1. Explain the principles of confidentiality in the health care environment. The principles of confidentiality are to maintain the patient’s privacy and confidentiality that all information about the treatment, the patient’s current medical conditions, prognosis and all other areas of the patient’s personal information be kept confidential. This means that it is legally and ethically wrong to disclose their information to a third party unless the nurse has gained consent from the patient to do so, the only time a nurse will disclose the patients information is if it falls within her professional duties and only discussed with other health care professionals (Koutoukidis, Stainton & Hughson 2013, p. 29).
The privacy and confidentiality are governed by the code of conduct and the code of ethics the nurse must work within these codes and their scope of practice, a breach in the patient’s confidentiality can lead to legal proceedings against the nurse (Nursing and Midwifery Board of Australia, 2014).
2. What are the types of small groups and work teams that nurses are likely to be involved in?
There are different groups or work team that nurses can be involved within the health care environment and will consist of two or more people, an example of the types of group could include, Infection control committee that promotes awareness of areas in infection control an example of this is the compliance in hand washing or using alcohol rub before and after procedures in the workplace and communicating the correct procedures in workshops and education sessions (infection control today 2014).
Nurses can also be involved in research teams and communication may come in the form of surveys or interviews to conduct studies on the ways a nurse learns, this could be studies on the way patient care is provided or how nurses manage situations, so the best evidence based practices can be implemented in the nursing profession (Lewis, Dirksen, Heitkemper, Bucher and Camera 2013,p.12).
Educational groups are also an area that nurse can work in an example of this is a Diabetic educator, were they teach people suffering with diabetes management strategies and risks of the illness, and health promotion to prevent the onset of this illness (Australian Diabetes Educators Association 2014)
3.what are dynamics and what are the attributes that aid groups in working effectively?
The definition of Group dynamics is the way that a group of people interact when grouped together (the free dictionary 2014), the benefits and attributes of group dynamics is the way communication and interaction are received and working as part of a team for a common goal, communication between a group should be are clear and concise, being an effective listener to all parties involved in the group, understanding that your opinion may differ to others, respect for yourself and others, to support each other and structure, all of these will help in team building and effective communication between nurses so that effective communication is achieved (Koutoukidis, Stainton & Hughson 2013, pp 98-100).
4. Describe the communication strategy that could be implemented when establishing a therapeutic relationship with the following types of clients.
When an Enrolled nurse is establishing a therapeutic relationship with patients the Enrolled nurse may need use a variety of different communication strategies to meet the patients’ health care needs, there are different techniques that the enrolled nurse will need to use to effectively communicate this includes showing the patient respect for their values and beliefs even if they go against what the nurses beliefs are, having a non-bias attitude, listening to the request of the patient, maintaining eye contact, and having a positive attitude can help a patient feel at ease (Koutoukidis, Stainton & Hughson 2013, pp 108-122).
When the Enrolled Nurse has a patient from a different cultural in their care, the nurse must be culturally sensitive and have a non-bias approach. For effective communication the nurse will need to respect the patient’s beliefs and values and communicate at a level that the patient and the family can understand this also may require the nurse to have an interpreter available if English is a second language ((Koutoukidis, Stainton & Hughson 2013, pp 114-115). ).
Religious beliefs are very similar to cultural beliefs, the nurse must have a non-bias approach and respect the patient’s beliefs and values. The nurse will need to ask questions to find out any special requirements and make any special arrangements available for the patient communication may be verbally or non verbally ((Koutoukidis, Stainton & Hughson 2013, pp 114-118).
When the Enrolled nurse is dealing with language barriers in the health care setting the nurse may be able to communicate with the patient through a family member, interpreter service or arrange to have visual aids that will be able to guide the patient ((Koutoukidis, Stainton & Hughson 2013, p.108).
When you are dealing with a patient with a physical disabilitie there is a variety of different materials available to help communicate with the patient this could include advising the patient of who you are and what you are their to help them with, using a normal tone in your voice, hearing aids and making sure there in working order, sign language, having pen and paper available, and talking books are some of the aids that can help with communicating, ((Koutoukidis, Stainton & Hughson 2013, pp 118 -120).
Intellectual disabilities/emotional disorders
When communicating with a patient that has an intellectual disabilitie or an emotional disorder it is important for the nurse to use the appriote communication, the nurse may need to slow down when explaining a process, using words that the patient can understand, listening to what the patients is communicating and showing empathy and understanding (Koutoukidis, Stainton & Hughson 2013, pp 108 -120).
5. Health care records are legal documents. What are the requirements of documentation in the health care environment?
The legal requirements of documentation in the health care setting that all events in in the correct order of which they happened and be dated and timed using the twenty four hour clock, that all paper work correctly displays the patients full name, date of birth and gender, That all documentation is legible, only the facts are recorded e.g.; only what you personally see, hear, touch or smell, That the signature and name of the nurse is on the paperwork, any mistakes on the paper work you are required to draw a line through the entry and initial it, Only put in the care that you have done is documented unless in an emergency situation, only use authorised abreviations, if there are any gaps are to be filled with a signal line to stop information being added at a later date (Koutoukidis, Stainton & Hughson 2013, pp 272-274).
6. Discuss the meaning of a nurse’s duty of care.
A nurses duty of care refers to using moral and ethical judgement when providing care for a patient without compromising their own moral values and the moral values of the patient, this means to me that you treat people the way you wish to be treated. The nurse has a duty to provide the best possible care and to act in a moral, ethical and professional manner to maintain the patients dignity and respect the wishes of the patient even if this conflicts with your own moral judgement (Crisp and Taylor 2010, pp 334-339)
7. Briefly explain five (5) potential constraints to effective communication?
An Enrolled nurse working in the health care environment needs to be an effective communicator to patients and other health care professional to build a good therapeutic relationships, some barriers that can effect the communication process are talking to a patient but not actively listening to what the patient has to say, abruptly changing the subject, being defensive and acting in a defensive manner, becoming distracted or daydreaming not paying attention to what the patient is saying and asking them to repeat themselves, giving the patient false reassurance when the patient asks a question that makes the nurse feel uncomfortable, and offering an opinion on what they think the patient should do (Koutoukidis, Stainton & Hughson 2013, pp 113-114)
8. What is e-Health and what are the advantages of e-Health?
E-Health is a secure summary of an individual’s personal health information that is available online. the advantages of having an e-Health account is that the individual has personal control over who can access their private information and what information the individual wishes to have recorded, having an e-health account allows the individual, their Doctor and Health care providers share information and allows the individual to have an active involvement in the treatment and insures that the approve care is provided (Australian Government Health Department 2014)
9. Explain the meaning of informed consent and give an example of informed consent in the health setting.
Informed Consent is providing the patient with the most current up to date facts and any associated risks for the prescribed treatment or procedure that is required to meet the health care requirements for the patient, this ensures that the patient can base their decision on all the information that they have been provided with. The nurse must ensure that the patient has understood this information and that the consent of the patient must be voluntary and coercion free. (Crisp and Taylor 2010,p.345) An example of informed consent is informing a patient that requires chemotherapy that all the evidence based facts on the benefits and side effects of the prescribe treatment, The patient will then need to sign a legal consent form prior to the commencement of treatment (Crisp and Taylor 2010,p.345).
10. Define open disclosure and briefly explain the key principles of open disclosure.
The definition of open disclosure is “an open discussion with the patient on adverse events to the patient while receiving health care” (Australian commission on safety on quality in the healthcare 2010). When openly disclosing information to a patient and their family the nurse must act in a professional manner and provide the patient with the facts of the adverse event even before all the information is available, an apology which should include “I am or we are sorry” (Australian commission on safety on quality in the healthcare 2010) for the what has happened, give the patient and family an opportunity to relate their experience, discuss the potential ramifications of the event, explain what is being done to prevent a recurrence, and understanding that open disclosure is a discussion between the patient and the health care facility and this will take time and numerous meetings over a period of time (Australian commission on safety on quality in the healthcare 2010).
11. Clinical handover can pose a high risk scenario for the client’s safety. There are dangers of discontinuity of care, adverse events and legal claims of malpractice. Describe the SBAR framework for handover.
The SBAR framework for handover can be done by the bedside of the patient or by phone when transferring care to a different healthcare facility, The SBAR framework for handovers ensures that an organised and efficient process of communicating the patients private and confidential information to other health care professionals, This process includes Identifying yourself and the patient, The current situation of the patients current medical condition, the background information on what has happened and any know medical conditions and medication that can help aid in the patients treatment, the nurses assessment of the patient including current observations or complaints the patients may have, and recommendations that the nurse has that will assist the patients conditions or recapping all the patients details to ensure that the correct information has been handed over (Koutoukidis, Stainton & Hughson 2013, pp 122- 123).
12. Describe the role of the Australian Health Practitioners Regulatory Agency (AHPRA).
The Australian Health Practitioners Agency in Australia has offices in each state and works with the fourteen national boards that are in charge for regulating the heath care profession and public protection (Australian Health Practitioners Regulatory Agency 2014). The primary role of AHPRA is to provide the public with registered health practitioner information, oversees the registration and renewal of nurses and students, investigates complaints of professional conduct issues, a health practitioner’s performance with the exception of New South Wales and Queensland. Provides support in developing the registration standards, codes and guidelines, guides and advises the Ministerial Council in relation to the National Registration and Accreditation Scheme (Australian Health Practitioners Regulatory Agency 2014).
13. Briefly describe two (2) nursing Codes and two (2) nursing Guidelines relevant to professional practice for the Enrolled Nurse?
The Code of Ethics for the Enrolled nurse is a set of self-imposed rules that ensures the decision, beliefs and the nurses action towards others is at the highest standard. The Enrolled Nurse will work with integrity a high moral standard that ensures the patient will receive the appropriate care whilst tin their care (Nursing and Midwifery Board of Australia 2014).
The Code of Professional Conduct ensures that the Enrolled Nurse work in a compitant and professional manner, The enrolled nurse will show respect to the patient, their culture and the patients values and beliefs, keep their the personal information private and confidential, and provide accurate information on the patients health care needs (Nursing and Midwifery Board of Australia 2014).
Professional Boundaries guidelines
The professional boundaries guidelines for the Enrolled Nurse outlines the importance of establishing a therapeutic relationship with the patient that only occurs to meets the patients healthcare need, and ensures that the Enrolled nurse acts in a professional manner, It is unprofessional for the Enrolled Nurse to enter into a personal relationship with the patient while in their care to except gifts, services or for financial gain (Nursing and Midwifery Board of Australia 2014).
The competency Standards for the enrolled nurse also outline areas that the Enrolled nurse must be competent in to perform their duties in a competent and professional manner and abide the legislations for the nursing profession, this ensures that the nurse will work within their scope of practice (Nursing and Midwifery Board of Australia 2014).
14. What are the functions of performance appraisal and development in the workplace? Promote learning reflect learning The function of the performance appraisal in the health care environment is to a evaluate the performance of the Enrolled Nurse working practices, this helps the Enrolled nurse and their manager to identify areas of improvement, areas where the healthcare facilities goals are being met, recognising areas of professional or personal development and promoting learning and continuous development in areas that will benefit the Enrolled nurse (Queensland Government of Health 2014)
15. Using the examples given below as your guide, research the following medical terms. Provide a definition for each and where possible, break the word down into the meanings of the prefix, words root and suffix.
16.Read the following case study and document the events that occurred. Be objective and keep to the facts, you are documenting as you would in the clients progress notes following an incident. Use the focus charting system outlines in Koutoukidis, Stainton and Hughson 2013.
1. Koutoukidis, Stainton & Hughson 2013, p. 29).
Nursing and Midwifery board of Australia viewed 23.6.14 code of conduct
12 Australian Health Practitioners Regulatory Agency 2014, viewed 25.6.14 “about”
2infection control today 2014 viewed 26.6.14”hand washing commitees”
Queensland Government Health 28.6.14 Cultural Communication 2014http://www.health.qld.gov.au/multicultural/health_workers/CCC-clinical.pdf Queensland Government Health 28.6.14 Cultural requirements http://www.health.qld.gov.au/multicultural/support_tools/islamgde2ed.pdf
(Koutoukidis, Stainton & Hughson 2013, pp 108-120).
10 http://www.safetyandquality.gov.au/wp-content/uploads/2013/03/Australian-Open-Disclosure-Framework-Feb-2014.pdf 2010
8 australian government health department 2014 viewed 28.6.14 “about e-health” < http://www.ehealth.gov.au/internet/ehealth/publishing.nsf/content/home>
11. Koutoukidis, Stainton & Hughson 2013, pp 272-274).
9 (Crisp and Taylor 2010,p.345).
13 NMBA viewed 29.6.14 “professional boundries” < http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Codes-Guidelines.aspx#practiceguide>
14 Queensland Government of Health 2014 viewed 30.6.14 “performance and development appraisal” < http://www.health.qld.gov.au/nmsdf/html/pad.asp> 6 Crisp and Taylor 2010, pp 334-339)
7 Koutoukidis, Stainton & Hughson 2013, pp 113-114