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Professional conduct and competence
Australasian Emergency Nursing Journal (2007) 10, 99—101
available at www.sciencedirect.com
journal homepage: www.elsevier.com/locate/aenj
EDITORIAL
Professional conduct and competence The professional standards adopted by the Australian Nursing and Midwifery Council (ANMC) in the early 1990s exist for all nurses. These standards relate to competency,1 conduct,2 and ethics.3 The ANMC’s National Competency Standards for the Registered Nurse are core competency standards which form an integral component of the regulatory framework that assists nurses and midwives in delivering safe and competent care. They are used by universities when developing nursing curricula and in assessing student and new graduate performance. The core competency standards also provide the framework for assessing nurses involved in professional conduct matters. That a registered nurse is responsible and accountable for their own actions is of paramount importance.1 The first domain of the ANMC’s National Competency Standards for the Registered Nurse is Professional Practice. This relates to the professional, legal and ethical responsibilities of a registered nurse which is demonstrated by a satisfactory knowledge base, accountability for one’s practice, functioning in accordance with legislation, and protecting the rights of individuals and groups.1 The second domain of the ANMC’s National Competency Standards for the Registered Nurse is Critical Thinking and Analysis. This relates to self-appraisal, professional development, and the value of evidence and research for practice. Reflecting on practice, feelings and beliefs and the consequences of these for individuals/groups is an important professional benchmark.1 The third domain of the ANMC’s National Competency Standards for the Registered Nurse is Provision and Coordination of Care. This relates to the coordination, organisation and provision of nursing care that includes the assessment of individuals/groups, planning, implementation and evaluation of care.1 The forth and final domain of the ANMC’s National Competency Standards for the Registered Nurse is Collaborative and Therapeutic Practice. This relates to establishing, sustaining and concluding professional relationships with individuals/groups. This domain also contains those competencies that relate to the nurse understanding their contribution to the interdisciplinary health care team.1 In 1993 the first Code of Ethics for Nurses in Australia was
developed, which was later reviewed during 2000. This Code of Ethics is relevant to all nurses in all practice settings with a primary premise that ‘‘the nurse’s primary professional responsibility is to people requiring nursing care.’’3 Value Statement 3 states: ‘‘Nurses promote and uphold the provision of quality nursing care for all people. Quality nursing care includes competent care provided by appropriately prepared nurses. Promotion of quality nursing care includes valuing life long learning and engaging in continuing education as a means of maintaining and increasing knowledge and skills. Continuing education refers to all formal and informal opportunities for education.’’3 Value Statement 5 states ‘‘Nurses fulfil the accountability and responsibility inherent in their roles. As morally autonomous professionals, nurses are accountable for their clinical decision making and have moral and legal obligations for the provision of safe and competent nursing care.’’3 The Code of Professional Conduct for Nurses in Australia2 sets the expected standards of conduct for Australian nurses. Nurses have a responsibility to provide safe and competent nursing care. A nurse must: 1. Practice in a safe and competent manner. • A nurse is personally accountable for the provision of safe and competent nursing care. Therefore, it is the responsibility of each nurse to maintain the competence necessary for current practice. • Maintenance of competence includes participation in ongoing professional education to maintain and upgrade knowledge and skills relevant to practice in a clinical, management, education or research setting. • A nurse must be aware that undertaking activities that are not within their scope of practice may compromise the safety of an individual. The scope of practice is based on each nurse’s education, knowledge, competency, extent of experience and lawful authority. 2. Practice in accordance with the agreed standards of the profession. • A nurse is responsible to ensure that the standard of that nurse’s practice conforms with professional
1574-6267/$ — see front matter © 2007 Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia Ltd. doi:10.1016/j.aenj.2007.07.001
100
Editorial
standards with the object of enhancing the safety of the individual, any significant other person and colleagues. • A nurse is responsible to ensure that the standard of that nurse’s practice conforms with professional standards with the object of enhancing the safety of the individual, any significant other person and colleagues.2 The College of Emergency Nursing Australasia Ltd. have published Standards for the Emergency Nursing Specialist4 which set the expected standards of practice for Australian emergency nurses. Emergency nurses have a responsibility to provide safe and competent nursing care.
Standard 5. Professional Development states Performance Standard Maintains a professional development profile • Has an up-to-date knowledge of current emergency nursing research. • Participates in quality improvement activities. • Accepts responsibility appropriate to role. • Contributes to educational presentations. • Reviews recent literature related to area of practice. • Participates in ongoing self-education, such as workplace lectures, undertaking postgraduate courses, and conference/seminar attendance. • Identifies areas of knowledge/skill deficits and seeks to address these areas.4 An individual nurse’s scope of practice is based upon their education, knowledge, competency, extent of experience and lawful authority. A nurse must be aware that undertaking activities outside their scope of practice compromises patient safety.2 Registered nurses are expected to maintain appropriate standards of professional conduct5 upon which their performance is assessed to retain their license to practice.1 All emergency nurses have a professional obligation to ensure they maintain an appropriate knowledge base for their practice area, be it as primary nurse for un-monitored beds, Clinical Initiatives Nurse or Triage, and to ensure they practice within their scope of practice. Every emergency registered and enrolled nurse must be cognisant of personal responsibilities and obligations in maintaining their professional competence. I urge all Emergency nurses to familiarise themselves with the above mentioned documents in the context of their individual work environment and to use them as a guiding framework when considering expanding the Scope of Practice of registered and enrolled nurses working in Emergency Departments.
Photo 1 Cpt. Jane Mateer (NSC, Ma International Security, G. Dip Nurse Practitioner, G. Cert Emergency Nursing, BA) during Operation CATALYST at work in the United States Air Force Theatre Hospital, Balad, Iraq.
The Nursing Service Cross (NSC) recognises outstanding performance of nursing duties in both operational and nonoperational situations. Awarded primarily to members of the Defence Forces, the NSC was introduced in 1989, as the first specific award for Australian nurses. Prior to 1989, from the Boer to the Vietnam wars, a nurse could be awarded the Imperial Royal Red Cross. The NSC is awarded by the Governor-General on the recommendation of the Minister for Defence. In this instance, as stated in the Commonwealth Gazette, an NSC was awarded ‘‘for outstanding devotion and
Emergency Nurse Honoured With the announcement of The Queen’s Birthday 2007 Honours List came news of a very deserving award recipient in emergency nurse, Jane Mateer NSC (Photos 1 and 2).
Photo 2
The Nursing Service Cross.
Editorial competency in nursing duties on Operation CATALYST at the United States Air Force Theatre Hospital, Balad, Iraq’’.6 ‘‘Captain Mateer was inspirational in her clinical competence and compassion while caring for critically injured casualties throughout her deployment in Iraq. Captain Mateer excelled in her efforts to save human life and in the care and attention she afforded to the deceased. Captain Mateer’s actions and dedication to duty were well above the call of duty and of the highest order, in keeping with the finest traditions of the Royal Australian Army Nursing Corps.’’7 Jane’s response to this honour was to acknowledge the work of her fellow nurses. Whilst awarded to an individual, I can genuinely say this particular honour was accepted on behalf of everyone who was there, because I consider my NSC to be a reflection of a combined effort by the Australians who were with me in Balad. Like any war zone, it is a place where success is a measure of the team you work with. Finally, in consideration of the nature of our work and in view of the nurses from Crimea to Vietnam who never received any recognition, did not make it home or who were forgotten about after the war, I consider it a great honour to have what we achieved in Balad recognised. The NSC recognises the contribution nurses have and continue to make to the lives and welfare of all those they care for and as war too frequently illustrates, those who will not make it home and who deserve a little final dignity. Jane Mateer has worked as an emergency nurse for 19 years and has been involved with the work of the College of Emergency Nursing Australasia Ltd. for 6 years. Jane has served as a Nurse in the Army Reserve, Australian Defence Force since 1988. Jane won Best Plenary paper at the 5th International Conference for Emergency Nurses at Sydney in October 2005, for her presentation the ‘‘Australian story: a military nurse in the Middle East’’ for which she received a standing ovation, only days after her return from Iraq.
101 Jane now works in Melbourne at the RMIT University as the Coordinator of the Postgraduate Emergency Nursing course. Jane also works for the Victorian Clinical Nursing Consortium, a joint venture by CENA and the Australian College of Critical Care Nurses as the coordinator of the Trauma Nursing Program and is busy planning the rollout of this Australian based course to other Australian States. Captain Jane Mateer is truly a value to Australian Emergency Nursing, a great example for professional conduct and competence, a worthy recipient of the Nursing Service Cross and an inspiration to others.
References 1. ANMC. National Competency Standards for the Registered Nurse; Canberra: Australian Nursing and Midwifery Council; 2005 [cited March 11, 2007]; Available from: http://www.anmc.org. au/docs/Competency standards RN.pdf. 2. ANMC. Code of Professional Conduct for Nurses in Australia; Canberra: Australian Nursing and Midwifery Council; 2003 [cited March 11, 2007]; Available from: http://www.anmc.org.au/ docs/Publications/ANMC%20Professional%20Conduct.pdf. 3. ANMC. Code of Ethics for Nurses in Australia; Canberra: Australian Nursing and Midwifery Council; 2002 [cited March 11, 2007]; Available from: http://www.anmc.org.au/docs/ANMC Code of Ethics.pdf. 4. CENA. Standards for the Emergency Nursing Specialist, 1st ed. Sydney: College of Emergency Nursing Australasia Ltd.; 2003. 5. NMB. Complaints and notifications; Sydney: Nurses and Midwives Board New South Wales; 2007 [cited 27 March 2007]; Available from: http://www.nmb.nsw.gov.au/complaints-and %20notifications/default.aspx. 6. Commonwealth of Australia. Special Gazette No. S102. The Queen’s Birthday 2007 Honours. Canberra: Governor-General, Commonwealth of Australia; 2007. 7. Defence Media Liaison. Media notes NSC; Canberra: 2007 [cited June 30, 2007]; Available from: http://www.gg.gov.au/res/ File/PDFs/honours/qb07/Media%20notes%20NSC.pdf.
Interim Editor-in-Chief Toni G. McCallum Pardey E-mail address: [email protected]
available at www.sciencedirect.com
journal homepage: www.elsevier.com/locate/aenj
EDITORIAL
Professional conduct and competence The professional standards adopted by the Australian Nursing and Midwifery Council (ANMC) in the early 1990s exist for all nurses. These standards relate to competency,1 conduct,2 and ethics.3 The ANMC’s National Competency Standards for the Registered Nurse are core competency standards which form an integral component of the regulatory framework that assists nurses and midwives in delivering safe and competent care. They are used by universities when developing nursing curricula and in assessing student and new graduate performance. The core competency standards also provide the framework for assessing nurses involved in professional conduct matters. That a registered nurse is responsible and accountable for their own actions is of paramount importance.1 The first domain of the ANMC’s National Competency Standards for the Registered Nurse is Professional Practice. This relates to the professional, legal and ethical responsibilities of a registered nurse which is demonstrated by a satisfactory knowledge base, accountability for one’s practice, functioning in accordance with legislation, and protecting the rights of individuals and groups.1 The second domain of the ANMC’s National Competency Standards for the Registered Nurse is Critical Thinking and Analysis. This relates to self-appraisal, professional development, and the value of evidence and research for practice. Reflecting on practice, feelings and beliefs and the consequences of these for individuals/groups is an important professional benchmark.1 The third domain of the ANMC’s National Competency Standards for the Registered Nurse is Provision and Coordination of Care. This relates to the coordination, organisation and provision of nursing care that includes the assessment of individuals/groups, planning, implementation and evaluation of care.1 The forth and final domain of the ANMC’s National Competency Standards for the Registered Nurse is Collaborative and Therapeutic Practice. This relates to establishing, sustaining and concluding professional relationships with individuals/groups. This domain also contains those competencies that relate to the nurse understanding their contribution to the interdisciplinary health care team.1 In 1993 the first Code of Ethics for Nurses in Australia was
developed, which was later reviewed during 2000. This Code of Ethics is relevant to all nurses in all practice settings with a primary premise that ‘‘the nurse’s primary professional responsibility is to people requiring nursing care.’’3 Value Statement 3 states: ‘‘Nurses promote and uphold the provision of quality nursing care for all people. Quality nursing care includes competent care provided by appropriately prepared nurses. Promotion of quality nursing care includes valuing life long learning and engaging in continuing education as a means of maintaining and increasing knowledge and skills. Continuing education refers to all formal and informal opportunities for education.’’3 Value Statement 5 states ‘‘Nurses fulfil the accountability and responsibility inherent in their roles. As morally autonomous professionals, nurses are accountable for their clinical decision making and have moral and legal obligations for the provision of safe and competent nursing care.’’3 The Code of Professional Conduct for Nurses in Australia2 sets the expected standards of conduct for Australian nurses. Nurses have a responsibility to provide safe and competent nursing care. A nurse must: 1. Practice in a safe and competent manner. • A nurse is personally accountable for the provision of safe and competent nursing care. Therefore, it is the responsibility of each nurse to maintain the competence necessary for current practice. • Maintenance of competence includes participation in ongoing professional education to maintain and upgrade knowledge and skills relevant to practice in a clinical, management, education or research setting. • A nurse must be aware that undertaking activities that are not within their scope of practice may compromise the safety of an individual. The scope of practice is based on each nurse’s education, knowledge, competency, extent of experience and lawful authority. 2. Practice in accordance with the agreed standards of the profession. • A nurse is responsible to ensure that the standard of that nurse’s practice conforms with professional
1574-6267/$ — see front matter © 2007 Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia Ltd. doi:10.1016/j.aenj.2007.07.001
100
Editorial
standards with the object of enhancing the safety of the individual, any significant other person and colleagues. • A nurse is responsible to ensure that the standard of that nurse’s practice conforms with professional standards with the object of enhancing the safety of the individual, any significant other person and colleagues.2 The College of Emergency Nursing Australasia Ltd. have published Standards for the Emergency Nursing Specialist4 which set the expected standards of practice for Australian emergency nurses. Emergency nurses have a responsibility to provide safe and competent nursing care.
Standard 5. Professional Development states Performance Standard Maintains a professional development profile • Has an up-to-date knowledge of current emergency nursing research. • Participates in quality improvement activities. • Accepts responsibility appropriate to role. • Contributes to educational presentations. • Reviews recent literature related to area of practice. • Participates in ongoing self-education, such as workplace lectures, undertaking postgraduate courses, and conference/seminar attendance. • Identifies areas of knowledge/skill deficits and seeks to address these areas.4 An individual nurse’s scope of practice is based upon their education, knowledge, competency, extent of experience and lawful authority. A nurse must be aware that undertaking activities outside their scope of practice compromises patient safety.2 Registered nurses are expected to maintain appropriate standards of professional conduct5 upon which their performance is assessed to retain their license to practice.1 All emergency nurses have a professional obligation to ensure they maintain an appropriate knowledge base for their practice area, be it as primary nurse for un-monitored beds, Clinical Initiatives Nurse or Triage, and to ensure they practice within their scope of practice. Every emergency registered and enrolled nurse must be cognisant of personal responsibilities and obligations in maintaining their professional competence. I urge all Emergency nurses to familiarise themselves with the above mentioned documents in the context of their individual work environment and to use them as a guiding framework when considering expanding the Scope of Practice of registered and enrolled nurses working in Emergency Departments.
Photo 1 Cpt. Jane Mateer (NSC, Ma International Security, G. Dip Nurse Practitioner, G. Cert Emergency Nursing, BA) during Operation CATALYST at work in the United States Air Force Theatre Hospital, Balad, Iraq.
The Nursing Service Cross (NSC) recognises outstanding performance of nursing duties in both operational and nonoperational situations. Awarded primarily to members of the Defence Forces, the NSC was introduced in 1989, as the first specific award for Australian nurses. Prior to 1989, from the Boer to the Vietnam wars, a nurse could be awarded the Imperial Royal Red Cross. The NSC is awarded by the Governor-General on the recommendation of the Minister for Defence. In this instance, as stated in the Commonwealth Gazette, an NSC was awarded ‘‘for outstanding devotion and
Emergency Nurse Honoured With the announcement of The Queen’s Birthday 2007 Honours List came news of a very deserving award recipient in emergency nurse, Jane Mateer NSC (Photos 1 and 2).
Photo 2
The Nursing Service Cross.
Editorial competency in nursing duties on Operation CATALYST at the United States Air Force Theatre Hospital, Balad, Iraq’’.6 ‘‘Captain Mateer was inspirational in her clinical competence and compassion while caring for critically injured casualties throughout her deployment in Iraq. Captain Mateer excelled in her efforts to save human life and in the care and attention she afforded to the deceased. Captain Mateer’s actions and dedication to duty were well above the call of duty and of the highest order, in keeping with the finest traditions of the Royal Australian Army Nursing Corps.’’7 Jane’s response to this honour was to acknowledge the work of her fellow nurses. Whilst awarded to an individual, I can genuinely say this particular honour was accepted on behalf of everyone who was there, because I consider my NSC to be a reflection of a combined effort by the Australians who were with me in Balad. Like any war zone, it is a place where success is a measure of the team you work with. Finally, in consideration of the nature of our work and in view of the nurses from Crimea to Vietnam who never received any recognition, did not make it home or who were forgotten about after the war, I consider it a great honour to have what we achieved in Balad recognised. The NSC recognises the contribution nurses have and continue to make to the lives and welfare of all those they care for and as war too frequently illustrates, those who will not make it home and who deserve a little final dignity. Jane Mateer has worked as an emergency nurse for 19 years and has been involved with the work of the College of Emergency Nursing Australasia Ltd. for 6 years. Jane has served as a Nurse in the Army Reserve, Australian Defence Force since 1988. Jane won Best Plenary paper at the 5th International Conference for Emergency Nurses at Sydney in October 2005, for her presentation the ‘‘Australian story: a military nurse in the Middle East’’ for which she received a standing ovation, only days after her return from Iraq.
101 Jane now works in Melbourne at the RMIT University as the Coordinator of the Postgraduate Emergency Nursing course. Jane also works for the Victorian Clinical Nursing Consortium, a joint venture by CENA and the Australian College of Critical Care Nurses as the coordinator of the Trauma Nursing Program and is busy planning the rollout of this Australian based course to other Australian States. Captain Jane Mateer is truly a value to Australian Emergency Nursing, a great example for professional conduct and competence, a worthy recipient of the Nursing Service Cross and an inspiration to others.
References 1. ANMC. National Competency Standards for the Registered Nurse; Canberra: Australian Nursing and Midwifery Council; 2005 [cited March 11, 2007]; Available from: http://www.anmc.org. au/docs/Competency standards RN.pdf. 2. ANMC. Code of Professional Conduct for Nurses in Australia; Canberra: Australian Nursing and Midwifery Council; 2003 [cited March 11, 2007]; Available from: http://www.anmc.org.au/ docs/Publications/ANMC%20Professional%20Conduct.pdf. 3. ANMC. Code of Ethics for Nurses in Australia; Canberra: Australian Nursing and Midwifery Council; 2002 [cited March 11, 2007]; Available from: http://www.anmc.org.au/docs/ANMC Code of Ethics.pdf. 4. CENA. Standards for the Emergency Nursing Specialist, 1st ed. Sydney: College of Emergency Nursing Australasia Ltd.; 2003. 5. NMB. Complaints and notifications; Sydney: Nurses and Midwives Board New South Wales; 2007 [cited 27 March 2007]; Available from: http://www.nmb.nsw.gov.au/complaints-and %20notifications/default.aspx. 6. Commonwealth of Australia. Special Gazette No. S102. The Queen’s Birthday 2007 Honours. Canberra: Governor-General, Commonwealth of Australia; 2007. 7. Defence Media Liaison. Media notes NSC; Canberra: 2007 [cited June 30, 2007]; Available from: http://www.gg.gov.au/res/ File/PDFs/honours/qb07/Media%20notes%20NSC.pdf.
Interim Editor-in-Chief Toni G. McCallum Pardey E-mail address: [email protected]