Newly Qualified Nurse Responsibilities

Newly Qualified Nurse ResponsibilitiesThe aim of this assignment is to discuss the global shargons and responsibilities of the impudently satisf answerory accommo betrothal. The exercise will begin by briefly looking at the transition from student to apply and thereafter outlining the basic roles of the impudently suitable absorb and try to fit them into portion paid skills. In addition, there will be a critical examination of two roles in more occurrence with one of them focusing on longanimous assort Directions (PGD), and justify their importance. We will then look at some legal, professional and ethical ingestations before making a conclusion on the future role development of the nurse.The NMC require a student nurse to demonstrate professional and ethical practice, be sufficient in foreboding delivery and care management, and show personal and professional development in pronounce to join the register (NMC, 2010). On becoming a qualified nurse, the lookations a nd dynamics of relationships changes fundamentally. Suddenly the newly qualified nurse is the one who must know the answer, whether it is a query from a patient, a carer, a make for colleague or a student. The newly qualified nurse will encounter m whatever challenge postal services where she or he must lead care delivery. This includes dealing with care management inwardly the team, dealing with patients/service commitrs, dealing with other professionals, and dealing with the required needs of the whole workplace environment.These changes require a large shift from the experience of being a student and a mentored supervised learner, so it is ingrained that one is equipped with all the skills required to successfully make the transition. The newly qualified nurse must demonstrate they are fit to enter the NMC register and therefore be eligible to practice as a qualified nurse. In all flakes, the newly qualified nurse is seen asProvider of careEducatorCounsellorCollaborator ResearcherChange AgentPatient AdvocateManagerThe in a higher place are typically the roles of a newly qualified nurse which merchantman be compressed into the NMC professional skills requirements listed belowMaintaining standards of careMaking ethical and legal finishsBeing taleableTeamworkingTeaching othersBeing in charge.It is recognized that there is a certain amount of circuit in these professional skills and that some concepts penetrate all of them, in that there are no clear lines drawn where one skill ends and other starts. For the purpose of this analysis, we will look at the issue of making ethical and legal finales and the Patient Group Direction.Decisions and actions are taken by nurses in the course of day-to-day practice. One would non usually consider each of the skills or concepts in isolation in relation to particular incidents moreover would make a decision based on the factors contributing to the situation. However, when analysing any situation, in the d ecisions made and the actions taken, some of the individual abstract regulations may be recognized and highlighted. For example, asking a member of mental faculty to complete a parturiency on your behalf is delegating. This fits neatly into leadership theory and alike relates to aspects of answerability. complemental a health and safety contributevass in the work environment might relate to management theory and responsibility taken on. Completing a review of an individuals care and setting goals for them in multidisciplinary meetings might relate to team working theory. coverage of poor practices or environments might relate to aspects of accountability and maintaining standards of care.However, all of the above aspects could arise from analysing one situation where the nurse has to make decisions about a certain aspect of care management thus emphasize the great importance of making ethical and legal decisions.DECISION MAKING PROCESSNurses are trouble solvers who use t he breast feeding process as their tool. The chief goal of ethical decision-making process is to determine flop and wrong in situations where clear demarcations are not apparent, and then search for the best answer. For a newly qualified nurse, the following will be a guide to making ethical decisionsState the plight State dilemma clearly, determine whether the problem/decision involves the nurse or however the patient, focus tending on ethical principles and follow the clients wishes first while considering the family input in case of unconsciousness.Collect and prove Data Know clients and familys wishes and all information about the problem. Keep abreast of any up to date legal and ethical issues which may in like manner overlap.Consider Choices of mapion Most ethical dilemmas have duplex terminations, some of which are more feasible than others. The more options that are identified, the more likely it is that an acceptable solution can be identified. It may require in put from outside sources and other professionals such as affectionate workers etc.Make the Decision The most difficult part of the process is making the decision, following with with the action, and then living with the consequences. Ethical dilemmas produce differences of opinion and not every one is pleased with the decision but it must be emphasized that clients wishes always supercede the decision by health care providers but ideally, a collaborative decision is made by client, family, doctor and nurse thus producing fewer complications.Act Once a course of action has been determined, the decision must be carried out. Implementing the decision usually involves collaboration with others.Evaluate Unexpected outcomes are common in crisis situations that result in ethical dilemmas. It is of import for decision makers to determine the impact an immediate decision may have on future ones. It is also alpha to consider whether a different course of action might have resulted in a let out outcome. If the outcome accomplished its purpose, the ethical dilemma should be resolved and if the dilemma has not been resolved, additional calculation is needed.Patient Group Direction (PGD)The legislation (Statutory Instrument, 200a) states that Patient Group Direction inwardness in joining with the supply of a prescription only medicine a written direction relating to the supply and government of a description or class of prescription only medicine or a written direction relating to the system of a description or class of description only medicine, and which in the case of either is signed by a doctor and by a chemist and relates to the supply and administration, or to administration, to persons generally (subject to any exclusions which may be set out in the Direction).In practice this mode that a PGD, signed by a doctor and agreed by a pharmacist, can act as a direction to a nurse to supply and/or administer prescription-only medicines (POMs) to patients us ing their possess assessment of patient need, without necessarily referring back to a doctor for an individual prescription.When can PGDs be utilize?The law is clear that the majority of care should be provided on an individual, patient-specific basis, and that the supply and administration of medicines on a lower floor PGDs should be reserved for those situations where this offers an advantage for patient care (without compromising safety), and where it is undifferentiated with appropriate professional relationships and accountability. The RCN interprets this to mean that PGDs should only be used to supply and/or administer POMs to homogeneous patient groups where presenting characteristics and requirements are sufficiently consistent for them to be include in the PGD e.g. infants and children requiring immunisation as part of a national programme.Which POMs can be supplied or administered under a PGD?PGDs can be used to supply and administer a abundant range of POMs although there are currently legislative and groovy practice restrictions in relation to controlled do drugss, antimicrobials and sullen triangle drugs.Controlled drugs The use of controlled drugs continues to be regulated under the Misuse of Drugs Act 1971 and associated regulations made under that Act. The dwelling Office has agreed to allow the supply and administration of substances on Schedule 4 (with the exclusion of anabolic steroids) and all substances on schedule 5 to be included in PGDs.Antimicrobials can be included within a PGD but consideration must be given to the risk of increased granting immunity within the general community. When seeking to draw up a PGD for antimicrobials, a local microbiologist should be heterogeneous and approval sought from the drug and therapeutics committee or equivalent.B leave out triangle drugs and medicines used outside the equipment casualty of the Summary of Product CharacteristicsBlack triangle drugs (i.e. those recently licensed and su bject to special reporting arrangements for unfavorable reactions) and medicines used outside the terms of the Summary of Product Characteristics (SPC) some ms called off label use (for example, as used in some areas of specialist paediatric care) may be included in PGDs. Their use should be exceptional and justified by best clinical practice, and a direction should clearly break the status of the products.How should PGDs be drawn up?The law (Statutory Instrument, 2000a) requires that PGDs should be drawn up by a pharmacist and the doctor who works with the nurses who will be using them. The relevant health authority should also ratify the PGD. In England, when PGDs are developed locally, HSC 2000/026 (NHSE, 2000) requires that a senior doctor and a senior pharmacist sign them off with authorisation from the appropriate health organisation, i.e. the trust, and that all nurses using the directions are specifically named within the PGD and signed by them. The RCN acknowledges this as good practice and recommends the following steps be taken end-to-end the UK.The NMC Standards for Medicines Management (2007) state that the administration of drugs via PGDs may not be delegated and students cannot supply or administer under a PGD. Students would however be expected to consider the principles and be involved in the process (NMC 2007). ruin to ascertain that a PGD is the most appropriate route can lead to waste of valuable time and resource and place increased risk on delivery and quality of patient care. Anyone involved with PGDs (whether developing, authorising or practising under them) should understand the scope and limitations of PGDs as well as the wider context into which they fit to ensure safe, stiff services for patients.Any extension to professional roles with regard to administration and supply of medicines must take into account the need to protect patient safety, ensure continuity of care and safeguard patient choice and convenience. It also has t o be cost effective and bring demonstrable benefits to patient care.Any practice requiring a PGD that fails to consent with the criteria falls outside of the Law and could result in criminal prosecution under the Medicines Act.With regard to the written instruction required for the supply and administration of medicines by non-professionals, Medicines Matters (2006) (3) clarifies that a suitably trained non-professional member of staff can only administer medicines under a Patient Specific Direction (PSD).Medicine Matters (2006) states that Patient Specific Direction is the traditional written instruction, from a doctor, dentist, nurse or pharmacist independent prescriber, for medicines to be supplied or administered to a named patient. The majority of medicines are still supplied or administered using this process.There is nothing in legislation to thwart PSDs being used to administer medicines to several named patients e.g. on a clinic list. PSDs are a direct instruction and the refore do not require an assessment of the patient by the health care professional instructed to supply or administer the medicine.Pharmacy Only (P) and General Sales describe (GSL) MedicinesMedicines legislation states that a PGD is not required to administer a P or GSL medicine. The use of a simple protocol is advisable for best practice and from a governance perspective. All medicines administered must be recorded in the patients medical record. Where a GSL medicine is to be supplied it must be taken from lockable premise and supplied in a pre-pack which is fully labelled and meets the GSL requirements. A PGD will be necessary for the supply of P medicines by anyone other than a registered pharmacist. Recommend further advice to be sought from a pharmacist. (Ref NPC PGDs 2004).For safe administration of drugs, the newly qualified nurse must give the accountability dose of the right drug to the right patient in the right route at the right time. When giving medications, the nurs e needs to be aware of possible interactions between the patients different drugs. It is the nurses responsibility to protect the patient from harm. If they think the wrong drug or the wrong dose has been ordered, they must ask for help from the nurse or the doctor in charge. The newly qualified nurse needs to know the doses of the drug which are safe to administer. Sometimes the chemists gives out drugs in grams when the order specifies milligrams, or the other way around. They need to know how to convert these.It is important to know what types of dilemmas newly qualified nurses may face during their careers and how they may deal with it. It is also important for nurses to understand what malpractice is and how they may protect themselves from a malpractice suit. Firstly, it is important to understand the difference between law and ethics. Ethics examines the determine and actions of people. Often times, there is no one right course of action when one is face with an ethical dil emma. On the other hand, laws are binding rules of conduct. When laws are broken, it is punishable by an authority.There are quartette types of situations that pertain to law and ethics. The first would be an action that is both legal and ethical. An example of this would be a nurse carrying out appropriate doctors orders asordered. A nurse may also be faced with an action that may be ethical but not legal, such as allowing a genus Cancer patient to smoke marijuana for medicinal purposes. The opposite may arise where an action may be legal but not ethical. Finally, an action may be neither legal nor ethical. For example, when a nurse makes a medication error and does not take responsibility to report to it appropriately.The right of service users to expect practitioners to act in their best interests is reinforced by professional codes of conduct and legislation such as the Mental Health Act. It is also reflected in equality of opportunity legislations such as the Sex inequality A ct and the Race Relation Act, which aim to ensure that everybody has equal access to and is offered equal care by health and social care service.Patients right to confidentiality under statutory duties is stipulated in the Data Protection Act, member 8 European Convention of Human Rights, Access to Personal Files Act 1987 and Access to Health drop off Acts 1990. The code does require that nurses must disclose information if they believe someone may be at risk of harm in line with the law.As a nurse, respecting autonomy means you must in effect communicate with patients, be truthful, enable patients to make decisions freely, provide appropriate information and accept the patients preferences. Legally, patients must be given enough information to make a balanced judgement however we must be aware that if nurses fail to comply with the legal trading of disclosure, they could face a negligence claim. However, under the principle of therapeutic privilege they can legally withhold info rmation that they think will harm the patientSome patients whether children or adults are unable either to make or to communicate their decisions therefore they lack (or have limited) capacity. The Mental Capacity Act 2005 that create and clarifies the common law on consent in England and Wales, affects everyone aged 16 and over, and provides a statutory framework to empower and protect people who may not be able to make some decisions for themselves.The moral justifications for acting without consent are the principles of beneficence (the duty to do good) and non-maleficence (the duty to do no harm). Paternalism is overriding someones autonomy because you think it is for their own good. However, it is justifiable if we can demonstrate that the patient is at risk of significant, preventable harm, or the action will probably prevent the harm, or the patients capacity for rational reflection is either absent or significantly impaired, or at a later time, it can be assumed that the pa tient will approve of the decision taken on his/her behalf, or the benefits to the patient of intervention outweigh the risks.Also, we live in a society where demands for accountability and taking responsibility are so commonplace that pinning the blame on someone or something has become almost a fad. The NHS culture of blame has developed basically because no one wants to be accountable or liable for actions or omissions hence there are no longer any accidents or mistakes. Principles of beneficence and non-maleficence underpin the concept of fault which lies at the heart of negligence law.Beneficence means that you must act in ways that benefit others (i.e. duty to care), and Non-maleficence means that you have a duty not to harm others nor subject them to risk of harm. Every nursing intervention that aims to benefit patients may at the same time also harm them. Sometimes the harm will be unavoidable or even intentional and at other times it can be unintentional and unexpected, t herefore it is appropriate to think about the principles of non-maleficence and beneficence together in order to balance harm and benefits against each other. We can resolve this problem responsibility and accountability. These words are sometimes used interchangeably because they do overlap but in actual fact they do not mean the same thing.Being responsible can mean that it is your job or role to deal with something and/or that you have caused something to happen. Accountability on the other hand is about justifying your action or omissions and establishing whether there are good enough reasons for acting in the way you did.Even where the newly qualified nurse delegate tasks to others, such as nursing auxiliaries or care assistants she/he is accountable to the patients through a duty of care, underpinned by a precedent duty to promote safety and efficiency, and legal responsibility through civil law, the employer as defined by your contract of employment, the profession as stated in the relevant codes of conduct and the public.ConclusionAll newly qualified nurses were faced with assumptions from others that they should know everything. This was also a high expectation they had of themselves. In meeting the NMC standards of increase the nurse should have demonstrated the relevant knowledge and skills in order to practise in their relevant specialized fields. However, it is important to recognize that not every nurse knows everything about everything in their field, especially if they are practising in highly specialized fields. What they need is to be able to develop and adapt to changing situations. Therefore, for the nurse it is impossible to know everything, but they should have developed the skills to find out relevant information, reflect on it, and apply this to their practice. In essence they should have learned how to learn. There is a great deal to be learned once qualified, especially related to a nurses new area of work and a good deal of the dev elopment needs to take place on the job.