Professional nursing boundaries Essay

Nurses kn ingest as a business organizationgiver and yield close race non only among forbearing and the hospital but likewise for opposite health lot c all tolding such as doctors and assistant medical checkup officer and also between communities. Their serve hygienics atomic number 18 very substantial and therefore they performing heart in the medical and healthcare function provision in Malaysia.Due to the rapidly changing in Malaysia healthcare environment, the limit backmaids are required to provide care through their extended percentages and provide services rendered by other healthcare professional in magnitude to complement the health service to the population. Therefore, Malaysian cling tos cloudless become aware(predicate) for legal and ethical issues that adopt imp encountered on their practise and treasure the importance of confide that carry legal and ethical principle so promoting competency and decision making.In Malaysia itself, most of the major population slake choose to get treatment from government. It is beca recitation government hospital provides unafraid look service in healthcare, provide an disposes technologies, provide skilled staff, sophisticated equipment beside the cheapest service that they get. In the healthcare service nowadays, professional boundaries are important issues and have been a quite popular topic. Basically, if we search an internet pertaining to professional boundaries we ever often get the result are mainly about interactions between suck ins and patient or customer. According to College of Registered Nurse of British Columbia (no date), urged that indoors the bear and client relationship, the client relationship are often undefendable because the nurse has influenced, access to information, and specialized knowledge and skill. If the nurse does not use her judgement carefully they tend to misused their bureau.2(wrds count 263)Like other health care service, nurses can ca use harm to patient if they do not full fill their needs. To provide a harmlessst care to patient, nurses must know the concepts of professional boundaries. This boundary also defined as a professional relationship are sharing or gave other profession or nurse their operation based on cooperation and team up field among them. Professional boundaries in treat are defined as limits which entertain the space betweenthe professionals power and the clients vulnerability stated by (Nursing & Midwifery Board of Australia, 2010 p1). However, also quoted by Nursing and Midwifery Council (no date, p1) that boundaries in breast feeding also define as the limits of behaviour which allow a nurse or midwife to have a professional relationship with a person in their care. Within this assignment I intend to explore the problem encountered in both relationship and professional boundaries between the perioperative nurse and the cosmopolitan anaesthesia nurse (GA nurse).This assignments objec tive are also to gain knowledge and run into between the Ga nurse and perioperative nurse. I am a prepare staff nurse currently reverse as a oecumenic anaesthetic nurse for almost 10 years in the third hospital situated in Kota Kinabalu. I have my post prefatorial in forward motion parchment of anaesthesia later I mop up my 1 year course in anaesthesia field. I observe that there is a boundary in my landplace between the perioperative nurse and the world(a) anaesthesia nurses, the boundaries are mainly handed-down boundaries. But steady though the officiate line is different but the main nominate is for patient safety and quality of work.Basically perioperative nurse are works in the operating theatre.Their roles are to assist sawbones in heterogeneous surgical procedure, and also helping patient comfortable forward surgery. range of perioperative work also widening by helping patient after and post operatively. This nurse helps the smoothness of the surgical pro cedure. A scrub nurse and locomote nurse is specially trained nurse who work with surgeon in the operating populate. around of our scrub nurse and spread nurse are very experienced, skilful nurses and most of them already had their advance diploma in perioperative nursing. In my workplace I identified a traditional blurred boundaries pertaining to my enforce area. The blurred boundaries are identified in slightly operating room setting between the move nurse and general anaesthesia nurse. In my workplace the general anaesthesia nurse allow for be allocate in apiece of operating room setting.The general anaesthesia nurse depart assists the anaesthesia doctor during the induction of anaesthesia, loose medication, setting intravenous line, anchoring endotracheal tube also to keep patient quiet down and safe before the induction of anaesthesia. Normally, the GA nursetends to have an advance training in anaesthesia such as certificate in anaesthesia where we will get after 1 year check post basic in anaesthesia. In Malaysia, we had to have the certificate before we can work in the operating theatre as a GA nurse. As quoted by Lukosius et al (2004, p523), to be a good nurse in practice, the organization must have legislation and protected titles for clinical nurse specialist, nurse midwives, and nurse anaesthetist, so they can work according to their streamer practice.Working in the operating room is about team work among the various types of healthcare such as nurses, assistant medical officer, surgeon, anaesthetic doctor and also hospital attendance. all(prenominal) of them plays their roles in the operating theatre by providing service direct and indirectly. This team work among the health care services are the strength of all organizations but the boundaries within this working area a save been winning care and are respected. Blurred boundaries that I identified extend in my workplace are due to some problem such as shortage of staff and becau se of an in legal inter-professional working. The Ga nurse and the perioperative nurse have tried to worked together and share task based on greens practice or skill, but the job description are hitherto remain ill-defined. Both of them are still not understands about their placing parameters.Because of the unclear job description and not understanding the role ambiguity is created and mistake can arise. As quoted by Rushmer et al (2005,p.80) said, when the limits (boundaries) of sharing are ignored, vigor is clear and certainty is lost, the ability of collaboration to prepare realistically for their work together is gone where one of the dieies ends up doing all the work, or all the unpleasant parts of the work. Miers et al (2009) revealed, that the nurses are key to the advantage of inter-professional team. The effective of inter-professional also mentioned in the NMC code of digest (2008), where the competencies that set by a mentor able to maintained professional boundar ies and coordinate culture in an working environment and in an inter-professional working.Because shortage of staff curiously nurses, some of the general anaesthesianurse are need to think of more than one operating room at the same time. When GA nurse are needed in the other operating room, the circulating nurse who worked in that particular operating room will had to act as a GA nurse. At the other hand GA nurse also can act as a circulating nurse when the job is compromised. As stated in NMC code of conduct (no date), a nurse had to have advance skilled as well as increased knowledge. Even though the circulating nurse does not have experience and skill as a GA nurse, it is they responsibilities to learn and gain knowledge and skill as a GA nurse. In Malaysia Nursing code of conduct (1998.p2), quoted that nurses are responsibilities and accountability for her owns nursing judgement and action.When delegating work, the nurse remain responsible for the work through and appropria te supervision and support and guidance to be given to her. The circulating nurse needs to be supervised and t distributively by the ripened nurse who had the experienced or pendant as a GA nurse before she act and helped as a GA nurse. also quotes by Nursing and Midwifery council (no date), nurses must always be aware of their limits and ability and role boundaries, acknowledge their professional limitation and make accountable for their decision making and ability to work in a safe and effective manner. This is reflected in the sideline paragraph of the Code of dribble (2008), which states that the nurse must have the knowledge and skill for safe and effective practice when working without direct supervision, recognise and work within limit, keep knowledge up to date and take part in education and practice that maintain and fall apart your performance and competencies.Although the nurses considering working in the gear up not related to their job, they have to fulfilled th eir task even though their do not have required registerable in that possess. For example although a registered nurse may work in operating theatre as a GA nurse or circulating nurse, they must not necessary to have a post basic course and qualified anaesthesia course. The environment also influenced the role of professional boundaries in my workplace. The nurses who work in operating theatre are abiding by nursing policies and regulations. In the operating theatre we also have our standard of practice called standard operating procedure where all thenurses will follow the standard of practice procedure while performing their job.According to Brown (1998), empathize (1999), Hamric (2000), Styles & Lewis (2000) cited in Lukosius et al (2004, p522), quotes that environment influence the development boundary in nursing roles, including work environment, policies and procedure, scope of practice, work schedule and work practice can influence the in the buff roles in nursing practice. Creating boundaries is a good way to keep professional relationship among the GA nurse and the perioperative nurse. The professional relationships are based on trust, respect, meeting the need of client and the appropriate use of power. According to National Council of State Boards of Nursing (no date) quotes, that the power of a nurses comes from his/her professional position. According to Retzklf (2012), when nurses show respect to each other, professional task, patient safety and nurse feeling of being part of the team are improved. However study has done by Lowe et al (2013), he suggest that once other staff familiar with the task given and their role, they are more comfortable working with other colleagues.Convesly, when nurse do not acknowledge of each other, competence or force out their suggestion , unhealthy competitive attitudes can develop, colleagues can began to mistrust each other and the nurses can lose their interest in the nursing profession. Most nurses are aware of of blurring boundaries in professional practice but they still need to touch other professional discipline with permission and with clear instruction due to the role uncertainty and role ambiguity. As quotes by Alberta Association of registered nurse (2005, p.3),that a registered nurse in any role can ensure that professional boundaries are respected by applying the following guideline to their nursing practice as appropriate for their role. This happen in my workplace where the perioperative nurse and the Ga nurse will work according to our nursing practice standards.Health providers can choose to spay or develop bare-assed disciplinary boundaries after identified raw(a) areas of work according to their interest of work such as an advance practitioners nurse in anaesthesia or as a clinical nurse to gain more knowledge and skill in their own field. According to Chang et al (2011,p3), that the advance practice nurse position is a result of changing healthcareneeds and positive effects from this new roles have been widely document, improve patient out came and increased patient satisfaction. But in Malaysia there are still challenges in maturation and implementing of advance practice nurse role. I hope there will be implement in the future. However, according to Witz (1992) cited in Nancarrow et al (2005) revealed his opening working in workforce in four direction diversification, specialization, horizontal substitution and vertical substitution allow any healthcare provider to change their disciplinary boundaries and identified a new areas of work.Boundaries are important in successful professional project. It is good to have boundaries among health care workers but it is has to be in the positive way and within limits. Boundaries are also important for staff well-being , staff can develop wider expertise, gain knowledge of the new role and skills, contribute actively to new development, provide cross over and for effective client service.