Nursing Practice and Professional Standards

This assignment delves into the complexities of nursing practice within the United States. It examines the influence of state boards of nursing on practice regulations, highlighting the importance of delegation protocols as outlined by the Texas Board of Nursing. The role of professional organizations like the American Nurses Association in establishing ethical standards and advocating for nurses is also discussed. The assignment emphasizes the significance of Nurse Practice Acts in defining legal boundaries for nursing practice and explores how historical figures like Florence Nightingale and Margaret Sanger contributed to the evolution of nursing.

Running Head: Professional roles and values
Professional roles and values
Name of the Student
Name of the University
Author note

1PROFESSIONAL ROLES AND VALUES
A.
The nursing theory that has influenced the personal goals and values is the Orem’s self-
care theory.
Nurses apply this theory by promoting the self-care among the patients with self-care
deficits. It may be promoted by various means such as education, compensation, empathy and
support. Education on medication and its side effects, or illness related aspects, treatment plan,
health-promoting behaviours such as exercise, or taking appropriate nutrition can promote the
self-care habits in patients such as being aware of treatment or rehabilitative measures (Riegel et
al., 2012).
The theory fits in the professional practice as I focus on assessing each individual's
ability to perform the self-care independently. When working with people with disability in
geriatric care to meet their self-care needs, I use this theory. It includes activities of daily living
and others.
B.
The two historical nursing figures in the 19th or 20th century are Florence Nightingale and
Margaret Sanger.
Contributions of the Florence Nightingale include nursing aspects for injured military
patients that emphasised on the sanitation, prevention of infection and other environment theory
that are widely influential.
On the other hand, Margaret Sanger contributed towards nursing specialised for a
pregnant woman to prevent miscarriages. She opened her first birth control clinic in the US and

2PROFESSIONAL ROLES AND VALUES
founded American Birth control league. She also contributed to prescription of contraceptives by
doctors (Forrester, 2016).
Both the contributions influence the professional practice. The environment theory by the
Florence Nightingale helps me promote the hygiene awareness in the patient and focus on
preventing the risk of infection. Similarly, nursing work of Margret Sanger influences my
advocacy for birth control. To implement any effective change in the health care organisation
and to work towards right cause she is my inspiration.
C.
1. The state board of nursing plays a crucial role in the protecting the welfare and health
of public. It ensures that licensed nurses provide safe and competent care. To achieve this
mission, the board has outlines the standards for safe nursing. It also issues the license to practice
nursing (Cherry & Jacob, 2016). On the other hand, the American Nurses Association
recognises the responsibility of the boards of nursing and reserves the issues related to the nurse
licensure by holding hearings, investigating the complaints. This organisation stands in the
forefront to improve the quality of health care for all. Its role is to advance the nursing profession
by fostering high standards of nursing practice. The organisation promotes the safe and ethical
work, bolsters the health and wellness of nurses and advocates on the health issues affecting the
public and nurses (Winland-Brown et al., 2015).
2. The first organisation helps to practice the nursing acts and standards. The second
organisation helps me by giving confidence to raise concerns on behalf of the patients in regards
to incompetent care and unsafe practices. From 2009-2011, the organisation has been helpful in
responding to the concerns of the Texas hospital nurses. In case of national significance, the

3PROFESSIONAL ROLES AND VALUES
second organisation speaks for nurses. I can take resources and referrals from the ANA if alerted
by the state board of nursing of a complaint or legal notification.
3.The requirement for license renewal in my state are having no default on the a Texas
Guaranteed Student Loan, meeting all the mandatory requirements of continuing nursing
education, not having been selected for audit or any criminal background check and having
matched the licensed number, and the social security number with the board’s files (Young,
2016).
The consequence of failure to meet the requirement of the state is no longer able to
practice nursing.
4. In case of compact states, the nurse does not need to obtain the license again in the
other member state to practice nursing. It is also regarded as a multi-state license. The same is
not the case of the non-compact states. The nurses must again obtain license in the new states
stating the license requirements of the previous state and inform both the new and previous state
board of nursing. It will need the change in the multistate nursing license to single-state status
(Ashton, 2016).
D.
FDA or Food and Drug Administration is the federal agency in the US. FDA regulates
the sale of medical device products; cosmetics and food products. It regulates food and drug
safety. Any company must receive approval from FDA for selling the particular food or drug
product to ensure it is safe and effective (Huston, 2013).

4PROFESSIONAL ROLES AND VALUES
On the contrary, the centre for Medicare & Medicaid Services is the federal agency
within the “within the United States Department of Health and Human Services (HHS)”. It
administers the Medicare program and is the partner of state government to administer Medicaid.
It is the health care financing administration that regulates the health care insurance programs
and the portability standards for health insurances. It is also involved in maintaining the quality
standards in the long-term care facilities, oversight of healthCare.gov, children's health
insurance program, responsible for administrative simplification standards from "Health
Insurance Portability and Accountability Act of 1996 ” (Oliver et al., 2014).
FDA helps me in safe use of the medical devices to prevent patient injuries and death. I
maintain profound knowledge of different medical devices that affect the patient outcomes. I can
report factors related to medical devices to FDA that are contributing to adverse outcomes. I
also need to be aware of the changes in the health care policies and how it affects the nursing
practice. Medicare and Medicaid services help to advocate the patients in accessing the health
care, during ICD-10 conversion, and make productive changes. It is my role to define the value
of these services to the patients and families. The pay for performance system allows ensuring if
a particular patient has received the antibiotic before surgery (Oliver et al., 2014).
I would promote the safety by explaining the pros and cons of the alternative therapy and
explain the science related to it. I will explain by being non-judgmental and respectful. I would
collaborate with the other health care practitioners to make an effective decision. In regards to
acceptance of the treatment, I will try to compromise and negotiate to make it feel more patient-
centred. More focus will be on evidence-based practice (Forrester, 2016).
E.

5PROFESSIONAL ROLES AND VALUES
The Nurse Practice Act enacted in all the states by state legislature to define the
responsibility and scope of the practice for nurses. It protects the patents from harm due to
unsafe and incompetent practice (Russell, 2012). The scope of practice for RN-
 Prevention of illness and maintenance of heath
 Assessment, intervention, observation, evaluation, rehabilitation, health teachings
of a person experiencing change in the health status
 Administering medicine as ordered by the supervisor
 Supervision and evaluation of nursing practice, policies and procedure
 Development of nursing care plan
 Request and receive sign for the prescription of the drug samples to the patients
and implement the authority to sigh wherever applicable
Delegation is defined as giving “authority to unlicensed person to provide nursing
services for retaining accountability” of the licensed person. According to Texas board of
nursing RN make delegate tasks taking into account licensure and scope of practice of other
RN/LVN’s. Tasks must be delegated if the RN/LVN co-signs the documentation. Nurses who
are delegating the task are hold responsible, and accountable, for errors. Delegations rules 224
and 225 are to be followed that define delegation. Some of the tasks that can be delegated are
medications and emergency procedures, health maintenance activities, Parameducs, EMT,
BIPAP and CPAP procedures (Bon.texas.gov, 2018).
F.
In the professional practice, I have played the role of scientist when doing the research
project. I had to conduct a survey in my ward to find the reason for patient’s falls.

6PROFESSIONAL ROLES AND VALUES
As a nurse, I have played the role of detective when one of my patients after knee surgery
was depressed and highly anxious. Using the active listening skills, I have received more
background information about the patient. Upon regular conversation, for 2 days I have
discovered that the major source of depression was her son who never visited during hospital.
Prior to discharge, I have referred her to the psychiatrist for mental well being.
I play the role of manager by directing the work of my juniors and reporting errors to the
nursing administrator. I do engage in feedback, sharing of experience and mentoring the new
joinees. I was also engaged in coordination of training programs.
G.
The two provisions of the ANA code of ethics-
 Nurses in all professional relationships must respect the human dignity, and
practice with compassion.
 Commitment of the nurses to the patients irrespective of the individual,
community or group (Winland-Brown et al., 2015)
In the clinical practice, the common errors that is highly likely to occur is the medication
error. For instance- in my experience, I have seen nurses using abbreviated form of medicines in
prescriptions, instead of full names. Similar drug names and lack of pharmacological information
contributed to medication error
The above mentioned provisions can be applied to this error. The medication error may
be regarded as the disrespect to human dignity, and therapeutic relationship with the patient. It
also means that the nurse did not collaborate with others to provide high quality care. As per the

7PROFESSIONAL ROLES AND VALUES
provision 2, it may lead to conflict of interest for nurses engaged in medication error. In such
case the practice becomes questionable.
H.
1. Four leadership traits that represent excellent nursing are- compassionate, emotional
intelligence, having realistic plan for professional growth, confident in evidence-based decisions
(Anonson et al., 2014).
Compassionate- It refers to caring, understanding, sensitive and empathetic
understanding during care process.
One of my patients John was mentally disturbed. As a leader at bedside, I had interacted
with him at the bed side empathically using active listening skills to know his interest. I was
compassionate in this care process. Using compassion skills I could reduce his anxiety before
knee surgery.
I had empathically communicated with my interdisciplinary team members to listen and
understand the patient’s concerns. I had requested them to help the patient deal with the anxiety
by incentivising activities .that promotes client centered care.
Emotional intelligence- is the capacity of developing self awareness, and handling
personal relationships empathetically.
I was able to manage my emotions when one of my patients on the bed narrated his
wife’s death due to cancer. He was stressed and anxious before his hip surgery. As a leader at
bedside, I have fostered positive feelings in him, by sharing success stories of knee and hip
surgery patients. I was able to handle the situation by emotional intelligent management.

8PROFESSIONAL ROLES AND VALUES
When dealing with the interdisciplinary team members, I have maintained my calm and
compose demeanour. I was hold accountable for medical error in one incident. However, I had
effectively handled the conflict, by being polite and respectful. Upon showing the relevant
documents to the concerning physician, it was confirmed the error was committed by other nurse
at night shift.
Having realistic plan for professional growth- is the leadership skills to accomplish goals
in desired time. This trait ensures precision of plan that brings confidence.
I have planned to complete the 150 CDP hours on learning the assessment of the older
person. As a leader at bed side, I can have better understanding of the ageing process and the
physiological changes. Therefore, I can affectively assess older people.
When working in the interdisciplinary team, I have developed a plan of care for a patient
chronically ill and with disabling conditions. It includes involvement of family, training of the
patient to use assistive device, incorporation of the evaluative data from research into nursing
practice.
Confident in evidence based decisions- Evidence based practice refers to executing an
action that is guided by research and guidines, clinical expertise and patient’s values for making
decisions related patient care.
As a leader at bed side, I have provided the oxygen to COPD patient as evidence based
practice. As per the evidence based protocol, it helps to prevent hypoxia as well as organ failure.
I have taken this step despite the belief that oxygen supply in COPD may lead to acidosis.

9PROFESSIONAL ROLES AND VALUES
I have confidently taken evidence-based decisions to prevent medical errors. Have used
survey to identify the falls in the geriatric care and recommended suggestions to interdisciplinary
team to prevent the same. One of the suggestions was to use yellow socks to recognise fall risk
patients. My plan for next six months is to enhance the technical tools knowledge, to better
engage with interdisciplinary team
2. My work environment demands cultivation of leadership skills owing to the
complexity of the chronic illnesses. In different situations particular leadership say
transformational leadership is not applicable. Therefore, there is a need for situational leadership
skill (Weiss & Tappen, 2014). Decision making is impacted when assisting the professionals in
the problem solving. It is due to time and workload. Financial limitations do hinder the
professional development. However, the programs imitated by the nurse leaders and educators
help achieve the professional development goals.

10PROFESSIONAL ROLES AND VALUES
References
Anonson, J., Walker, M. E., Arries, E., Maposa, S., Telford, P., & Berry, L. (2014). Qualities of
exemplary nurse leaders: perspectives of frontline nurses. Journal of nursing
management, 22(1), 127-136.
Ashton, L. M. (2016). Compact state licensure: Take the “fast lane” to nursing
practice. Nursing2016, 46(12), 50-54.
Bon.texas.gov. (2018). Texas Board of Nursing - Practice - Delegation Resource
Packet. Bon.texas.gov. Retrieved 15 January 2018, from
https://www.bon.texas.gov/practice_delegation_resource_packet.asp
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management.
Elsevier Health Sciences. Retrieved from: https://books.google.co.in/books?
hl=en&lr=&id=vzzdCwAAQBAJ&oi=fnd&pg=PP1&dq=US+state+board+of+nursing+
+and+AMerican+nurses+association+&ots=mNqi2qBwjx&sig=ubVwabtlu5nGLY7yNS
Hqq4rPEYQ#v=onepage&q=US%20state%20board%20of%20nursing%20%20and
%20AMerican%20nurses%20association&f=false
Forrester, D. A. (Ed.). (2016). Nursing's Greatest Leaders: A History of Activism. Springer
Publishing Company. Retrieved from: https://books.google.co.in/books?
hl=en&lr=&id=1v1qCwAAQBAJ&oi=fnd&pg=PP1&dq=florence+nightingale+and+mar
garet+sanger&ots=5n86IJJZ7p&sig=TEILDS5JJja-zSQjT9Fs--
iYWFI#v=onepage&q=florence%20nightingale%20and%20margaret%20sanger&f=false

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Huston, C. J. (2013). Professional issues in nursing: Challenges and opportunities. Lippincott
Williams & Wilkins.
Oliver, G. M., Pennington, L., Revelle, S., & Rantz, M. (2014). Impact of nurse practitioners on
health outcomes of Medicare and Medicaid patients. Nursing Outlook, 62(6), 440-447.
Riegel, B., Jaarsma, T., & Strömberg, A. (2012). A middle-range theory of self-care of chronic
illness. Advances in Nursing Science, 35(3), 194-204.
Russell, K. A. (2012). Nurse practice acts guide and govern nursing practice. Journal of Nursing
Regulation, 3(3), 36-42.
Weiss, S. A., & Tappen, R. M. (2014). Essentials of nursing leadership and management. FA
Davis.
Winland-Brown, J., Lachman, V. D., & Swanson, E. O. C. (2015). The new code of ethics for
nurses with interpretive statements. 2015: Practical clinical application, Part I. Medsurg
Nursing, 24(4), 268-71.
Young, G. G. (2016, July). License Renewal Experience in the US: Continue to Seek Long Term
Operation or Shutdown?. In ASME 2016 Pressure Vessels and Piping Conference (pp.
V007T07A011-V007T07A011). American Society of Mechanical Engineers.