The conclusion of this essay will focus on the future ole development of the newly qualified nurse . In present years the role of nurses Is changing continuously . The newly qualified nurse Is far more Involved , responsible and accountable for every aspect of care towards the patient. The current ( NC, 2010) code of conduct states that every student nurse need to train and learn following the guidelines of professional and ethical practice . Len order to progress and become a qualified nurse It Is necessary to Join the register .
Every student nurse need to show competency In delivering care combined with personal and professional development . The period of transition from being a student to becoming a staff nurse can be overwhelming , challenging and faced with stress for being accountable for every action . The changes are fundamental because now the newly qualified nurse must know the answer to different queries from patients , relatives or other multidisciplinary team members .
This transition require a big change from the experience of being a learner under the supervision of a mentor to the stage where as a newly qualified nurse has to deal with care management within a team , become a mentor and have the skills to manage the needs of the work lace . Department of Health ( 2009) proprietorship framework outline the importance of proprietorship programmer for the newly qualified nurse . This programmer integrated in the transition period will give the newly qualified nurse the time to develop confidence in preparing for the role and time for feedback from the preceptor.
Following such programmer the newly qualified nurse will gain the confidence in leading an accountable role in practice. To be recognized by the NC register and fit for practice the newly qualified nurse will need to have the ability to cake multiple roles and responsibilities including : provider of care, decision maker , educator ,patient advocate , researcher , accountability, autonomy , collaborator and manager . Patient Group Direction ( Peg’s) ” A patient group direction ( PEG) Is a written direction related to the supply and lord administration of a named medicine , In an Identified clinical situation. To a group of patients who may not be Individually Identified prior to the presentation for treatment ( DOD , 2010). Let Is a legal document that allows specific prescription declines to be supplied or administered by a named registered care professional without of an Individual prescription -Instructions with regards to Peg’s need to be about Peg’s in this paper is in relation with the role of newly qualified nurse because he/she has to administer safely medication under the NC code of conduct 2008.
Newly qualified nurse must have the knowledge and information about the legal and professional implication when administering medication and this is an important aspect for the role . Department of Health 2009 stated that ” A PEG provides a legal Achaeans by which medicines can be supplied and / or administered to patients by a specific range of healthcare professionals ” .
The group of patients that can receive this type of direction must clearly fit the criteria and must be used when provide an advantage without affecting the care received by the patient being suitable only for short term condition considering assessment of the patient prior. This type of direction is not suitable for long term conditions like cardiac diseases and diabetes . Newly qualified nurses roles and responsibilities must be assessed as competent in order to administer medicines under PEG and training should be provided .
Comparing to Patient Specific Direction ( SD) which is an instruction directed for a named patient assessed by prescribes that prescribe the prescription but give the instruction to another healthcare professional to administer or supply the medication , PEG is not a prescription and can not be delegated ( Royal College of Nursing 2006 ) NC requires that newly qualified nurses need to have the core essential skills of medicine management , drug calculation and have an understanding of all methods available for drug prescribing including PEG.
PEG can be used in areas like emergency care , immunization clinics and contraceptive medication and can be directed not solely by emergency nurse practitioners , practice nurses , pharmacists and school nurses ( RCA 2006) . Newly qualified nurses must work within the legal and ethical framework for an effective medicine management and she/ he become accountable by law when administer medication to patients in care (NC ,2010).
Even there is not available mandatory a specific training for the newly qualified nurse when it comes to the use of PEG , she/he need o be qualified for at least six month so this period will allow to improve their competences and gain more expertise . But newly qualified nurses need to maintain a good practice should be in contact with the use of PEG as this will offer them the opportunity to identify the benefits offered by PEG compared with SD.
Department of Health in published in 2010 the framework that illustrate best practice for nurses and identified the newly qualified nurse as a healthcare professional that should have information about the competences of working with PEG even they are not able o direct one . Even NC guidelines are not created to cover every situation in practice , nurses have the professional responsibility to apply their rationale in the best interest of the patient . N addition as a newly qualified nurses should have an understanding of local and national policies and make reference to them depending on the situation in accordance with NC Standard of Medicine Management (2009) . As a student nurse I am not allowed in any circumstances to give medication to patients without the supervision of a mentor or a registered nurse . Administering medication as a nurse must always take in consideration professional accountability as the patient should receive the correct medication as per standards and type of direction used .
Medication must be administered to the patient in its indication , contra-indication and make sure the label of the medicine is clearly written by the pharmacist . Len addition should be considered clinical status ,condition of the patient and ” six rights ” rule followed . ” Patient Group Direction ” should clearly contain the dates when the direction started and when it expires along with ascription of medicine with appropriate dose allowed , frequency of administration and length of the period which medicine can be administered (NC , 2008).
Medicine Management Act 1968 and 1987 was created to regulate the way healthcare professionals administer and supply medication and newly qualified nurses should abide to it avoiding unsafe practice as they become accountable under public law . Newly qualified nurse is expected to be competent in various environments and situations . Therefore nurses will not have all the knowledge and know the answer for everything in their practice but they need to be able to develop and adapt with every changing situation .
Field (2004) indicates that even nurses after qualifying are able to delegate responsibilities to others they will still be accountable for their decisions and will have the responsibility to Justify every decision taken . Marquee and Huston ( 2012) define delegation as getting other people to do the work for you and explain the importance of delegation within nursing and how challenging aspect of the Job it is because is not always a very easy to delegate tasks to others .
Being part f the team there are many positive aspects about delegating because this aspect of the nursing Job can built the trust and strength whit-in that team and best care can be provided to the patients . Therefore it is paramount that nurses need to use analytical principles to explain their decisions and they will require to use evidence based practice . Good communication it is very important in providing nursing care to patients and interacting with colleagues and other multidisciplinary team members .
Failing to maintain good communication in nursing process care for the patients will e affected resulting in complains about service ( Mashers and Pearce 2011). Working effective in a team with other professionals improves the care outcomes for the patient and define better a patient centered approach. It is essential that newly qualified nurse respect patients as individuals , adopt a non- Judgmental approach and involve patients or careers in decision making process.
By providing this support all the way in the care Journey offered to the patient , nurse become a patient advocate and accountable for all care aspects . One of the aspects that the author will continue to discuss refers to accountability . Whitehead et al ( 2008) refers to accountability as a legal duty and responsibility that need to be taken in different situation and confers certain duties on the newly qualified nurse which empowers decision making in the care provided to patients .
Nurses become accountable for their actions to the law and need to comply with code of professional conduct of the NC . It is suggested that different types of accountability can be identified as : professional , ethical , legal and social . The NC( 2008 ) code states that all nurses have to demonstrate a certain level of induct in practice settings and this can be defined as professional accountability . As a nurse once qualified and registered with NC , you become newly qualified nurse will be taken into account not only by the NC but also by the law .
Every nurse must remain professional in every aspect of care and every action that she/he perform towards the patient. There are also certain principles in practice that nurses should maintain according to NC code of conduct . As being part of the team newly qualified nurses become accountable to other team members whose patients they are caring for. Ascension Health ( 2011) states that ” the reminisces like respect and autonomy implies that one should be free from coercion in deciding to act and that others are obligated to protect confidentiality ,respect,privacy ,and tell the truth.
In the practice of health care , a person’s autonomy is exercised through the process of obtaining informed consent If a patient refuses to take medication for a specific reason the nurse should clearly identify the cause of refusal and review available option . This example illustrate that nurses should have respect for patient choices and therefore give them necessary information so the patient can exercise his autonomy .
Furthermore another principle that is connected to accountability was illustrated by Béchamel and Childless(1994) who discuss about principle of beneficence as being ” at the heart of every practice ” and was identified that nurses are required in their actions to ” help preventing harm , removing harm and promoting good Beneficence outlined in nursing practice the fact that nurses should act in the best interest on the patient based on an early assessment of the situation encountered . F we relate this principle to the example discussed above and the nurse identify that the refuse of the patient o take his medication is related to the side effects caused by them and nurse will crush the medication and give it to the patient in his food or drink , the nurse action become unethical even she intended to do good . Verbal the nurse brake the principle of beneficence and by her action become accountable for omission in her practice and should have Justification for her action ( NC, 2008) Another type of accountability is the ethical and this reflect the moral values and principles exposed in practice and in the same time focus on duty and the accountability that nurses have for their actions . The Adair Review ( Adair , 2008 ) describe the importance of accountability and fairness of the health service . Further more this review suggest that nurses play an important role in providing an effective and safe health service .
Each qualified nurse need to have specific knowledge , skills and demonstrate proficiency in a variety of contexts. Newly qualified nurses are requested to show their abilities to work with other agencies and underpin all the ethical principles of being accountable when promoting rights of the service users . Patients are now more aware of their rights and the nurses by making independent sections in practice increase their accountability in the law context when negligence is happening . Once a nurse is qualified she / he become subject to the law of the land . Furthermore the law of the land can be divided in criminal and civil law .
Student nurses are still legally accountable for specific actions that are performed to the patient while undertaking the training . Even considered yet learners student nurses if make a mistake in their practice and perform wrongly an act of care they become potentially accountable for the error as well as their mentor . For example if student nurse still from a patient , this become a criminal offence and as individual outlined from criminal and civil law and this give the opportunity to patients and their relatives choices to bring civil action in trying to receive any form of compensation against any harm caused .
Armstrong described legal accountability as being accountable under criminal law to the public and under civil law to the patient (Armstrong ,2011) . Proprietorship in nursing was identified in 1986 by CHUCK and was established that is highly beneficial to nurses . Later Department of Health published Proprietorship Framework for Newly Registered Nurses, Midwives and Allied Health Professionals in 2010. This framework describe what is expected from newly qualified nurses and the employer during this period .
Chatty and Black ( 2011) discuss about transition period from being a student to the role of the newly qualified nurse as a ” reality shock ” that sometimes can cause stress and modify the newly qualified nurse ability to cope with the role demands and a lack of support in dealing with increased accountability . This sometimes can even cause newly qualified nurses to leave their reversion and chose to work another Job where accountability does not put pressure on the role they have .
On Adair review ( 2008) it was suggested that investments in nurses proprietorships programmer will offer a form of protection for newly qualified nurses in gaining their knowledge from more senior colleagues in the first year after qualification . For example British Journal of Nursing identified that in USA there is no proprietorship programmer for newly qualified nurses and the research discovered that 41% of the newly qualified nursing staff wish to leave the Job in the first 18 months after qualifying due to difficult and stressful conditions of the work .
In I-J for example if a newly qualified nurse is during her proprietorship programmer and an error or incident occurs overall accountability could be shared . As a newly qualified nurse it is very important to understand and know the limitations and to not carry out any type of procedure if there is any feeling of uncertain and competence was not awarded for the specific procedure . Let is always advisable identify situation when help is needed rather then committing and error ( Stirring , 2012).
This paper identified and highlighted the importance of the role of the newly qualified nurse in relation to accountability and Patient Group Direction . Being a student nurse I observe from the newly qualified nurses that I meet during my previous placements that transition to the new role can be challenging but in the same time rewarding because option for care is what made us embrace this profession . The most important goal that newly qualified nurses must achieve relates to the quality of care that is offered because patients have confidence that every healthcare professional is competent and accountable .
Newly qualified nurses must relate the care offered to their patients to the evidence base practice and follow policies and laws set . Furthermore newly qualified nurses should be able to demonstrate responsibility and accountability when an error in Judgment was made and could affect the patient care status . Newly qualified nurses therefore should understand the use of Patient Group Direction in their practice ,when should be used without compromising patient care and in relation to this paper discussion the importance of accountability in their practice .
