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Legal and professional issues.
Learning Outcomes
 The attendees will be able to describe a number of
legal and professional areas for consideration when
employed as a practice nurse.
 The attendees will be able to describe how to access
the Competency Standards for Nurses working in
General Practice.
Legal and professional issues: Considerations
 Licensure
 Scopes of practice
 Supervision of the Enrolled Nurse ( Div. 2)
 Competency standards
 Codes of Ethics
 Codes of Professional Conduct
 Other relevant legislation
Scope of Nursing Practice
 The scope of nursing and midwifery practice is
that which nurses and midwives are educated,
competent and authorised to perform. The
actual scope of an individual nurse’s or
midwife’s practice is influenced by:
– The context in which they practice the client’s
health needs;
– The level of competence, education and
qualifications of the individual nurse or midwife;
and
– The service provider’s policies
Competency Standards for nurses in General Practice
 Nurses use competency standards as their
professional framework against which to measure
performance and prepare a professional
development plan so that competence is
maintained and enhanced.
 Nurse regulatory authorities in each state and
territory use competency standards to determine
the eligibility of people applying for a licence to
practice as a nurse and to assess nurses required to
demonstrate continuing competence.
Competency Standards for nurses in General Practice
REGISTERED NURSE ( Div.1):
 ANMC national competency standards for the registered nurse;
 Competency standards for the registered nurse in general practice;
 Competency standards for the advanced registered nurse;
 Competency standards for the nurse practitioner.
ENROLLED NURSE (Div. 2):
 ANMC national competency standards for the enrolled nurse;
 Competency standards for the enrolled nurse in general practice;
 Competency standards for the advanced enrolled nurse.
www.anf.org.au/nurses_gp
What is a Professional Portfolio?
 A professional portfolio is a comprehensive record
of your professional roles.
 It is updated on an annual basis at the minimum.
 A professional portfolio is a confidential document
although you can use copies of some of the
information when applying for a new position or a
pay increase, applying to undertake some further
education, or when audited by the nurse regulatory
authority for the purposes of continuing
competence.
Code of Ethics for Nurses in
Australia
 Identify the fundamental moral commitments of the
profession;
 Provide nurses with a basis for professional and self
reflection on ethical conduct;
 Act as a guide to ethical practice; and
 Indicate to the community the moral values which
nurses can be expected to hold.
Code of Professional Conduct for Nurses in Australia
 The nursing profession expects that nurses will
conduct themselves personally and professionally
in a way that will maintain public trust and
confidence in the profession.
 Nurses have a responsibility to the individual,
society and to the profession to provide safe and
competent nursing care which is responsive to
individual group and community needs, and the
profession.
Code of Professional Conduct for Nurses in Australia
 Set of expected national standards of conduct for
the nursing profession;
 Identifies the minimum requirements for conduct
in the profession;
 Informs the community of the standards for
professional conduct of nurses in Australia; and
 Provides consumer, regulatory, employing and
professional bodies with a basis for decisions
regarding standards of professional conduct.
STATEMENT 1
A nurse must practise in a safe and competent manner.
STATEMENT 2
A nurse must practice in accordance with the agreed standards
of the profession.
STATEMENT 3
A nurse must not bring discredit upon the reputation of the
nursing profession.
Code of Professional Conduct for Nurses in
Australia
STATEMENT 4
A nurse must practise in accordance with laws relevant to the
nurse’s area of practice.
STATEMENT 5
A nurse must respect the dignity, culture, values and beliefs of
an individual and any significant other person.
STATEMENT 6
A nurse must support the health, well being and informed
decision-making of an individual.
Code of Professional Conduct for Nurses in
Australia
STATEMENT 7
A nurse must promote and preserve the trust that is inherent
in the privileged relationship between a nurse and an
individual and respect both the person and property of that
individual.
STATEMENT 8
A nurse must treat personal information obtained in a
professional capacity as confidential.
STATEMENT 9
A nurse must refrain from engaging in exploitation,
misinformation or misrepresentation in regard to health care
products and nursing services.
Code of Professional Conduct for Nurses in
Australia
Insurance for Nurses in General Practice
 Vicarious liability
 Professional indemnity
 Workers’ compensation
 Legal fees
 Income protection
 Accident or injury
Ongoing licensure requires that
you:
 practice within your scope
 practice competently
 practice in accordance with your code of ethics
 practice in accordance with your code of professional
conduct
 practice within a legislative framework.
The Nurse as an employee
 Employers are legally responsible for an employee’s
negligence, based on the principle of vicarious
liability. Under this principle, an employer is legally
liable for the negligent acts and omissions of its
employees where those acts and omissions arise
from or occur in the scope and course of the
employment relationship.
 It is important to understand that the principle of
vicarious liability does not absolve the nurse
working in general practice from responsibility or
remove their legal exposure.
The Nurse as an employee
 On rare occasions the employer may seek to recover
costs from a nurse employee or join them in legal action
in relation to a medical negligence claim, or very rarely,
the patient and the patient’s lawyers may decide to sue
the nurse alone, or may sue the nurse as well as the
employer.
 The nurse working in general practice may also face
exposure additional and unrelated to the prosecution of
a claim for compensation. For example, they may face
disciplinary proceedings or may have their management
investigated by the coroner.
The Nurse as an independent contractor
 The principle of vicarious liability does not apply in
this instance. If the nurse is an independent
contractor from a Nursing Agency, Division of
General Practice or similar and is not an employee
of a general practice, liability for any negligent act
by a nurse lies with that nurse. A nurse who is an
independent contractor should therefore obtain
his/her own professional indemnity cover and the
practice who has engaged the nurse should ensure
that the nurse has this cover.
Practice considerations
 If a patient is harmed, or is allegedly harmed, as a
result of the negligent acts or omissions of a nurse
working in general practice, the general
practitioners legal responsibility in part depends on
whether the practice nurse is:
– An employee of the practice; or
– An independent contractor.
 The distinction between these two, while often
clear, can sometimes be quite difficult to make.

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legal and professionalissues

  • 2. Learning Outcomes  The attendees will be able to describe a number of legal and professional areas for consideration when employed as a practice nurse.  The attendees will be able to describe how to access the Competency Standards for Nurses working in General Practice.
  • 3. Legal and professional issues: Considerations  Licensure  Scopes of practice  Supervision of the Enrolled Nurse ( Div. 2)  Competency standards  Codes of Ethics  Codes of Professional Conduct  Other relevant legislation
  • 4. Scope of Nursing Practice  The scope of nursing and midwifery practice is that which nurses and midwives are educated, competent and authorised to perform. The actual scope of an individual nurse’s or midwife’s practice is influenced by: – The context in which they practice the client’s health needs; – The level of competence, education and qualifications of the individual nurse or midwife; and – The service provider’s policies
  • 5. Competency Standards for nurses in General Practice  Nurses use competency standards as their professional framework against which to measure performance and prepare a professional development plan so that competence is maintained and enhanced.  Nurse regulatory authorities in each state and territory use competency standards to determine the eligibility of people applying for a licence to practice as a nurse and to assess nurses required to demonstrate continuing competence.
  • 6. Competency Standards for nurses in General Practice REGISTERED NURSE ( Div.1):  ANMC national competency standards for the registered nurse;  Competency standards for the registered nurse in general practice;  Competency standards for the advanced registered nurse;  Competency standards for the nurse practitioner. ENROLLED NURSE (Div. 2):  ANMC national competency standards for the enrolled nurse;  Competency standards for the enrolled nurse in general practice;  Competency standards for the advanced enrolled nurse.
  • 8. What is a Professional Portfolio?  A professional portfolio is a comprehensive record of your professional roles.  It is updated on an annual basis at the minimum.  A professional portfolio is a confidential document although you can use copies of some of the information when applying for a new position or a pay increase, applying to undertake some further education, or when audited by the nurse regulatory authority for the purposes of continuing competence.
  • 9. Code of Ethics for Nurses in Australia  Identify the fundamental moral commitments of the profession;  Provide nurses with a basis for professional and self reflection on ethical conduct;  Act as a guide to ethical practice; and  Indicate to the community the moral values which nurses can be expected to hold.
  • 10. Code of Professional Conduct for Nurses in Australia  The nursing profession expects that nurses will conduct themselves personally and professionally in a way that will maintain public trust and confidence in the profession.  Nurses have a responsibility to the individual, society and to the profession to provide safe and competent nursing care which is responsive to individual group and community needs, and the profession.
  • 11. Code of Professional Conduct for Nurses in Australia  Set of expected national standards of conduct for the nursing profession;  Identifies the minimum requirements for conduct in the profession;  Informs the community of the standards for professional conduct of nurses in Australia; and  Provides consumer, regulatory, employing and professional bodies with a basis for decisions regarding standards of professional conduct.
  • 12. STATEMENT 1 A nurse must practise in a safe and competent manner. STATEMENT 2 A nurse must practice in accordance with the agreed standards of the profession. STATEMENT 3 A nurse must not bring discredit upon the reputation of the nursing profession. Code of Professional Conduct for Nurses in Australia
  • 13. STATEMENT 4 A nurse must practise in accordance with laws relevant to the nurse’s area of practice. STATEMENT 5 A nurse must respect the dignity, culture, values and beliefs of an individual and any significant other person. STATEMENT 6 A nurse must support the health, well being and informed decision-making of an individual. Code of Professional Conduct for Nurses in Australia
  • 14. STATEMENT 7 A nurse must promote and preserve the trust that is inherent in the privileged relationship between a nurse and an individual and respect both the person and property of that individual. STATEMENT 8 A nurse must treat personal information obtained in a professional capacity as confidential. STATEMENT 9 A nurse must refrain from engaging in exploitation, misinformation or misrepresentation in regard to health care products and nursing services. Code of Professional Conduct for Nurses in Australia
  • 15. Insurance for Nurses in General Practice  Vicarious liability  Professional indemnity  Workers’ compensation  Legal fees  Income protection  Accident or injury
  • 16. Ongoing licensure requires that you:  practice within your scope  practice competently  practice in accordance with your code of ethics  practice in accordance with your code of professional conduct  practice within a legislative framework.
  • 17. The Nurse as an employee  Employers are legally responsible for an employee’s negligence, based on the principle of vicarious liability. Under this principle, an employer is legally liable for the negligent acts and omissions of its employees where those acts and omissions arise from or occur in the scope and course of the employment relationship.  It is important to understand that the principle of vicarious liability does not absolve the nurse working in general practice from responsibility or remove their legal exposure.
  • 18. The Nurse as an employee  On rare occasions the employer may seek to recover costs from a nurse employee or join them in legal action in relation to a medical negligence claim, or very rarely, the patient and the patient’s lawyers may decide to sue the nurse alone, or may sue the nurse as well as the employer.  The nurse working in general practice may also face exposure additional and unrelated to the prosecution of a claim for compensation. For example, they may face disciplinary proceedings or may have their management investigated by the coroner.
  • 19. The Nurse as an independent contractor  The principle of vicarious liability does not apply in this instance. If the nurse is an independent contractor from a Nursing Agency, Division of General Practice or similar and is not an employee of a general practice, liability for any negligent act by a nurse lies with that nurse. A nurse who is an independent contractor should therefore obtain his/her own professional indemnity cover and the practice who has engaged the nurse should ensure that the nurse has this cover.
  • 20. Practice considerations  If a patient is harmed, or is allegedly harmed, as a result of the negligent acts or omissions of a nurse working in general practice, the general practitioners legal responsibility in part depends on whether the practice nurse is: – An employee of the practice; or – An independent contractor.  The distinction between these two, while often clear, can sometimes be quite difficult to make.