It has been almost a century since state governments enacted legislation to protect, supervise, and defend the public from harmful nursing practices. These statutes are combined to form the Nursing Practice Act, which is enforced by state legislatures. Because the NPA alone is insufficient to govern the profession, each NPA is accompanied by a board of nursing, which has the authority to create regulations that make the norms more explicit. Before they are enacted and enter full force law, the rules are reviewed by the public. The NPA includes the composition and power of the board of nursing, education standards for a nursing program, the scope of the practice, the type of licenses and titles, requirements to acquire a license and the grounds to acquire a disciplinary action including possible remedies (NCSBN, 2017). A profession as sensitive as nursing cannot be practiced without proper laws and regulations to ensure that the public is well protected from malpractice, and that is why we need policies to clearly state how each procedure is carried out and by who.
Nursing is a practice that requires special knowledge and skill with various levels of decision making. Careers in nursing take divergent paths depending on setting, type of client, rehabilitation level, therapeutic approach or type of disease. In addition, nurses are sophisticated and mobile and are required to practice in a society which is changing, same as their clients. This results to consequential harm in the practice of providing healthcare. Due to the fact that the practice of nursing by incompetent or unprepared professionals can pose risks to the public, the state should come up with policies and regulations to protect the citizens from this kind of harm, through reasonable laws and regulations applicable to the nursing profession (NCSBN, 2017).
California Board of Registered Nurses states that nursing is a field full of dynamics and it requires a legislature that provides clear rules with common acceptance. There also exists overlapping duties between registered nurses and physicians and there is need to recognize the sharing of duties between the two professionals in the organized system of health care. The organized system of heath care has rules provided in the chapter 2 section 1250 division 2 of health and safety code which covers health agency, community health services, physicians’ offices and clinics. A registered nurse is required to provide an ongoing assessment to the patient as stipulated in the Business and Professions Code, section 2725(d). The assessment performed should be documented in the patients’ medical report during every shift or transfer to another unit. Any registered nurse is accountable for any comprehensive assessment including data collection, analyzing it and drawing conclusions from it in order to make judgments such as diagnosis, delivery of care and discharge plans. A registered nurse is required to use a scientific knowledge to make judgments during occurrences of abnormalities and recommend changes based on complex and independent decision making in accordance with BPC 2725 and CCR 1443.5(4) (2017).
A registered nurse is considered to be competent according to section 1443.5 (3) when he or she can successfully transfer knowledge from a scientific background to social, physical and biological processes applying in the nursing practice. These practices include performing essential skills in accordance with the necessary actions, explaining treatment to client and family and teaching the family how to cater for the patients’ medical needs. The competence of a registered nurse is measured through their ability to evaluate and recommend an effective care plan through observing the behavior and physical conditions of the client, correctly diagnosing the signs of illness and reaction to medication through communication with team members and the client, and modifying the care plan as need arises as stated in the section 1443.5 (5).
The care plan is discussed and developed through the coordination of the patient, his family, other stakeholders when appropriate and any other staff member who is involved in his care. Any competent registered nurse is entitled to perform the above functions without necessarily following the orders of a physician, provided the nurse is knowledgeable. The registered nurse is accountable for making judgments on the effectiveness of health care and making any necessary changes as treatment advances and he is responsible to seeing that potential patients’ health problems are addressed and recorded on the care plan. He or she is expected to be the patients advocate and to demonstrate knowledge of the care given to address the patient’s wishes and needs. Advocacy is measured through clarification of orders and a clear care plan, ensuring consent for care, timely plan for discharge, recording a quality variance record of the patient, monitoring the patient’s response to treatment and ensuring the patients’ assignments are properly supervised as quoted in BPC2725 and CCR 14434.5.
Conclusion
The Nursing Practice Act’s main purpose is to protect the public from illegal practices by inexperienced nurses. Besides, it clearly gives the correct steps of carrying out procedures throughout the care of patients to ensure that healthcare provision in medical facilities is to the optimum level in ensuring the wellbeing of the public. The physicians are given their specific duties from the nurses and in any case where the duties may overlap, it is clearly stated in the Act how far the overlapping may go. There is a nursing board in place to enforce the laws stated in the act and ensure that the nurses are not breaking any of the laws, and that their rights have been considered. The training of the nurses can only be done in schools that have been allowed by the nursing boards to give education and award certificates. Application of licenses is also regulated by the nursing board.
References
California Board of Registered Nurses. (2017). Understanding the Role of The Registered Nurse and Interim Commitee . The California Board of Regulations, 1-8. Retrieved February 13, 2017, from www.rn.ca.gov/pdf/.../npr-b-53.pdf
NCSBN. (2017). Nurse Practice act, rRules and Regulations. Retrieved February 13, 2017, from National Counsil of State Boards of Nursing: https://www.ncsbn.org/nurse-practice-act.htm
