This paper examines key dimensions of professional nursing practice, with a focus on coronary care unit staff. It covers the meaning of ongoing competence and self-evaluation, flexible working arrangements and European Working Time Directive compliance within the NHS, and the professional standards governing general practice nurses in Australia. The paper also addresses evidence-based practice, therapeutic communication, and the ethical obligations nurses hold toward patients, colleagues, and the broader community. Drawing on the Australian Nursing and Midwifery Federation's Code of Ethics and several national standards documents, the paper presents a comprehensive overview of what effective, accountable nursing practice requires.
Competence refers to a set of demonstrated abilities, skills, attitudes, knowledge, and values underlying effectual, safe, and high-quality performance in any occupation or profession. Ongoing competence refers to midwives' and nurses' ability to demonstrate that they have sustained competence within their present field of practice. Midwives and nurses are only capable of doing this if they have access to an environment that facilitates efficient, effective, and high-quality patient care. Self-evaluation must involve reflection, peer review, patient and patient outcome evaluation, and critical incident assessment. Though the National Registration Standard does not mandate peer reviews of competence in nursing, peer review is an unbiased performance assessment for nurses against National Competency Standards (Continuing Competence, 2013).
An in-depth evaluation of the National Health Service (NHS) Staff Survey of 2009 revealed that scarcely under three-fourths (72%) of staff members had accepted the option of flexibility in working hours. The most prevalent flexible working forms among NHS midwives and registered nurses (RNs), as per a 2008 survey (the latest survey whose statistics have been analyzed), are units autonomously making rota-related decisions, followed by decreased hours working — for example, flexi-time and part-time jobs (Mercer, Buchan, & Chubb, 2010). This survey indicated that roughly one RN or midwife in five (22%) worked approximately 29 hours weekly, while more than three-fourths (78%) worked 30 hours or more per week in 2008 (Mercer, Buchan, & Chubb, 2010). The major distinguishing aspect is that, over the past decade, the fractions have marginally changed across specialties, with a slight rise in education and psychiatry personnel and a trivial fall in staff engaged in community services. Across all NHS staff, about 44% stated that the trust they worked for was devoted to helping staff balance work and personal life; this proportion was higher compared to prior years, depicting a steady trend of trusts committing themselves to developing flexible working systems.
Under the European Commission's Working Time Directive (EWTD), the maximum working hours of nursing staff must be 48 hours weekly (Mercer, Buchan, & Chubb, 2010). It was discovered by the National Audit Office (NAO) that more than four-fifths (88%) of trusts could monitor working hours of permanent nursing and bank staff, but none could supervise hours worked extra — on other trusts' banks or via agencies — because of data protection laws. This is a cause for concern and may likely place patients at risk. National Health Service Professional (NHSP) report using the EWTD as a guideline to review time worked, with a focus on patient safety (Mercer, Buchan, & Chubb, 2010).
Professional Practice: Irrespective of their employment setting, nursing professionals are regulated and held responsible and accountable for their practice. Their practice must conform to existing general practice and nursing laws, rules, guidelines, and standards (Foley, Bryce, Ashley, Halcomb, & Stephens, 2014).
Nursing Care: Nursing professionals possess the skills and knowledge required to provide evidence-based, comprehensive nursing care to patients in general practice. They play a central role in the planning, execution, coordination, supervision, and evaluation of healthcare in general practice. Their functions include assessing and managing immediate issues as well as preventive care, comprehending the psychological and social context, health screening, and health maintenance and promotion (Foley, Bryce, Ashley, Halcomb, & Stephens, 2014).
General Practice Environment: Nurses who work in general practice in Australia are faced with unique challenges. To perform in this work environment efficiently, nurses need specific general practice-related skills and knowledge and must be aware of its role in the wider context of primary healthcare. Apart from clinical expertise, these nurses must also be acquainted with the principles of sustainability and viability of small businesses (Foley, Bryce, Ashley, Halcomb, & Stephens, 2014).
Collaborative Practice: General practice nurses create and cultivate relationships with team members, practice populations, community agencies, other health experts, and organizations in order to optimize consumer outcomes. Owing to the ongoing, close relationship of nurses with patients, their guardians, and families, nursing professionals are well placed to evaluate and manage numerous health requirements (Foley, Bryce, Ashley, Halcomb, & Stephens, 2014).
"Role of EBP in updating and guiding nursing care"
"Interpersonal communication skills and patient relationships"
"Ethical duties to patients, colleagues, and community"
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