Scope of practice

Scope of Practice

The term Scope of Practice refers to the range of roles, functions, responsibilities and activities, which a registered nurse, or registered midwife is educated, competent, and has the authority to perform.

Scope of practice for nurses and midwives in Ireland is determined by legislation, EU directives, international developments, social policy, national and local guidelines, education and individual levels of competence. (An Bord Altranais).

Occupational Health Nurses/Advisors, as with all Registered Nurses have a professional and ethical responsibility to work within their Scope of Practice.

Nursing practice is underpinned by values that guide the way in which nursing care is delivered. An Bord Altranais lists the following as values which should underpin nursing practice and provide the basis for the formulation of a philosophy of nursing:

In making decisions about an individual nurse’s scope of practice, the best interests of the patient/client and the importance of promoting and maintaining the highest standards of quality in the health services should be foremost.

Nursing care should be delivered in a way that respects the uniqueness and dignity of each patient/client regardless of culture or religion.

Fundamental to nursing practice is the therapeutic relationship between the nurse and the patient/client that is based on trust, understanding, compassion, support and serves to empower the patient/client to make life choices.

Nursing practice involves advocacy for the individual patient/client and for his/her family. It also involves advocacy on behalf of nursing within the organisational and management structures within which it is delivered.

Nursing practice is based on the best available evidence.

Nursing practice should always be based on the principles of professional conduct as outlined in the latest version of the Code of Professional Conduct for each Nurse and Midwife produced by An Bord Altranais.

The full text can be accessed here –  Scope of Nursing and Midwifery Practice Framework April 2000

Code of Professional Conduct

At present the guidance on professional conduct is provided by the ‘Code of Professional Conduct for each Nurse and Midwife April 2000’, which is provided by An Bord Altranais. As professionals it is every Nurses responsibility to know and to work to this Code. The nursing profession demands a high standard of professional behaviour from its members and each registered nurse is accountable for his or her practice. The code includes guidelines on confidentiality.

Information regarding a patient’s history, treatment and state of health is privileged and confidential. Professional judgement and responsibility should be exercised in the sharing of such information with professional colleagues. The confidentiality of patient’s records must be safeguarded.

The nurse must uphold the trust of those who allow him/her privileged access to their property, home or workplace.

Competence is the ability of the registered nurse or registered midwife to practice safely and effectively fulfilling his/her professional responsibility within his/her scope of practice. In determining his/her scope of practice the nurse or midwife must make a judgement as to whether he/she is competent to carry out a particular role or function. The nurse or midwife must take measures to develop and maintain the competence necessary for professional practice. The nurse or midwife must acknowledge any limitations of competence and refuse in such cases to accept delegated or assigned functions

The full text can be accessed here – Code of Professional Conduct for each Nurse and Midwife April 2000.

The Nurses and Midwives Act 2011, which repeals the Nurses Act 1985, requires the regulator, the Nursing and Midwifery Board of Ireland, to establish a code of professional conduct for the nursing and midwifery professions and to provide guidance on all aspects of ethical and professional conduct. The Act has prompted the review of the Code of Professional Conduct for Each Nurse & Midwife (2000). A wide range of other factors have also necessitated the development of updated guidance for nurses and midwives. These include: changes in health and information technology, advances in areas as diverse as genetics and social media, increased cultural and religious diversity within Ireland, legislation and policy initiatives, the proliferation of varied practice settings, the move toward a more community-based care model, and an increasingly varied healthcare team skill-mix.

The development of a new draft Code has been influenced by the European Council of Nursing Regulators’ reference document, the Code of Ethics and Conduct for European Nursing. This document is structured by principles, values, and general statements of conduct, and provides a common framework for regulatory bodies to use in developing guidance. The importance of broad consultation, critical review, and analysis of ethical and professional matters has also been recognised as central to the process of developing a guidance framework that can support and advise nurses and midwives in Ireland, as well as provide responsive and up-to-date regulation.

The new draft code the ‘Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives’ is still under consultation. A review of the Draft Code can be viewed at this link – Draft Code of Professional Conduct and Ethics