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4 Domains with 7 Principles

Domain 1. Practice legally
(i) Legal compliance
 Domain 2. Practice safely, effectively and
(ii) Person-centred practice
(iii) Cultural practice & respectful relationships
 Domain 3. Act with professional integrity
(iv) Professional behaviour
(v) Teaching supervising and assessing
(vi) Research in health
 Domain 4. Promote health and wellbeing
(vii) Health and wellbeing


Domain 1. Practice legally

 Obligations under the Health Practitioner
Regulation National Law
 Lawful behavior to maintain the good
reputation of the profession
 Mandatory reporting to protect vulnerable


Domain 2. Practice safely,
effectively and collaboratively

 Nursing practice should be in accordance with the
standards of the profession, person-centred and
 Decision making should be shared with the person
and the healthcare team (or legal guardians) and
respect the person’s right to a second opinion
 Informed consent should be facilitated through
education in a language the person can
understand & opportunity for questions
 Abide by principles of open disclosure and non
punitive approaches when adverse events occur


Principle 2.2 Cultural practice
and respectful relationships

Understanding the impact of colonisation on
Aboriginal and Torres Strait islander peoples’
 Provide culturally safe and respectful practice
 Communicate effectively when language and
cultural barriers exist
 Bullying and harassment is not acceptable (never
engage in or ignore this behavior)
 Maintain confidentiality and privacy
 Provide culturally appropriate, supportive end of
life care and understand the limits of healthcare
to prolong life


Domain 3. Act with
professional integrity

 Maintain professional behavior through
appropriate professional boundaries, honest
advertising and professional representation of self,
clarify their role in third party legal or insurance
assessments, avoid conflicts of interest, avoid
financial arrangements outside normal fees or
significant gifts
 Carry out research ethically
 Provide students and colleagues opportunities to
learn and be honest objective and fair in your


Domain 4. Promote health
and wellbeing

 Of yourself and your colleagues to enable
provision of safe care (fitness to practice)
 Advocate for community and population
health by using expertise and influence,
and the principles of primary and public


Requirements of Practice
Nurses must practice within the following
professional codes or legal framework

 1. Australian Law ✓
 2. Code of Professional Conduct for Nurses
in Australia ✓
 3. A Nurse’s Guide to Professional Boundaries
and social media policy
 4. Code of Ethics for Nurses in Australi


Part 3a
Professional boundaries

Therapeutic relationships
➢ Care must meet a therapeutic need of
the patient
➢ Nurse’s values must not intrude into
patient care
➢ Care can never be withheld
➢ Coercion is an abuse of power
➢ Respect clients comfort zones related
to touch
➢ A sexual relationship with a patient is
professional misconduct


In order to manage professional
boundaries, we must understand:

“An inherent power imbalance exists within
the relationship between people receiving care
and nurses that make the persons in their care
vulnerable and open to exploitation.
Nurses actively preserve the dignity of people
through practiced kindness and respect for the
vulnerability and powerlessness of people in
their care…
This vulnerability creates a power differential
in the relationship between nurses and persons
in their care that must be recognised and


A continuum of professional development

disinterested/ neglectful (under involvement)
therapeutic relationship (zone of helpfulness)
boundary violations (over involvement)


Boundary violation examples

 Excessive self-disclosure
 Secretive behaviours
 Super nurse behavior
 Singled-out treatment or favouritism
 Selective communication
 Flirtation
 Sexual misconduct and assault


Social Media Policy

The NMBA Social Media Policy is based on
▪ Your legal obligations under the Health
Practitioner Regulation National Law (NSW,
▪ ICN Code of Ethics (2012)
▪ NMBA Code of Professional Conduct (2016)
 Applies whether access is restricted or open


Social media does have benefits, but
inappropriate use can result in harm to the
patient and the profession:

 Breaches of confidentiality
 Defamation of colleagues or employers,
violation of practitioner–patient
 Unintended exposure of personal
information to the public, employers,
consumers and others


Common pitfalls of social
media in healthcare

 Patient confidentiality
 Cultural awareness, safety and practitioner
and patient beliefs – social and clinical
 Professionalism – be aware of how you
represent nurses
 Maintain professional boundaries – friending
patients is not recommended
 Public health messages – must be consistent
with NMBA codes, standards & guidelines,
public health and best available scientific
 Advertising – must not make false claims


Requirements of Practice

1. Australian Law ✓
2. Code of Professional Conduct for Nurses in
Australia ✓
3. A nurse’s Guide to Professional Boundaries and
social media policy ✓
4. Code of Ethics for Nurses in Australia