AHPRA has developed seven Registered nurse standards for practice that all nurses and midwives are supposed to observe throughout Australia. The standards of practice are formulated to cater to the varied needs of different Australian communities, their cultures, and histories, as well as nursing requirements (AHPRA, 2018). They are also premised on scientific evidence and person-centered patient care grounding, and professional relationships with other healthcare providers. In the conduct of their duties during direct clinical or during autonomous practice, nurses are supposed to exploit fully their professional proficiency, due diligence and care for the benefit of the people they serve (Pulcini, Jelic, Gul, & Loke, 2010). In this paper, the focus will be on reflecting on two of the AHPRA Registered Nurse Standard of Practice by way of describing their relevance and importance in practice. In doing so, the paper will draw insights from experiences gained during undergraduate nursing clinical practice as well as my imminence of becoming a registered nurse after my studies.
Standard 1: Thinks Critically and Analyses Nursing Practice
This standard exposes nurses to the significance of utilizing their nursing skills and knowledge to advance the best kind of care to patients and their families. While under training, nursing students are exposed to different critical and creative thinking strategies that they can exploit to advance the best kind of care to their patients. Moreover, nursing students are also exposed to ways of exploiting available scientific evidence to enable them to reach informed nursing decisions during practice (Waters, Crisp, Rychetnik, & Barratt, 2009). This standard, therefore, is concerned with the importance of putting into practice critical thinking and scientific nursing evidence for purposes of providing secure, quality nursing practice (Bittner, & Gravlin, 2009).
During my nursing practice placement, I was assigned patient care tasks in the mental health care unit. One day I was to take care of a 65 year old Aboriginal and Torres Strait Islander woman who had been diagnosed with post-traumatic stress disorder (PTSD). The woman narrated to me her life history which was full of many traumatic episodes with the most depressing one being the recent death of her husband. The woman was therefore in dire need of therapy to help relieve the chronic depression and anxiety that had accumulated for many years. After my own personal analysis and assessment, I started to think critically on how best to take care of her mental illness. I finally came to the conclusion that the best clinical care intervention was to advance her both psychotherapy and pharmacotherapy treatment. I, therefore, started off cognitive-behavioral therapy (CBT) sessions and administered antidepressants such as serotonin. I also thought of ways of how I could engage her and her family in her own care in which case I deduced that strength-based approaches could work best.
To this end, the standard is keen at guiding nurses to their assumption of nursing practices that promote effective patient treatment and ethical principles. Nurses are encouraged by the standard to always comply with laid down nursing regulations, policies, legislation, guidelines, and standards while making any nursing decisions (LeDuc & Kotzer, 2009). Moreover, the standard calls upon nurses to always maintain comprehensive, timely and accurate patients' records management documents with all actions and evaluations intact. This is critical at elevating their decision making, planning and execution of action plans while in practice De Casterlé, Izumi, Godfrey, & Denhaerynck, 2008). With my becoming a registered nurse eminent, I promise to abide by the provisions of this standard as it plays a critical role in shaping a nurse's thought process besides laying adequate action plans in providing the best kind of nursing care to patients.
Standard 2: Engages In Therapeutic and Professional Relationships
This standard recognizes the significance of the formation of purposeful and result-oriented workplace relationships with fellow nurses and other healthcare practitioners. Forging effective and engaging therapeutic and professional relationship with fellow practitioners is very critical in the delivery of holistic person-centered patient care. There is a very high likelihood for patient care to be compromised in instances where healthcare practitioners are not in tandem or in unison in advancing care to their patients (Gardner, et al. 2008). Healthcare practitioners work in interdisciplinary and multidisciplinary, especially when attending patients with acute illnesses or those needing intensive care services. Laschinger (2008) asserts that if these healthcare practitioners are not in good working relationships, then patient treatment outcomes are compromised. This standard, therefore, is keen at establishing and sustaining healthcare professional relationships that mark boundaries between private and professional relationships.
In taking care of the Aboriginal and Torres Strait Islander mentally ill patient, several healthcare providers were involved including psychiatrists, mental illness specialists, social workers, and nurses. All these practitioners worked in collaboration to see the mental health of the patient improve at their various capacities. Prudent communication, treatment procedures, and patient clinical documentation were employed to connect all healthcare practitioners involved. Being a nurse, I was the one expected to journey with the patient throughout her treatment and management encounter. To this end, I was expected to keep all the healthcare practitioners informed of the progress of the patient's recovery as well as reporting any anomalies. My relationship with the patient was purely therapeutic. I also made sure my relationship with my fellow healthcare practitioners was fully professional. This made me attend to the needs of the patient better than it would have been if the relations were more or less personal.
Chiarella, Thoms, Lau, and McInnes (2008) perceive that such a standard is an ardent advocate of directing healthcare practitioners to resources that promote greater health outcomes. In doing so, the standard proactively promotes a culture of safety, learning, and development. Healthcare practitioners are provided with an opportunity to share knowledge and practices that promote person-centered outcomes. Moreover, professional healthcare relationships make delegation, collaboration, coordination, supervision, referral and consolation easy within the healthcare industry which by extension improves healthcare outcomes (Rassin, 2008).
During my nursing clinical practice, I encountered many other instances in which I was supposed to showcase my prowess in collaborating with other healthcare practitioners in the treatment of different patients. As a novice nurse, I appreciated the manner in which I was treated by the more experienced nurses as they delegated me assignment under their supervision and coordination. This assisted me greatly in getting accustomed to the nursing practice besides the engagement becoming an ample platform for sharing knowledge and learning. I was also involved in several multidisciplinary tasks in which I appreciated the professionalism showcased by different practitioners and the respect they gave each other according to their different specializations. As I transition to becoming a fully registered nurse, I have learned that respect is very critical in the formulation of grounded therapeutic and professional relationships in the healthcare industry.
The Nursing and Midwifery Board of Australia (NMBA) and the Australian Health Practitioner Regulation Agency (AHPRA) have been instrumental at regulating Australian nurses and midwives as well as students pursuing these professions with a view of protecting the public. The two work in very close partnership to regulate the conduct of these healthcare professionals by promptly registering them, developing codes, standards, and guidelines of practice as well as taking care of their practice concerns (AHPRA, 2018). Registered nurse standards for practice are very critical in giving nurses an ample platform over which to develop their nursing practice. The two nursing standards discussed in this paper are very central to the nursing practice in Australia. All practicing registered nurses have an obligation to observe them.
AHPRA (2018). Registered nurse standards for practice [Retrieved from] https://www.nursingmidwiferyboard.gov.au/documents/default.aspx?record=WD16%2f19524&dbid=AP&chksum=R5Pkrn8yVpb9bJvtpTRe8w%3d%3d. Assessed 31/8/2018
Bittner, N. P., & Gravlin, G. (2009). Critical thinking, delegation, and missed care in nursing practice. Journal of Nursing Administration, 39(3), 142-146.
De Casterlé, B. D., Izumi, S., Godfrey, N. S., & Denhaerynck, K. (2008). Nurses' responses to ethical dilemmas in nursing practice: meta?analysis. Journal of advanced nursing, 63(6), 540-549.
Chiarella, M., Thoms, D., Lau, C., & McInnes, E. (2008). An overview of the competency movement in nursing and midwifery. Collegian, 15(2), 45-53.
Gardner, A., Hase, S., Gardner, G., Dunn, S. V., & Carryer, J. (2008). From competence to capability: a study of nurse practitioners in clinical practice. Journal of Clinical Nursing, 17(2), 250-258.
Laschinger, H. K. S. (2008). Effect of empowerment on professional practice environments, work satisfaction, and patient care quality: Further testing the nursing work life model. Journal of nursing care quality, 23(4), 322-330.
LeDuc, K. & Kotzer, A.M., (2009). Bridging the gap: A comparison of the professional nursing values of students, new graduates, and seasoned professionals. Nursing education perspectives, 30(5), 279-284.
Pulcini, J., Jelic, M., Gul, R., & Loke, A. Y. (2010). An international survey on advanced practice nursing education, practice, and regulation. Journal of nursing scholarship, 42(1), 31-39.
Rassin, M., 2008. Nurses' professional and personal values. Nursing Ethics, 15(5), pp.614-630.
Waters, D., Crisp, J., Rychetnik, L., & Barratt, A. (2009). The Australian experience of nurses' preparedness for evidence?based practice. Journal of Nursing Management, 17(4), 510-518.