Professionalism in Nursing Study Guide Part 5

Registration and Licensing Standing Committee The Registration and Licensing Standing Committee meets every month. It deals with the registration, enrolment and licensing of nurses for nursing practice. This is applicable to those trained in Kenya and those trained outside Kenya. Kenyan law states that nurses are not allowed to practice nursing prior to registration, enrolment or licensing by the Nursing Council. This Committee also licenses nurses for private practice and processes licensing for practice and retention of nurses in the registers, rolls and records. Investigations Standing Committee This committee investigates all cases of professional misconduct, negligence, malpractice and impropriety. This is to establish whether the alleged crime has been committed and whether the nurse has a case to answer or not. A recommendation is then made to the Full Council which in turn institutes disciplinary proceedings. Finance Standing Committee This committee deals with all financial issues of the Council in relation to income and expenditure. Disciplinary Committee This is a Standing Committee which deals with disciplinary cases recommended by the investigations standing committee. It is independent of the Full Council. Members are drawn from experienced nurses practicing general nursing, midwifery, community health nursing, mental health and psychiatric nursing, the legal advisor and a representative of the Chief Nursing Officer. The registrar is the secretary. The Nursing Council Secretariat All activities of the Nursing Council are coordinated by the Secretariat. The Nursing Council Secretariat conducts the day-to-day activities of the Council. The Secretariat is composed of council officers and council staff. The council officers who are the registrar, education officers, examination officers, registration officers and standards and ethics officers are currently employees of the Ministry of Health deployed to work at the council. They coordinate various Standing Committees and Subcommittees as discussed earlier. As a practicing nurse you may be familiar with the offences under the 257 Act. The council staff includes the accountant, accounts assistant, secretaries, copy typists, records clerk, driver and supportive staff who are employees of the Council. Nursing Council Elections The Nursing Council of Kenya conducts elections of council members every three years. All registered nurses are eligible to vie for representation of various disciplines for example general nurses, midwives, community health nurses and mental health and psychiatric nurses. The nurses may be practising either in clinical practice, nursing education or leadership and management Legal Aspects of Nursing in Kenya As a nurse you are liable to the national laws as well as professional ethics related to your practice. You have already studied the functions of the Nursing Council and the Disciplinary Committee. Examples of Offences NEGLIGENCE: You will be charged with this offence if you do not provide the expected care to a patient or client in the field you were trained in. MISCONDUCT Is improper behavior or deliberate violation of standards. Its usually intentional Misconduct includes stealing drugs or hospital property, forgery or fraud, coming on duty while drunk, fighting while on duty or use of abusive language. MALPRACTICE Remember you are a trained nurse. If you provide substandard care to patients, you will be charged of malpractice. In addition, if you also perform procedures that are out of your scope of practice you may be charged with malpractice. IMPROPRIIETY As a nurse the profession binds you to conduct yourself professionally while on duty or off duty. If you fight in a bar or anywhere or conduct yourself unprofessionally you will have discredited or shamed the nursing profession and will, therefore, be liable to be charged with impropriety. Legal acts Related to Nursing Practice The following are some of the laws that are relevant to nursing practitioner The Public Health Act (cap 242) This Act is commonly referred to as the mother Act among the Acts of Health Professionals. It describes the health delivery services in the country. Pharmacy and Poisons Act (Cap 244) You should be familiar with this law because of drug prescription and administration. Medical Practitioners and Dentists Act Cap (253) In your community health nursing practice or private nurse practice you will be expected to diagnose and treat minor ailments, this encroaches on this law. Narcotic Drugs and Psychotropic Substances (Control) Act 1994 While dealing with the dangerous drugs, you will be required to be familiar with this law. This also applies to dealing with drug misuse and abuse. Mental Health Act Cap (248) You have been exposed to mental health and psychiatric nursing. You will interact with such patients in your practice as a general nurse, midwife and community health nurse. Other Laws Related to Nursing Practice Medical Laboratory Technicians and Technologists Act (1999) You will be taking body specimens from patients and clients. You should therefore be familiar with this law. Clinical Medicine Act This law is related to the medical Practitioners and Dentists Act because of diagnosing and treating minor ailments. Food, Drugs and Chemicals Act You will be dealing with the nutritional status of the patient. In addition, you are one of the food handlers in the hospital. Familiarize yourself with the law. Children and Young Persons Act In your practice you will be interacting with babies, children, adolescents and teenagers. This may be in wards, departments, clinics, maternity, school health and the community. Remember children have rights • Enjoyment of rights and freedoms is recognized and guaranteed irrespective of race, ethnic group, color, sex, language, relation, political or other opinion, national and social origin of the child's parents or legal guardians. This includes fortune, birth or status. • Best interests of the child should be the primary consideration. • The right to life is inherent and should be protected by law. Death sentence should not be pronounced for crimes committed by the child. • Right from birth to a name. The child should be registered immediately after birth, and has a right to acquire a nationality. • Freedom of expression. • Freedom of association. • Freedom of thought, conscience and religion. • Protection of privacy. • Right to education. • Right to rest and leisure, to engage in play and recreation and cultural activities appropriate to the age of the child and to participate freely in cultural life and the arts. • A mentally or physically disabled child has the right to special measures of protection in keeping with his physical and moral needs under conditions which ensure his dignity, promote his self-reliance and active participation in the community. • Right to enjoy the best attainable state of physical, mental and spiritual health. • Protection from all forms of economic exploitation and from performing any work that is likely to be hazardous or to interfere with the child's physical, mental, spiritual, moral or social development. • Protection from all forms of torture, inhuman or degrading treatment, especially physical or mental injury or abuse, neglect or maltreatment including sexual abuse while in the care of a parent, legal guardian, or school authority or any other person who has the care of the child. Bill of Rights In the process of the provision of health care, both the patients and the nurse have a Bill of Rights. You will study them separately. The Patient's Bill of Rights Earlier in the unit we discussed that health care is a right to every individual in this country. You should always remember that as you provide care to the patient, they have a right to: • Considerate and respectful care. • Obtain complete information concerning their treatment, progress and prognosis of the disease/condition. In certain situations the patients may not be in a reasonable condition to understand or it may be medically inadvisable to give particular information. Therefore, an appropriate person should be given the information on their behalf. • Know by name the person caring for them. • Receive information necessary for them to give informed consent prior to the commencement of any procedure and/or treatment except for emergencies. The information given should include specific procedures and/or treatment, the medical risks involved, probable duration of incapacitation, where alternative significant medical care or treatment exist, or when the patient requests for information concerning medical alternatives, they have the right to such information. The patients also have the right to know the name of the person providing the treatment. • Refuse treatment to the extent permitted by law but must be informed of the medical consequences of their action. • Privacy concerning their care. Those persons not directly involved in the care must get permission from the patient in order to be present. • Confidentiality with regard to all communication and records pertaining to their care. • Expect that a hospital within its capacity can make reasonable response to the patient's request for service. The hospital must provide evaluation • • • • • service and/or referral as determined by the urgency of condition. When medically permissible, patients may be transferred to another health facility only after they have received adequate information and explanation concerning the need for and alternatives to such a transfer. The receiving health institution must first have accepted the transfer for the patients. Obtain information as to any relationship of their hospital to other healthcare facilities and education institution in so far as their care is concerned. Obtain information regarding the existence of any professional relationship among individuals by name who are treating them. Be advised if the hospital proposes to engage in or perform human experimentation affecting their care or treatment. Patients have the right to refuse to participate in such research. Expect reasonable continuity of care and have the right to know in advance appointment times and doctors’ availability. Question and receive an explanation of their bill regardless of source of payment (Note - some medical practitioners may unnecessarily inflate the bill if the patient is insured). • Know what hospital rules and regulations apply to his/her conduct as a patient. Nurses Bill of Rights You as a nurse have many rights. You are entitled to human rights, and the rights of a worker. As a worker you have the right to a safe environment, adequate working tools and supplies, right to risk allowance, right to professional autonomy and the right to opportunities for further education, promotion and career development. Code of Regulations As an employee you must acquaint yourself with the code of regulations of the organization you have joined. If you are employed by the government of Kenya, then it is worthy to familiarize yourself with the government code of regulations which contains: • Organization of government and procedures or conduct of government business • The Public Service Commission • • • • • • Correspondence; Publication and Printing Terms and conditions of employment Annual staff appraisal reports Rules of conduct Salaries, increments and seniority Advances, allowances, transport, housing, medical privileges, leave, examinations and courses of training etc. You are now aware that the Nursing Council of Kenya is responsible for the provision of quality care to patients and clients. This is why it is a requirement by the Council that all nurses in the country update their knowledge and skills through continuing education and professional development. You are now able to differentiate between the National Nurses Association of Kenya and the Nursing Council of Kenya Scope of practice in Kenya It’s a document that describes the range of interests, capabilities and professional activities of nurses in Kenya. The major principle of the scope of practice is that members of the nursing profession will provide only those services for which they are adequately prepared through their academic and clinical training and experience. SCOPE OF NURSING PRACTISE FRAMEWORK 1.Nursing is autonomous 2.Nursing practice responds to client’s health needs along the continuum of health 3.Nursing practice is based on application of nursing process to patient care 4.Nursing interventions include promotive, curative, preventive and rehabilitative care 5.Nursing practice embraces knowledge, skills, and attitude to ensure that clients or patients receive quality care 6.In providing care, the nurse functions as a multidisciplinary healthcare team to ensure interests and rights of the patients 7.Using innovative strategies, the nurse advocates for safe and supportive working environments that facilitate the provision of quality care in various settings