Registered Nurse's Scope of Practice, Laws, and Professional Duties

This report provides a comprehensive overview of the practice of a registered nurse (RN), examining the scope of practice, relevant legislation, and the ethical, legal, and professional obligations associated with the role. The introduction defines the RN's role in the healthcare sector, highlighting responsibilities for improving public wellbeing. The main body of the report addresses the scope of practice, including the roles and responsibilities of RNs in hospitals, their accountability, and the factors influencing their practices, such as education and collaboration. The report explores the impact of Australian laws, such as the Medical Indemnity Legislation 2005, the Medical Indemnity Contribution Amendment Act 2003, and the Medicare Guarantee Act 2017, on clinical care practices, particularly in relation to medication administration and patient safety. The ethical, legal, and professional obligations of nurses are discussed, emphasizing the importance of ethical codes, legal frameworks, and professional standards in ensuring quality care and patient safety. The conclusion summarizes the key findings, emphasizing the RN's role in providing quality services and the importance of adhering to ethical, legal, and professional guidelines to prevent unsafe practices.

PRACTICE OF A
REGISTERED NURSE

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
MAIN BODY..................................................................................................................................1
Question 1....................................................................................................................................1
Question 2....................................................................................................................................3
Question 3....................................................................................................................................4
CONCLUSION................................................................................................................................5
REFERENCES................................................................................................................................6

INTRODUCTION
Registered nurses are the specialists who play significant role in health and social care
sector. They are responsible to improve wellbeing of public and increase mortality rate as well
(Stuart, 2014). Present study will examine term ‘scope of practice ‘in context to practices of
registered nurses Further, it will explain relevant legislation which are necessary to administer
medication. Report will discuss impact of these laws on clinical care activities of professionals.
In addition, it will outline the ethical, legal and professional obligations of nurses.
MAIN BODY
Question 1
Registered nurses (RN) are the practitioners those who have all licensing requirements of
nurses. Scope of practice can be defined as range of role and responsibilities that nurses have to
perform in hospitals (Smolowitz & et.al., 2015). They are accountable to maintain competency in
their working practices. It is knowledge and comprehensive application that assists in addressing
needs of patients. Nurses are required to identify needs of service users to maintain highest
standards of quality. Practitioners are bound to respect all patients and treat them equally. Scope
of nursing practices defines that there should be therapeutic relationship between staff and
convalescents. All registered nurses are responsible for communicating effectively with patient
in order to gain their trust. Patients need to be empowered to make their own decision and life
choices (Bryant‐Lukosius & et.al., 2016). For example: self employed nurses need to get
approval from ARNNL for working as nurse in society. Enrolled nurses have to work under the
guidance of registered nurses; they have to perform responsibility of plan of care. They are
accountable for their practices that have been established by their delegators.
There are various factors that influence these practices of nursing such as education,
professional practices, collaborative aspects, needs of individuals, care outcome, etc. (McGilton
& et.al., 2016). There are various principles of scope of practices,
 Respect and maintain dignity
 Professional responsibility and accountability
 Quality of practice
 Trust and confidentiality
 Collaboration with others
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All these principles help the nurses in examining their scope and performing their duties
well. Registered practitioners have to double check medications before giving it to any patient.
For example, if in case nurses develop informal relationships with patients which is outside
scope of practice for the RNs, then in this case individuals develop relationship with patient to
understand their actual problem which helps them in providing effective care. In accordance with
this, the nurses are responsible for following scope of practice during treatment which cannot
avoided due to any informal practices (Osborne & et.al., 2015).
Local guidelines, policies have to be considered by RN in order to perform duties well.
Registered nurses utilise their skills and knowledge in order to assess medical needs of patients
and provide them support accordingly. Registered nurses have to work in different clinical
context as per their education and experiences (Ironside, McNelis & Ebright 2014).
Figure 1Scope of practice
Source:( Scope of practices for registered nurses, 2011)
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Nurses can offer care services to patients within their scope of practice. NNBA (nursing
and Midwifery Board of Australia) has developed framework that helps them RN in making
correct decision. These are such as Continuing Professional Development, endorsement for
scheduled medicines, etc. These principles and guidelines allow professionals in addressing
medical needs of individuals (Scope of Nursing and Midwifery Practice Framework, 2018).
Question 2
Government of Australia has prepared many laws in order to improve health care practices
in the country (An Act to establish the Medicare Guarantee Fund, and for related purposes,
2017). These laws impact on clinical care practices of registered nurses. Impact of these laws
has been described as below:
Medical Indemnity Legislation 2005
This belongs from parliament of Australia. Government has designed this law in order to
remove competitive advantage in the medical industry. Thus, cost of medical indemnity remains
affordable for all (Legislation covering medicines, 2018). This has positively impact on clinical
care services, by this way people can get quality care in affordable price. This act has ensued to
reduce cost of medication by reducing competitive advantage, now hospitals and registered
nurses have to concentrate on providing quality care to patients rather than cost of entire
treatment.
Medical Indemnity Contribution Amendment Act 2003
This law belongs to parliament of Australia. This law has been made to stop misuse of
drugs and to minimise harmful effects of these drugs (Medical Indemnity (IBNR Indemnity)
Contribution Amendment Act 2003, 2003). There are many people who supply drugs illegally.
This act prevents patients from harmful drugs. This legislation supports in minimising
medication errors related to use of wrong drugs in the health and social care sector (Stevenson &
et.al., 2015). This has supported in improving clinical care practices of registered nurses because
harmful drugs have been prohibited to use thus, accidents of using wrong or harmful drugs have
been minimised to great extent. Administration of medicines is considered as key element in the
field of health and social care sector. Approx 7000 doses of medications are used in hospitals
every day and thousands of drugs are self administered by patients (Bryant‐Lukosius & et.al,
2016). There are many drugs that have adverse impact on individuals. Now registered nurses
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have to closely monitor the situation of patient, they have to prescribe medicines as per the
condition and prescription of patient. Public safety is the main considering point for government,
if any nurse gives wrong dose of drug to patient by mistake then licence of the professional can
be cancelled (Smolowitz & et.al, 2015).
Medicare Guarantee act 2017
This regulation is enforced by Australian government, the main purpose of designing this
law is to make payment of Medicare benefits and pharmaceutical benefit scheme. This law
ensure that health care services of the nation can be improved and death rate can be minimised.
Medicare benefits assists in implementing advance technologies that can help in treating patients
well (Ironside, McNelis & Ebright 2014). Now registered nurses are bound to use advance
equipments for treating the patients so that their health can be improved soon this has improved
their care services to great extent. These laws concentrate on the fact that medicines need to be
provided by following 5 rights of medication, these are the right drug, right patient, right dose,
right route, and right time. This helps in protecting patients from harmful effects of drugs. There
are many factors that restrict the professionals when administering medicines. Registered nurses
are required to identify medical needs of individuals (Stuart, 2014).
Therapeutic Goods Act 1989
This regulation is enforced by Australian government to control quality, safety, timely
availability and efficacy of medication. This legislation has come into existence in the year 1989,
this emphasise on medical products that are being used by professionals to treat human being.
This law is responsible for controlling over supply of drugs, advertisement, import, etc. It
ensures that blood products, vaccines, medical devices are being supplied in appropriate manner.
Previously inexperienced and unlicensed people were supplying drugs due to which accidents of
using wrong drugs and incidents of misuses were high but now this act has prohibited people
from supplying drugs. (Ironside, McNelis & Ebright 2014). These legislation impacts clinical
care practices that provided by registered nurses.
Question 3
Ethical obligations
Government and health care authorities have prepared ethical codes for the nurses and
professionals. These ethical principles provide guidance to the practitioners and support them in
making correct decision. Codes of ethics for registered nurses describe that nurses need to be
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attentive in their workplace. RN is responsible for ensuring client’s safety (Legislation covering
medicines, 2018). The duty of professionals is to treat all individual equally and provide them
correct treatment. It is the ethical responsibility of nursing staff to take care of individual’s
medical needs and provide them correct dose of medicine at right time.
There are many situations in which these professional gets fail to fulfil their ethical
obligations. For example: Nurses have to fulfil their ethical duty of providing clear information
to patients and their family members. If in case nurses hide patient information then it is
considered as breach of duty and can impact patient safety (Scope of Nursing and Midwifery
Practice Framework, 2018). Apart from this, ethical obligation of nurses revolves around
principles of fairness, respect, dignity and honesty. They have to maintain self-integrity and high
personal moral standards.
Doctors have to give rights to patients to take their own decision. Furthermore, it is
ethical duty of RNs to maintain confidentiality in patients’ information which cannot be shared
with third person.
Legal obligations
The legal framework of the nursing act 1991is related with role and responsibility of
nurses. It clearly describes roles and responsibility of each RN and their scope of practices in the
hospital. It is the legal duty of nurses to follow principles and report to higher authorities about
misconduct activities of their peer group. For example, there are many medicines that are banned
and it is duty of nursing staff to give correct dose of drugs to patients. Therefore, if in case care
provider finds anyone giving wrong treatment to patient then it is the legal responsibility of RN
to stop the health care provider from conducting unlawful activity (McGilton & et.al, 2016).
Professional obligations
A professional obligation of registered nurses is to ensure duty of care. The nurses are
responsible for providing quality care services to patients. They are professional individuals who
have good knowledge about nursing practices. Maintaining patient’s dignity is the main
obligation of medical staff. They have to ensure that their activities do not hurt dignity of service
users. Self integrity is another obligation of RN; they have to maintain wholeness of their
character. For example, it is the duty of nurses to respect patients and own scope of practices.
However, not following professional guidelines and framework can hamper patient safety and
health outcome. They have to manifest positive wholeness of character. This assists them in
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gaining trust of patients and offering them quality services. It is the duty of medical professional
to be accountable and responsible. Doctors are responsible for continuing competences
(Smolowitz & et.al, 2015). It is the duty of nurses that to provide high quality care to patient
(Scope of Nursing and Midwifery Practice Framework, 2018).
CONCLUSION
From the above study it can be concluded that registered nurses are responsible for offering
quality services to patients and improving their health condition as well. Australian government
has made many laws for administrating medicines, all the acts assist in improving care practices
of RNs so that they can contribute effectively by reducing medical errors. It can be articulated
that safety of individuals is the first priority of the professionals and they are responsible for
fulfilling their ethical, legal, professional’s obligations so that unsafe and unprofessional practice
can be avoided.
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REFERENCES
Books and Journals
Bryant‐Lukosius, D. & et.al., (2016). Framework for evaluating the impact of advanced practice
nursing roles. Journal of Nursing Scholarship. 48(2). 201-209.
Ironside, P. M., McNelis, A. M., & Ebright, P. (2014). Clinical education in nursing: Rethinking
learning in practice settings. Nursing Outlook. 62(3). 185-191.
McGilton, K. S. & et.al., (2016). Recommendations from the international consortium on
professional nursing practice in long-term care homes. Journal of the American Medical
Directors Association. 17(2). 99-103.
Osborne, S. & et.al., (2015). The primacy of vital signs–acute care nurses’ and midwives’ use of
physical assessment skills: a cross sectional study. International Journal of Nursing
Studies. 52(5). 951-962.
Smolowitz, J. & et.al., (2015). Role of the registered nurse in primary health care: meeting health
care needs in the 21st century. Nursing Outlook. 63(2). 130-136.
Stevenson, K. N. & et.al., (2015). Registered nurses’ experiences of patient violence on acute
care psychiatric inpatient units: an interpretive descriptive study. BMC nursing. 14(1).
35.
Stuart, G. W. (2014). Principles and Practice of Psychiatric Nursing-E-Book. Elsevier Health
Sciences.
Online
An Act to establish the Medicare Guarantee Fund, and for related purposes. 2017. [Online].
Available through < https://www.legislation.gov.au/Details/C2017A00071 >
Legislation covering medicines. 2018. [Online]. Available through <https://www.health-
ni.gov.uk/articles/legislation-covering-medicines >
Medical Indemnity (IBNR Indemnity) Contribution Amendment Act 2003. 2003. [Online].
Available through < https://www.legislation.gov.au/Details/C2004A01205 >
Scope of Nursing and Midwifery Practice Framework. 2018. [Online]. Available through
<https://www.nmbi.ie/Standards-Guidance/Scope-of-Practice >
Scope of practices for registered nurses. 2011. [Online]. Available through <
http://www.nurses.ab.ca/content/dam/carna/pdfs/DocumentList/Standards/
RN_ScopeOfPractice_May2011.pdf>
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