NRS162 ASSESSMENT 2 WORKPLACE LEARNING SCENARIO
OVERVIEW
ASSESSMENT DETAILS
Value: 40%
Due Date: 6-Sept-2023
Return Date: 28-Sept-2023
Length: 1000 words
Submission method options: TurnItIn Assignment Portal (online)
ASSESSMENT RESOURCES
The following are downloadable documents to use in your preparation (they are all available in the Assessment 2 folder – you have likely already downloaded a few!)
• THIS OVERVIEW DOCUMENT
• MARKING RUBRIC
• DESCRIPTOR WORDS (document to Help with your understanding of the rubric)
• TEMPLATE
• VIDEO SLIDES
• ASSESSMENT EXAMPLE
These have been kept separate to avoid submission to Turnitin (the TEMPLATE is the only document to be uploaded to Turnitin)
INSTRUCTIONS
Using the provided scenario and the information available in Modules 1 and 2 in the NRS162 Interact2 site, provide responses as they apply to the SPROUT model of reflection. Please note, you may include learnings from Module 3a if you feel comfortable and find it is relevant to your application of SPROUT.
Using the SPROUT reflective model, address each of the following points as they relate to the provided scenario (see below)
• Situation: describe the events of the scenario. In your description, ensure you include your thoughts and feelings connected to the scenario. (approx. 100 words)
o Guided Thoughts
? Where were you located? What were you doing? What did you do? Who else was there? What was the outcome?
? What was the main issue in the scenario?
? How are you feeling and what are your thoughts surrounding this situation/ issue?
• Past & previous: describe one (1) previous learning that has influenced your thoughts and feelings when viewing the scenario. This can be either a theoretical or physical experience you have encountered previously. (approx. 100 words)
o Guided Thoughts
? How can you relate your thoughts and feelings mentioned in the previous paragraph?
? Have you had a physical experience that you can relate this situation to?
? Can you relate these thoughts and feelings to a theory such as those you have learnt previously in the degree?
• Read & refer: describe evidence-based understanding (using sources from the literature) to further inform your knowledge and supports your understanding the scenario. (approx. 150 words)
o Guided Thoughts
? What evidence can be related to this scenario?
? Was there any breach in scope of practice from anyone? In your response, define and describe scope of practice for the student Registered Nurse in Australia and how it differs from that of the RN. This definition requires support from the literature (this means – references!)
• Other information: describe one (1) internal and one (1) external factor that has influenced your experience when viewing the scenario. Include at least one (1) example from the scenario in your response. (approx. 150 words)
o Guided Thoughts
? What are your personal values and beliefs in relation to the doing the right thing?
? Did the student or yourself demonstrate a lack of awareness and understanding of the WPL handbook?
? Is there any external pressure to do well or to meet certain expectations when on workplace learning?
• Understanding: outline the information gathered in the previous stages and include at least one (1) example from the scenario in your response to make a connection between each stage. (approx. 200 words)
o Guided Thoughts
? What would you do on a future placement if a similar incident arose?
? Should you or the other students have intervened as those aware of the situation? Could there be any implications for you or the other students?
? Does this link to any broader circumstances such as advocating for your patient, a medication error or even a more serious event such as major misconduct or negligence? Could these ‘minor’ issues lead to more serious ones?
? Consider the reputation of the university at the facility, integrity/ reputation of the student, delay of unit & course completion, increased costs for the student & university (if student is sent home from placement due to breach); consider what failing the ANSAT (this is a legal document and an assessment item) means for a student. For example, failing this assessment item means failing the subject.
• Take it forward: outline what knowledge has been taken from this reflective process. Included in your response should be one (1) strategy on how you will share this new knowledge in your professional or personal lives. (approx. 200 words)
o Guided Thoughts
? Include at least one (1) SMART goal as your action plan
? What would you do to avoid this type of incident from happening again?
? Are there courses you can take, people you should speak to, policies to follow?
Please note that an introduction and conclusion is not required.
A reference list will be required as will in-text referencing to support your thoughts throughout your paper.
At least 3 sources are expected to be awarded a passing grade
Consider including the following as supporting literature
– BN WPL Handbook
– RN Standards for Practice
– The Code of Conduct for Nurses
– The ICN Code of Ethics for Nurses
– The Road to Nursing textbook
– The Clinical Placement textbook
– Any other relevant sources related to scope of practice, workplace learning (clinical placement, work integrated learning), values of healthcare professionals along with legal and ethical requirements in healthcare
Scenario
You are a first year Bachelor of Nursing student attending your first clinical placement for NRS173. Your first 2 week allocation is in a geriatric unit of a local regional hospital. You are excited as most students had received placements in Residential Aged Care Facilities and you have not worked in a hospital before. As this is your first placement, you are hoping to do well and very keen to practice the skills you have learnt in NRS163 and, this far, in NRS174.
You are attending placement with three other first year students. All four of you have passed the NRS174 OSCE based on medication administration and wound assessment and management.
At lunch on Friday of the first week, you have a discussion with the other students about your experiences so far. You are excited to share you have participated in vital sign monitoring, documentation, wound dressings and medication administration with your RN preceptor. One of your colleagues mentions that they administered paracetamol to a patient as they complained of pain. They state they did this without the RN as the patient had “pleaded with them to do something”. This student also mentioned they are an AIN with a medication administration competency so know how to administer paracetamol safely.
Back on the unit, you overhear the student talking with a patient’s family about how they should have been given credit for their first year. The student stated they had been working for a long time as an AIN and can complete many tasks without the RN present. They also shared the RN takes too long when they are ready to undertake a task and do not want to keep the patient waiting.
You are unsure how to proceed with this information and the other 2 students who were present at lunch did not say anything. You decide to approach your preceptor to discuss the situation during your debrief at the end of the shift.
MARKING CRITERIA AND STANDARDS
10 marks equates to 100 words; 15 marks equates to 150 – 200 words
CRITERIA DESCRIPTOR
PASS Described: provide an account of, outline the features
CREDIT Discussed: consider from more than 1 point of view; provide arguments for and against and draw a conclusion
DISTINCTION Explained: provided a detailed account, offer reasons why, describe cause and effect
HIGH DISTINCTION Examined: describes in detail, explores the meaning and implications
HD (85-100%) DI (75-84.5%) CR (65-74.5%) PS (50-64.5%) FL (0-49.5%) Mark
Situation:
Describe the events of the scenario including your thoughts and feelings about the scenario. You have examined the events of the scenario.
You have examined your thoughts and feelings about the scenario.
(8.5 – 10 marks) You have explained the events of the scenario.
You have explained your thoughts and feelings about the scenario.
(7.5 – 8.4 marks) You have discussed the events of the scenario.
You have discussed your thoughts and feelings about the scenario.
(6.5 – 7.4 marks) You have described the events of the scenario.
You have described your thoughts and feelings about the scenario.
(5 – 6.4 marks) You have not described the main events of the scenario.
You have not described your thoughts and feelings about the scenario.
(0 – 4.9 marks) /10
Past & previous:
Describe at least one (1) previous learning or experience that has influenced your thoughts and feelings when viewing the scenario.
You have examined and applied your previous learning or experience that has influenced your thoughts and feelings about the scenario.
You have made connections from your previous learning or experience with the scenario and discussed why or why you have not been guided by these previous learning.
(8.5 – 10 marks) You have explained your previous learning or experience that has influenced your thoughts and feelings about the scenario.
You have made connections from your previous learning or experience with the scenario.
(7.5 – 8.4 marks) You have discussed your previous learning or experience that has influenced your thoughts and feelings about the scenario.
(6.5 – 7.4 marks) You have described at least one (1) previous learning or experience that has influenced your thoughts and feelings about the scenario.
(5 – 6.4 marks) You have not described one (1) previous learning or experience that has influenced your thoughts and feelings about the scenario.
(0 – 4.9 marks) /10
Read & refer:
Describe evidence-based understanding (using sources from the literature) to further inform your knowledge and supports your understanding the scenario.
Include at least one (1) source in your response.
You have examined multiple evidence-based sources to support to further informs your knowledge and supports your understanding of the scenario.
Multiple sources have been used in your response.
(12.7 – 15 marks) You have explained multiple evidence-based sources to support your knowledge and supports your understanding of the scenario.
Multiple sources have been used in your response.
(11.2 – 12.6 marks) You have discussed evidence-based sources that further informs and supports your knowledge.
There are at least two (2) sources used in your response.
(9.7 – 11.1 marks) You have described evidence-based sources to support your knowledge.
There is at least one (1) source used in your response.
(7.5 – 9.6 marks) You have not described evidence-based literature to support your knowledge.
There are no sources used in your response.
(0 – 7.4 marks) /15
Other information:
Describe one (1) internal and one (1) external factor that has influenced your thoughts and feelings about the scenario. Include at least one (1) example from the scenario and at least one (1) source in your response.
You have examined one internal factor that has influenced your thoughts and feelings about the scenario.
You have examined one external factor that has influenced your thoughts and feelings about the scenario.
Multiple examples from the scenario have been included in your response.
Multiple sources have been used in your response.
(12.7 – 15 marks) You have explained one internal factor that has influenced your thoughts and feelings about the scenario.
You have explained one external factor that has influenced your thoughts and feelings about the scenario.
Multiple examples from the scenario have been included in your response.
Multiple sources have been used in your response.
(11.2 – 12.6 marks) You have discussed one internal factor that has influenced your thoughts and feelings about the scenario.
You have discussed one external factor that has influenced your thoughts and feelings about the scenario.
There are at least two (2) examples from the scenario included in your response.
There are at least two (2) sources used in your response.
(9.7 – 11.1 marks) You have described one internal factor and one external factor that has influenced your thoughts and feelings about the scenario.
There is at least one (1) example from the scenario included in your response.
There is at least one (1) source used in your response.
(7.5 – 9.6 marks) You have not described one internal factor and one external factor that has influenced your thoughts and feelings about the scenario.
There are no examples from the scenario included in your response.
(0 – 7.4 marks) /15
Understanding:
Outline the information gathered in the previous stages and include at least one (1) example from the scenario in your response to make a connection between each stage.
You have examined the information discussed in previous stages and made connections to how it relates to the scenario.
Multiple examples from the scenario have been included in your response.
Multiple sources have been used in your response.
(12.7 – 15 marks) You have explained the information discussed in previous stages and made connections to how it relates to the scenario.
Multiple examples from the scenario have been included in your response.
Multiple sources have been used in your response.
(11.2 – 12.6 marks) You have discussed the information in previous stages and made connections to how it relates to the scenario.
There are at least two (2) examples from the scenario included in your response.
There are at least two (2) sources used in your response.
(9.7 – 11.1 marks) You have outlined the information in previous stages and made connections to how it relates to the scenario.
There is at least one (1) example from the scenario included in your response.
There is at least one (1) source used in your response.
(7.5 – 9.6 marks) You have not discussed the information in the previous stages and have not made connections to how it relates to the scenario.
There are no examples from the scenario included in your response.
(0 – 7.4 marks) /15
Take it forward:
Outline what knowledge has been taken from this reflective process.
Outline one (1) strategy, in the form of a SMART goal, about how you will share this knowledge in the future.
Include at least one (1) source in your response You have examined the knowledge that has been taken from this reflective process.
You have examined one (1) strategy on how you will share this knowledge in the future.
Multiple sources have been used in your response.
(12.7 – 15 marks) You have explained the knowledge that has been taken from this reflective process.
You have explained one (1) strategy on how you will share this knowledge in the future.
Multiple sources have been used in your response.
(11.2 – 12.6 marks) You have discussed the knowledge that has been taken from this reflective process.
You have discussed one (1) strategy on how you will share this knowledge in the future.
There are at least two (2) sources used in your response.
(9.7 – 11.1 marks) You have outlined the knowledge that has been taken from this reflective process.
You have outline one (1) strategy on how you will share this knowledge in the future.
There is at least one (1) source used in your response.
(7.5 – 9.6 marks) You have not outlined what knowledge has been taken from this reflective process.
You have not outlined one (1) strategy on how you will share this knowledge.
(0 – 7.4 marks) /15
Communicates Professionally (Academic writing and presentation).
Language features and structures are used to convey meaning effectively, clearly, unambiguously, concisely, and in a formal academic style, with few spelling, grammatical, or punctuation errors.
Presentation guidelines have been followed.
(8.5 – 10 marks) Language features and structures are used to convey meaning effectively, clearly, unambiguously, and in a formal academic style, with occasional minor spelling, grammatical, or punctuation errors.
Presentation guidelines have been followed.
(7.5 – 8.4 marks) The meaning is apparent to the reader, although text contains minor errors in spelling, grammar, word choice, and/or structure, and lacks clarity occasionally.
Presentation guidelines have been followed.
(6.5 – 7.4 marks) The meaning is apparent to the reader, although text contains many errors in spelling, grammar, word choice, and/or structure, and lacks clarity occasionally.
Presentation guidelines have been followed and/or 10% over or under the set word limit.
(5-6.4 marks) Presentation guidelines have not been followed with multiple errors.
Frequent, intrusive errors in spelling, grammar, punctuation, word choice and/or structure prevent the meaning from being apparent to the reader.
(0 – 4.5 marks) /10
Uses evidence to support and build knowledge in practice (Academic referencing).
The assessment is supported by & related to a wide variety of peer reviewed references which include journal articles, professional manuals and documents, textbooks, and module readings.
Referencing is comprehensive, demonstrates academic integrity, and is error free for the APA 7th ed. style conventions.
(8.5 – 10 marks) The assessment is supported by & related to a variety of peer reviewed references which include journal articles, professional manuals and documents, textbooks, and module readings.
Referencing is comprehensive, demonstrates academic integrity, and conforms to APA 7th ed. style conventions, with one or two errors.
(7.5 – 8.4 marks) The assessment is supported by more than three (3) peer reviewed references from module readings, textbooks, and professional manuals and documents.
Referencing is comprehensive and mostly accurate according to APA 7th ed. style conventions.
Up to five (5) minor errors or omissions in style and formatting choices have no impact on the transparency and traceability of the source, or the demonstration of academic integrity.
(6.5 – 7.4 marks) The assessment is supported by at least three (3) peer reviewed references from module readings, textbooks, and professional manuals and documents.
Referencing is comprehensive and mostly accurate according to APA 7th ed. style conventions with few minor errors.
Up to ten (10) minor errors or omissions in style and formatting choices that have no impact on the transparency and traceability of the source, or the demonstration of academic integrity.
(5 – 6.4 marks) The assessment is supported by less than three (3) peer reviewed references from module readings, textbooks, and professional manuals and documents, and/or no references are evident
Referencing is not accurate according to APA 7th ed. style conventions.
Errors or omissions in style and formatting choices have an impact on the transparency and traceability of the source, or the demonstration of academic integrity.
(0 – 4.9 marks) /10
Academic Integrity
Turnitin report indicates adherence to academic integrity principles and referencing conventions. Turnitin similarity report indicates a clear attempt has been made to adhere to academic integrity and referencing conventions and avoid plagiarism. It is evident that the student has taken steps to show respect for and acknowledge others’ work appropriately, as per the Charles Sturt Academic Integrity Policy https://policy.csu.edu.au/document/view-current.php?id=387 .
SY Turnitin similarity report indicates the student has not adhered to the Academic Integrity Policy.
US SY/US
MARK /100
TEMPLATE
Title page
Please remove or replace all italicised and highlighted writing from this template prior to submitting your assessment. Please remove all subheadings (marks will be deducted for failing to do so; these are in reference to presentation guidelines).
Feel free to create your own title page for your assessment, being as creative or simple as suits you.
Your title page must include:
• Subject name and code: (NRS162 Nursing Workplace Learning 1)
• Assessment Title (Assessment Item 2: Reflection on Workplace Learning Scenario)
• Due Date
• Subject Convenors name (and campus academic if you wish)
• Student name and number
Situation (100 words)
Paragraph 1: Describe the events of the scenario. In your description, ensure you include your thoughts and feelings connected to the scenario.
Past and Previous (100 words)
Paragraph 2: Describe one (1) previous learning that has influenced your thoughts and feelings when viewing the scenario. This can be either a theoretical or physical experience you have encountered previously.
Read and Refer (150 words)
Paragraph 3: Describe evidence-based understanding (using sources from the literature) to further inform your knowledge and supports your understanding the scenario.
Other Information (150 words)
Paragraph 4: Describe one (1) internal and one (1) external factor that has influenced your experience when viewing the scenario. Include at least one (1) example from the scenario in your response.
Understanding (200 words)
Paragraph 5: Outline the information gathered in the previous stages and include at least one (1) example from the scenario in your response to make a connection between each stage.
Take it forward (200 words)
Paragraph 6: Outline what knowledge has been taken from this reflective process. Included in your response should be one (1) strategy on how you will share this new knowledge in your professional or personal lives.
References (this must be on a new page)
APA 7th edition; minimum 3 sources (apply the CRAP test)
Don’t forget to remove or replace all italicised and highlighted writing from this template prior to submitting your assessment.
EXAMPLE
An Example of Applying SPROUT in Clinical Practice
Situation
On placement, after lunch, I stopped by Mr. X’s room to check on him. I noticed he appeared visually uncomfortable so I asked him how are you feeling. He told me that he had bad chest pain I nodded and asked him to rate his pain out of 10. He answered 7/10, so I reassured him I would do something about it. Firstly, I directed Mr. X to sit down and relax while I removed his socks and loosened his other articles of tight clothing. I then proceeded to contact the RN. While awaiting the nurse I took Mr. X’s vitals, the results were blood pressure 134/88, O2 saturation 98%, pulse 81, and respirations 24. After observing Mr. X, the nurse informed me the source of his pain was GORD and administered PRN anti-inflammatories. I checked up on Mr. X shortly after the PRN and asked him to rate his pain again this time he noted no pain.
Past experience
From previous learning, at university, I was able to utilise my knowledge of PQRST to gain an accurate clinical assessment of his pain. I recalled that effective pain management improves quality of life by increasing a person’s phycological and physical functioning. Promptly after discovering Mr. X was experiencing chest pain, I drew upon previous workplace training that outlined if have suspicions of a person suffering cardiovascular failure you must help the person remain calm, sit down and loosen any tight clothing to reduce the stress on the heart. Further, my university study taught me the importance of collecting vital signs as they determine what treatments are required and are critical in making life-saving decisions.
Read and refer
I consulted the RN about possible ways to improve my clinical practice and help identify between a heart attack and GORD. The RN advised me to review an article by Frieling (2018) that outlines heartburn appears as a burning sensation that typically occurs after eating and is usually accompanied by regurgitation of food, while a heart attack occurs at any time and characteristically creates an abnormal heart rate and a dull chest pain. In the case of Mr. X. GORD symptoms as outlined by MacFarlane (2018) can be managed through avoiding certain foods like chocolate or coffee, eating smaller portions, and sitting upright for two hours after eating. The RN further referred me to Michaelides & Zis (2019) article that explains while pain is an individual experience conditions like depression and anxiety commonly result in a decreased pain threshold. The RN explained above all else it is the responsibility of nurses to holistically care for patients and follow best practice to ensure optimum health outcomes.
Other influencing factors
Through reflection of my internal and external beliefs, I was able to uncover blind spots in my understanding of chest pain. My internal belief that all chest pain is cardiac-related is hazardous as it leads to premature closure that results in misdiagnosis and potential for serious injury or death. Additionally, my erroneous internal belief that GORD conditions wouldn’t score a 7/10 as described by Mr. X is inappropriate as it dismisses the individual experience of pain. Further, my external frustration influenced my practice as the AIN’s dismissal of Mr. X’s pain as anxiety-driven irritated me as I know this is not best practice to make assumptions about a patents condition. As anchoring to a diagnosis is dangerous as it inhibits the clinical reasoning cycle and prevents the person from achieving therapeutic healthcare. Moreover, my external anxiety about being in a new environment enabled me greatly empathise with Mr. X’s discomfort. This motivated me to alert the RN as I must advocate for patients to provide them the opportunity to receive high-quality healthcare and health outcomes.
Understanding
This situation highlights the danger of anchoring to a diagnosis and the importance of following the clinical reasoning cycle to minimise errors and provide high-quality healthcare. Further, I have learnt pain is an individual experience that can be influenced by emotions and conditions like anxiety and depression (Michaelides & Zis, 2019). This knowledge enables me to treat a person’s physical and mental health in unison to help alleviate pain and promote physical and mental wellbeing. Overall, this experience enhanced my understanding of GORD by providing me first-hand experience and knowledge that can be utilised to help future patients.
Taking it forward
Should a similar situation arise in the future, I will need to advocate for the patient by not anchoring to a diagnosis and following the clinical reasoning cycle. To achieve this, I must check my patients’ medical and social history to better understand their individual needs and tailor my care to provide high-quality person-centred care. Further, as outlined in the Nursing and Midwifery Board of Australia, (2016), Standard 3, I will continually advance my knowledge of disease processes and symptoms through literature to ensure a high standard of practice and to promote patient safety.
References
Athena, M., & Panagiotis Z. (2019). Depression, anxiety and acute pain: links and management challenges. Postgraduate Medicine, 131(7), 438-444, http://doi.org.10.1080/00325481.2019.1663705
Frieling, T. (2018). Non-cardiac chest pain. Visceral Medicine, 34(2), 92-96. https://doi.org/10.2147/IPRP.S142932
MacFarlane B. (2018). Management of gastroesophageal reflux disease in adults: a pharmacist’s perspective. Integrated Pharmacy Research & Practice, 7, 41–52.
Nursing and Midwifery Board of Australia. (2016). Registered nurses’ standards for practice. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx
ASSESSMENT WRITING HELP
Consider using the tips below the instructions and this video on the Interact 2 site
• Searching the literature and making a plan
• Core Resources to Help with your assessment
• Editing/ Reviewing
• Reflection
How do I maximise my marks?
Follow the instructions! These are presentation guidelines
Scholarly papers, reports, or other similar assessment items must be ‘word processed’ and not handwritten. Requirements include:
• Leave 2 cm margins and double line space your work;
• Use 12pt font, Arial or Times New Roman;
• Number all pages;
• Insert your student name and number in header or footer of every page of every assignment; and
• Include a title page that includes the subject name and code, title of the assessment task, due date, lecturer’s name, your name and your student number.
• Please write in the first person. Helpance with this can be found at this link: First vs Third person
• Examples of sources not suitable as resources include blogs, magazines, Wikipedia and commercial websites (e.g. with .com or .co included in the web link).
Format & Structure
• Write this paper in first person
• Follow the template to help you get started and finished!
• No colloquialisms!
• No contractures!
• Isn’t, don’t, can’t, won’t
• Please identify abbreviations or acronyms in full on first mention
• For example, Nursing and Midwifery Board of Australia [NMBA]
• Consider grammar, spelling, punctuation – submit to STUDY SUCCESS for feedback
Referencing
• Correct and consistent referencing is an important component of producing professional and credible academic work. Marks will be awarded for high quality referencing.
• A minimum of three (3) credible and scholarly sources must be used to support your work.
• APA 7th edition style MUST be applied.
• References cannot exceed 7 years (we will accept up to 2015 however) in age, unless they are guidelines/frameworks or seminal works.
o This can include sources used as Module readings
• We will accept a previous edition of a text if the new edition has only just been published
o Clinical Reasoning & The Clinical Placement are examples of this
• Credible websites are acceptable for this paper as sources.
o In order of credibility – .gov, .edu and .org.
• Please do not use the I2 site as a source, but rather use the information that was used for the content via the sources that support this.
• The Study Success Team can Help you with your referencing
o Have you visited the Academic Referencing Tool [ART]?
o Have you submitted your paper to Studiosity?
Turnitin Submission Portal
Please refer to the Subject Outline for comprehensive information regarding your assessment:
• Please only submit a WORD document of your work
• Please use the DRAFT TURNITIN portal to assess your document for paraphrasing issues
• Students are able to resubmit (overwrite) the document for this task in Turnitin, up until the due date – once this date has passed, any submission is final.
• On submitting your document, a (green) confirmation text will appear in your dashboard, allowing you also to download a digital submission receipt – you can also obtain this receipt at a later time via the options button, to the right of your submitted file.
• Allow enough time to ensure you can manage any technical difficulties you might experience
• Make sure you keep the TURNITIN receipt for your submission (this may be needed if there are issues with the timing or documents in your submission)
• Make sure you submit the right file type (Microsoft Word Document) and the right version of your paper (e.g. not a draft or an assessment for another subject).
Reminders
• Use the resources found on the Interact 2 site
• Review the due date and plan your assessment preparation time
• Attend the Drop In Sessions (at the time of recording, the dates and times were TBC
• Request an extension via the Special Consideration portal if needed
– 5% (5 marks) per calendar day deduction for late submissions
• Raise any questions you may have in class, via email, in a drop-in session or on the discussion board
_________________________________
Situation:
I was on my first clinical placement as a first year Bachelor of Nursing student at a local regional hospital’s geriatric unit. On the Friday of the first week, myself and three other first year students had lunch together to discuss our experiences so far. One student mentioned they had administered paracetamol to a patient without the RN as the patient had pleaded for pain relief. They stated they were comfortable doing this as they had a medication competency from working as an AIN. I felt uneasy about this but didn’t say anything at the time. Later, I overheard this same student telling a patient’s family they should have been given more credit for their experience as an AIN and that they could complete tasks without the RN. They also expressed frustration that the RN took too long to complete tasks. I was concerned by these comments and decided to discuss the situation with my preceptor at the end of the shift.
Past & Previous:
I recalled learning in NRS163 Professional Nursing Practice about the importance of scope of practice and working within your level of competence as a student nurse (Australian Nursing and Midwifery Council, 2018). As an undergraduate student, our scope is limited and we must work under the direct supervision of an RN. From my experience working as a customer service Helpant, I understand the frustration of wanting to help but not being able to due to role boundaries. However, in healthcare the risks of working outside your scope can be much greater.
Read & Refer:
The RN Standards for Practice (Nursing and Midwifery Board of Australia, 2016) clearly define the RN scope as being responsible and accountable for assessing, planning, implementing and evaluating care. Students work under the direction and supervision of an RN and cannot practice independently (p.3). Administering medication without assessment or following due process is considered a breach of scope (Nursing and Midwifery Board of Australia, 2018). The ANSAT (Australian Nursing Standards Assessment Tool) we must pass outlines professional standards including working within legislative boundaries and under professional supervision (Australian Nursing and Midwifery Accreditation Council, 2012). By administering medication alone, this student demonstrated a lack of understanding of their role and responsibilities that could compromise patient safety.
Other Information:
Personally, I value putting patient safety above all else in healthcare. However, I understand the external pressures students can feel to impress clinical staff and meet expectations. The WPL handbook we received in our preparatory workshop clearly stated students must work under RN supervision at all times (University of XYZ, 2022). This student’s actions showed a lack of awareness of policies and procedures put in place to guide safe practice.
Understanding:
This situation highlights the importance of following due processes, even when well-intentioned to help expedite care. Administering medication alone was a breach of this student’s scope of practice that could have serious consequences for the patient and their learning. If a similar issue arose, I would discuss it immediately with my preceptor to ensure we address any misunderstandings and maintain professional standards and patient safety. All students witnessing this event should have reported it, as we have a duty to advocate for safe, ethical care. Not doing so could enable unsafe practices and set a concerning precedent.
Take it Forward:
This reflective process has reinforced for me the significance of strict adherence to policies and procedures in healthcare. To apply this learning, I will set the goal of reviewing my faculty’s WPL handbook monthly to ensure I have a strong working knowledge of expectations and limitations in practice. Should any issues arise on future placements that cause me concern, I will address them promptly and professionally with my preceptor or the relevant authority. In my personal life, I will be mindful not to overstep boundaries in my roles and advocate for due process at all times.
References:
Australian Nursing and Midwifery Council. (2018). National competency standards for the registered nurse. Nursing and Midwifery Board of Australia. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx
Australian Nursing and Midwifery Accreditation Council. (2012). Registered nurse accreditation standards. ANMAC. https://www.anmac.org.au/sites/default/files/documents/ANMAC_Accreditation_Standards_2012.pdf
Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice. Nursing and Midwifery Board of Australia. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx
Nursing and Midwifery Board of Australia. (2018). Code of conduct for nurses. Nursing and Midwifery Board of Australia. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx
