal with difficult
issues, it is a system issue and getting advice and recommending institutions provide written
policies or guidelines is a way to ensure obligations are met both ethically and legally.
Chapter 7: Professional governance (pp. 124–147).
The Nursing and Midwifery Board has published professional standards that are
variously referred to as codes, guidelines, and policies. These provide the public with
clear statements of what they should expect from a professional.
It is these publications that are used to measure complaints against a practitioner
should an investigation and hearing be carried out in response to a complaint.
Code of ethics
Codes of professional conduct Guidelines
Competency standards Decision making framework
Guidelines for registration standards Professional boundaries
Professional practice guidelines Re-entry to practice
Policies Social media
A nurse’s guide to professional boundaries. This document gives direction for professional
boundaries. Unlike the codes and standards that govern practice by providing a framework for
legally, professionally accountable, and responsible nursing practice in all clinical, management
education and research domains, in Australia and New Zealand this publication drills down to
specific situations and considerations. It aims to give nurses certainty in their practice. Risky
behaviours are described and consideration of many “what if” situations is covered.
Understanding these will provide you with a personal, professional decision-making framework.
The codes and guidelines, standards of practice and regulation of education all combine to
provide a benchmark against which the professional is measured. You have already seen in your
readings about the tort of negligence that courts will use these documents to identify what the
profession believes is a standard against which they can measure the behaviour of an individual
nurse.
Summary
The existence of policies and protocols as well as codes of practice for obtaining consent should
mean that there would be no risk that a client could feel their right to consent has been
overridden. The routine nature of pre-procedure consent may in fact be a cause of problems as
health professionals may fail to treat clients as individuals and be so focused upon the task that
they forget the patients. Recognising that some clients may refuse or withhold consent and
others may lack the capacity to consent does not mean health professionals are helpless or freed
of professional responsibility. If a client decides that health staff members believe is based on
unsound judgment or one that puts the client at risk, where treatment has benefits, there are
procedures to follow. If the rights of the patient, not the preference of the service provider, take
precedence it is unlikely to be an issue. There are regular media reports about cases exploring
the right of client or family to refuse treatments or to withdraw life-saving technology. Sometimes
these cases get to court to clarify the law and to protect all parties from a fear of consequences;
often they are ethical dilemmas. It is not just one nurse’s responsibility to deal with difficult
issues, it is a system issue and getting advice and recommending institutions provide written
policies or guidelines is a way to ensure obligations are met both ethically and legally.
Chapter 7: Professional governance (pp. 124–147).
The Nursing and Midwifery Board has published professional standards that are
variously referred to as codes, guidelines, and policies. These provide the public with
clear statements of what they should expect from a professional.
It is these publications that are used to measure complaints against a practitioner
should an investigation and hearing be carried out in response to a complaint.
Code of ethics
Codes of professional conduct Guidelines
Competency standards Decision making framework
Guidelines for registration standards Professional boundaries
Professional practice guidelines Re-entry to practice
Policies Social media
A nurse’s guide to professional boundaries. This document gives direction for professional
boundaries. Unlike the codes and standards that govern practice by providing a framework for
legally, professionally accountable, and responsible nursing practice in all clinical, management
education and research domains, in Australia and New Zealand this publication drills down to
specific situations and considerations. It aims to give nurses certainty in their practice. Risky
behaviours are described and consideration of many “what if” situations is covered.
Understanding these will provide you with a personal, professional decision-making framework.
The codes and guidelines, standards of practice and regulation of education all combine to
provide a benchmark against which the professional is measured. You have already seen in your
readings about the tort of negligence that courts will use these documents to identify what the
profession believes is a standard against which they can measure the behaviour of an individual
nurse.
401007 Approaches to Professional Nursing Practice
Professional discipline
The regulating body has powers to investigate, discipline and deregister a nurse. Legislation
specifies that AHPRA can initiate an investigation if it receives notification/complaint
electronically, hardcopy letter or telephone call and it is the legislation that identifies the types of
behaviour that falls within AHPRA’s obligation to investigate and act. Complaints can be referred
from State Health Complaints entities and the State’s Ombudsman.
In NSW, the entire notifications process is managed by the Health Care Complaints Commission
(HCCC) and health professions councils, meaning that the National Boards and AHPRA are not
involved.
Administrative law
Administrative law is another specialised branch of law where there are rules and limits to
authority. Administrative law is the body of law regulating both the executive branch of
government and the interaction of tribunals and courts. Professional disciplinary committees and
tribunals exist through delegated legislation and must adhere to the rules governing all tribunals.
Tribunals operate at both state and federal level.
There are two main components of administrative law: 1. judicial review, which is concerned with
the proper exercise of power and evolved through the common law but is now governed by
codes of practice and regulations; and 2. merits review, which is concerned with whether the
decision was correct or preferable.
Merits review is solely statute based. One administrative law rule relates who must prove the
issue. In civil law the plaintiff must prove that their facts are true ‘on the balance of probabilities’;
for a crime, the prosecution is required to prove that the facts are true ‘beyond reasonable doubt’.
In administrative law, the burden of proof falls between the two and every individual is entitled to
defend any claims made against them.
Summary
Professional governance is a fact of the professional’s life. Taking advantage of the knowledge
and expertise embedded in professional boards is possible by utilising their guidelines,
publications, websites, and the information that accompanies annual registration applications.
The point of having professional governing bodies is to protect the public and they do this by
informing, monitoring, and ensuring their professional members satisfy standards. This chapter
has also introduced a new area of law, Administrative Law and developed on some of the legal
concepts that have been raised earlier. The notion of natural justice and the application of rules
of law used to review investigations of complaints means that while frivolous, unfounded or
malicious complaints will be investigated as rigorously as genuine complaints the professional
under scrutiny can be confident that the procedures will be fair and open to review and their right
to privacy and protection will be upheld by a tribunal.
Informed consent, ethics, and confidentiality
Consent can be implied—nodding of the head, extending arm for injection or blood pressure,
saying 'yes'. Consent may also be expressed as verbal—the patient states 'yes' to the request
from a nurse to perform a procedure; or written—a patient signs a consent form after an
explanation from a medical officer.
Professional discipline
The regulating body has powers to investigate, discipline and deregister a nurse. Legislation
specifies that AHPRA can initiate an investigation if it receives notification/complaint
electronically, hardcopy letter or telephone call and it is the legislation that identifies the types of
behaviour that falls within AHPRA’s obligation to investigate and act. Complaints can be referred
from State Health Complaints entities and the State’s Ombudsman.
In NSW, the entire notifications process is managed by the Health Care Complaints Commission
(HCCC) and health professions councils, meaning that the National Boards and AHPRA are not
involved.
Administrative law
Administrative law is another specialised branch of law where there are rules and limits to
authority. Administrative law is the body of law regulating both the executive branch of
government and the interaction of tribunals and courts. Professional disciplinary committees and
tribunals exist through delegated legislation and must adhere to the rules governing all tribunals.
Tribunals operate at both state and federal level.
There are two main components of administrative law: 1. judicial review, which is concerned with
the proper exercise of power and evolved through the common law but is now governed by
codes of practice and regulations; and 2. merits review, which is concerned with whether the
decision was correct or preferable.
Merits review is solely statute based. One administrative law rule relates who must prove the
issue. In civil law the plaintiff must prove that their facts are true ‘on the balance of probabilities’;
for a crime, the prosecution is required to prove that the facts are true ‘beyond reasonable doubt’.
In administrative law, the burden of proof falls between the two and every individual is entitled to
defend any claims made against them.
Summary
Professional governance is a fact of the professional’s life. Taking advantage of the knowledge
and expertise embedded in professional boards is possible by utilising their guidelines,
publications, websites, and the information that accompanies annual registration applications.
The point of having professional governing bodies is to protect the public and they do this by
informing, monitoring, and ensuring their professional members satisfy standards. This chapter
has also introduced a new area of law, Administrative Law and developed on some of the legal
concepts that have been raised earlier. The notion of natural justice and the application of rules
of law used to review investigations of complaints means that while frivolous, unfounded or
malicious complaints will be investigated as rigorously as genuine complaints the professional
under scrutiny can be confident that the procedures will be fair and open to review and their right
to privacy and protection will be upheld by a tribunal.
Informed consent, ethics, and confidentiality
Consent can be implied—nodding of the head, extending arm for injection or blood pressure,
saying 'yes'. Consent may also be expressed as verbal—the patient states 'yes' to the request
from a nurse to perform a procedure; or written—a patient signs a consent form after an
explanation from a medical officer.
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