Week 9 PDF - Law and Ethics

Law and ethics  WELCOME E u n i c e Ta n , F re m a n t l e a n d B ro o m e C a m p u s e s Carlo Serrano, Sydney Campus School of Nursing and Midwifery ACKNOWLEDGEMENT OF COUNTRY The University of Notre Dame Australia is proud to acknowledge the trad...

Law and ethics  WELCOME E u n i c e Ta n , F re m a n t l e a n d B ro o m e C a m p u s e s Carlo Serrano, Sydney Campus School of Nursing and Midwifery ACKNOWLEDGEMENT OF COUNTRY The University of Notre Dame Australia is proud to acknowledge the traditional owners and custodians of this land upon which our University sits. The University acknowledges that the Fremantle Campus is located on Wadjuk Country, the Broome Campus on Yawuru Country and the Sydney Campus on Cadigal Country. Copyright statement Objectives By the end of this lecture, you will be familiar with: ❑ Nursing governance Background  A national scheme National Registration and Accreditation Scheme (NRAS) ❑ State and territory governments established the National Registration and Accreditation Scheme (NRAS) for health practitioners in 2010 by introducing consistent legislation in all jurisdictions ❑ NRAS is not an Australian Government scheme, it affects the health workforce across the country  A national scheme The NRAS is important because it: ❑ ensures all regulated health professionals are registered against consistent, high-quality, national professional standards ❑ makes it easier for health professionals to work across different states and territories in Australia, as they don’t have to re-register in each jurisdiction. Codes and standards Codes and standards ❑ Apply to Registered Nurses ❑ Students are expected to adhere to them as part of their pre- registration training ❑ Effect, RNs will get struck off, students will not be allowed register for health notifications (performance and conduct can only be applied to qualified RNs) ❑ Which do you think is more difficult for the authority to implement? ICN Code of ethics The purpose of the ICN Code of Ethics is: ❑ The ICN Code of Ethics for Nurses is a guide for action based on social values and needs. It will have meaning only as a living document if applied to the realities of nursing and health care in all settings in which nursing care is delivered. Code of ethics There are four Principal elements that outlined the standards of ethical conduct : 1. Nurses and patients or other people requiring care or services 2. Nurses and practice 3. Nurses and the profession 4. Nurses and global health Code of conduct Seven principles under one of four domains ❑ Practise legally ❑ Practise safely, effectively and collaboratively ❑ Act with professional integrity ❑ Promote health and wellbeing Standards for practice Registered nurse standards for practice ❑ [The] seven Registered nurse standards for practice should be evident in current practice, and inform the development of the scopes of practice and aspirations of the registered nurse Codes and standards A breach of the codes or standards may result in a notification (complaint) being made about the nurse or student to a relevant authority National authorities Registration Registration ❑ All health professionals are registered with their relevant board under the Australian health professional regulation agency (APHRA) ❑ Nurses and midwives are registered with the Nursing and Midwifery Board of Australia (NMBA) AHPRA AHPRA ❑ The Australian Health Practitioner Regulation Agency (AHPRA) role since 2010 is to administer the regulation of Australian practitioners in health care AHPRA AHPRA ❑ Maintains the register of health practitioners ❑ Receives mandatory notifications about all relevant Australian health practitioners ❑ Maintains public list of Australian Nursing and Midwifery Accreditation Council (ANMAC) approved study programs ❑ Provides administrative and procedural assistance to National Boards, including the NMBA ❑ Provides advice to the Ministerial Council AHPRA AHPRA ❑ Can receive notifications on behalf of National Boards (but will refer to HCCC in NSW) ❑ Gathers information on notifications before referring to National Board ❑ Receives mandatory notifications about all relevant Australian health practitioners ❑ AHPRA also has responsibility for issuing yearly nurse registrations AHPRA What is a nurse registration? ❑ A nurse registration is a license. License means to grant permission: or the document granting that permission ❑ A license grants permission to do something that might be harmful in the wrong hands. ❑ In nursing that includes allowing the nurse to undertake invasive procedures, dispense therapeutic substances, even hold persons for short periods against their will in rare and isolated circumstances AHPRA What type of data does APHRA collect? (This information is not available to the public) ❑ Name ❑ Student ID ❑ Date of birth ❑ Mailing address and email ❑ Date on which the student started their program and their expected completion date ❑ Reasons why you completed or ceased NMBA Nursing and Midwifery Board of Australia (NMBA) ❑ Maintains the register of nurses ❑ Criminal record checks ❑ Registers and imposes restrictions with AHPRA ❑ Approves accreditation standards, codes and guidelines NMBA NMBA ❑ Assesses English language and education requirements ❑ Monitors continuing professional development [CPD] ❑ Assess notifications referred from AHPRA (except in NSW) ❑ Publish accountability guidelines for nursing practice decisions NMBA NMBA ❑ Details the names of all nurse registrants in Australia ❑ The rationale for this – is that the public should be able to access information related to those who care for them ❑ Protection of the public ❑ http://www.nursingmidwiferyboard.gov.au Notifications Notifications Notifications ❑ Notifications (another word for complaints) can be made to State and National authorities (will be elaborated upon in your tutorial) Notifications Notifications (Complaints) ❑ Any person may make a notification about a nurse or nursing student ❑ The Health Practitioner Regulation National Law 2009 requires health practitioners, employers and education providers to make mandatory notifications to the Australian Health Practitioner Regulation Agency (AHPRA) if they believe a nurse or midwife, or student has behaved in a way that constitutes notifiable conduct Notifications Mandatory notifications must be made to AHPRA ❑ Health practitioners must make a mandatory notifications if they form a reasonable belief that: ❑ another health practitioner has demonstrated notifiable conduct ❑ or a student has an impairment that may detrimentally affect their ability to undertake clinical training Notifications Examples of notifications that cannot be made (Because they are not registered with a National Board and AHPRA) ❑ A person misrepresenting themselves as a registered nurse, registered midwife or enrolled nurse ❑ A person that is not a registered health practitioner ❑ A health service or a business ❑ The fees charged by a health service provider Notifications Representations ❑ For all notifications the nurse may make representations (tell their side of the story) and have a support person accompany them. The support person may be an Australian legal practitioner or not, but may NOT represent the nurse or midwife legally Notifications 1. Health notification ❑ The key aim of the health pathway is allow nursing authorities to deal with identified concerns relating to a nurse or student with an impairment. It relies on cooperation from the nurse or student. Proceedings are strictly confidential Notifications Statutory definition of Impairment. ❑ A nurse is impaired if they have a physical or mental impairment, disability, condition or disorder (including substance abuse or dependence) that detrimentally affects or is likely to detrimentally affect their capacity to practise nursing, or for a student, the student's capacity to undertake clinical training Notifications Impaired nurse or student ❑ If a health assessor concludes that a nurse or student is impaired ❑ The relevant authority discusses and negotiates with the nurse or student any treatment, monitoring and restrictions on practice that may be necessary to ensure the safety of the nurse, or student and the public while allowing the nurse or midwife to continue practising, or the student to continue studying ❑ On occasions there may be an agreement made that the nurse or midwife ceases practising while they recover from their health problem Notifications 2. Performance notification ❑ The key aim of the performance pathway is the successful remediation of a nurse's professional performance. It relies on cooperation from the nurse and is strictly confidential Notifications Conditions ❑ Conditions may be imposed in relation to a nurse's professional practice ❑ A written statement of decision and reasons should be given within one month to the nurse and relevant governing authority. A copy of the decision may also be provided to any person deemed relevant ❑ The nurse may appeal to the Tribunal against a decision. The nurse may appeal to the Supreme Court against the decision and actions of the Tribunal Notifications The review ❑ A performance review must be terminated if during, or prior to the performance review, a significant issue of public health or safety is raised that requires investigation ❑ This may suggest unsatisfactory professional conduct or professional misconduct Notifications 3. Conduct notification ❑ The conduct pathway allows authorities to deal with notifications that may constitute unsatisfactory professional conduct or professional misconduct Notifications Unsatisfactory professional conduct ❑ Unsatisfactory professional conduct of a registered health practitioner - the knowledge, skill or judgment possessed, or care exercised, in practice is significantly below the standard reasonably expected of a practitioner of an equivalent level of training or experience ❑ It includes conduct of a lesser standard than what is reasonably expected by the public or professional peers. Notifications Professional misconduct in NSW ❑ (a) unsatisfactory professional conduct of a sufficiently serious nature to justify suspension or cancellation of the practitioner’s registration; or ❑ (b) more than one instance of unsatisfactory professional conduct that, when the instances are considered together, amount to conduct of a sufficiently serious nature to justify suspension or cancellation of the practitioner’s registration Notifications Professional misconduct in WA ❑ (a) unprofessional conduct by the practitioner that amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and ❑ (b) more than one instance of unprofessional conduct that, when considered together, amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and ❑ (c) conduct of the practitioner, whether occurring in connection with the practice of the health practitioner’s profession or not, that is inconsistent with the practitioner being a fit and proper person to hold registration in the profession. Notifications Professional misconduct ❑ Professional misconduct includes conduct by a health practitioner that is substantially below the expected standard and which, whether connected to practice or not, is inconsistent with being a fit and proper person to be registered in the profession. Notifications Following investigations Conduct complaints may be prosecuted or not based on: ❑ the likelihood of proving the complaint ❑ the seriousness of the allegations ❑ any submissions the nurse/midwife may have made ❑ the protection of the public health and safety Notifications Conduct ❑ More serious complaints are heard before the Tribunal, which has the power to suspend or "deregister” the nurse Notifications The Tribunal ❑ A notification is referred to the state Tribunal (NSW or WA) if, were it proved, it would result in suspension or cancellation of a nurse or student's registration (except in the case of impairment) ❑ The Tribunal also considers repeals and reviews of lower decisions Notifications If a complaint against a nurse is proved the Tribunal may do one or more of the following: ❑ caution or reprimand the nurse ❑ impose conditions on the nurse's registration ❑ order the nurse to seek and undergo medical or psychiatric treatment or counselling ❑ order the nurse to complete an educational course ❑ order the nurse to report on his or her practice ❑ order the nurse to seek and take advice in relation to the management of his or her practice Notifications Criminal charges ❑ Investigative actions do not negate or prevent the laying of charges for criminal conduct Questions Please bring any questions you have about this lecture to your weekly tutorial References Australian Health Practitioner Regulation Agency. (2023). https://www.ahpra.gov.au Government of Western Australia Health and Disability Service Complaints office. (2018). https://www.hadsco.wa.gov.au/ Health Practitioner Regulation National Law (No. 86a) 2009 (NSW). Health Practitioner Regulation National Law 2010 (WA). International Council of Nurses. (2012). ICN Code of ethics for nurses. http://www.icn.ch/who-we-are/code-of-ethics-for-nurses/ Nursing and Midwifery Board of Australia. (2018). Code of conduct for nurses. http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines- Statements/Professional-standards.aspx Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice. http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines- Statements/Professional-standards.aspx Nursing and Midwifery Council of NSW. (2023). https://www.nursingandmidwiferycouncil.nsw.gov.au Staunton, P.J., & Chiarella, M. (2020). Law for nurses and midwives (9th ed.). Elsevier.