DOMAIN 1: PROFESSIONAL RESPONSIBILITY

1.1 Accepts responsibility for ensuring that his/her nursing practice and
conduct meet the standards of the professional, ethical, and relevant
legislated requirements.

Choose 3 key policies from your facility, list them below.

I. Profession- assessment, diagnosis, planning, implementation, and evaluation of the
outcome.
II. Ethical- Verbal and informed consent, confidentiality and provide full information regarding
care. Equal distribution of quality of health.
III. Legislation- Valid competencies in medication administration, intravenous therapy, and First-
Aid management.

Pick one and describe how you have worked as a Registered Nurse within that policy to
care for a patient

During my placement, I noticed that Mr. B had new skin peeling on his left shin. I followed

the wound management policy and assessed the wound. I used a paper ruler to measure

the wound size and took a picture for reference. I informed my preceptor that the skin was

peeling but with no signs of infection. Following my preceptor's guidance, I cleaned the

wound with normal saline and applied an Allevyn dressing. I updated the information in the

documentation and notified the doctor and family. Additionally, I initiated a wound care

plan monitored the wound, and provided daily dressing. These measures helped to promote

wound healing.

Write an example of how you have gained informed consent from a patient

During my morning shift, Mrs. F complained of right upper abdominal pain that was not

relieved by regular pain management. Her GP ordered an MRI to confirm the diagnosis. I

spoke with Mrs. F and explained her condition, emphasizing the importance of getting the

MRI to help her GP confirm the diagnosis and provide appropriate care. I also discussed the

potential consequences of the MRI and informed her that she would need to be transferred

to another facility's radiology department. Mrs. F agreed and provided consent. I informed
my preceptor, who then notified the GP. The GP sent an email to the radiology department,

and we were able to secure an urgent appointment.

Give a detailed description of caring for a patient while working within the patient Code of

Rights

During my placement, I entered Mr. P's room with my preceptor to provide his medication.

However, he refused to take it because he was tired and not in a good mood. I reassured

him that he would be okay, and then checked his vital signs which showed normal results. I

asked him about his sleeping pattern and diet, and he responded well. He expressed that he

wanted to rest at that time and would take the medication later. I respected his decision

and provided the medication after an hour upon his request.

1.2 Demonstrates the ability to apply the principles of the Treaty of

Waitangi/Te Tiriti o Waitangi to nursing practice.

Describe how you address/assess a Māori patient's cultural needs.

During my placement, I entered a Maori resident's room after knocking on the door. I

introduced myself and explained why I came to her room - to provide nail care. I also

explained the purpose and importance of the procedure. This helped me develop a

therapeutic relationship with Mrs. G. First, I sought permission to touch the patient and she

agreed. While providing the nail care, I ensured the resident and a family member were

present to be aware of the procedure. Additionally, I made sure to close the door for privacy

and positioned Mrs. G comfortably to ensure her protection.

List 3 Māori Models of Health

1. Te whare tapa wha

2. Te Pae Mahutonga

3. Te Wheke
Pick one of the Māori Modules and describe how you would work with a patient

Te whare tapa wha

This model of health is considered the holistic approach. It has four elements such as

I. Taha tinana ( physical)

II. Taha wairua (Spiritual)

III. Taha Hinangara ( mental & emotional)

IV. Taha whanau ( family & social)

V. Taha Whenua ( lands, roots)

I had a Maori resident during my placement. I made sure that she was feeling well and

didn't have any physical problems. I made sure she was in a comfortable position, provided

a diet to meet her nutritional needs, and administered her medications on timeI provided

reassurance, involved her in prayer, and encouraged her to make decisions to help her feel

spiritually at ease. With her permission, I took her to activities such as painting, coloring,

and soap making, which helped enhance her mental and emotional well-being. I also

suggested to her family members that they should visit Mrs. M and involved them in the

planning of her care. When she was participating in some activities, she was socially

engaged, cheerful, and comfortable.

Explain health inequity in NZ Māori & Non-Māori

The life expectancy of Maori people is significantly lower compared to non-Maori people.

Maori have higher mortality rates at all ages when compared to non-Maoris. One of the

reasons for this is that non-Maoris are not utilizing primary care or outpatient healthcare,

and are not getting regular physical check-ups. Maori health status is unequal to that of non-

Maoris across most chronic and infectious diseases, as well as injuries, including suicide.

Maori have less access to services and generally experience poorer outcomes.
1.3 Demonstrates accountability for directing, monitoring and evaluating

nursing care that is provided by Registered Nurses, Enrolled nurses and

others.

List the 5 Rights of Delegation

1. Right task

2. Right circumstances

3. Right person

4. Right direction/ communication

5. Right Supervision/ Evaluation

Describe the difference between an RN and EN scope of practice

Enrolled nurses assist health consumers with their daily activities, observe changes in their

conditions, and report these to the registered nurse. Enrolled nurses can administer

medications in the presence of a registered nurse and undertake other nursing care

responsibilities based on their assessed competence. Registered nurses have overall

responsibility for developing care plans for health consumers.

Give 2 examples of Directing/Delegating to members of the healthcare team

1. The registered nurse (RN) delegates duties and responsibilities to the caregivers,

assigning a specific number of residents to each caregiver. They provide instructions

for tasks such as personal care, maintaining food and fluid charts, and managing

elimination. The RN also supervises these tasks periodically and evaluates the care

provided.

2. Residents will receive wound dressing after being evaluated by the wound care nurse

specialist. The specialist will provide instructions on the materials to use for the
 dressing and the frequency of changing it. All details will be documented, and proper

management will be carried out to evaluate the outcome of the care provided.

1.4 Promotes an environment that enables patient safety, independence,

quality of life, and health.

Give an example of improving a patient’s quality of life and /or independence

During my placement, I observed the residents spending time in the lounge after their

morning routines. They ate their meals independently in the dining room and used low

walking frames to move around the corridors. The residents were actively participating in

various activities like soap making, painting, coloring, and towel folding, all under the

supervision of caregivers and diversional therapists. It was encouraging to see the residents

engaged in activities such as using the restroom, walking, showering, and grooming, as these

activities can help boost their confidence and independence, ultimately improving their

quality of life and health.

Give an example of how you have improved a patient’s health status

While on my placement, I entered Mrs. B’s room and engaged in therapeutic

communication. During our conversation, I noticed that Mrs. B was having difficulty

breathing and a blocked nose. I immediately informed my preceptor and proceeded to

check her vital signs. When the general practitioner (GP) conducted rounds, I relayed the

findings to the GP, who then consulted with Mrs. B. Following the GP’s instructions, I

initiated coughing exercises and administered medications for 5 days. Mrs. B's condition

improved, with all her vital parameters returning to within normal limits. She also expressed

feeling more comfortable.

Give an example of how you have maintained patient safety

 While administering medication, I knocked on the resident's door and entered after

receiving permission. I explained the purpose of my visit and the procedure for instilling eye

drops in both of her eyes, including the dosage, frequency, and potential side effects. I also

made sure to respect the patient's rights. After obtaining verbal consent from the patient, I

washed my hands, put on gloves, and administered the eye drops. I then asked the patient

how she was feeling. After the procedure, I removed my gloves, washed my hands again,

and documented the administration in the medimap system with guidance from my

preceptor.

Give an example of how you have maintained your own or others' safety in the clinical

placement setting

Before and after the procedure, I made sure to maintain hand hygiene to prevent cross-

infection. When approaching infectious patients, I wore personal protective equipment and

ensured proper disposal of those items. While handling injections, I made sure not to recap

the needles and disposed of sharp objects in containers to prevent needle stick injuries.

Prior to each procedure, I explained everything clearly to the residents, obtained their

consent, and documented it in the electronic system. I communicated all relevant

information about the residents to the GP, clinical care manager, senior nursing care leads,

and the family with guidance from my preceptor. I also encouraged the residents to practice

proper coughing and sneezing etiquette to prevent infection. My priority was to provide a

safe environment for the residents and ensure culturally safe care.
1.5 Practices nursing in a manner that the patient determines as being

culturally safe.

Describe what you think culturally safe practice is

In my opinion, culturally safe practice involves including patients in the care plan and

encouraging them to make decisions in all aspects of their care. This includes actively

involving them in the care provided and ensuring their partnership to achieve positive

outcomes.

Give 2 examples from your clinical placement of how you have provided culturally safe

care.

Remember to comment on the patient's point of view or their feedback.

1. During my morning shift, one of my residents experienced a severe headache and

rang the emergency bell. I went to her room after knocking on the door to address

her concern. Mrs. V appeared distressed and uncomfortable. When I asked her

about her concern, she told me that she had a severe headache, which she rated as

8 out of 10 on a numerical scale. I helped her get into a comfortable position and she

requested a controlled drug to relieve her pain. I informed my preceptor about her

request, checked her vital signs, and my preceptor administered the medication to

Mrs. V. After that, she asked me to turn off the lights and help her go to sleep. I went

to assess her condition half an hour later, and she was sleeping well. Later on, I

assisted her in going to the lounge and encouraged her to participate in diversional

therapies. She was happy and engaged in her peer groups and the activities.

2. I had a Maori patient during my placement. I entered her room after knocking and

informed her that I had come to provide a lactulose suppository because she was
feeling constipated. I gave her all the information about the lactulose suppository,

including its indications, action, dose, frequency, and side effects, and she agreed to

take it. After closing the door and drawing the curtains for privacy, I obtained her

consent to expose her and placed her in the left Sim's position. I asked her about her

dietary pattern and explained the importance of consuming green leafy vegetables

and oral fluids. She agreed to increase her oral fluid intake and asked for salads and

vegetables according to her preferences. I also suggested that she walk in the

corridors, as it would help improve circulation and elimination. Two days later, she

expressed her appreciation and told me that her constipation was relieved.