As a future member of License Practical Nurses, it is our duty to know our responsibilities and duties set forth by the College of Licenced Practical Nurse of British Columbia (CLPNBC). The CLPNBC, is an organization which sets the guideline of nursing practice to efficiently and effectively apply to avoid unsafe practices that could harm our patient.
According to CLPNBC (n. d.):
CLPNBC is one of 22 regulatory colleges governed by the Health Professional Act. CLPNBC regulates nurses by setting standards, supporting LPNs to meet standards and acting if LPNs do not meet these standards. It is made up of two separate yet interdependent entities: the Board and the staff. The CLPNBC board governs controls and administers the affairs of CLPNBC in accordance with the Health Professional Act. The Board also establishes and monitors governance policies. The staff comprises with the Chief Executive Officer which is the only employee of the Board and is responsible for the administration of CLPNBC. The Chief Executive Officer reports directly to the Board. CLPNBC staff report to the Chief Executive officer. Board decisions are given to the Chief Executive Officer, who is responsible for ensuring that they are implemented by the staff. The role of CLPNBC are is establish, implement, enforce and evaluate, practical nursing education standards and recognizing practical nursing education programs in BC.
The purpose of Professional Standards is to reflect the values of the nursing profession, clarify what the profession expects of licenced practical nurses, and represent the criteria that CLPNBC uses to measure LPN practice in BC. This document sets out four professional standards for LPNs. They are: responsibility and accountability, competency-based practice, client-focused provision of services and ethical practice. Each standard has a series of indicators attached to it. These indicators provide specific criteria that are used to measure the actual performance of an individual LPN (CLPNBC, n. d.). Practice Standards is a set of requirements for specific aspects of LPN practice. They link other CLPNBC standards, policies and bylaws and all legislation relevant to LPN practice. In this journal, I will discuss these practice standards and reflect on how they apply in work like scenario.
From the scenario, LPN Jill demonstrates practice standard of responsibility and accountability. Jill was aware of her client’s allergy and acts to promote safe and competent care by communicating with the dietary staff about Mr. Petry’s food allergy. She ensures that Mr. Petry gets a replacement meal. Jill maintains own competence to practice by making notes about her clients at the start of her shift. This allows Jill to organize and coordinate her day as she anticipates the heavy workload due to short staff. Lastly, Jill forgot to administer a topical Voltaren to Mr. Petry. By filling out medication error incident report and communicating to her manager, Jill recognizes that she is “accountable and responsible for own nursing decisions, actions and professional conduct” (CLPNBC, n. d.). From my personal perspective I would have been probably worried about missing a medication, but I realize also that filling incident report can prevent errors in practice and meet professional standards.
Professional standard also requires Competency-Based Practice (CLPNBC, n. d). When Jill noticed on the cork board that an in-service was being provided by the health authority about the use of different incontinence products such as briefs and barriers creams, she signs up to attend. By attending in-services or education, this ensures that nursing practice is based on “current evidence from nursing science, other science and humanities” (CLPNBC, 2018). Another example is Jill’s timely and accurate documented Mrs. Summer’s unwitnessed fall. As well, Jill attended to Mrs. Summer’s immediate need to be assessed and assisted off the floor to ensure patient is safe and unharmed. In doing so, Jill is able to meet practice standard to document “client assessment, care needs, planned interventions and outcomes in a timely manner”. Third example, is when Jill made a note of this in her chart and left a note on the 24-hour report to ensure that Mrs. Summer is turned at least every 2 hours. Jill also left a note to have the occupational therapist assess her to a ROHO cushion for her wheelchair. These actions demonstrate the she “knows how and where to access to support and provide care safe, competent and ethical nursing practice and care for clients” (CLPNBC, n. d.).
Professional standard requires a Client-Focused Provision of Service to our patients (CLPNBC, n. d.). In every client-interaction Jill has with her clients, she maintains a client-focused approach in providing care. Despite the challenge with communicating and obtaining blood sample from Mrs. Tsang, Jill makes the primary focus of her care. She was not distracted with the difficulty of coordinating with the translator and lab technician in order to obtain blood sample from Mrs. Tsang. She was focused with the task and her actions ensure Mrs. Tsang receives appropriate nursing care. By doing so, Jill meet “practice standard requirement for a nurse to communicate, collaborate and consuls with clients and other member of the health care team about client care” (CLPNBC, n. d.). Another example, is when Jill joined the care aides helping Mrs. Summer. She assesses the client’s coccyx herself and then assigned the healthcare assistant the task of applying fresh barrier cream. According to CLPNBC, an LPN “supervises, leads and assigns appropriately to other members of the healthcare team” (CLPNBC, n. d.).
As LPN’s, we have a duty to understand and promote ethical practice when providing care. Jill demonstrates ethical practice by clearly stating her title as LPN and role to Mrs. Tsang’s daughter. When she spoke with the client’s daughter she introduced her self as LPN and explained her role of taking care of Mrs. Tsang for the day. Jill protects clients’ information and maintains privacy and confidentiality when she stopped her colleague nurse Karen from going thru Mr. Petry’s chart. Jill is aware that collecting information and sharing of information whether family or friends is unethical as it violates patient privacy and confidentiality. Ethical Practice applies when Jill stopped a care aid from pictures of herself with the clients. Jill’s action demonstrates respect and protection of her client’s worth and dignity as those pictures could be posted and circulated on social media with-out the knowledge and consent of the clients.
In nursing, we can become attached to our clients and the LPN’s practice standards guide’s nurses. The first practice standard requires “Boundaries in the Nurse-Client Relationship” (CLPNBC, n. d.). Jill maintains nurse-client boundaries when Mrs. Tsang’s daughter asked her if she was interested in doing home care for Mr. Tsang and Jill declined the offer. Another important practice standard is “Communicable Diseases and Preventing Nurse-Client-Transmission” (CLPNBC, n. d.). Jill prevents transmission of diseases between clients and nurses by washing her hands before and after providing care to her clients.
As LPNs, we have a professional, ethical and legal duty to provide their clients with safe care, including protecting them from the risk of infection (CLPNBC, 2018). Jill prevents conflict of interest when she declines the hefty offer of being paid double to care for another patient outside of her worksite. There would have a conflict of interest if Jill was to provide care for Mrs. Tsang and be paid to care for Mr. Tsang outside the facility.
“Nurses must identify and seek to avoid actual, potential or perceived conflicts of interest” (CLPNBC, n. d.). Asking consent to provide care is required as clients have the right to refuse care. After realizing that she missed Mr. Petry’s Medication she asked him if he would prefer to have his Voltaren from noon. Jill respected Mr. Petry’s decision not to have the medication.
Documentation or charting is very important part of practice standards as it protects and ensures safety of the patients and nurses as well. Jill fulfills her duty to document event such as filing incident report regarding Mrs. Summer’s unwitnessed fall. Documentation must be precise, accurate and done in timely manner.
Nurses have a Duty to Provide Care. Despite the challenges in dealing with Mrs. Tsang who have a language barrier, Jill arranged and coordinated with the Lab technician and interpreter to be able to provide care.
We also have a duty to report and in this scenario, when Jill reported the care aid taking selfies with the residents. Jill’s action supports the principle that states “LPNs may report incompetent or impaired practice or unethical conduct to their supervisor” (CLPNBC, n. d.). Part of the daily task of nurses is to administer medication.
Practice standards require “safe medication administration” (CLPNBC, n. d.). Jill demonstrates safe medication administration when she clarified with the doctor about an antibiotic order prior to giving the medication to her client.
Nurses also have a duty to uphold “Privacy and Confidentiality when caring for patients” (CLPNBC, n. d.). Jill maintains patient privacy and confidentiality when she stopped Nurse Karen as she was going through Mr. Petry’s chart to provide information to the clients’ family. “LPNs must safeguard information learned in the context of the nurse-client relationship and disclose this information outside of the healthcare team only with the client consent or when there is an ethical or legal obligation to do so” (CLPNBC, n. d.).
“Use of LPN titles are for the nurses who are registrants and are authorized to practice nursing care or provide nursing services” (CLPNBC, n. d.). In every patient-interaction Jill clearly states her title as an LPN. When working with Healthcare Assistant, LPN’s have a duty to lead, supervise and delegate care. Jill demonstrates this as she is able to direct and delegate care aides to perform task such as applying fresh barrier cream.
The role of CLPNBC as it applies to personal is that this mandate will serve as a guide in practicing nursing. It enables nurses to provide care that is ethical, just, safe, competent and evidenced based. Most importantly, it ensures that our clients receive appropriate care and according to the clients needs. From my personal perspective, it helps me ascertain actions which may or may not violate patient’s rights, privacy or confidentiality. When an incident arises such as taking pictures with clients with- out their consent, it will serve as my guide to be able to act and conduct my nursing practice in accordance to the professional and practice standards.
Furthermore, as a novice nurse and new to nursing practice, I anticipate that I will have experiences that would challenge my critical thinking and knowledge and to deal with such scenarios I can look up to CLPNBC website and the professional and practice standards for clarification and guidance for my practice. LPNs need to review these documents regularly to be updated on the new developments or changes in nursing practice. Reviewing these documents regularly also maintains my knowledge of my nursing practice and professional standards.
College News & Events. (n.d.). Retrieved January 10, 2018, from https://www.clpnbc.org/