Professional Practice As An Enrolled Nurse Is Crucial For Providing Quality Care.

Nursing Policies and Professional Expectations

1.The following website may assist with this question

Professional practice as an enrolled nurse requires a sound understanding of what professionalism means, the expectations of consumers, employers, the profession and society in general, and the implications for nursing practice.

Examine a Nursing and Midwifery Board of Australia policy and its associated professional expectations. Consider how this policy will impact on your practice and professional growth as an enrolled nurse.

2.Why is it important to set goals?

 Goal setting is an important method of:

• Deciding what is important for you to achieve in your career / life
• Separating what is important for you from what is irrelevant and staying focussed on what is important to you
• Motivating yourself to achievement
• Building your self-confidence based on measured achievement of goals

Set Specific Goals

Set specific measurable goals. If you achieve all conditions of a measurable goal, then you can be confident and comfortable in its achievement. If you consistently fail to meet a measurable goal, then you can adjust it or analyse the reason for failure and take appropriate action to improve skills.

Set Measurable Goals

Clearly define the criteria in your mind for success or achievement of the goal. There should be definable limits on your goals so you know whether or not you have achieved it.

Set Performance, not Outcome Goals (Achievable goals)

This is very important. You should take care to set goals over which you have as much control as possible - there is nothing as dispiriting as failing to achieve a personal goal for reasons beyond your control such failure to gain a particular rotation, rostering issues,  injury, or just plain bad luck. Goals based on outcomes are extremely vulnerable to failure because of things beyond your control.

If you base your goals on personal performance or skills or knowledge to be acquired, then you can keep control over the achievement of your goals and draw satisfaction from them. For example, you might set yourself a goal of caring for a person with a tracheostomy, but the opportunity to do so does not arise. If you had set your goal to gain more knowledge and skill in the care of a person with a tracheostomy tube, you have more control over what is possible from research and clinical skills sessions, and can draw satisfaction and self-confidence from its achievement.

Set Realistic Goals

Goals may be set unrealistically high for the following reasons:

• Other people: Other people can set unrealistic goals for you, based on what they want. Often this will be done in ignorance of your goals, desires and ambitions.
• Insufficient information: If you do not have a clear, realistic understanding of the skills and knowledge to be mastered, it is difficult to set effective and realistic goals.
• Always expecting your best performance and
• Lack of respect for self: If you do not respect your right to rest, relaxation and pleasure in life then you risk burnout.

Set time frames on your goals

Timelines will place limits on how long you are willing to persist along a particular path, and provide the opportunity to reassess either the goal itself, or the steps you have outlined to achieve the goal.

Setting Goals at the Right Level

Setting goals at the correct level is a skill that is acquired by practice.

You should set goals so that they are slightly out of your immediate grasp, but not so far that there is no hope of achieving them: no-one will put serious effort into achieving a goal that they believe is unrealistic. Personal factors such as tiredness, other commitments and the need for rest, etc. should be taken into account when goals are set.

Thinking a goal through

When you are thinking about how to achieve goals, asking the following questions can help you to focus on the sub-goals that lead to their achievement:

• What skills do I need to achieve this?
• What information and knowledge do I need?
• What help, assistance, or collaboration do I need?
• What resources do I need?
• What can block progress?
• Am I making any assumptions?

Goal Setting for Professional Growth

Is there a better way of doing things?

a.Discuss a professional goal that you have and discuss the steps that are needed to achieve your goal.  

b.What support networks may you require to reach your goal? Where are they available?

c.What further training or specialist advice do you need to reach your goal?

3.The following website may assist with this question

With the increasing emphasis on efficiency and effectiveness in health care, how a nurse manages their time is an important consideration. Time management is recognised as an important component of work performance and professional nursing practice.  Discuss the strategies you will use to develop your time management skills.

4.The following website may assist with this question

Self-care is imperative to personal health, sustenance to continue to care for others, and professional growth. Describe how you would care for yourself to ensure that you are able to continue to care for others? Examples may include exercise, relaxation classes, reading, art classes

5.The following website may assist with this question

Learning strategies and styles are described in a range of ways. Following are two examples of ways to categorise different learning strategies and styles. The aim of providing these examples is to stimulate you to think about different learning styles.

Use this information to think about the ways you may have learnt and identify your preferred

approach. Once you have identified your preference you can put into place strategies to

assist you to learn more effectively.

Example One: Visual, auditory and Kinesthetic learning styles

Visual learning styles – this means you learn by seeing and looking.

You will:

• Take detailed notes rather than get involved in discussions
• Tend to sit in the front so you can see clearly
• Benefit from illustrations and presentations, and especially those in colour
• Make comments like: “How do you see the situation?”, “What do you see stopping you?”, “Do you see what I am showing you?”

Auditory learning style – this means you learn by hearing and listening.

You will:

• Enjoy discussions and talking things through and listening to others
• Acquire knowledge by reading aloud
• Hum and/or talk to yourself
• Make comments like: “I hear you clearly.”, “I’m wanting you to listen.”, “This sounds good.”

Kinesthetic learning style – this means you learn by touching and doing.

You will:

• Need lots of breaks and will want to move around
• Speak with your hands and gestures
• Remember what was done, but have difficulty with what was said or seen
• Learn through doing activities
• Make comments like: “How do you feel about this?”, “Let’s move forward together.”, “Are you in touch with what I am saying?”

Example Two: Felder-Silverman Learning Style Model

Sensing learners Concrete, practical, oriented towards facts and procedures.	Intuitive learners Conceptual, innovative, oriented toward theories and meanings.
Visual learners Prefer visual representations of presented material – pictures, diagrams, flow charts.	Verbal learners Prefer written and spoken explanations.
Inductive learners Prefer presentations that proceed from the specific to the general.	Deductive learners Prefer presentations that go from the general to the specific.
Active learners Learn by trying things out, working with others.	Reflective learners Learn by thinking things through, working alone.
Sequential learners Linear, orderly, learn in small incremental steps.	Global learners Holistic, systems thinkers, learn in large leaps.

The learning environment is recognised as having an impact in either encouraging or impeding a positive learning experience.

Which learning style/s do you believe represents your own learning style?

6.How would you identify personal and professional development opportunities and options?

7.The following websites may assist with this question

How can you ensure that you operate within legal and ethical considerations for reviewing and improving own practice, including:

• Codes of practice
• Duty of care
• Rights and responsibilities of workers and employers
• Work role boundaries – responsibilities and limitations

8.The following website may assist with this question

Reflective practice enables nurses to develop their skills, increase their knowledge, and deal with emotionally challenging situations. Discuss how you will develop reflective practice, including feedback from supervisors and colleagues.

9.The following website may assist with this question

The ability to give and receive constructive feedback is crucial to the success of any professional workplace relationship. Think about a time when you were given feedback as a student nurse.

a.How involved did you feel in the feedback process?  Did you self assess your own skills before being given feedback?  Did you understand the feedback given to you?  What did you learn about yourself and your skills as a result of the feedback?

b.Did you make any changes to your practice following the feedback?  If yes, what was it about the way the feedback was delivered that enabled you to change your practice?  If no, why was this?

c.Discuss how you would seek support and specialist advice for further training.  

d.What support networks, internal and external, are available to health professionals within the health sector?  List support networks that you may contact if required.

Question 10

Continuous professional development (CPD) is defined by the Nursing and Midwifery Board of Australia as “the means by which members of the professions maintain, improve and broaden their knowledge, expertise and competence, and develop the personal and professional qualities required throughout their professional lives”. As an enrolled nurse you are required to obtain 20 hours per year of CPD. How will you reflect on your practice to inform your continuous professional development? Where and how can you find access and review information on current and emerging industry developments to improve and inform evidence-based practice? How will you plan your continuous professional development?

Nursing Policies and Professional Expectations

1.Policy of Midwives in private practice

This policy defines the roles of the midwives engaged in private practice. This applies to the situation when the woman they were caring for was admitted as a public patient in a healthcare facility. During such a situation, the responsibility of the midwife is to enable a safe transition of the woman from home to the healthcare facility. She also has to ensure a comprehensive and efficient handover of the patient to the healthcare professional of the facility. During the handover, the medical history of the woman and the on-going treatment plan is informed to the healthcare professionals in a comprehensive manner to ensure safety of the patient. The midwife has the right to withdraw when the patient she was caring for is admitted to a professional healthcare system. However, if the patient chooses to obtain support from the midwife, then the midwife can remain.

The professional expectations of the midwife include providing both practical and emotional support to the patient. Moreover, in cases where the woman who was cared for by the midwife is transferred to a healthcare facility, then the personnel if requested can stay as a support system and not take the role of  a midwife, which will be considered a breach of the standards of professional practice by the nursing and midwifery board of Australia. It is expected that the midwife during her service to the patient, explain to her that she will be unable to carry out midwifery care when the patient is transferred to a healthcare facility.

Enrolled nurses work in medical facilities, hospitals, nursing homes, clinics, among others. However, when a patient under the care of a midwife is transferred to a medical facility, the responsibility for her treatment will be transferred from the midwife to the healthcare professional. However, if the midwife prefers the services of the midwife, then she can serve as a support system to the patient. In such a case, the services of the enrolled nurses are not required. Such a policy has a serious impact on the practice and professional growth of the enrolled nurse.

2.a.Discuss a professional goal that you have and discuss the steps that are needed to achieve your goal.  

My professional goal is to gain more knowledge through research and clinical training in caring for patients with mental illnesses. Nurses caring for adults with mental illnesses require them to have knowledge about proper communication skills that would enable them to interact with the patients. It is also necessary for them to enhance their knowledge about various nursing interventions that are required for such patients. It is necessary for them to assist the patients in their daily activities, providing physical as well as psychological support and comfort, monitoring of the patient’s health, collecting and documenting healthcare information, assisting and collaborating in planning and evaluation of the nursing care.

In order to become a nurse involved in caring for adults with mental illnesses, it is necessary to set a proper goal consisting of informations about the proper skills, knowledge or degree level, resources, help, barriers, among others that can enable me in achieving my goal. First, it is necessary to obtain a bachelor’s and master’s degree in nursing. However, in order to enhance the knowledge, it is necessary to pursue a doctorate degree in nursing practice. This will enable me to enhance my knowledge in the subject. Then it is necessary to obtain a registered nurse license. It is also necessary for me to develop key skills in this field, which includes perceptiveness and social awareness skills, ability to solve problems, ability to assess the patient’s behaviour and monitor them in a timely basis, critical thinking and reasoning abilities, compassion, communication skills for efficient understanding of the patient’s needs, sensitivity, medical software and data entry skills, ability to use instruments like the electrocardiographs, surgical lasers, defibrillators, among others. Other skills include observational and psychosocial skills and interpersonal communication. It is also necessary to gain knowledge about when to use restraints in order to prevent non self destructive and nonviolent behaviors.

Goal Setting for Professional Growth

b.What support networks may you require to reach your goal? Where are they available?

Support networks required to achieve my goal include: obtaining a diploma in nursing, which usually takes 12-24 months to reach completion. Students can carry out full and part time studies. Other support network including the enrolled nurse transition to practice programs like Clinical Development Nurses (EN CDNs) as well as specialist ward CDNs.

Diploma in nursing can be obtained from registered training organizations like TAFE, NSW, NSW health registered training organizations and other private organizations.

c.What further training or specialist advice do you need to reach your goal?

To work as a registered mental health nurse, a pre-registration nursing program is to be completed. This should be carried out in a Nursing and Midwifery Council approved nursing or educational institutions. The nursing programs here include adult, learning disability, children and mental health. Special skills are also needed to be developed. These are excellent skills of observation, looking out for signs of anxiety and tension, communication skills, skills in good decision making and management of stress.

3.Time management is essential for every nurse to carry out all nursing activities and look after the needs of the patients in a timely manner. It is necessary to monitor the patients and record informations in a timely manner. The strategies to carry out proper time management include: a time management sheet. Important informations regarding the patients are noted down in these sheets. Moreover, other informations like lab work details, medication times, new orders and other relevant informations are noted down. Other strategies include managing interruptions. It is necessary for the nurse to go back to the work plan, which was generated after getting interrupted by various situations.

4.Nurses go through a lot of stress in order to manage both work as well as their social life. Nursing is a highly demanding job and takes a serious toll on a person’s health. However, in order to overcome these stresses, the nurses can carry out a number of activities that would enable them to lead a healthy life. It will also help them to remain focused at work and manage work in a highly efficient and timely manner. These activities include exercising, yoga, meditation that would help them to have a healthy body and mind. Proper exercising will help them to stay fit and not feel lethargic. It is necessary for the nurses to get involved in other activities like stretch breaks, reading, art classes, relaxation classes that would help them to release the stress generated during work. It is also necessary for the nurses to eat healthy food and have good sleep in order to feel refreshed for a new day at work.

5.The learning styles that represent my learning style includes: sensing learners and visual learners. It is necessary for nurses to have knowledge and skills to carry out procedures, which are concrete and practical. Moreover, it is also necessary for nurses to learn through visual aids like flow charts, diagram, pictures, among others. For a nurse dealing with mental health patients, it is necessary to learn the patient hand and face gestures to identify any problems faced by the patients.

Effective Time Management Strategies for Nurses

6.A personal and professional development plan is to be generated in order to carry out further progress and development in nursing. An important feature of continuing professional development is training. This type of training is structured to suit the career type and creates job specific learning opportunities. Continuing professional development helps in ensuring that the right training is carried out to enhance expertise to do the job correctly. It is necessary to carry out collaborations with doctors and other healthcare members in order to gain new knowledge and learn about new technologies and interventions that would help to ensure a continuous growth and development. It also ensures a long-term employability.

7.The nurse should demonstrate understanding and knowledge of state, territory and commonwealth legislation and other common laws in association to nursing practice.

The enrolled nurse should fulfil the duty of care in the undertaking of enrolled nurse practice.

Should have knowledge about NMBA standards, guidelines and codes. The necessary implications should also be known.

Provide nursing care according to the plan, procedural guidelines, professional standards and workplace policies.

Identification and clarification of enrolled nurse responsibilities with respect to delegated care in collaboration with healthcare workers and registered nurses.

It is necessary to recognize the competence as well as limitations in practice. Whenever necessary, it is necessary to seek guidance from registered nurses.

Activities are not to be undertaking where, competence, training, experience and education is limited.

It is necessary to ensure safe outcomes and identify potential risks.

It is necessary to report occurrences of unsafe practices to registered nurses.

Negotiation with registered nurses to ensure proper addressing of patient’s rights.

8.It is necessary to analyze the activities and reflect on it, in order to find the necessary problems associated with it. It is necessary to identify the competence areas, as well as challenging areas, so that future improvements can be made. Creating the portfolio for educators can also help to develop reflective practice. An iterative process enables the development of reflective practice with respect to experiences that enables them to act in a different way after reviewing their past experiences. Experimentations can also be done in order to develop reflective practice. Experimentation will help to determine the pros and cons associated with the research. Another process called the vertical process can enable the development of reflective practice through critical analysis, process and content reflection, understanding of the situation, validation, among others. Feedbacks from colleagues and supervisors about the practices carried out can also help to develop reflective practice. New approaches can be carried out based on the feedbacks of seniors and experts.

9.a.How involved did you feel in the feedback process?  Did you self assess your own skills before being given feedback?  Did you understand the feedback given to you?  What did you learn about yourself and your skills as a result of the feedback?

Yes, I was very much involved in the process of feedback. It is necessary to actively communicate with the doctors, senior nurses and also patients, in order to understand their evaluation.

Self-care for Nurses

Yes, self-assessment of skills and practices is very important. It is necessary to self analyze to identify the limitations associated with the practices carried out.

Yes, the feedback was understood, however, certain queries about the feedback was solved by consulting the doctors and registered nurses.

After getting the feedback, I understood that practices need to be revised, however, they should still be effective, valuable and relevant. However, the good feedbacks encouraged me to carry out the necessary practices and if possible bring about changes that can improve the practice outcomes.

b.Did you make any changes to your practice following the feedback?  If yes, what was it about the way the feedback was delivered that enabled you to change your practice?  If no, why was this?

Yes, changes in practice were made in order to ensure that the necessary practice outcomes are improved. The feedback described the need for possible improvements in patient outcome practices. It was necessary to enhance the skills through education and training to become an expert in this field.

c.Discuss how you would seek support and specialist advice for further training.  

It is necessary to build networks within the healthcare organization, in order to obtain new information and learn new approaches that would help to enhance the knowledge and also help to get information about new training programs.

It is also necessary to find a mentor, who will act as a role model and guide through the process of knowledge gain and enhanced practices by providing new information as well as advice about training programs that increase knowledge and also provide work experiences.

d.What support networks, internal and external, are available to health professionals within the health sector?  List support networks that you may contact if required.

Internal support networks may include:

• Doctors
• Registered nurses
• Clinical coordinators
• Palliative care experts
• Patient care committees
• Therapeutic subcommittees
• The Australian government mental health websites
• Australian college of Mental Health Nurses

10.Reflection of practices is highly essential for nurses to carry out a continuous professional development. Reflection of past practices is necessary in order to bring about improvements in the practice, thereby bringing about favorable patient outcomes. This in turn ensures a continuous professional development. Analytical and critical thinking are also contributors to continuous professional development.

Various research articles, particularly the nursing journal articles can provide access to various informations and can help to review the current and emerging developments in the nursing practices. This helps to ensure developments in the field of evidence based practice.

Planning a continuous professional development requires a proper and honest assessment of the current situation and defining development goals for at least 2 years. These goals will be addressed towards achievements and learning. It is necessary to act upon the goals, which requires time management and motivation. So time management is also an essential part of continuous professional development. It is also necessary to record the progresses for future assessments. Continuous professional development also requires reflection and critical analysis of one’s works. It is necessary to understand the applications of the progresses made and how it will benefit the client or the patient. Moreover, it is also necessary to determine whether additional developments are necessary to help in the progress of one’s continuous professional development.