Theme 12

Professional Organization

Professional Organization
Objectives Describe the core function of the Nurses,Midwives,Nurse Practitioners Board

Understand the core function of the Public Service Commission

Reading and References

Review of the role ,functions & structure of the Fiji Nurses, Midwives & Nurse Practitioners Board Scope of Practice Decision-Making Framework December,2006 Laws of Fiji

Nurses and Midwives Board

Nurse and Midwives Act under the Laws of Fiji Chapter 25 Started on 29th September,1948 Revised in 1959,1966,1970,1982 and 1985 Amended in 1999/Enacted by Parliament Delete Nurses, Midwives Board Substituting Nurses, Midwives and Nurse Practitioners Board

Nurses, Midwives and Nurse Practitioners Board

Nurses Midwives Nurse Practitioners Extended roles Specialized skills Advanced skills

Regulate practice of Nurses, Midwives and NPs

NMNP Board is empowered under the ACT To arrange for & regulate courses of training for Nurses, Midwives & NPs and the examination of such person seeking admission to the register.

NMNP Act
This Act 1.deals principally with matters related to criteria for entry to the profession Provision to restrict the right of practice or discipline nurses where necessary in the public interest

Govt funded statutory Authority NMNP Board

Set policies & direction for Nursing in Fiji Provide advice to the Minister for Health on all matters relating to our function.

Functions of the Board

1. To provide for the REGISTRATION of nurses, midwives and nurse practitioners and to REGULATE their practice.

Admission to the Register

Has undergone a course of training approved or prescribed by the Board in an institution approved, by the Board and has passed, to the satisfaction of the Board, an examination approved by the Board.

Register
Legal authority to be a Registered Nurse Only those who are registered by the NMNP Board are entitled to use the term Registered Nurse in Fiji [Fiji Registered Nurse[FRN] Legal authority to provide health care - Honor the role

Registrable profession
Nurses Doctor Dentists Pharmacist Radiographers Not Registrable Physiotherapist-private practice Dietitian and Health Inspectors

Registration Status
Board keeps the register Principal Act-NMNP Board act Register for Life Power to remove from the register De registered Annual renewal of license for nurses is being considered by the Board

Movement of Nurses
No barrier for nurses to practice in Fiji Government and Private sectors Private Practice for nurses, midwives and nurse practitioners in Fiji- not permitted under the Act

Function-register and regulate

WHY? Protection-both the patient and nurse Nurses are fully aware of duties as a professional practitioners and also as a responsible member of the community Ensure that the patients lives are in safe and competent hands Ensure that nurses 'well being is protected

2.Practice and Standard

Professional Standard Ensuring Standard of professional conduct [Fiji Code of Ethics and Conduct] Competency and practice standard Guidelines on scope of practice and delegation of care

Nursing Standards
Ensure that the Quality nursing care Identifying of patient s needs and meet the needs Standard 1 - Nursing Assessment Standard 2 Nursing Care Plan Standard 3 Nursing Notes Standard 4 Nursing Audit

Legal basis of Nursing Practice

Duty Moral or legal obligation and responsibility Negligence Carelessness-failure to do something that a reasonable man would do or doing something that a reasonable man would not do

Professional negligence
Involving someone with a special skill, that person is expected to show the skill of an average member of his/her profession. Fails to do something which an average nurse or midwife would do in the same situation or circumstances or Does something which the average nurse or midwife would not do in the same situations or circumstances.

Liability
Every person has a duty to take care not to harm other people. By virtue of specialized skills/ training, health professionals have a particular duty to take care in their professional work not to cause harm to those within their care.

Liability of practitioner
Every health professional is responsible, accountable and therefore legally liable for their own action Applies to nurses, midwives and NPs under the Act. Those who are registered under the ACT are accountable to the public thru the Board.

NMNP Board
A registration authority responsible to the people thru the Parliament for the standards of entry to the profession Maintenance of professional standards of practice and conduct of those on the registration

3.Education and Accreditation

Board approves the curriculum and the institution [FSN and Sangam] FNU Decree-not yet Accredited by the NMNP Board Board register and give approval to practice in Fiji

4. Policy
NMNP Board developed policies to Empower the nurse to carry out procedures that has been endorsed by the Board There are 11 written policies in the Board

NMNP Board-Policy
Facilitate the: Development In the form of : Codes Relating to: Professional conduct

Dissemination

Standards

Professional practice

Application

Guidelines

Accreditation of education Curriculum and programs Assessment system Good governance Administration

Review

Procedures

Policy Manual for Nurses

1 2 3 4 5 Revised screening of Cancer by Nurses Management of Cardiac Arrest by certified nurses Management of Wounds,suturing,episiotomy Role function and education of nurses in Immunization Revised policy on the role of the nurse in the administration of IV therapy and medication.

Policy on Dangerous Drugs

Policy manual for nurses

7 Position Statement on Nurses and HIV Syndrome 8 Salbutamol inhalation at Nursing Station

Syndromic Approach in the treatment of STI

10

Policy on Insertion of IUCD

11

Guidelines for reporting Professional Misconduct

Policy
Other documents Scope of Nursing Code of ethics and code of conduct National Nursing Standard

Policy no 11-Guidelines for reporting Professional Misconduct

Include: Physically or verbally abusing patient Stealing from patient Failing to care for patient s property Failing to keep proper records Committing serious criminal offences

Proving Misconduct
If allegations are serious to justify removal they must also be provable The Board must be satisfied 'beyond reasonable doubt that an allegation is proved Evidence Witness who directly saw and heard what happened Willing to give written statement

Unfit to practise
Examples of conditions Alcohol dependency Drug dependency Untreated serious mental illness Serious personality disorder Major illness

5. Scope of Nursing Contribution

James Cook University Queensland Nursing Council Nurses Board of Western Australia WHO in Suva Fiji Fiji Nursing Association Nurses of Fiji

Scope of nursing
Scope

Boundary or how far you can go or reach

Scope of Nursing
Queensland Nursing Council the scope of nursing practice is that which nurses are educated, competent and authorized to perform .

Definitions
Registered Nurse-A registered nurse is a person with the appropriate educational qualification and competency and who is registered under the NMNP Act to practise in Fiji. Midwife-a midwife is a person with the appropriate educational qualifications and competency and is registered under the NMNP Act to practise as a midwife in Fiji

Scope of Nursing
Midwives function with an advanced scope of practice to registered nurse. A Nurse Practitioners is a person with the appropriate educational qualifications and competency and is registered under the NMNP Act to practise as a nurse practitioner in Fiji. NP function with the advanced scope of practice to registered nurses.

General Principles for Scope of Nursing practice in Fiji [to be used when deciding if nursing intervention can be implemented by a RN]
Preparation and experience Is my preparation and experience sufficient for me to undertake the activity Will I be acting in accordance with the relevant legislation, nursing and Ministry of Health policy requirements

Legality

Confident of Beneficial outcomes Am I confident in my ability to achieve a beneficial outcome for the patient Risk management Clinical Assessment Have I considered any potential hazards and developed strategies to avoid them Have I considered the consequences of my actions and is there a clinical reason for me to proceed?

Unregulated workers
Student Nurses Ward assistants Under supervision- procedures taught Activities of daily living Preparation of equipment Activities of daily living-oral medication/vitals Assist community health nurses Deliver babies emergency when RN is not available

Orderlies Community Health workers TBA

Nurses Uniform
NMNP Board Colour Pattern Badges Diploma, Midwives PH etc Any change-go thru the board Write a letter to request recommend the change

Proposal to the Board

PROPOSAL FOR CHANGE OF NURSES UNIFORM IN ACCIDENT AND EMERGENCY UNIT,CWMHOSPITAL

NMNP board
Purpose Introduction and background Rationale-reasons given for actions Recommendations approves the request

Thank you

Membership
Members - 11 Chairman-The Permanent Secretary for Health Registrar The Director of Nursing The Head of School - Fiji School of Nursing Manager Nursing CWM Manager Nursing - Lautoka Hospital

Minister of Health Nominees

A registered nurse-employed not less than 5years as a nurse in charge of other nurses. A registered midwife in charge of other midwives. 3 members registered under the Act.[person] A registered nurse practitioner. Term is 2years and is eligible for reappointment

Meeting
Conducted quarterly Held in different divisions Cent East, North and West

Summary
Registration Examination Practice and Standard Code of Ethics and Conduct Education and Accreditation Accreditation of education Policy Scope of nursing Nurse Unregulated workers Midwife Application Develop

Safe and Competent

Competency on Assessment scope of system practice Delegation of care Management of conduct, health and performances Good governance and administration

Dissemination

Practice

Review

Nurse Practitioners

Public Service Commission

Public Service Commission

To make appointments to public offices To remove persons from public offices To take disciplinary action against holders of public office

PSC
Employment Contract employment Temporary employment

Appointment

Appointment to be on probation Confirmation of appointment

Promotions

Appointment of promotion

PSC
Transfers Transfer an employee without employee's agreement Retirement at age of 55 Compulsory retirement for ill health Leads the development of workplace culture. Acceptable behavior of how things are done to meet the internal and external expectations. Breach the PSC code of conduct Terminate the officer/suspend the officer Reduce the grade redeploy to other duties Procedure for grievance to be followed Appeal board e.g. filling of posts Retirement Conduct and Values

Discipline

Grievances Appeals

PSC-values
What are values [Values=ethics=moral principles] Character of an individual Set of moral principles that have a special value

Code of Conduct
Set of rules within a group which members should live by Acceptable behavior of how things are done Help to meet internal and external expectations

Importance
Leads to the development of workplace culture Acceptable behaviour of how things are done in order to meet internal and external expectations Moral and ethical norm are of special values Authority and responsibility requires ethics

PSC Code of Conduct

Codes of conduct specify actions in the workplace and values are general guides to decisions Looks after the interests of the society and the state, influences all members

PSC Code of Conduct

Members should have standards that are binding to all. The Service has to be morally regulated Values guide you as professional managers in public administration in public offices

PSC Conduct
Employees in the public Service must: 1.Behave honestly and with integrity 2.Act with care and diligence 3.Treat every one with respect and courtesy without coercion or harassment of any kind

Conduct
4.Comply with all applicable Acts and subordinate legislations 5.Comply with all lawful and reasonable direction given by persons of authority in your Ministry or parliament body.

PSC Conduct
6.Maintain appropriate confidentiality about dealings you may have with any Minister or any staff member of a ministry. 7.An employee must disclose and take reasonable steps to avoid any conflict of interest[real or apparent] in connection with employment in the public service

PSC conduct
8.An employee must not, in the course of or in connection with employment in the public service provide false or misleading information in respond for information that is made for official purpose.
.

Conduct
9.A person must not ,in the course of or in connection with employment in the public service provide false or misleading information in respond to the request for information that is made official purpose

PSC Conduct
10.An employee must not make improper use of official information or of the employees duties,status,power or authority in order to gain or seek to gain a benefit or advantage for the employee or for anyone else.

Code of conduct
11.An employee must not except in the course of his or her duties as an employee or with the express authority of the Chief Executive of his or her Ministry, department or parliamentary,body,give or disclose directly or indirectly any information about public business or anything of which the employee has official knowledge

PSC Conduct
12. An employee must at all times behave in a way that upholds the public service values & the integrity and good reputation of the public service.

PSC conduct
13. An employee on duty overseas must at all times behave in a way that upholds the good reputation of the State 14. An employee must comply with any other conduct requirements prescribed by regulations, specified in directions or required of the employee by his or her Chief Executive. I5. In this section employee includes a wage earner

PSC Values
1.The Public Service respects the Values,Policies,Rights & Freedom of each individual citizen according to the Republic Fiji Constitution. 2.Employment appointment decisions are made with the prerogative of the authority of Ministries and the Public Service without favoritism or political influence. 3.Promotions are based on merit in accordance with the PSC criteria of selection.

PSC Values
4. Men & women equally have equal opportunities for training and advancement within the Public Service. 5. Government policies and programmes should be delivered effectively & efficiently with limited resources. 6. Responsible to the Government in providing honest, comprehensive, accurate and timely advice for implementation of government policies and programmes.

PSC Values
7. Provide a working environment that is free from discrimination. Perform its functions in a neutral, professional and apolitical manner. 9. Accountable to the people of the Fiji within the framework of the Constitution, the Public Finance Management Act 1999, the Government and the Parliament. 10. Public Service should reflect equal ethnic composition of the population occupational preferences.

PSC Values
11. The highest ethical standards, particularly for integrity & honesty. 12. The delivery of services fairly, effectively & courteously. 13. Developed and maintained leadership of the highest quality, at all levels. 14. Provided a fair,flexible and rewarding workplace. focusing on achieving results and managing performance.

PSC Act 1999

A breach of the PSC code of conduct by an employee is a ground for disciplinary action under the regulation of the Commission

Penalties
Terminate the employees employment Reduce the employees grade Transfer/deploy the employee to other duties Defer merit increase in remuneration for the employee for a specified period Reduce the level for the employees remuneration Impose a penalty not more than $500.00 Reprimand the employee

Theme 12
Acquiring good values and adhering to professional Codes of Ethics is something you have to earn. It is a process of doing the right things at the right time.

Theme 12
Objectives Describe the core function of the Nurses,Midwives,Nurse Practitioners Board

Understand the core function of the Public Service Commission