Delegation Justification and Ethical Dilemmas
Delegation Justification and Ethical/Legal Dilemmas for a Student Re-entry/International Registered Nurse in Australia
Abstract
This essay focuses on the scope of practice for a student re-entry/international nurse at the start and end of his clinical placements. The nursing care that he should focus on are also discussed, including the negotiations taking place with the Registered Nurse Buddy for the delegation of these nursing care. Furthermore, ethical and legal dilemma of his colleague nurse is discussed using the codes and standards for nursing in Australia and how he will approach towards the issue at hand.
Delegation Justification and Ethical/Legal Dilemmas for a Student Re-entry/International Registered Nurse in Australia
Recently, the importance and recognition given to the re-entry or international registered nurses in Australia is the outcome of the shortages of nurses and midwifes in the country, as well as around the globe (Long and West, 2007). For this reason it is important to study and analyse various aspects of the role and duties of a student re-entry/international registered nurse so that a healthy working environment is maintained. The purpose of this essay is to analyse the situation given at hand in the assigned video and apply complete knowledge and understanding to the delegation justifications and apply ethical and legal frameworks and professional codes and guidelines to nursing practice.
By discussing the delegation and supervision requirements of a student re-entry or international nurse on clinical placement and the legal and ethical dilemmas faced by a student nurse, I will be able to demonstrate Ethical and Professional responsibility, Self-management, Knowledge and Cognitive and Technical skills.
There will be two sections to this essay which will be devised after watching the assigned video. Section 1 will focus on the beginning of the clinical placement, i.e., the first week, of a student re-entry/international nurse. This would include the scope of practice as a student re-entry/ international nurse, the nursing cares that are appropriate to perform in the first week and the how these nursing cares would be delegated to the Registered Nurse Buddy, using the decision making framework of the Nursing midwifery Board of Australia. After focusing on the beginning of the clinical placement, the end of the clinical placements for the student re-entry or international nurse (week 4 and week 6 respectively) will be discussed, including the scope of practice, appropriate nursing cares and how they would be delegated to the Registered Nurse Buddy.
Section 2 will cover the assignment requirements to shed light on the ethical dilemma regarding a situation encountered during my clinical placement of another student taking “selfies” with patients. In this section, I will explain how I will approach this situation using the laws, standards and codes that are applicable to ensure practice according to the laws in the workplace.
Section 1
In this section I will discuss the scope of practice, appropriate nursing cares and delegation of duties for a student re-entry/International nurse on clinical placement for the first week.
Scope of Practice for a Student Re-entry/International Nurse
For student re-entry or international nurse, it is important to know the procedures and actions that he/she is permitted to undertake while keeping in mind the standards of the Nursing and Midwifery Board of Australia, which ensures that any nurse or midwife who is registered is safe and competent to practice. Returning to clinical practice means that the nurse/midwife needs to ensure professional development in accordance with the Registered Nurse Standards for Practice (NMBA, 2016), which are as follows:
- To think critically and analyse the nursing practice
- To engage in therapeutic and professional relationships
- To maintain the capability of practice
- To conduct assessments comprehensively
- To develop plans for nursing practice
- To provide safe, appropriate and responsive quality nursing practice
- To evaluate outcomes to inform nursing practice.
The above standards are applicable to all registered nurses, however, each standard is interpreted according to the context of each Registered Nurse’s, for example, in this case a student re-entry nurse or an international nurse.
In the beginning of the clinical placement, a student re-entry nurse or an international nurse would search for best available evidence for decision making and strategic thinking for a safe and quality nursing practice. He/ she must keep in mind the common laws and policies and maintain accurate and timely documentation inclusive of assessments, planning, decision making, actions and evaluations. This is important as it forms the basis of all the activities that the nurse will follow. Effective communication, generosity, trust and respect and collaborative practice is required so that all future activities are carried out in a smooth manner.
During the clinical placement for four weeks (re-entry student nurse) or six weeks (international student nurse) and at the end of these time periods, the scope of practice that I will follow will remain the same as mentioned above, however, these can be influenced by the ‘context in which an individual practices, consumer’s health needs, level of competence, education, qualifications and experience of the individual and service provider’s policy, quality and risk management framework and organisational culture’ (Nursing and Midwifery Board of Australia, 2007).
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Nursing Cares
In the first week of my clinical placement, the nursing care activities should be focused towards improved quality of care towards patients.as described by Kitson et al (2010) and Huisman‐de Waal et al (2018), the nursing care includes ‘communication and nutrition, care for breathing, elimination, cleanliness and dressing, mobility, rest and sleep, body temperature, expressing sexuality and safety (prevention of complications).’
It is necessary that I should exhibit confidence throughout the clinical placement which will make the patient comfortable in discussing the treatment he is undergoing. The essential start to nursing care comes from effective communication which forms the basis of daily care activities and important for treatment and clinical and health outcomes. I should pay attention to the needs and requirements of the patient and what he wants. Maintaining trust through effective communication with the patient can lead to better planning and management. Nutrition should be the next essential nursing care element as the diet of the patient comes in the routine settings of the nursing activities. The patient in the assigned video has a loose stomach, I should ensure a diet plan being taken accordingly. Being a re-entry student nurse, I should make sure that my patient is not facing malnutrition. Other nursing activities include taking correct patient’s vitals and providing comfort, rest and sleep, hygiene and a safe environment. My nursing care plan should include assessment of the patient, diagnosis, outcomes, interventions, rationale and evaluation.
The patient’s situation will be observed, the number of stools he passed, the number of visits to bathroom, his diet intake and his vitals. His food will be restricted according to the diagnosis and he will be provided with a calm and hygienic environment. His medication will be administered and any venoclysis and intravenous replacements would be provided if needed. Rationales for these would be provided in the documentation of nursing care plan and the results would be evaluated.
In the last week of my clinical placement as student re-entry/international nurse, I should be able to provide a complete and comprehensive documentation and record of the patient’s health care and treatment; his current status regarding his health issues, medications and the follow up he needs. This will be possible through effective planning, timely recording, management and effective and communication. I will also brief the patient with his current condition and explain his future treatment. I will take feedback from the patient of the care he is being provided and follow activities accordingly.
Delegation of Nursing Care with the Registered Nurse Buddy
Delegating the nursing care activities to the Registered Nurse Buddy is the act of handing over the responsibilities, of providing the right health care service to the patient at the right time, to a less experienced person from the same discipline or to a person from another discipline. This facilitates learning and professional development of the student nurses (Russell, Williamson, and Hobson, 2017). This is to ensure monitoring and safety of patient through appropriate teachings and assessments.
