An Analysis of Two Registered Nurse Standards of Practice Report

This report provides an analysis of two key standards of practice for registered nurses as defined by the Nursing and Midwifery Board of Australia (NMBA). The report focuses on the importance of engaging in therapeutic and professional relationships with patients, emphasizing the need for active listening, empathy, and respect for patient autonomy, culture, and beliefs. It highlights the role of nurses in guiding patients' decisions and fostering patient-centered care. The report also examines the standard of comprehensively conducting assessments, detailing the different types of assessments (admission, shift, and focused) and the importance of accurate data collection. It emphasizes the holistic and culturally appropriate nature of assessments, ensuring the well-being of patients is considered. The report further discusses professional issues inherent in these standards, acknowledging the emotional impact on nurses and the potential influence of personal experiences on their practice. The analysis underscores the significance of these standards in guiding nurses' behavior and promoting improved patient outcomes.

Running Head: NURSE STANDARD OF PRACTICE
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An Analysis of Two Standards of Practice of a Registered Nurse
Student’s Name
Institutional Affiliation

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Table of Contents
Introduction................................................................................................................................3
Relevance of the standards.........................................................................................................3
Engages in Therapeutic and Professional Relationships............................................................3
Professional Issues Inherent in the Two Standards....................................................................6
Conclusion..................................................................................................................................6
References..................................................................................................................................8

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Introduction
Nurses play a key role in the health sector (Louisiana State University at Alexandria,
2016). The practice and behaviour of nurses are defined by the professional standards guiding
them (Warwick, 2015). The Nursing and Midwifery board of Australia (2017) provided seven
registered nurse standards for practice. As provided by the standards, a registered nurse on
practice: engages in therapeutic and professional relationships and comprehensively conducts
assessments among other standards (NMBA, 2017). Each standard has a criteria on how it
should be demonstrated. The criteria is interpreted in the context of practice. The nurses
support these standards by adhering the thus promoting their professional identity (Terry,
Stirling, Bull & Fassett, 2015).
This paper focuses on two of the standards provided. The standards are: engages in
therapeutic and professional relationships and comprehensively conducts assessments. The
paper further analyses the relevance between the standards and future nursing practice and
identifies the professional issues inherent in the standards.
Relevance of the standards
In an article, Cashin et al (2016) acknowledged that the benefits of the registered nurse
standards of practice is that they are not restricted to only some roles performed by a nurse
but rather they accommodate all the possible roles of a registered nurse on practice (Cashin,
et al., 2016).The scholars also state that another advantage of the standards is that they are
interrelated and can therefore facilitate the regular changes of the roles of registered nurse
practice.
Engages in Therapeutic and Professional Relationships

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Therapeutic relationships are described as a ‘primary component of all health care
interactions’ (Kornhaber, Walsh, Duff &Walker, 2016).The relations facilitate the
improvement of a patient. The registered nurse on practice is required to listen and respond to
the patient. This way the patient's emotional health is catered for. These kind of relationships
promote patient centeredness and this will lead to improvement of health (Kornhaber, et al,
2016). All the questions, anxieties and doubts of not only the patient but also their families
are acknowledged and in this way the medical practitioners can identify the unmet needs and
unclear issues that needs to be handled. During these interactions, it is the duty of the nurses
to guide the patient’s in the right direction as they make decisions that will have an impact on
their health. A challenge that faces the relationships is that it can be viewed as a task and
thus not done effectively by the nurse (Kornhaber, et al, 2016)
In order to improve the therapeutic relationships, hospitals should come up with a system
of nurse leader rounds (Morton, Brekhus, Reynolds & Dykes, 2014). It is a system which
allows the nurses to go round talking to patient’s in the hospital so as to get their feedback.
However, it is important for the nurses to keep in mind the professional relationships amidst
their friendliness with the patient (NMBA, 2017).The nurses also ought to respect the
patient’s on the grounds of culture, values, beliefs, autonomy and also their rights. The
registered nurses on practice are expected to work in collaboration with other health care
practitioners to promote the patient centred care.
According to Cashin et al (2016), there is a need for clear standards to ‘override’ the
regular views of nursing such as limitation of nurses in their helper roles. The scholars argue
that this type of view imposes a future risk of lack of proper nurse representation in planning
situations.
I have worked in a mental health facility within Australia and have greatly
incorporated the criteria of this standard in my practice. The mental health department is a

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sensitive one that requires facilitating relationships based on mutually exclusive trust and
respect. In order to give hope and empowerment to my patients, I knew I had to work in
collaboration with my care colleagues in the gratification of my patient’s mental, spiritual,
emotional as well as physical needs. I was sensitive to culture and personal beliefs of the
patient and that way, they were subjective to care and consequently achieved better improved
care outcomes towards recovery.
a) Comprehensively Conducts Assessments
It is the duty of the registered nurses to conduct satisfactory assessments which are
systematically and comprehensive. There are different types of assessments done by nurses
according to the Royal Children's Hospital Melbourne (2017). These include: admission
assessment which entails knowing the patient's medical history and checking his or her vital
signs, shift assessments which entails checking the condition of an admitted patient at
different times and focused assessment which is carried out on a specific body system
depending on the patient's health status. It is very important for the nurses to record correct
data which will be later assessed. A registered nurse is required to conducts assessments that
are holistic as well as culturally appropriate (NMBA, 2017). None of the patient’s condition
should not be assumed. The registered nurse should ensure that the well-being of the patient
is considered.
The registered nurse should start by assessing all the available resources at the initial
stages of data collection in a case of conducting holistic assessments. The nurses should use
different techniques to collect the data ranging from asking questions, filling questionnaires,
observing and using books and other scholarly materials. The data collected will aid not only
the nurses but also other medical practitioners in knowing how best to help the patient's. This
kind of approach is useful, for example, in a research carried out by a registered nurse to find

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out how to improve the therapeutic relationships in the hospital so as to promote the patient
centeredness health care.
This standard was very crucial in my clinical experience in a hospital in Victoria. I
was working as a lead nurse in a surgery department whereby I was supposed to lead in a
comprehensive pre-operative assessment of patients. Most of the elderly patients scheduled
for surgery could not express themselves so well verbally especially in matters regarding to
medical history. In that case, I would coordinate a comprehensive analysis of all factors that
would lead to an accurate decision regarding the patient’s health history. This included
contacting their close family carers.
Professional Issues Inherent in the Two Standards.
Registered nurses are human beings .In as much as they try to remain professional as
they carry out their own duties, they can be deeply affected by loss ,heart break and
tribulation of not only their personal but also professional lives (Kartz & Johnson, 2016).This
can affect the way they perform their duties. They can make decisions according to their own
personal views and this will have an impact on the patient's health status.
Conclusion
The NMBA Registered Nurse Standards of practice guide the behaviour and professional
conducts of the nurses. The criteria for each standard is provided by the NMBA. These
standards are adhered to by all the registered nurses. The standards cover all the areas that a
registered nurse may handle .These standards accommodate the evolving nursing practice and
will still be valid in the coming years due to this feature. It is the duty of a registered nurse on
practice to comprehensively conduct assessments. This aids in the treatment of patients. Data
collected for assessment should be accurate and arranged in a clear order. It is the duty of the
registered nurse to engage in therapeutic and professional relationships. This promotes a

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patient cantered approach which can transform the patient's experience and as a result,
improve his or her health outcome. The nurses should not be discriminatory in their duties but
rather should accept and value the patient's beliefs, culture, race and values. They should also
work with and accept the views of other medical practitioners so as to ensure better patient
outcome. However, when carrying out their duties, it is important for them to limit the
influence of their emotional experience as they advise the patient’s and also their families.

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References
Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., & Cox, D. et al. (2018).
Standards for practice for registered nurses in Australia. Collegian,24 (3), 255-266.
Retrieved 16 Sep. 2018 from https://epubs.scu.edu.au/hahs_pubs/2242/
doi:10.1016/j.colegn.2016.03.002
Cousin, G., Mast, M.S., Roter, D.L. and Hall, J.A., 2012. Concordance between physician
communication style and patient attitudes predicts patient satisfaction. Patient
education and counseling, 87(2), pp.193-197 doi: 10.1016/j.pec.2011.08.004.
Kornhaber, R., Walsh, K., Duff, J., & Walker, K. (2016). Enhancing adult therapeutic
interpersonal relationships in the acute health care setting: An integrative
review. Journal of Multidisciplinary Healthcare, 9, 537-546.
doi:10.2147/jmdh.s116957
Louisiana State University at Alexandria. (2016). What Is the Role of Nurses in Healthcare? |
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healthcare.aspx
Morton, J.C., Brekhus, J., Reynolds, M. and Dykes, A.K., 2014. Improving the patient
experience through nurse leader rounds. Patient Experience Journal, 1(2), pp.53-61.
Nursing and midwifery board of Australia (2017). Registered nurse standards for practice.
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Renée S Katz & Johnson, T.A (2016). When professionals weep: Emotional and
countertransference responses in palliative and end-of-life care. New York:
Routledge.
Royal Children's Hospital Melbourne (2017) Nursing assessments Retrieved 16 Sep. 2018
from content://com.sec.android.app.sbrowser/readinglist/0915233925.mhtml
Terry, K., Stirling, C., Bull, R., & Fassett, D. (2017). An overview of the ways nurses
understand and utilise the existing Australian Competency Standards for Registered
Nurses. Collegian, 24(2), 109-116. doi: 10.1016/j.colegn.2015.10.003
Warwick, C. (2015). The NMC Code: Professional standards of practice and behaviour for
nurses and midwives | RCM. Retrieved 16 Sep. 2018 from
https://www.rcm.org.uk/news-views-and-analysis/views/the-nmc-code-professional-
standards-of-practice-and-behaviour-for