Licensure and Scope of Practice

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Licensure and Scope of Practice

Licensure and Scope of Practice

This week’s case deals with a nurse working on a chronically understaffed unit. The nursing managers have informed the administration of this situation. The nurse makes a medication error on a shift where the nurse patient ratio is very high. The nurse is referred to the Board of Nursing for discipline.

The joint commission as well as other state and federal standards mandate that health care institutions must provide adequate staffing with qualified personnel. This includes not only numbers of staff, but also the legal status of the staff members and the staffing mix. Adequate and safe nurse staffing is critical to ensuring the delivery of quality patient care, and changed in staffing levels, including changed in the overall number and/or mix of nursing staff should be based on a comprehensive and inclusive evaluation of multiple nursing –sensitive indicator. Adequate staffing should be based on the consideration of three critical factors: the maintenance of the quality of patient care, the quality of the organizational outcomes, and the quality of nurse’s work life (ANA, 2005)

Nurses are accountable and responsible for their own morals, decisions and behaviors. Nurses have some responsibilities to ensure that understaffing does not persist. The issues and concerns should be discussed with the nurse manager. The nurse should document specific problems related to the understaffing, such as failure to perform ordered treatments, not being able to timely administer medications or having insufficient time to administer medication safely. The nurse should also keep a record of all requests for additional staffing. This ensures an accurate record of what transpired should litigation develop as a result of staffing. This document may not prevent some liability but it would show what steps were taken by the nurse to address the problem. (Wacker, 2010).

The institution is...