Reflection Essay ( Contemporary Ingenious Health Well being )
For this assessment, it is required that you use a validated reflective framework to underpin the discussion of your attitudes, beliefs and values towards Aboriginal & Torres Strait Islander people that have arisen in this subject. An example of a validated framework is ‘Gibbs model of reflection’.
Task: 1. Go back and review what you submitted in assessment item 1, i.e. your initial assumptions at the beginning of your journey through this subject. Tip: Do not merely repeat what you wrote before but look at the feedback you received.
2. Review and analyse what you submitted in assessment item 1 along with the subject content. Reflect and describe thoughts, feelings and emotions that have been experienced while participating in the subject. Use three (3) specific examples of learning activities. Tip: this is an extension of assessment item 1 not a repetition of what you have already written, it is a description of your personal journey in this subject. It is suggested that you use the ABCD Cultural assessment tool to enhance your discussion.
3. Explain how you think what you have learnt in this subject might impact on your future nursing practice with Aboriginal & Torres Strait Islander people. You are required to embed the Graduate Attributes, RN standards and UTS Indigenous Graduate Attributes.
92441 and 92456 Contemporary Indigenous Health and Wellbeing Assessment 3: Guided Reflection 40%
HD D C P Z
Provides an overview of
how your values and
beliefs in relation to
interacting with
Aboriginal & Torres
Strait Islander people
have or have not
changed since you
wrote your intial
reflection in assessment
item 1. Uses a validated
framework for
reflection.
(Potential 5 marks)
SLO A
The reflection uses a
validated framework to
provide a clear, well-
structured and in depth,
personal insight into how
your own beliefs and values
beliefs in relation to
interacting with Aboriginal
& Torres Strait Islander
people have or have not
changed since you wrote
your intial reflection in
assessment item 1.
The reflection uses a
validated framework for
reflection to provide a
clear, well-structured and
personal insight into the
students own beliefs and
values in relation to
interacting with Aboriginal
& Torres Strait Islander
people have or have not
changed since you wrote
your intial reflection in
assessment item 1.
The reflection uses a
validated framework for
reflection to provide a
mostly clear and mostly
well-structured insight into
the students own beliefs
and values in relation to
interacting with Aboriginal
& Torres Strait Islander
people have or have not
changed since you wrote
your intial reflection in
assessment item 1.
The reflection uses a
validated framework for
reflection to provide some
insight into the students
own beliefs and values
impacted in relation to
interacting with Aboriginal
& Torres Strait Islander
people have or have not
changed since you wrote
your intial reflection in
assessment item 1. Work is
not clear and well
structured at all times.
The reflection did not use a
validated framework for
reflection to provide insight
into the students own
beliefs and values in
relation to interacting with
Aboriginal & Torres Strait
Islander people have or
have not changed since you
wrote your intial reflection
in assessment item 1. The
writing requires effort to
understand due to serious
errors in grammar and
vocabulary that affect
clarity of communication.
Using 3 specific
examples of learning
activities from the
subject, reflect on and
describe your thoughts,
feelings and emotions
experienced have
changed in relation to
interacting with
Aboriginal & Torres
Strait Islander people.
Uses a validated
framework for
reflection.
(Potential 15 marks)
SLO B, C
The reflection uses a
validated framework for
reflection and 3 specific
examples of learning
activities from the subject
to provide a well-structured
and in depth, personal
insight into how this subject
may change your decision
making in relation to
interacting with Aboriginal
& Torres Strait Islander
people. Written expression
is clear throughout
including correct spelling,
grammar and punctuation.
The reflection uses a
validated framework for
reflection and 3 specific
examples of learning
activities from the subject
to provide a well-structured
and personal insight into
how this subject may
change your decision
making in relation to
interacting with Aboriginal
& Torres Strait Islander
people. Written expression
is clear throughout
including correct spelling,
grammar and punctuation.
The reflection uses a
validated framework for
reflection and 3 specific
examples of learning
activities from the subject
to provides insight into how
this subject may change
your decision making in
relation to interacting with
Aboriginal & Torres Strait
Islander people. Written
expression is mostly clear
throughout with minor
errors in spelling, grammar
and/ or punctuation.
The reflection uses a
validated framework for
reflection and 3 specific
examples of learning
activities from the subject
to provide some insight into
how this subject may
change your decision
making in relation to
interacting with Aboriginal
& Torres Strait Islander
people. Written expression
mostly clear with some
errors in spelling, grammar
and/ or punctuation.
The reflection did not
demonstrate personal
insight into how the 3
examples may change your
decision making in relation
to interacting with
Aboriginal & Torres Strait
Islander people or did not
provide 3 examples. The
writing requires effort to
understand due to serious
errors in grammar and
vocabulary that affect
clarity of communication.
Reflect on how the
subject may impact
your future nursing
practice with Aboriginal
The discussion uses a
validated framework to
provide a well-structured
and in depth, personal
The discussion uses a
validated framework for
reflection to provide a well-
structured and personal
The discussion uses a
validated framework for
reflection to provide a well-
structured insight into how
The reflection uses a
validated framework for
reflection to provide some
insight into how this subject
The reflection did not
demonstrate personal
insight into how this subject
may impact your future
and Torres Strait
Islander people
incorporating the RN
standards, the UTS
Graduate Attributes
and UTS Indigenous
graduate attributes.
Uses a validated
framework for
reflection.
(Potential 15 marks)
SLO B, D
insight into how this subject
may impact your future
nursing practice in relation
to Aboriginal & Torres Strait
Islander people. The RN
standards, UTS Graduate
Attributes and Indigenous
graduate attributes are
clearly embedded
throughout the discussion
and current and relevant
evidence based literature
from a variety of sources is
incorporated correctly and
effectively.
insight into how this subject
will impact the students’
future nursing practice in
relation to Aboriginal &
Torres Strait Islander
people. The RN standards,
UTS Graduate Attributes
and Indigenous graduate
attributes are clearly
embedded throughout the
discussion and current and
relevant evidence based
literature from a variety of
sources is incorporated
correctly and effectively.
this subject may impact
your future nursing practice
in relation to Aboriginal &
Torres Strait Islander
people. The RN standards,
UTS Graduate Attributes
and Indigenous graduate
attributes are included in
the discussion and current
and relevant evidence
based literature is mostly
incorporated correctly.
may impact your future
nursing practice in relation
to Aboriginal & Torres Strait
Islander people. The RN
standards, UTS Graduate
Attributes and Indigenous
graduate attributes are
referred to and current and
relevant evidence based
literature is mostly included
correctly, however could be
developed further.
nursing practice in relation
to Aboriginal & Torres Strait
Islander people. The RN
standards, UTS Graduate
Attributes and Indigenous
graduate attributes are not
linked to the discussion.
Written expression is not
clear and/or is not
adequately supported using
relevant evidence-based
literature.
Ability to portray
Aboriginal and Torres
Strait Islander Peoples
sensitively in writing
(Potential 5 marks)
SLO B
Writing demonstrates
cultural respect in how
people are represented. All
language used in the essay
is appropriate regarding
history, society, naming,
culture, spirituality and
classifications of Aboriginal
and Torres Strait Islander
peoples. Where
appropriate, Aboriginal
People are referred to by
their country, nation, or
language group rather than
generic identifiers such as
Aboriginal or Indigenous.
Writing demonstrates
cultural respect in how
people are represented.
Terminology referring to
Indigenous Peoples is
correct and proper nouns
are capitalised. Where
appropriate, Aboriginal
People are referred to by
their country, nation, or
language group rather than
generic identifiers such as
Aboriginal or Indigenous.
Writing demonstrates
cultural respect in how
people are represented.
Terminology referring to
Indigenous Peoples is
correct and proper nouns
are capitalised.
Writing mostly uses
appropriate terminology to
demonstrate cultural
respect, but some use of
acronyms present and
some capital letters for
nouns missing.
Writing does not reflect
cultural respect of
Aboriginal and Torres Strait
Islander Peoples, with
frequent use of acronyms,
generalisations and lack of
support from relevant
literature.
From: Cultural Relevance in End-of-Life Care
http://ethnomed.org/clinical/end-of-life/cultural-relevance-in-end-of-life-care
1
Kagawa-Singer and Blackhall developed a cultural assessment mnemonic approach to assess the degree of
cultural adherence to help avoid stereotyping and decrease the risk of miscommunication (Kagawa-Singer &
Backhall, 2001). The ABCD cultural assessment is outlined below:
Relevant Information Questions and Strategies for the Health Care
Provider
Attitudes of parents and families:
• What attitudes does this ethnic /cultural
group in general –
and the patient and family in particular –
have about truth telling with regard to
diagnosis and prognosis?
• What is their general attitude towards
discussion of death and dying?
• Do they have positive or negative attitudes
about particular aspects of care?
• Increase one’s knowledge about the
values, beliefs, and attitudes of the
cultural group most frequently seen in
your practice.
• Determine the patient and family’s
perception of an illness: “What does your
illness/sickness mean to you?”
• Determine if the patient uses traditional
healing practices and for what problems.
• Determine if the patient or family has
positive or negative attitudes about a
particular aspect of care being addressed,
such as advance directives.
Beliefs:
• What are the patient’s and family’s
religious and spiritual beliefs, especially
relating to the meaning of death and
dying, the afterlife, and miracles?
• “Spiritual or religious strength sustain
many people in times of distress. What is
important for me to know about your faith
or spiritual needs?”
• “How can we support your needs and
practices?”
• “Where do you find your strength to make
sense of what is happening to you?”
Context:
• Determine the historical and political
context of the patient’s and family’s lives,
including place of birth, refugee or
immigrant status, poverty, experience with
discrimination, health disparities, language
spoken, and degree of integration within
their ethnic community and the degree of
assimilation into Western culture.
• “Where were you born and raised?”
• “How long have you lived in the United
States?” What has your experience been
since coming to the U.S. (or the city)?”
• “How has your life changed since coming
to the U.S.?”
• “What language are you most comfortable
using when talking about your health
care?”
• “What were other important times in your
life that might help us better understand
your situation?”
Decision-making style:
• What is the general decision-making style
of the cultural group and specifically of the
patient and family?
• Is the emphasis on the individual decision-
making process or the family decision-
making process?
• “How are decisions about health care
made in your family?”
• “Who is the head of the family?”
• “Is there anyone else I should talk to in
your family about your condition?”
http://ethnomed.org/clinical/end-of-life/cultural-relevance-in-end-of-life-care�
From: Cultural Relevance in End-of-Life Care
http://ethnomed.org/clinical/end-of-life/cultural-relevance-in-end-of-life-care
2
Environment:
• What resources and support are available
to the patient and family?
• What resources are available to assist the
health care provider to interpret the
significance of the patient’s culture?
• Identify community resources that may be
of assistance to the health care provider
and the patient and family, such as
translators, health care workers from the
same community as the patient,
community associations, religious leaders,
and healers.
Kagawa-Singer, M., & Backhall, L. (2001). Negotiating cross-cultural issues at end of life. Journal of American Medical
Association, 286(3001), 2993-.
http://ethnomed.org/clinical/end-of-life/cultural-relevance-in-end-of-life-care�
- Kagawa-Singer & Blackhall’s ABCD Cultural Assessment Model
Nursing and Midwifery Board of Australia
G.P.O. Box 9958 | Melbourne VIC 3001 | www.nursingmidwiferyboard.gov.au | 1300 419 495
Fact sheet
March 2018
Code of conduct for nurses and Code of conduct for midwives
Introduction
The Nursing and Midwifery Board of Australia (NMBA) undertakes functions as set by the Health
Practitioner Regulation National Law, as in force in each state and territory (the National Law). The NMBA
regulates the practice of nursing and midwifery in Australia, and one of its key roles is to protect the
public. The NMBA does this by developing registration standards, professional codes, guidelines and
standards for practice which together establish the requirements for the professional and safe practice of
nurses and midwives in Australia.
Registration as a nurse and/or midwife requires you to meet the NMBA mandatory registration standards
and to practise within the relevant NMBA approved standards, codes, guidelines and frameworks.
This fact sheet provides guidance about the Code of conduct for nurses (2017) and Code of conduct for
midwives (2017) (the codes).
Why was the Code of professional conduct for nurses in Australia and the Code of
professional conduct for midwives in Australia replaced with the Code of conduct for
nurses and the Code of conduct for midwives?
Since the introduction of the National Scheme in 2010, the NMBA has established a systematic process
to review, consult on and develop all standards, codes and guidelines in keeping with good regulatory
practice.
The development of the codes incorporated the first review since 2008 of the current Code of
professional conduct for nurses in Australia (2008) and Code of professional conduct for midwives in
Australia (2008). The Nurse’s guide to professional boundaries and Midwife’s guide to professional
boundaries (2010) were also reviewed for the first time since 2010.
The codes now reflect current nursing and midwifery practice in all contexts and are up to date, relevant
and useful.
Why have the guidelines for professional boundaries been incorporated into the codes?
As part of the review of the codes, the NMBA commissioned research to inform its decision-making. This
research suggested that the presence of multiple codes and guidelines makes them less memorable and
may have a negative impact on nurses and midwives using the documents. The NMBA has been
thorough in the integration of professional boundaries into the codes, ensuring that all aspects of
expected conduct and behaviour can be accessed in one document.
What are the main features of the codes?
The Code of conduct for nurses and Code of conduct for midwives have the following features:
• conduct is framed around seven principles, each with a supporting values statement
− the principles are categorised into four domains
Fact sheet: Code of conduct for nurses and Code of conduct for midwives Page 2 of 3
− ‘person’ is used to refer to the those in a professional relationship with a nurse
− ‘woman’ is used to refer to those in a professional relationship with a midwife
• they apply to all nurses and midwives across all areas of practice
• they are founded on evidence-based practice, and
• they are designed to be read in conjunction with NMBA standards, codes and guidelines.
The glossary is also important to understanding the meaning of key terms used in the codes.
The new codes have been modelled on the multi-profession shared code of conduct used by
most registered health professions.
Why are there separate codes for nurses and midwives?
As a part of public consultation, the NMBA specifically sought stakeholders’ views on having combined or
separate codes of conduct for nurses and midwives. The NMBA’s original position was to maintain
separate codes and this was supported by feedback in the public consultation. However, the NMBA has
made a commitment in the future to consider the inclusion of nursing and midwifery in the multi-profession
shared code of conduct.
I am a nurse and a midwife, which code applies to me?
If you hold dual registration as a nurse and a midwife, both codes apply to you.
My employer has a code of conduct. Do I also have to comply with the NMBA code/s?
Yes. The NMBA codes are used in the regulation of all nurses and midwives in Australia and therefore all
nurses and/or midwives must comply with the code. Most organisations also have their own code of
conduct to which employees must comply for employment and industrial purposes.
My practice does not involve direct clinical care. Do the codes apply to me?
Yes. The principles of the codes apply to all types of nursing and midwifery practice in all contexts. This
includes any work where a nurse and/or midwife uses nursing and/or midwifery skills and knowledge,
whether paid or unpaid, clinical or non-clinical. This includes work in the areas of clinical care, clinical
leadership, clinical governance responsibilities, education, research, administration, management,
advisory roles, regulation or policy development. The code also applies to all settings where a nurse
and/or midwife may engage in these activities, including face-to-face, publications, or via online or
electronic means.
What is ‘cultural safety’ and why is it a requirement in the codes?
Aboriginal and Torres Strait Islander peoples experience poorer health outcomes than non-Indigenous
peoples.
Cultural safety is a proven way for nurses and midwives to contribute to better health outcomes and
experiences for Aboriginal and/or Torres Strait Islander peoples.
Cultural safety is about acknowledging the social, historical and structural factors that can have an impact
on the health of Aboriginal and/or Torres Strait Islander peoples. Rather than saying ‘I provide the same
care to everyone regardless of difference,’ cultural safety means providing care that takes into account
Aboriginal and/or Torres Strait Islander peoples’ needs.
Cultural safety is recognising the ways you can provide care that meets Aboriginal and/or Torres Strait
Islander peoples’ needs and reflect on the ways that your own culture and assumptions might impact on
the care you give.
When nurses and midwives challenge beliefs based on bias or assumption, and work in partnership with
people and communities, they contribute to better healthcare experiences for Aboriginal and Torres Strait
Islander peoples.
Many nurses and midwives will already be practising cultural safety, even if they have not heard of the
term. The new codes of conduct guide all nurses and midwives on a cultural safety.
Fact sheet: Code of conduct for nurses and Code of conduct for midwives Page 3 of 3
The NMBA worked in partnership with the Congress of Aboriginal and Torres Strait Islander Nurses
and Midwives (CATSINaM), who provided expert advice and evidence on cultural safety.
What is ‘culturally safe and respectful practice’?
The codes of conduct provide guidance around the key principles of culturally safe and respectful practice.
These principles are about respecting and acknowledging different cultures, beliefs, identities and
experiences and practising in a way that takes these differences into account.
Culturally safe and respectful practice requires nurses and midwives to challenge bias and beliefs based
on assumption, such as assumptions based on gender, disability, race, ethnicity, religion, sexuality, age or
political beliefs.
Why do the codes have a specific section on bullying and harassment, when it is usually an
employment or performance related issue?
All elements of the review process (including the research, notification analysis and consultation)
recommended that the NMBA include a specific section on bullying and harassment. The NMBA acted on
the evidence and has clearly stated in the codes that bullying and harassment is not acceptable and
should not be tolerated.
However, in most circumstances issues relating to bullying and harassment should be managed by the
employer as a performance issue. It is only in circumstances where cases of bullying and harassment
directly affect public safety that a notification to the NMBA, Nursing and Midwifery Council in New South
Wales, or the Health Ombudsman in Queensland is required.
For more information
• Visit www.nursingmidwiferyboard.gov.au under Contact us to lodge an online enquiry form
• For registration enquiries: 1300 419 495 (in Australia) +61 3 9275 9009 (overseas callers)
http://www.nursingmidwiferyboard.gov.au/
Nursing and Midwifery Board of Australia
RegisteRed nuRses
stAndARds FOR PRACtiCe
1 June 2016
NMP00011
2 Registered nurses standards for practice | Nursing and Midwifery Board of Australia | 1 June 2016
RegisteRed nuRses
stAndARds FOR PRACtiCe
Orienting statements
Registered nurse (RN) practice is person-centred and
evidence-based with preventative, curative, formative,
supportive, restorative and palliative elements. RNs
work in therapeutic and professional relationships
with individuals, as well as with families, groups and
communities. These people may be healthy and with
a range of abilities, or have health issues related to
physical or mental illness and/or health challenges.
These challenges may be posed by physical, psychiatric,
developmental and/or intellectual disabilities.
The Australian community has a rich mixture of cultural
and linguistic diversity, and the Registered nurse
standards for practice are to be read in this context.
RNs recognise the importance of history and culture to
health and wellbeing. This practice reflects particular
understanding of the impact of colonisation on the
cultural, social and spiritual lives of Aboriginal and
Torres Strait Islander peoples, which has contributed to
significant health inequity in Australia.
As regulated health professionals, RNs are responsible
and accountable to the Nursing and Midwifery Board
of Australia. These are the national Registered nurse
standards for practice for all RNs. Together with the
Nursing and Midwifery Board of Australia standards,
codes and guidelines, these Registered nurse standards
for practice should be evident in current practice, and
inform the development of the scopes of practice and
aspirations of RNs.
RN practice, as a professional endeavour, requires
continuous thinking and analysis in the context of
thoughtful development and maintenance of constructive
relationships. To engage in this work, RNs need to
continue to develop professionally and maintain their
capability for professional practice. RNs determine,
coordinate and provide safe, quality nursing. This
practice includes comprehensive assessment,
development of a plan, implementation and evaluation
of outcomes. As part of practice, RNs are responsible
and accountable for supervision and the delegation of
nursing activity to enrolled nurses (ENs) and others.
Practice is not restricted to the provision of direct
clinical care. Nursing practice extends to any paid or
unpaid role where the nurse uses their nursing skills
and knowledge. This practice includes working in a
direct non-clinical relationship with clients, working
in management, administration, education, research,
advisory, regulatory, policy development roles or other
roles that impact on safe, effective delivery of services
in the profession and/or use of the nurse’s professional
skills. RNs are responsible for autonomous practice
within dynamic systems, and in relationships with other
health care professionals.
How to use these standards for
practice
The Registered nurse standards for practice consist of the
following seven standards:
1. Thinks critically and analyses nursing practice.
2. Engages in therapeutic and professional
relationships.
3. Maintains the capability for practice.
4. Comprehensively conducts assessments.
5. Develops a plan for nursing practice.
6. Provides safe, appropriate and responsive quality
nursing practice.
7. Evaluates outcomes to inform nursing practice.
The above standards are all interconnected (see Figure
1). Standards one, two and three relate to each other, as
well as to each dimension of practice in standards four,
five, six and seven.
3 Registered nurses standards for practice | Nursing and Midwifery Board of Australia | 1 June 2016
RegisteRed nuRses
stAndARds FOR PRACtiCe
Figure 1: RN standards
Thinks critically and analyses
nursin
g practice
Engages in therapeutic and
professional relationships
Maintains the capability for
practice
standard 1
standard 4 standard 5 standard 6 standard 7
C
om
preh
en
sively con
du
cts assessm
en
ts
D
evelops a plan
for
n
u
rsin
g practice
P
rovides safe, appopriate an
d respon
sive
qu
ality n
u
rsin
g practice
E
valu
ates ou
tcom
es to in
form
n
u
rsin
g
practice
standard 2
standard 3
Each standard has criteria that specify how that standard
is demonstrated. The criteria are to be interpreted in
the context of each RN’s practice. For example, all RNs
will, at various times, work in partnerships and delegate
responsibilities, however, not every RN will delegate
clinical practice to enrolled nurses. The criteria are not
exhaustive and enable rather than limit the development
of individual RN scopes of practice.
The Registered nurse standards for practice are for all
RNs across all areas of practice. They are to be read
in conjunction with the applicable NMBA companion
documents such as the standards, codes and guidelines,
including the Code of conduct for nurses, National
framework for the development of decision-making
tools for nursing and midwifery practice, Supervision
guidelines for nursing and midwifery, and Guidelines for
mandatory notifications. The glossary is also important
for understanding how key terms are used in these
standards.
RN standards for practice
Standard 1: Thinks critically and analyses nursing
practice
RNs use a variety of thinking strategies and the best
available evidence in making decisions and providing
safe, quality nursing practice within person-centred and
evidence-based frameworks.
The RN:
1.1 accesses, analyses, and uses the best available
evidence, that includes research findings for safe
quality practice
1.2 develops practice through reflection on experiences,
knowledge, actions, feelings and beliefs to identify
how these shape practice
1.3 respects all cultures and experiences, which
includes responding to the role of family and
community that underpin the health of Aboriginal
4 Registered nurses standards for practice | Nursing and Midwifery Board of Australia | 1 June 2016
RegisteRed nuRses
stAndARds FOR PRACtiCe
and Torres Strait Islander peoples and people of
other cultures
1.4 complies with legislation, common law, policies,
guidelines and other standards or requirements
relevant to the context of practice when making
decisions
1.5 uses ethical frameworks when making decisions
1.6 maintains accurate, comprehensive and timely
documentation of assessments, planning, decision-
making, actions and evaluations, and
1.7 contributes to quality improvement and relevant
research.
Standard 2: Engages in therapeutic and
professional relationships
RN practice is based on purposefully engaging in
effective therapeutic and professional relationships. This
includes collegial generosity in the context of mutual
trust and respect in professional relationships.
The RN:
2.1 establishes, sustains and concludes relationships
in a way that differentiates the boundaries between
professional and personal relationships
2.2 communicates effectively, and is respectful of a
person’s dignity, culture, values, beliefs and rights
2.3 recognises that people are the experts in the
experience of their life
2.4 provides support and directs people to resources to
optimise health related decisions
2.5 advocates on behalf of people in a manner that
respects the person’s autonomy and legal capacity
2.6 uses delegation, supervision, coordination,
consultation and referrals in professional
relationships to achieve improved health outcomes
2.7 actively fosters a culture of safety and learning
that includes engaging with health professionals
and others, to share knowledge and practice that
supports person-centred care
2.8 participates in and/or leads collaborative practice,
and
2.9 reports notifiable conduct of health professionals,
health workers and others.
Standard 3: Maintains the capability for practice
RNs, as regulated health professionals, are responsible
and accountable for ensuring they are safe, and have
the capability for practice. This includes ongoing self-
management and responding when there is concern
about other health professionals’ capability for practice.
RNs are responsible for their professional development
and contribute to the development of others. They are
also responsible for providing information and education
to enable people to make decisions and take action in
relation to their health.
The RN:
3.1 considers and responds in a timely manner to the
health and well being of self and others in relation to
the capability for practice
3.2 provides the information and education required to
enhance people’s control over health
3.3 uses a lifelong learning approach for continuing
professional development of self and others
3.4 accepts accountability for decisions, actions,
behaviours and responsibilities inherent in their
role, and for the actions of others to whom they have
delegated responsibilities
3.5 seeks and responds to practice review and feedback
3.6 actively engages with the profession, and
3.7 identifies and promotes the integral role of nursing
practice and the profession in influencing better
health outcomes for people.
5 Registered nurses standards for practice | Nursing and Midwifery Board of Australia | 1 June 2016
RegisteRed nuRses
stAndARds FOR PRACtiCe
Standard 4: Comprehensively conducts
assessments
RNs accurately conduct comprehensive and systematic
assessments. They analyse information and data and
communicate outcomes as the basis for practice.
The RN:
4.1 conducts assessments that are holistic as well as
culturally appropriate
4.2 uses a range of assessment techniques to
systematically collect relevant and accurate
information and data to inform practice
4.3 works in partnership to determine factors that affect,
or potentially affect, the health and well being of
people and populations to determine priorities for
action and/or for referral, and
4.4 assesses the resources available to inform planning.
Standard 5: Develops a plan for nursing practice
RNs are responsible for the planning and communication
of nursing practice. Agreed plans are developed in
partnership. They are based on the RNs appraisal of
comprehensive, relevant information, and evidence that
is documented and communicated.
The RN:
5.1 uses assessment data and best available evidence to
develop a plan
5.2 collaboratively constructs nursing practice plans
until contingencies, options priorities, goals, actions,
outcomes and timeframes are agreed with the
relevant persons
5.3 documents, evaluates and modifies plans accordingly
to facilitate the agreed outcomes
5.4 plans and negotiates how practice will be evaluated
and the time frame of engagement, and
5.5 coordinates resources effectively and efficiently for
planned actions.
Standard 6: Provides safe, appropriate and
responsive quality nursing practice
RNs provide and may delegate, quality and ethical goal-
directed actions. These are based on comprehensive and
systematic assessment, and the best available evidence
to achieve planned and agreed outcomes.
The RN:
6.1 provides comprehensive safe, quality practice
to achieve agreed goals and outcomes that are
responsive to the nursing needs of people
6.2 practises within their scope of practice
6.3 appropriately delegates aspects of practice to
enrolled nurses and others, according to enrolled
nurse’s scope of practice or others’ clinical or non-
clinical roles
6.4 provides effective timely direction and supervision to
ensure that delegated practice is safe and correct
6.5 practises in accordance with relevant nursing
and health guidelines, standards, regulations and
legislation, and
6.6 uses the appropriate processes to identify and report
potential and actual risk related system issues
and where practice may be below the expected
standards.
Standard 7: Evaluates outcomes to inform nursing
practice
RNs take responsibility for the evaluation of practice
based on agreed priorities, goals, plans and outcomes
and revises practice accordingly.
The RN:
7.1 evaluates and monitors progress towards the
expected goals and outcomes
7.2 revises the plan based on the evaluation, and
7.3 determines, documents and communicates further
priorities, goals and outcomes with the relevant
persons.
6 Registered nurses standards for practice | Nursing and Midwifery Board of Australia | 1 June 2016
RegisteRed nuRses
stAndARds FOR PRACtiCe
Glossary
These definitions relate to the use of terms in the
Registered nurse standards for practice.
Accountability means that nurses answer to the people
in their care, the nursing regulatory authority, their
employers and the public. Nurses are accountable
for their decisions, actions, behaviours and the
responsibilities that are inherent in their nursing
roles including documentation. Accountability cannot
be delegated. The RN who delegates activities to be
undertaken by another person remains accountable
for the decision to delegate, for monitoring the level of
performance by the other person, and for evaluating
the outcomes of what has been delegated (Nursing and
Midwifery Board of Australia 2013). See below for the
related definition of Delegation.
Criteria in this document means the actions and
behaviours of the RN that demonstrate these Standards
for practice.
delegation is the relationship that exists when a RN
delegates aspects of their nursing practice to another
person such as an enrolled nurse, a student nurse or
a person who is not a nurse. Delegations are made to
meet peoples’ needs and to enable access to health
care services, that is, the right person is available at
the right time to provide the right service. The RN who
is delegating retains accountability for the decision to
delegate. They are also accountable for monitoring of the
communication of the delegation to the relevant persons
and for the practice outcomes. Both parties share the
responsibility of making the delegation decision, which
includes assessment of the risks and capabilities. In
some instances delegation may be preceded by teaching
and competence assessment. For further details see
the NMBA’s National framework for the development of
decision-making tools for nursing and midwifery practice
(2013).
enrolled nurse is a person who provides nursing
care under the direct or indirect supervision of a
RN. They have completed the prescribed education
preparation, and demonstrate competence to practise
under the Health Practitioner Regulation National
Law as an enrolled nurse in Australia. Enrolled nurses
are accountable for their own practice and remain
responsible to a RN for the delegated care.
evidence-based practice is accessing and making
judgements to translate the best available evidence,
which includes the most current, valid, and available
research findings into practice.
Person or people is used in these Standards to refer to
those individuals who have entered into a therapeutic
and/or professional relationship with a RN. These
individuals will sometimes be health care consumers,
at other times they may be colleagues or students, this
will vary depending on who is the focus of practice at
the time. Therefore, the words person or people include
all the patients, clients, consumers, families, carers,
groups and/or communities that are within the RN
scope and context of practice. The RN has professional
relationships in health care related teams.
Person-centred practice is collaborative and respectful
partnership built on mutual trust and understanding
through good communication. Each person is
treated as an individual with the aim of respecting
people’s ownership of their health information, rights
and preferences while protecting their dignity and
empowering choice. Person-centred practice recognises
the role of family and community with respect to cultural
and religious diversity.
Registered nurse is a person who has completed
the prescribed education preparation, demonstrates
competence to practise and is registered under the
Health Practitioner Regulation National Law as a RN in
Australia.
scope of practice is that in which nurses are educated,
competent to perform and permitted by law. The actual
scope of practice is influenced by the context in which
the nurse practises, the health needs of people, the
level of competence and confidence of the nurse and the
policy requirements of the service provider.
standards for practice in this document are the
expectations of RN practice. They inform the education
standards for RNs; the regulation of nurses and
determination of the nurse’s capability for practice; and
guide consumers, employers and other stakeholders on
what to reasonably expect from a RN regardless of the
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Frameworks.aspx
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Frameworks.aspx
7 Registered nurses standards for practice | Nursing and Midwifery Board of Australia | 1 June 2016
RegisteRed nuRses
stAndARds FOR PRACtiCe
area of nursing practice or years of nursing experience.
They replace the previous National competency standards
for the registered nurse (2010).
supervision includes managerial supervision,
professional supervision and clinically focused
supervision. For further details see the NMBA’s
Supervision guidelines for nursing and midwifery (2015).
therapeutic relationships are different to personal
relationships. In a therapeutic relationship the nurse
is sensitive to a person’s situation and purposefully
engages with them using knowledge and skills in
respect, compassion and kindness. In the relationship
the person’s rights and dignity are recognised and
respected. The professional nature of the relationship
involves recognition of professional boundaries and
issues of unequal power. For further details see the
NMBA’s Code of conduct for nurses.
References
Nursing and Midwifery Board of Australia (2010) ‘A
nurse’s guide to professional boundaries’. Retrieved
05 January 2015, www.nursingmidwiferyboard.gov.au/
Codes-Guidelines-Statements/Professional-standards.
aspx
Nursing and Midwifery Board of Australia. (2007)
‘National framework for the development of decision-
making tools for nursing and midwifery practice’.
Retrieved 05 January 2015, www.nursingmidwiferyboard.
gov.au/Codes-Guidelines-Statements/Frameworks.aspx
Nursing and Midwifery Board of Australia.
(2015) ‘Supervision guidelines for nursing and
midwifery. Retrieved 25 September 2015’, www.
nursingmidwiferyboard.gov.au/Registration-and-
Endorsement/reentry-to-practice.aspx
http://www.nursingmidwiferyboard.gov.au/Registration-and-Endorsement/reentry-to-practice.aspx
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Frameworks.aspx
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Frameworks.aspx
http://www.nursingmidwiferyboard.gov.au/Registration-and-Endorsement/reentry-to-practice.aspx
http://www.nursingmidwiferyboard.gov.au/Registration-and-Endorsement/reentry-to-practice.aspx
http://www.nursingmidwiferyboard.gov.au/Registration-and-Endorsement/reentry-to-practice.aspx