The Scope of Professional Practice
A number of years ago the 'extended role' of the nurse
was established which 'allowed' nurses to undertake certain tasks
that were previously the domain of doctors. These tasks had to be
authorised by the employer, training had to be given, competence
assessed and a certificate issued. There was no on-going assessment
of competence after this and the range of tasks nurses could perform
was limited by hospital protocols. The UKCC considered the 'extended'
or 'extending' roles as unsuitable and the Scope of Professional
Practice was therefore introduced in 1992. This recognises that
nurses have the potential to develop their role to include aspects
of care for which they did not necessary hold a certificate.
In order to bring into proper focus the professional
responsibility and consequent accountability of individual practitioners,
it is the Councils principles for practice rather that certificates
for tasks which should form the basis for adjustments to the scope
of practice.
The Scope of Professional
Practice, UKCC 1992
The principles which should govern adjustments to
the scope of professional practice are those which follow:
The registered nurse, midwife or health visitor:
- must be satisfied that each aspect of practice
is directed to meeting the needs and serving the interests of the
patient or client;
- must endeavour always to achieve, maintain and
develop knowledge, skill and competence to respond to those needs
and interests;
- must honestly acknowledge any limits of personal
knowledge and skill and take steps to remedy any relevant deficits
in order effectively and appropriately to meet the needs of patients
and clients;
- must ensure that any enlargement or adjustment
of the scope of personal professional practice must be achieved
without compromising or fragmenting existing aspects of professional
practice and care and that requirements of the Councils Code of
Professional Conduct are satisfied throughout the whole area of
practice;
- must recognise and honour the direct or indirect
personal accountability borne for all aspects of professional practice
and - must, in serving the interests of patients and clients and
the wider interests of society, avoid any inappropriate delegation
to others which compromises those interests.
The Scope of Professional
Practice, UKCC 1992
The principles are based on the Councils Code of Professional
Conduct and in particular on the emphasis which the Code places
on knowledge, skills, responsibility and accountability.
The Scope of Professional Practice 'allows' nurses,
midwives and health visitors to undertake tasks previously the remit
of doctors, as long as the enhanced roles are in the best interests
of the patient, not detrimental to nursing care and that the nurse
is skilled and competent to do them. However, nurses must also acknowledge
any limitations in knowledge and skills and should not perform tasks
they do not feel skilled or competent to perform.
It is therefore important that nurses are confident
they have the necessary qualifications, experience, skills and personal
qualities to be able to undertake the role and responsibilities
required of them. As well as knowing how to perform specific tasks,
the nurse also needs to exercise professional judgment as to whether
such a procedure needs to be undertaken, by them, at that particular
time.
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