Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment.”

Below are the two initial posts of two peers need to respond to.:

1. Gayle

Scope of Nursing Practice


The purpose of this posting is to discuss the scope of nursing practice. The nursing scope of practice as described by the American Nursing Association “as the “who,” “what,” “where,” “when,” and “how” of nursing practice.” (2018) As Registered Nurses, there are many components that we apply to our everyday practice without realizing it. From assessing situations, advocating, educating, and administering treatment or interventions for all patients in need and remaining compassionate and caring.

The Ohio Administrative Code defines the Scope of RN practice as: “Providing to individuals and groups nursing care requiring specialized knowledge, judgment, and skill derived from the principles of biological, physical, behavior, social, and nursing sciences.” (Lawriter, 2017).

How did I provide this care and uphold theses definitions? One example is a patient that was I was taking care of in an acute hospital setting was 1 day post-op from colorectal surgery in which he received an ileostomy. After receiving routine labs, his Hemoglobin resulted in <7.0. Per protocol, the Resident on call was notified. After assessment, 2 units of PRBC were ordered. After 1 unit was administered, new onset of symptoms including hypotension, dizziness, pallor, lightheadedness and an ostomy bag now displaying bright red blood. Our Rapid Response team was notified and the ultimate result was a transfer to the Surgical ICU. The Resident was furious that I paged the RR team rather than to notify him again.

I upheld the scope of nursing practice by utilizing my knowledge, judgement and skills that came from education, advocating and interventions. It is important to know the nursing practice act as it upholds you to react to keep the patient safe. If I had reacted by just hanging the 2nd unit of blood or ignoring the new onset of symptoms, the nursing practice act may determine that I am not competent to care for patients. Nurses have a duty of reasonable care. (ANJ, 2019). At the end of the day, it’s my duty as a nurse to protect, promote and optimize health. (ANA, 2018).

References:

American Nurses Association. (2018). Nursing: scope and standards of practice (3rd ed.). Silver Spring, Maryland.

The Elements of a Nursing Malpractice Case, Part 1: Duty : AJN The American Journal of Nursing. (2019, July). Retrieved November 13, 2019, from https://journals.lww.com/ajnonline/Fulltext/2019/0…

Lawriter Ohio rules and laws. (2017). Retrieved November 13, 2019, from http://codes.ohio.gov/oac/Search/scope of rn.

2.Andrea

Scope of Nursing Practice


The purpose of this posting is to discuss the understanding of the nurse’s scope of practice as defined by the ANA and through the Ohio Board of Nursing. It is important to each nurse to have a clear understanding to provide safe and efficient care to each patient. The standards of practice are guidelines of how every nurse should be caring for each individual patient. They describe a competent level of nursing care as demonstrated by the critical thinking model, assessment, diagnosis, outcomes, identification, planning, implementation and evaluation, otherwise known as the nursing process. The Ohio Board of Nursing defines the nursing scope of practice as providing to individuals and groups nursing care requiring specialized knowledge, judgment, and skills derived from the principles of biological, physical, behavioral, social, and nursing sciences.

A scenario that I have encountered that pertains to this discussion is a patient who came into the Emergency Department experiencing shortness of breath. Upon arrival to the ED through triage the patient was pale and tachypnic. When I attached the pulse oximeter the patient’s oxygen saturation read 89%, after this assessment I applied 2 liters via nasal cannula. I made sure my patient remained stable, performed the EKG and then found the provider to obtain an order for oxygenation administration. It is within our scope of practice to administer O2 with an oxygenation saturation below 92%. After reassessing my patient, the O2 saturation read 95% and the patient was breathing within normal limits. By implementing the nursing process, I was able to stabilize the patient and prevent them from going into further respiratory distress.

Understanding the nursing scope of practice is extremely important due to the fact that nurses can be put into situation and I believe it is better to ask yourself, a manager or check with someone else before you perform an action that is out of your scope of practice. When you step out of your scope of practice you are putting that license you worked so hard for on the line. Our patients depend on us and trust us, we must be able to provide the care that they deserve.

American Nurses Association (2010). Nursing: Scope and Standards of Practice (2nd ed.). Silver Spring, MD: American Nurses Association.

Ohio Board of Nursing (2018). Scopes of Practice: RN and LPN. Retrieved from http://nursing.ohio.gov/wp-content/uploads/2019/10…

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