Nursing practice

Registered Nurse Standard of Practice

Nursing practice is directed by specific professional standards enlisted by the Nursing
and Midwifery Board of Australia (NMBA). NMBA has listed each of the professional standards
alongside the specific measures required to achieve those standards (NMBA, 2016). The
following is a discussion of two nursing professional standards, their interpretation, and analysis
concerning their importance and relevance.
One of the nursing practice standards is that registered nurses should apply critical
thinking and analyze nursing practice. According to the Australian Health Practitioner
Regulatory Authority, (AHPRA), (2017), nursing is a profession which is patient-centered and
based on evidence. Nursing practice is a science. The availability of evidence concerning disease
patterns, treatment outcomes and other factors that determine the severity of the disease changes
with time (Lowe, Plummer, & Boyd, 2013). New evidence concerning nursing practice,
education, and research form the basis for the development of new and appropriate nursing
practices. The registered nurse functions by applying nursing knowledge and skills in clinical
practice, policymaking, education, and research and professional regulation (NMBA, 2016). In
all the aspects of nursing practice, the aim is to improve the outcomes of patient care. Therefore,
the continuous improvement of nursing practice to meet the patients’ needs implies that the
modes of nursing practice will undoubtedly change over time (Button, Harrington, & Belan,
One of the examples of nursing practice that requires critical thinking and analysis is
nursing informatics. The application and adoption of health information technology in nursing
are increasing rapidly. Information technology systems change frequently. In the same way,
nursing information technology improves rapidly. Health information technology is adopted and
applied to improve the overall quality of nursing care outcomes, safeguard the patient safety and
reduce the cost of healthcare services. Registered nurses should critically think about the best
ways of applying information technology to achieve improved nursing care outcomes, improve
patient safety and reduce healthcare expenditure. The decision on the most appropriate
application should be based on the available evidence on information technology. Registered
nurses should be informed about research and recommendations for various practices in nursing
informatics. Additionally, registered nurses are required to critically analyze the present and
potential future challenges in applying nursing informatics (NMBA, 2016).
Registered nurses are required to apply critical thinking in applying principles of research
to plan, design and implement research studies to come up with findings on practice problems
and gaps in knowledge. Critical analysis in nursing practice involves adherence to the current
practice guidelines. Nursing care follows provided standardized nursing procedures and

interventions. For instance, the management of healthcare conditions requires approved protocols
of care (Gardner, Duffield, Doubrovsky, & Adams, 2016; Foster, 2015).
Engagement in professional and therapeutic relationships is another professional nursing
practice standard according to APHRA. Registered nurses work with other healthcare
professionals. Interdisciplinary teamwork has been recommended to achieve the optimal patient
outcome and avoid conflicting views on patient care. During my placement experience, several
healthcare professionals, including nurses, were involved in providing care to the same patient.
Registered nurses should clearly define personal and professional relationships within the
working environment. Personal relationships in nursing practice have a negative impact on the
work outcome (AHPRA, 2017).
One of the ways of achieving professional relationships is to perceive and address people
concerning their cultural background. In order to accurately understand the contribution of
culture to health, the registered nurse should reflect on the specific patient’s cultural background
and its contribution to current patients’ presenting problem. Cultural diversity has been
increasing due to immigration and the movement of individuals from one country to another.
Improvement in transport and other systems implies that cultural diversity will increase in the
future. Registered nurses should apply experience and knowledge in working with patients and
colleagues from diverse cultural backgrounds. Adherence to the relevant ethical and legal
implications is another way to maintain professional relationships. Legal provisions streamline
the working relationship with professionals from diverse cultural backgrounds (Markus, 2014).
Ethical codes of conduct and the laws describe the expected conduct of registered nurses in
practice. The aim of ethical codes of conduct and the laws is to define the relationships between
registered nurses, the patients and healthcare professionals within the working environments.
The ethical codes of conduct and the laws are changed frequently over time. The changes are
meant to address new nursing practice issues. The registered nurse should, therefore, be informed
on codes of conduct and offer nursing services through methods that are consistent with the
ethics and laws (Pulcini, Jelic, Gul, & Loke, 2010).
Advocacy and protection of clients’ autonomy and legal capacity are additional ways to
achieve standards of the professional relationship by registered nurses. Registered nurses are
mandated with the responsibility of seeking policy change that improves the patient quality of
healthcare. The registered nurse should observe patients’ needs that can be addressed through
policy change. The registered nurse, therefore, should prepare and present a proposal for policy
changes to the policymakers. Registered nurses further evaluate policies that have been put into
place (Scanlon, Cashin, Bryce, Kelly, & Buckely, 2016).
One of the issues that impair critical thinking and application of research evidence in
nursing is lack of professional and institutional strategies. Conduction of research studies to find
answers to the current nursing care issues is a long and involving systematic process. The
process requires allocation of resources and devotion of time by nursing professionals.
Healthcare institutions and the government authorities in charge of health do not sufficiently
fund evidence-based nursing practice through research. Therefore, the registered nurses are less
involved in the process of implementing the evidence based practice. The increased workload for
registered nurses reduces the practice of critical thinking and analysis in nursing care. The
application of critical thinking in nursing practice requires comprehensive patient assessment
including; thorough history taking, conduction of all relevant investigative procedures and
application of theory into practice. Registered nurses provide clinical therapeutic procedures and

assist patients to perform impaired functions. The significant amount of time is required to
conduct comprehensive assessments and provision of nursing service. Therefore, registered
nurses have limited time to critically analyze patients’ care (Forrest, Lean, & Dunn, 2016).
The second nursing practice standards entail maintenance of professional relationships
among nursing professionals and patients. The nursing professional standards require that
registered nurses perceive patients based on their values, beliefs, and cultural practices. Some of
the cultural practices and values do not encourage the positive health-seeking behavior.
Registered nurses are social beings and therefore form social groups within the working
environment. Social groups have a specific mode of communication and interaction. The social
groups that include registered nurses are barriers towards the maintenance of relations that define
the boundaries between professional and personal relationships. Nursing professional standards
of practice include collaborative teamwork among the registered nurses and other healthcare
professionals. The healthcare professional team works collaboratively to makes decisions on
patient care. The process of arriving at a common clinical guideline takes to harmonize different
professional views (Forrest, Lean, & Dunn, 2016).
In summary, critical thinking and analysis in nursing practice and maintenance of the
professional relationships are some of the nursing professional standards enlisted by The
Australian Health Practitioner Regulation Agency. However, there are some issues with the
implementation of two nursing professional standards.


Australian Health Practitioner Regulation Agency. (2017). Registered nurse standards for
Button, D., Harrington, A., & Belan, I. (2014). E-learning & information communication
technology (ICT) in nursing education: A review of the literature. Nurse education today,
34(10), 1311-1323.
Foster, J. (2015). Nursing informatics and eHealth in Australia. In Introduction to nursing
informatics (pp. 305-322). Springer, London.
Gardner, G., Duffield, C., Doubrovsky, A., & Adams, M. (2016). Identifying advanced practice:
A national survey of a nursing workforce. International Journal of Nursing Studies, 55,
Lowe, G., Plummer, V., & Boyd, L. (2013). Nurse practitioner roles in Australian healthcare
settings. Nursing Management, 20(2).

Markus, A. (2014). Attitudes to immigration and cultural diversity in Australia. Journal of
Sociology, 50(1), 10-22.
Nursing and Midwifery Board of Australia. (2016) ‘Supervision guidelines for nursing and
Pulcini, J., Jelic, M., Gul, R., & Loke, A. Y. (2010). An international survey on advanced
practice nursing education, practice, and regulation. Journal of nursing scholarship,
42(1), 31-39.
Scanlon, A., Cashin, A., Bryce, J., Kelly, J. G., & Buckely, T. (2016). The complexities of
defining nurse practitioner scope of practice in the Australian context. Collegian, 23(1),

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