Professional Experience Placement

This study undertaken in Ireland by Brady et al (2015) investigated the database of telephone enquiries (n=978) made by registered nurses and midwives to the national regulatory body between 2001-2013. Thematic analysis was undertaken to elicit key themes. The rationale for this study was due to a national review of the scope of practice framework; development in the scope of practice in Ireland; and expansion and changes of role definition in healthcare.

The highest proportion (20%) were from nurses working in a general setting. Public health and community nursing (14%) and psychiatric and intellectual disability (13.7%) also elicited high levels of enquiries. The information varied during the years of collection. Over one-third of queries were related to medication management from nurses were working alone. The authors noted that the challenges of working in isolation with limited resources created the need for professional guidance. There was confusion about medication protocols between patient groups within communities and institutions. Dispensing of medications issues included repeat prescription and transcription issues. First aid situations, non-nurse medication administration and voluntary provision of nursing services also caused concern.

The boundaries of the scope of practice due to it evolving was a source of concern from the enquiries logged. Outside the practitioner’s comfort zone, delegation and independent practice were raised. The authors discussed these findings in relation to increased efficiency, cost containment and limited resources. They also acknowledged that recruitment restrictions created issues.

Although this study was undertaken in Ireland, similar issues pertain to Australia where nurses are expected to work solo, with limited resources and within budget. Clinical supervisors have the responsibility of ensuring their students understand their scope of practice, so at graduation they are aware of their professional boundaries. It is also essential that students understand the aim and purpose of their scope and critically analyse their position in relation to it during and after their preparation for registration as a nurse.

If you have any comments about scope of practice, you are welcome to post them here. Join us @PEPCommunity.