Work in the Nursing Profession

1a Explain the differences between modern day nursing education and the old hospital based training model Modern day nursing is quite a different experience and process when compared to the old hospital based training system.

Today’s nursing is theory based. Nurses learn the theory behind actions, procedures and decisions, before gaining the experience of performing the action or duty within the profession.In stark contrast the hospital based system is on the job, training where the nurses learn various processes as they present themselves and the theory is explained after the process has been demonstrated or when the applicable lesson comes to pass. The training was often governed by the skills required on the ward on that particular day, rather than the broad range of skills and knowledge that is achieved with the modern evidence based training model (Koutoukidis, Stainton & Hughson 2013 pp. 4 – 19).

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1b When did the Diploma of Nursing become the nationally recognised entry level qualification for Enrolled Nurses in Australia? Why did this occur? The diploma of nursing was nationally recognised in 2010, it coincided with the establishment of the Australian Health Practitioners Regulation Authority (AHPRA). This was essential as previously each state had a different system and standards and this was not practical for national management .This was evident when nurses would transfer jobs between states and find that the skill sets were not equal (Koutoukidis, Stainton & Hughson 2013, pp 10)(Australian Health Practitioners Regulatory Agency 2012).

2a Discuss two primary health care strategies which aim to combat health issues such as poor nutrition, diabetes, obesity or tobacco smoking in aboriginal or Torres Strait Islander communities Smoking is responsible for one in five of all aboriginal deaths (Dept of health and ageing-1 2011), and as such is an excellent candidate for a primary health care strategy. The Australian Government is funding a national network of tobacco action coordinators; this will implement community based smoking prevention programs and activities tailored to Aboriginal and Torres Strait Islander communities.A tobacco action workforce will deliver smoking cessation programs and existing workforce will be retrained in a team based approach. Nationally quit smoking role models, peers and ambassadors- people who have kicked the habit- will travel and be avail to talk and help smokers give up. Quit line services will provide new content designed to serve the communities. Even social media will contain campaigns to reinforce the life change messages (Dept of health and ageing-1 2011). The Indigenous chronic health care package aims to reduce the incidence of diseases such as diabetes, cancer, chronic respiratory disease, diabetes, cancer, cardiovascular disease and kidney disease (Dept of health and ageing-2 2011).The Australian Government is funding coordinated and primary health care in both community controlled health care and mainstream general practice.

Programs are designed to involve local communities in healthy lifestyle programs and financial incentive for services providing better health care to indigenous people with chronic diseases (Dept of health and ageing-2 2011). Also removal of barriers such distance and finance so that patients can receive allied health services, pharmaceutical benefits scheme and specialist care, increasing the capacity of the indigenous primary health care workforce (Dept of health and ageing-2 2011). 2b What are some of the challenges that may need to be overcome in order for these strategies to work effectively?The key challenges with these strategies are community tradition and opinion; it is very difficult to change the habits and lifestyle choices of an individual and their community (Health promotion journal of Australia 2010). Another issue is the proximity and availability of health care services, as some of the clientele come from low socio economic backgrounds, live in remote areas, may have minimal education levels. Also language can be another barrier that may make the message difficult to understand (Koutoukidis, Stainton & Hughson 2013, pp 159-169).3a If a patient is from a low socio economic background, how might this affect their health and well-being? When nursing a patient from a low socio-economic background there are often additional factors affecting health outcomes- Inability to afford medications and insurance can directly affect the success of any current or future health treatment. Levels of education or ignorance can lead to embarrassment and /or confusion and can directly affect an individual’s realisation that there may be a health problem and possible lengthen the delays in seeking treatment or advice (Koutoukidis, Stainton & Hughson 2013, pp 80-83).Levels of hygiene and general cleanliness may also factor in the prevalence of health issues.

As a result of poor knowledge or lack of money, a patient’s nutritional requirements may not be sufficiently met, resulting in compromised health and immunity. (Koutoukidis, Stainton & Hughson 2013, pp 80-83) 3b Explain how cultural factors impact on clients in the health care environment and affect views about health and illness Cultural factors can impact health care clients in a number of ways. Some cultures do not have faith in western medicine and may believe in alternative treatments such as prayer or herbal and traditional cures (Koutoukidis, Stainton & Hughson 2013, pp 110-115).Actions routinely taken as part of the treatment process may be against the ideals and rules of their beliefs, for example some cultures do not approve of male to female interactions when un-related and accommodation’s may need to be made .While some cultures and religions do not believe in blood transfusion , even when death may be the result of refusal. Language barriers are another example that may cause confusion and miscommunication (Koutoukidis, Stainton & Hughson 2013, pp 110-115).

4a Describe the role of the following professional nursing bodies: Nursing and Midwifery Board of Australia Australian Nursing Federation Australian College of Nursing/Royal College of Nursing Australia Australian Nursing and Midwifery Accreditation Council The Nursing and Midwifery board of Australia works in association with Australian Health Practitioner Registration Association (AHPRA) to set and evaluate codes, standards and guidelines that define the nursing Profession and nursing professionals can refer to (Nursing and Midwifery Board of Australia 2012).The Australian Nurses Federation is the Union for enrolled and registered nurses, midwives and assistants they serve as advocates for nursing professionals and provide advice and assistance with conflicts (Australian Nursing Federation 2013). The Australian College of nursing is the Australian member of the International Council of Nurses (ICN) they serve as advocates for the Nursing industry and provide Continuing Professional development (CPD) opportunities for Australian Nurses (Australian college of nursing 2008). The Australian Nursing and Midwifery Accreditation council (ANMAC) is the body that provides and monitors both accreditation and registration of nurses and midwives across Australia (Australian Nursing and Midwifery Accreditation Council 2012).4b Explain the important occupational health and safety considerations for professional nursing practice in the health care environment The nursing workplace contains a wide range of potential hazards.

A number of steps should be taken to provide a safe work environment with the following considerations; biologic and Infectious hazards, chemical hazards, physical hazards and psychosocial hazards (work 2012). Tools and training are paramount for safe nursing practice. Some key proficiencies would include use of personal protection equipment, infection control, self preservation, manual handling, reporting systems, emergency and operating procedures, as well as induction and training programs (New South Wales Nurses’ Association 2004).5a Explain how Enrolled Nurses can ensure that legal and ethical aspects are duly considered when providing care for a young person with a moderate intellectual disability The code of ethics and the code of conduct provide some guidance for professional nurses. It is important to be an advocate for the patient while showing respect, empathy, professionalism and confidentiality. Taking steps to ensure that the patient or guardian is aware of the options and authority or consent is gained. Ensuring the best possible outcome for the patient at all times (Nursing and Midwifery Board of Australia 2012).

5b Explain how the enrolled nurse can provide appropriate support to a client and their family when they are dealing with death and dying The prospect of death and dying is extremely confronting for many patients. A nurse should remain professional during this difficult time. Compassion, empathy and understanding can be used to provide some consolation. If required a nurse can direct the affected party to suitable counselling agencies, financial assistance agencies and provide information on who to notify regarding the situation (Koutoukidis, Stainton & Hughson 2013, pp 235).6a describe the roles and responsibilities of an enrolled nurse with in the multidisciplinary health care team in the following health care environments Aged care setting Acute care setting Nurses working within a multi-disciplinary aged care team are required to participate in identifying expected health outcomes, liaising with respect to development of Care Plan, collect and report all patient data to the care team, participate in team meetings, organise the actioning of the health care plan, assist in the review of the care plan, support and assist other health team members with the heath care plan (Stroke Foundation 2011) The focus for aged care will be often a long term plan with the focus on maintaining overall health levels, in contrast, a multidisciplinary acute care team will focus on short term goals with a focus of improving overall health levels.The nurse’s responsibilities to the health care team in acute care are very similar to aged care, only the goals and time frame will be shorter. 6b In your own words explain the purpose of the following documents National competency standards for the enrolled nurse (anmc, 2002) Code of ethics for nurses (anmc, 2008)Code of professional conduct for nurses (anmc, 2008) The national competency standards illustrate a benchmark by which all enrolled nurses can be assessed and held accountable, it gives nurses a baseline that ensure effective and professional nursing practice.

The code of ethics is a guide for all levels of nursing and relates directly to the ethos of being a professional nurse, it shows the mindset and considerations in the decision making required at all levels of nursing. The code of conduct is a guide for the nursing profession as to how they should represent to an observer or college, this applies to both decision making and reputation, so that the laymans confidence and overall impression of nursing is promoted.7a List four types of continual professional development activities that enrolled nurses might complete in order to update or complete their skills As an Enrolled nurse Continual professional development can be achieved through attending conferences relevant to nursing .Attending workshops relevant to nursing, reading nursing journals and attending or providing in-services or in job training sessions (Nursing and Midwifery Board of Australia 2010)7b explain how the following may be used to assist enrolled nurses with improving their professional practice- Professional portfolio Reflective Journal Performance review A nurse’s professional portfolio is a record and collection of achievements and milestones throughout the career in regards to scope of practice, training and demonstrated achievements. A reflective journal is a record that allows a nurse to self-assess past decisions and situations; it can be used for self-improvement and reflective practice. A performance review is conducted by peers or supervisors and is an assessment that can highlight areas that could require improvement or further education; it also serves to widen your scope of practice.8a name four sources of employment opportunities for enrolled nurses in the contemporary health care environment The nursing profession is wide and varied an example of some areas of employment are aged care, hospitals, defence force, royal flying doctors.

8bWhat does an enrolled nurse need to do to prepare for a job interview (e.g. what materials might they need to prepare) For a job interview a nurse will need to have an up to date professional resume, professional attire , winning attitude, professional portfolio, up to date certificates and vaccines, it is also sage advice to do some research on the history and operational requirement of the prospective organisation (ANM Healthcare 2008).

9a Give two workplace example of when you may need to refer to the nursing practice decision flowchart (anmc2007) before proceeding with nursing care. Explain how it can be used in each case The nursing flow chart is very versatile, for example if a nurse is asked to take a blood sample from a patient – by following the simple yes and no steps of the flow chart it shows that this operation is routinely carried out by someone with phlebotomist training and the procedure should be referred to them unless the nurse has the necessary training and is supported by the organisational rules (Australian Nursing and Midwifery Council 2007). Another example is if an enrolled nurse was asked to hold the keys to the dangerous drugs safe, the first question is whether that is within the scope of practice for an enrolled nurse – the answer is no, in addition to this the organisation is not looking at changing this rule, so the keys need to be held by the appropriate person – in this scenario an authorised registered nurse.9b In your own words briefly explain what is meant by scope of practice as an enrolled nurse The scope of practice is the level of applicable expertise and experience; it is governed by the training level, the rules of the establishment and the laws that govern a position.

It is generally considered to be what you have been trained and are competent to do and what is acceptable for the client and service provider.10a what are four types of health records regularly used to communicate client information to the healthcare team An example of some commonly used health care notes are, care plans, progress notes, bowel charts and patient charts.10b in your own words briefly describe the meaning of a holistic and consumer or client centred approach to healthcare in the contemporary Australian health care system. The modern Holistic approach looks at more than just the symptom, for example if an elderly person presents with a scraped knee, the holistic approach looks at the treatment but also overall health, why did this happen, will this happen again, does this happen often, where did this happen, how are they feeling otherwise, how are they looking and how can we best ensure this patient has the best possible long term health outcome.