Professional Nursing Practice: An Update

1 Material Protected by Copyright Professional Nursing Practice: An Update This course has been awarded five ( ) contact hours. This course expires on July 7, 2014. Copyright 2011 by All Rights Reserved. Reproduction and distribution of these materials are prohibited without the express written authorization of First Published: July 7, 2011 1 Contents Acknowledgements .. 3 Purpose & Objectives .. 4 Disclaimer .. 5 Defining Nursing .. 6 A Model of Professional Nursing Practice .. 6 Foundational Documents of Professional Nursing .. 7 Case Study: How Long Does Your Education Continue .. 7 Nursing : Scope of Practice and Standards of Practice .. 8 Standards of Practice for All Registered Nurses (ANA, 2010b) .. 9 Case Study: .. 10 Does a Standardized Plan of Care Meet Standards? .. 10 Standards of Professional Performance (ANA, 2010b) .. 11 Case Study: You Collaborate for Your Patient s Benefit.

2 12 Competencies .. 12 Case Study: Your Patient Faces a Momentous Decision .. 13 History of the Code of Ethics .. 14 Purpose of the Code of Ethics .. 14 Case Study: Your Nursing Assistant is Newly Certified in Additional Skills .. 15 Provisions of the Code of Ethics .. 16 Case Study: You Are Floated to the Ortho Unit .. 18 Case Study: Your Colleague Takes a Shortcut .. 19 Case Study: Overtime or Time for You? .. 20 Nursing s Social Policy Statement .. 20 Nursing Specialty Certification .. 21 State Nurse Practice Acts .. 21 Administrative Rules .. 22 Case Study: Your RN Colleague is Negligent .. 22 Your State Board of Nursing .. 23 Elements of State Nurse Practice Acts* .. 23 Scope of Practice: Limitations .. 25 Limitations in Dispensing Drugs .. 26 Limitations to Exclude Medical Diagnosis .. 26 Case Study: Your Patient s Condition Worsens .. 27 Accountabilities .. 28 Exemptions for Emergency Assistance .. 28 Exemptions for Practice in Special Circumstances.

3 29 Requirements for Initial Licensure and for Licensure of Nurses Registered in Other States .. 29 Requirements for Maintaining Your License .. 30 Case Study: Your License Expires .. 31 Discipline, Grounds for Discipline, Violations, and Penalties .. 32 Case Study: .. 34 Your RN Co-worker Participates in a Rehabilitation Program .. 34 Diversion .. 36 Misrepresenting Oneself as a Licensed Nurse .. 37 Delegation .. 37 Case Study: Can the LPN Administer Blood? .. 38 Delegation: One State s Example .. 39 2 Delegation: An RN Accountability .. 40 Definitions .. 40 Your Competency: Your Responsibility .. 41 Abandonment - An Issue of Special Concern .. 42 Connect with Your State Board of Nursing .. 42 Your Facility s Policies and Procedures .. 43 Self-Determination .. 43 Using Professional Resources to Practice Effectively .. 44 Conclusion .. 44 Professional Practice Resources .. 46 References .. 48 Ready to Take the Post Test?

4 50 3 Acknowledgements acknowledges the valuable contributions .. Bette Case Di Leonardi. Since 1993, Bette has practiced as an independent consultant to a broad spectrum of healthcare organizations including AMN Healthcare, Professional schools, Professional organizations, hospitals, disease management companies, managed care organizations, a public health department and providers of continuing Nursing education. She works with her clients to assist them in achieving their goals by using educational, competency management and quality improvement strategies. She presents continuing education offerings at a variety of national and regional conferences. She has published on the topics of critical thinking, test construction, competency testing, precepting and career development. She has also written numerous continuing education self-study courses and prepared competence tests for a variety of Nursing specialties.

5 She serves on the editorial board of the Journal of Continuing Education in Nursing , on a regional advisory board for Advance Magazines, and on the ANCC Nursing Professional Development content expert panel. Prior to establishing her consulting practice, Dr. Case di Leonardi held leadership positions in the school of Nursing and the Nursing department at Michael Reese Hospital and Medical Center in Chicago, IL, and taught Nursing students of all levels and college of education students. As a practicing nurse she enjoyed the roles of staff LPN, medical surgical staff nurse, school health nurse and camp nurse. Dr. Case di Leonardi is an active member of the Nursing Staff Development organization (NNSDO) and was among the first group of nurses to receive certification in Nursing Staff Development and Continuing Education from the American Nurses Association Credentialing Center (ANCC). She earned her BSN at Syracuse University and her MSN and in educational psychology at Loyola University of Chicago.

6 4 Purpose & Objectives The purpose of this course is to provide guidelines and information to concerning Professional standards of care, the code of ethics for nurses, and state nurse practice acts. After successful completion of this course, the participant will be able to: 1. Explain the purpose of the component documents of the American Nurses Association s (ANA) Foundations of Nursing Package 2010: a. Code of Ethics for Nurses (2008, reissue 2010) b. Nursing : Scope and Standards of Practice (2010) c. Nursing s Social Policy Statement (2010) 2. Identify the nine provisions of the Code of Ethics for Nurses (ANA, 2010a). 3. Identify the six standards of Nursing practice contained in Nursing : Scope and Standards of Practice (ANA, 2010b). 4. Identify the ten standards of Professional performance contained in Nursing : Scope and Standards of Practice (ANA, 2010b). 5. Identify the purpose of State Nurse Practice Acts.

7 6. Identify the purpose of the Administrative Rules and Regulations that pertain to the State Nurse Practice Act. 7. Identify the key elements and provisions common to all Nurse Practice Acts. 8. Describe what is included in the Scope of Nursing Practice in Nurse Practice Acts. 9. Identify the examples of the requirements for maintaining the RN license. 10. List grounds for discipline commonly found in Nurse Practice Acts. 11. Define alternatives to discipline programs as contained in Nurse Practice Acts. 12. Name the delegation issues addressed in most Nurse Practice Acts. 13. Give examples of Professional practice resources available from Nursing specialty organizations. 5 Disclaimer IMPORTANT INFORMATION strives to keeps its content fair and unbiased. The author has no conflicts of interest to disclose. The planners of the educational activity have no conflicts of interest to disclose. (Conflict of Interest Definition: Circumstances create a conflict of interest when an individual has an opportunity to affect Education content about products or services of a commercial interest with which he/she has a financial relationship.)

8 There is no commercial support being used for this course. Participants are advised that the accredited status of does not imply endorsement by the provider or ANCC of any products/therapeutics mentioned in this course. The information in the course is for educational purposes only. There is no off label usage of drugs or products discussed in this course. 6 Defining Nursing Dictionaries, encyclopedias, Nursing theorists, Nursing textbooks, Nursing organizations, and healthcare facilities all define Nursing with slightly different emphases and shades of meaning. Whatever definition of Nursing best fits your own personal philosophy, as a nurse practicing in the USA you must comply with the legal definition in your specific state, and the policies and procedures of your employing facility. You must also exercise your Professional role in an ethical and competent manner. Nursing is: Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.

9 (ANA, 2010c) A Model of Professional Nursing Practice The Model of Professional Nursing Practice Regulation (Styles, et al., 2008) envisions Nursing practice as a 4-level pyramid building toward the outcomes of safe, quality, evidence-based Nursing practice. The pyramid rests on a base of Nursing Professional Scope of Practice, Standards of Practice, Code of Ethics, and Specialty Certification. Built upon the base, Nurse Practice Acts and Rules and Regulations form the next level of regulation. The third level is Institutional Policies and Procedures. The apex of the pyramid is Self-Determination. Building on the base, each level of the model incorporates progressively specific laws and guidelines that govern practice, culminating in self-determination. Within laws and guidelines, the Professional nurse plays a role in determining his or her own practice. Within this course are examples from a number of different states.

10 Each state varies in terms of the individual Nurse Practice Act, but the examples within the course offer you examples of where you might find the information in your state s nurse practice act. 7 Foundational Documents of Professional Nursing ANA has published 3 resources that inform nurses thinking and decision-making and guide their practice: Nursing s Social Policy Statement: The Essence of the Profession (2010c) defines Nursing , conceptualizes Nursing practice, and describes the social context of Nursing . Nursing : Scope and Standards of Practice (2010b) states the RN scope of practice and presents standards and competencies that outline the Professional role of the RN. Code of Ethics for Nurses with Interpretive Statements (2001a) establishes the ethical framework for RNs across all roles, levels, and settings. Case Study: How Long Does Your Education Continue The Staff Educator for your unit is encouraging staff members to attend a one-day workshop on evidence-based practice.