Criteria 5: Understanding the Professional, Ethical and Legal requirements of the Registered Nurse and/or Midwife

Question 1

A patient is scheduled to have an invasive procedure during

your shift. What are your responsibilities?

Answer 1

 Check hospital policy and procedures for information regarding procedure
 Check for valid Consent (if not, inform NUM or DR)
 Discuss with team leader, educator, or senior RN
 Assess the patient - ie stable condition for procedure
 Education of patient by RN or Dr, check for understanding
 Administer premed if ordered
 Reassure the patient
 Document care and observations
 Ensure notes, etc go with patient
 Ensure information discussed at handover
 Check pt Identification

Question 2

After checking out a Schedule 8 medication with you, the RN
states that she is busy and leaves before you have
administered the medication. How are you going to manage
this situation?

Answer 2

 Do not administer unless a second person present
 Awareness of legal responsibilities
 5 Rights: pt, drug, dose, time, route
 Find someone else to check, RN, educator, role of EEN (medication endorsed EN)
 Utilise Conflict management skills, be assertive & confident & discuss with RN
 If RN has already checked & signed the medication, if she/he not prepared to go with
you to the bedside, medication must be discarded appropriately & signed in DD book
 Notify NUM/ RN in charge
 Be aware of Policy & procedures, Hospital protocols re medication administration

Question 3

The doctor has ordered the insertion of an indwelling catheter
for one of your patients but pt consent has been refused.
What action would you take?

Answer 3

Assess patient
 Identify grounds for refusal, reassure if appropriate
 Clarify patients understanding of procedure
 Respect patients right to refuse
 Need valid consent/ Informed decision required
 Explain procedure and rationale & consequences of refusal
 Refer to senior staff/Dr
 Document discussion & outcome
 Be compassionate & respectful
 Consent can only be obtained by D

Question 4

What responsibilities & accountabilities do you have as a

Registered Nurse when administering an S8 medication?

Answer 4

 Legal responsibilities
 5 Rights: pt, drug, dose, time, route, pt ID
 Appropriate witness: must be a RN, DR, pharmacist
 Correct checking procedures
 Accuracy/ legality of prescription
 Explain procedure to patient and maintain privacy
 Safe handing of syringe and needle
 Documentation
 Understand medication and side effects
 Assess patient for effect, contact Dr if not effective
 Be aware of Policy & procedures, Hospital protocols re medication administration

Question 5

You are doing an 8am medication round and the morning antihypertensive tablet is due. You notice that the medication has
not been given for the last three days. How are you going to
manage this situation?

Answer 5

 Talk to the patient, assess pt ie vital signs
 Re check medication & check observation chart
 Review notes & handover ? why withheld
 Contact Doctor for review
 Follow-up/do not just leave it
 Report to NUM/ DR
 Incident notification if required
 Document/ IMMS
 Give medication if requested

Question 6

You are caring for a patient who has a diagnosis that is
unfamiliar to you. How would you ensure your nursing care is
safe?

Answer 6

 Read pt notes
 Discuss diagnosis with another RN, team leader, Dr & related care
 Assess pt & their needs, look at the whole picture, medication etc
 Read policy or procedures related to pt diagnosis, fact sheets, text books, utilise
internet, CIAP etc
 At the end of shift, use reflective practice to reinforce learning & understanding of
condition

Question 7

One of your patients is awaiting a procedure, she is anxious &
teary and is thinking of refusing the procedure. How are you
going to manage this situation?

Answer 7

 Need a valid consent
 Talk to the patient; try to establish an understanding of why
 Use of good communication skills, empathetic, listening skills
 Provide support
 Therapeutic relationship
 Find out the issues
 Explain the procedure, ensure adequate information
 Is the patient able to make decisions and understand the procedure (cognitively intact)
 Is the family involved and could they assist
 Problem solve (may include getting the doctor to talk to them)
 Notify NUM/ notify person doing the procedure
 Document

Question 8

A staff member is discussing another member of staff in an

unprofessional manner. How would you deal with this situation?

Answer 8

 Zero tolerance to bullying & harassment
 Unprofessional practice
 Code of conduct
 Respect
 Remain non judgmental
 Ask staff member to stop the conversation
 Report to manager
 Acknowledge this is a difficult situation to deal with as a new graduate and the need for
support

Question 9

Social media responsibilities

Answer 9

The Australian Health Practitioner Regulation Agency (AHPRA) and National Boards have published a new guide to help registered health practitioners understand and meet their obligations when using social media.

• act ethically and professionally
• privacy and confidentiality of pt.
• code of conduct
• professional boundaries
• not presenting information that is false, misleading or deceptive; COVID vax