1 postsRe: Topic 5 DQ 1

Through championing the nursing profession, nurses give a voice to the essential role that they play in advancing access to high-quality, affordable care. With energetic participation in advocacy, every nurse can help the profession to improve and move to higher levels. The American Nurses Association (ANA) believes that advocacy is a pillar of nursing. Nurses instinctively advocate for their patients, in their workplaces, and in their communities; but legislative and political advocacy is no less important to advancing the profession and patient care. The ANA serves to amplify the voice of nurses by advocating directly with decision-makers on Capitol Hill as policies are conceived, debated and implemented. The ANA provides support for state nurses associations as they advance their own advocacy agendas and help federal agencies and elected officials propose and enforce new laws that will advance the nursing profession. The ANA creates long-lasting relationships with nurses and their representatives, working to establish a health system where care is accessible, of high quality, and recognizes the nursing profession as an integral component. Registered nurses represent the largest segment of health professionals, with more than 4 million nationwide. Nurses not only represent an incredible force by sheer numbers, but policymakers rely upon their expertise as they work to improve our nation’s health system. Through participation in professional organizations, nurses can actively contribute to legislative changes that can affect patient care and the way they conduct their work. Nurses are continually looking for and exploring new ways to provide patients with quality care (GCU, 2018).

 

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2 postsRe: Topic 4 DQ 2

To be professionally accountable in nursing is necessary and vital for patient care and safety. According to The American Nurses Association Code of Ethics, the definition of accountability “ is to be answerable to oneself and others for one’s own actions.”
The nurse has to ensure that while delivering care, accountability is owed to themselves and the client, the client’s family, colleagues, the workplace and the profession.

An example of professional accountability is during the admission process of a client to a psychiatric unit for the first time. The client is involuntary and is not sure what this status means for them. With professional accountability, the nurse explains the involuntary status and also ensures that the family understands what this status is in a psychiatric facility. Due to the fact that the hospital is a teaching facility and nursing students are always present, each opportunity must be seen as a teaching moment, so nursing students can understand how professional accountability impacts the care of clients from the time of admission.

A senior nurse knows that establishing a therapeutic relationship allows the client to feel safe and being professionally accountable impacts both client and student especially during the assessment phase. Here the nursing process is key to clinical expertise and using the nursing process demonstrates that quality of care must start from the point of admission to discharge. This nursing process is kept in mind by a highly educated nurse who also uses evidence-based practice to deliver safe and effective care.

Evidence-based practice in professional accountability allows the nurse to have a better understanding of the practice and how accountability influences her to make decisions that fully impacts patient care.(Brower & Nemec,2017) An example of evidence-based practice in mental health is to form a client-centered plan of care to ensure all decisions are shared-decision making. The care team and the client seeking help with mental health issues come together to have client-centered care and self-directed care. 

With accountability to the client and self, the nurse is an advocate for the client and ensures that the latest evidence is used to drive change for better patient outcomes. ( Brower & Nemec, 2017).

Professional Accountability is one of the best ways for a nurse to self regulate, be conscious of the care and their impact when imparting knowledge to the future generation of nurses.

 

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 e: Topic 4 DQ 1

The reason for standards of practice in nursing is to promote, guide, direct, and regulate the professional practice. Each province in Canada sets a standard of Nursing that every nurse has to adhere by. These standards ensure that the legal and professional standards of nursing are upheld. Hence the reason a license is issued for a nurse to practice so the public can be protected and safeguarded.

In Ontario, The College of Nurse’s of Ontario is the body that sets standards and practice guidelines for nurses. The main purpose of these guidelines is to provide safe and ethical nursing care for the people of Ontario.

Practice standards:
These outline the expectation of nurse contribution to public protection.
The nurse needs to be aware of the accountability to the public.
To make the public aware of what is expected of the nurse.
These standards apply to every nurse,

Practice Guideline:
In these guidelines, nurses understand their responsibilities and how to make ensure that they make safe and ethical decisions.

The other legislative body that is key to where I work is the Legislation relevant to mental health in Ontario. (RSO 1990, C.M.7-Ontario.ca).
The Mental Health Act sets out the guidelines for when a person is admitted to a specially designated psychiatric facility. The admission designation should be voluntary, involuntary or informal.
The health care consent act which states the rules determining capacity are in three areas, treatment decision, admission, and personal assistance care.
The Substitute decision Act allows for the individual who is capable to appoint another person to make decisions for them in case they become incapable.
Then there is the Health Information act of 2004. This legislation was enacted to ensure that health care providers understood the unique demands of providing mental health care for individuals and that there is no disclosure of information without the consent of the client or a substitute decision maker.
In the mental health setting, I work it is imperative to establish the status of the client immediately on arrival. Meaning if the client is voluntary, involuntary, or informal. Treatment decisions are made with this in mind. Adherence to the College of Nurses guidelines and the mental health legislation is important because depending on the capacity of the client, some immediately request a lawyer on admission who is routed through a Rights Adviser. A Rights Advisor is one of the hospital’s employees and can be reached through an extension. This information is usually posted so the client can have easy access. While trying to ensure that that client is safe and needs are met, it’s within the patient’s right to be treated immediately, and have access to an attorney. This is also a very important aspect of their lives.

 

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2 postsRe: Topic 4 DQ 1

Standards of nursing practice provide guidance and expectations of nursing practice and nursing performance, which help define the responsibilities of the nurse. Standards of practice include assessment, diagnosis, planning, coordination of care, health teaching, consultation, prescriptive authority, and evaluation while the standards of performance include ethics, education, evidence-based practice and research, quality of practice, communication, leadership, collaboration, professional performance evaluation, resource utilization, and environmental health (Case de Leonardi, 2014 and cited by Green, S.Z. (2018). Each state has their own Nurse Practice Act that addresses the scope and standard of practice specifically for that state and empowers a board of nursing which creates the administrative rules. Once adopted these rules have the same weight and effect as law (Green, 2018).

The Georgia Board of Nursing has the power to enforce the regulations as defined in the Nurse Practice Act as well as amend them if deemed necessary. The board is in charge of developing state nursing standards, license enforcement and evaluate nursing programs on a regular basis. The board also investigates any complaints against licensed nurses and imposes a disciplinary process. It has the authority to require the surrender of a nursing license during any pending action. The board’s primary purpose is to protect the public.

The Georgia Board of Nursing Nurse Practice Act recognizes that assessment, nursing diagnosis, planning, intervention, evaluation, teaching and supervision are the major responsibilities of a nurse. The steps of the nursing process include assessment, nursing diagnosis, planning, implementation, and evaluation. The Standards of Practice delineate the quality of nursing care that a patient/client should receive regardless of whether it is provided solely by a RN or by a RN in collaboration with other licensed or unlicensed personnel. My current position is in quality. These Standards ensure a responsibility and an accountability of the RN to the patient for the quality of nursing care rendered (Georgia Board of Nursing, Nurse Practice Act, Rules Chapter 410-10 Standards of Care).

 

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