As a nurse, it is important to know the scopes and limitations of one’s practice. This is because this can certainly spell the difference between a highly successful treatment regimen for a patient and a disastrous one—perhaps even one that ends in litigation. In this paper, I used the 5 Rs of reflection namely reporting, responding, relating, reasoning, and reconstructing to outline one of the meaningful experiences in my nursing practice.
One of the most meaningful experiences wherein I was able to use my knowledge of Attribute 2.5 of the NMBA Competency Standards for the Registered Nurse was when I was assigned to look after a patient and administer a nursing treatment when one person requested that I allow him enter the room. Now, the hospital’s protocol was that only direct family members were allowed to visit the patient in his room. When I asked the person knocking at the door about her identity, it turned out she was the fiancé of the patient.
She was well aware of the hospital policy but was nonetheless pleading that I give her permission to visit his fiancé. I was at the turning point back then because I knew how hard it must have been for her to not be able to visit her fiancé given the situation but I knew I was supposed to follow hospital protocols. I knew that even though I wanted to make the two of them meet, I did not have the authority to do so. So, being aware of the Attribute 2.5, I raised the concern to the appropriate registered nurse (i.e. the most senior among the staff nurses) .
That way, I removed myself from a position wherein I may be held accountable and or responsible should anything untoward happen as a result of any of the succeeding actions. I also assessed the consequences of the different decisions I could have done back then and I think I made the right decision to seek authorization from my seniors. Our head nurse then consulted the situation with the other members of the healthcare team and eventually, the family members of the patient until she was given the approval to visit the patient although this was made as an exemption.
In that situation, I was able to properly follow the chain of command when it comes to clarifying decisions and or interventions. That situation may not be related directly to a nursing treatment but it was significant nonetheless because as nurses, we have the obligation to protect and honor the patients’ rights, one of which is their right to privacy and confidentiality .
When I consulted my superiors, I was able to address two things. The first one was my accountability and responsibility as a nurse. I protected myself first from any consequences that may arise as a result of any rush decisions. Surely, it would have been a mistake if I just simply allowed the visitor to enter the room without asking for authorization from my seniors. The second one was the request of the patient. I thought that the patient also wanted to see his fiancé and so I helped the two facilitate a workaround in that somehow complicated situation.
In conclusion, I was able to fully apply into practice Attribute 2.5. I think I was able to apply all of them. I learned how limited my actions should be as a nurse considering that I am handling lives in my profession and that I am under oath to protect my patients including their rights as one. I was also able to experience the feeling of being liability-free. My job was to be a nurse and I am not supposed to partake in any matter that is related to the patients’ personal life and this is why I stuck with the protocol regardless of how emotion things were at that time.
References
Australian Health Practitioner Regulation Agency. (2016). National Competency Standards for the Registered Nurse. Nursing and Midwifery Board of Australia, 01-11.
Bain, J., Ballantyne, R., Mills, C., & Lester, N. (2002). Reflection on Practice: Student Teachers' Perspectives. Post Pressed: Flaxton, Qld.
Choi, P. (2015). Patient Advocacy: The Role of the Nurse. Nursing Standard, 52-58.
