Nursing And Midwifery Board Of Australia And Australian Nursing And Midwifery Federation: Overview And Standards

Overview of Nursing and Midwifery Board of Australia (NMBA)

Question:

Discuss about the Nursing Care for Midwifery Board of Australia.

The main function of the NMBA is to conduct proper registration process of the nurses and midwifery practitioners. They are the sole body who develops nursing standards, guidelines and codes of conducts for nursing and midwifery profession. The code of professional conduct for nurses in Australia as defined by NMBA furnishes 10 different standards, which the nurses need to abide by while working as registered nurses in a healthcare institution. They also frame code of ethics for nurses in Australia. There are 8 different codes, which instruct the nurse to practise in an ethically competent manner. They also handle notifications, complaints, carry out investigation and disciplinary hearings in the domain of nursing and nursing profession related to healthcare. They also assess the overseas trained practitioners who are interested in practising in Australian states. NMBA also holds rights to approve the accreditation standards and courses of study under the nursing profession. NMBA has also established state and territory boards in order to support the work of the National Board under the national scheme. Here the National Board will frame policies and nursing professional standards and on the other hand, the state territory boards will continue their work to make separate notifications and other registration decisions, which will affect the individual nurses and midwives. The function carried by NMBA is supported by the Australian Health Practitioner Regulation Agency (AHPRA), which also looks after the legislation governing the nursing profession (Nursing and Midwifery Board of Australia - Home, 2017).

ANMF is a special union that serves registered nurses, midwives and enrolled nurses along with the assistants in the nursing who are serving nursing profession or as nurse assistant in the sates or the territories legislated under Australia. It is the largest union in Australia with more than 249,000 members. There are 8 different branches of ANMF throughout Australia. The federal bodies of ANMF co-ordinates the function of the branches in accordance to the national issues which are relevant in the field of nursing profession. The rules framed by ANMF are directed towards the organisation, membership, government, officers of the federation, finance, industrial and legal matters and election of the federal officers. The rules are mostly directly towards the promotion and protection of the interest of the members of the ANMF. It also aims in improving the statutory and industrial rights of the nursing profession for the betterment of the members. These rights included reform in employment condition, high standard nursing practise along with professional advancement in nursing domain (Thomas & Butler, 2017).

Code of Professional Conduct, Ethics and Standards by NMBA

This registration standards frame the minimum requirement that is important for the continuing professional development (CPD) among the midwives and the enrolled and registered nurses. This registration standard is helpful for me because, when I am serving as a nursing practitioner and holding an endorsement for scheduled medicines, the as per the rule, I need to complete certain CPD requirements. There CPD requirement will help to increase my horizon of knowledge regarding prescribing medicines, administration of medicines followed by diagnostic investigations, proper consultation and referral. (Nursing and Midwifery Board of Australia - Continuing professional development, 2017)

The registration standards in the domain of the criminal history in nursing care is aimed in deciding whether the criminal history of a health care professional is relevant with their professional life, or their tenure of practice under the health care service. As per the registration standards in criminal history, one needs to judge the nature and gravity of the offence committed by the health care personnel and its relation with the health care practice before claiming his or her as guilty. It also helps in determining whether a health care professional’s history is related to criminal offense is properly documented. I will relate these standards in my future practice via applying these rules in accessing the severity of the guilt committed by the healthcare practitioner (Nursing and Midwifery Board of Australia - Criminal history, 2017).

According to NMBA, all the applicants during their initial registration are need to demonstrate their English language skill and need to prove them to be suitable for the registration. In order to attain success in the field of nursing career, I will attend and then successfully complete a minimum six years of secondary and primary language education in English. I will also make sure that my qualification and English skills are relevant with my professional discipline in nursing. Shaping up my soft skills in English language will help me to excel in my communication skills, one of the important soft skills in the field of nursing profession (Nursing and Midwifery Board of Australia - English language skills, 2017).

This registration standard sets out minimal requirement in the field of professional indemnity insurance (PII) arrangements in nursing profession. It encompasses registered nurses, enrolled nurses and midwives. Under this registration standard, I will make sure that when I will practice as a midwife or a nurse, I will be covered under any third party PII arrangements that suffice all the locations where I am aiming to practice, either it is private or government or s full time or part-time. I will also ensure that my OII cover includes a civil liability, automatic reinstatement and other retroactive cover. I will also ensure that I will not practice healthcare profession unless and until my PII arrangements are amended in relation to the healthcare profession (Nursing and Midwifery Board of Australia - Professional indemnity insurance arrangements, 2017).

Role of NMBA in Nursing Profession in Australia

It sets out minimal requirement for the recency of practice under the banner of the nursing profession. I will ensure that I have successfully completed my post graduation degree in nursing and have a valid registration from well recognised nursing regulatory authority before venturing into the professional nursing career (Nursing and Midwifery Board of Australia - Recency of practice", 2017).

This legislation has been framed for the requirement of the endorsement as a nursing practitioner under the section of 95 Health Practitioner Regulation National Law. Under this registration, I will ensure that I am capable of demonstrating three-years of full time experience with a successful completion of an NMBA approved course, leading towards the program of endorsement along with proper compliance with the NMBA’s nursing practise standards (Nursing and Midwifery Board of Australia - Endorsement as a nurse practitioner, 2017). I will strictly obey the standards because if I do not meet the standards, NMBA will refuse my registration or endorsement.

A fine bore nasogastric tube is defined as a narrow tube that is passed into the stomach through the nasal cavities. It helps to support the nutritional needs of the patients who are unable to maintain their normal nutritional value via oral intake of food.

According to the Code of Professional Conduct for Nurses in Australia, nurses must practise in a safe and competent manner and in accordance with the standards of the profession and the broader health care system. So when I was asked to replace and insert nasogastric tube, about which I am not aware off, I took help from my senior registered nurse and then under her guidance I performed the task of nasogastric tube insertion (Fine Bore Nasogastric Feeding Tubes for Adult Policy, 2017).

The specific skills and knowledge those are required while the insertion of nasogastric tube includes: observation of patient’s condition before and after the insertion of the nasogastric tube. Here the observation includes proper documentation of the temperature, blood pressure, pulse, respiratory rate, oxygen saturation. After the insertion of the nasogastric tube, the position of the tube must be confirmed radiologically and the pH must be adequate that is < or equal to 5. Moreover, if the patient is known to be suffering from the oesophageal varices or severe coagulopathy then I will recommend the insertion of the nasogastric tube under the presence of the experts of the radiology unit. For the patients who are suffering from dry mouth, I will always moisten the mouth with the help of a moist cotton bud prior insertion of the tube. In spite of taking preventive measures, the procedure of nasogastric tube can turn out to extremely uncomfortable for the patients. I will consider prescribing small amount of Lidnocaine gel inside the nostril or spray the same medication on the back side of the throat to reduce the rate of discomfort. However, before using Lindocaine gel, I will cross-verify whether the patient has any reported cases of allergy with the Lidonocaine gel (Fine Bore Nasogastric Feeding Tubes for Adult Policy, 2017).

Overview of Australian Nursing and Midwifery Federation (ANMF)

During my course of work as Graduate Enrolled Nurse in acute medical ward, I learnt the standard process of nasogastric tube insertion based on the guidelines of NSW, Ministry of Health Australia. The patient must be postured in an upright position with optimal head/neck alignment in order to assist insertion. Then the nostrils need to be checked in order to detect any deformity in it and to determine best side for the insertion. Then proper measurement needs to be done from the tip of the nose to the earlobe and xiphisternum, the measurements must be done in cm and must be simultaneously marked in the tube. After measurements, the tube must be lubricated and then passed via nostrils and then the positioning is checked via radiograpy. If the patient is found coughing or experiencing breathing problem then the entire setup needs to be uninstalled. However, absence of coughing does not necessarily rules out the condition of misplacement of the tube (Fine Bore Nasogastric Feeding Tubes for Adult Policy, 2017)..

I learnt that incorrect insertion of the nasogastric tube can lead to trauma in the surrounding areas along with occurrence of pneumothorax in extreme cases. Other threats include aspiration associated with the process of tube dislodgement and appearance of condition like pneumonitis when the nasogastric feeds get deposited into the pulmonary cavities. At times, misplacement of tubes can occur, mainly inside the lungs and is common in patients with cribriform plate disruption, intracranial insertion (Fine Bore Nasogastric Feeding Tubes for Adult Policy, 2017).

During my future course of work with nasogastric tube, I will keep in mind that the patients who are critically ill are at an increased risk of getting affected with the nasogastric tube complications for example the patients who are suffering from neurological deficits. Moreover, I will also try to remain alert while inserting fine bore nasogastric tube into a patient with low or zero reflexes, as fractional negligence in this ground can cause accidental insertion of the tubes into other adjoining anatomical structures. I will also exercise caution while inserting nasogastric tube in patients with impaired blood clotting and are on anticoagulant medication. The same measure of caution goes with the patients who are suffering from tracheostomy because there is always lays a risk factor of inadvertent tracheal intubation. Last but not the least, a fine bore nasogastric tube may lead to leakage of the gastric contents from the stomach causing fatal oesophageal erosions with patients who are diagnosed with gastro-oesophageal reflux disease (GERD). So before insertion, I will cross-check the nasogastric tube properly and will also refrigerate the nasogastric tube before insertion (Fine Bore Nasogastric Feeding Tubes for Adult Policy, 2017).

I will also recheck nasogastric tube position after the initial insertion, before administration of food or medication in order to side-pass unwanted complications.

References

Fine Bore Nasogastric Feeding Tubes for Adult Policy. (2017) (pp. 1 to 8). Australia. Retrieved from https://www1.health.nsw.gov.au/pds/ActivePDSDocuments

Lee Thomas, A., & Annie Butler, A. (2017). Australian Nursing & Midwifery Federation. Anmf.org.au. Retrieved 31 October 2017, from https://anmf.org.au/

Nursing and Midwifery Board of Australia - Continuing professional development. (2017). Nursingmidwiferyboard.gov.au. Retrieved 31 October 2017, from https://www.nursingmidwiferyboard.gov.au/Registration-Standards/Continuing-professional-development.aspx

Nursing and Midwifery Board of Australia - Criminal history. (2017). Nursingmidwiferyboard.gov.au. Retrieved 31 October 2017, from https://www.nursingmidwiferyboard.gov.au/Registration-Standards/Criminal-history.aspx

Nursing and Midwifery Board of Australia - Endorsement as a nurse practitioner. (2017). Nursingmidwiferyboard.gov.au. Retrieved 31 October 2017, from https://www.nursingmidwiferyboard.gov.au/Registration-Standards/Endorsement-as-a-nurse-practitioner.aspx

Nursing and Midwifery Board of Australia - English language skills. (2017). Nursingmidwiferyboard.gov.au. Retrieved 31 October 2017, from https://www.nursingmidwiferyboard.gov.au/Registration-Standards/English-language-skills.aspx

Nursing and Midwifery Board of Australia - Home. (2017). Nursingmidwiferyboard.gov.au. Retrieved 31 October 2017, from https://www.nursingmidwiferyboard.gov.au/

Nursing and Midwifery Board of Australia - Professional indemnity insurance arrangements. (2017). Nursingmidwiferyboard.gov.au. Retrieved 31 October 2017, from https://www.nursingmidwiferyboard.gov.au/Registration-Standards/Professional-indemnity-insurance-arrangements.aspx

Nursing and Midwifery Board of Australia - Recency of practice. (2017). Nursingmidwiferyboard.gov.au. Retrieved 31 October 2017, from https://www.nursingmidwiferyboard.gov.au/Registration-Standards/Recency-of-practice.aspx