Case Study 3: The Scope of Practice Decision Making Framework Case Study 2
An enrolled nurse was delegated the task of removing a patient’s wound drain. Although educationally prepared , the enrolled nurse had not performed the procedure before but was prepared to undertake the procedure.
Choose one of the scenarios above and use the Scope of Practice Decision Making Flowchat, evaluate each step to determine if the action take was appropriate 1. Identified client need/benefit 2. Regulated nursing practice 3. Accepted nursing or midwifery practice 4. Organisational support 5. Within the scope of practice 6. Appropriate to proceed
Answer
In Healthcare environment where change is a constant feature, nurses are expected to be flexible and to respond to change in ways that benefit health consumers.
When making decisions nurses need to consider that individual have differences in the education , experience and competnece and their respective profession’s scope of practice.
According to Nursing practice decisions summary guide by Nursing and Midwifery Board of Asutralia first the nurse need to identify client need /benefit and nurse need to reflect on scope of practice and nursing practice standards before making decision and nurse need to consider context of practice/ organisational support and last not the least nurse need to select appropriate and competent person to perform the activity.

In this case study the enrolled nurse was educationally prepared but she had not perform the procedure which she was delegate to drain the patient’s wound. But she was prepared to undertake the procedure which is not appropriate to proceed .Firstly the enrolled nurse have to think about the patient’s benefit. Is the task doing by her will meet the patient’s need . As she has only educationally prepare so she need to think about her capability and confident to do that task safely . The enrolled have to think about that the task she is going to do is within her scope of practice or not . It is important for enrolled nurse that she is legally responsible for their own actions and that, although the enrolled nurse works under the supervision of registered nurse ,this does not relieve them of personal liability. Nurses have a responsibility to themselves and their clients , to refuse to perform an activity if: * They are asked to do something that is beyond the legal and professional scope of their role * They have not been prepared to perform a function safely
The enrolled nurse also need to consider about the organisational support , whether they decent level of support or to perform safely anyone who supervise the task. Whether they have stategies to avoid or reduce the potential risks .
To practise in a safe and competent manner its not appropriate for the enrolled nurse to make decision about to under take the procedure which she was delegated.

References * Nursing – Summary – Guide – Final – 2010
( Nursing and Midwifery Board of Australia) * A national framework for the development of decision- making tools for nursing and midwifery practice