ENROLLED NURSE (Parentcraft) / ENROLLED NURSE (Mothercraft)

The term “scope of practice” is defined as the actions and procedures that are permitted by law for a specific profession. The scope of nursing practice refers to the broad framework and context of practice that includes: [1]

• the range of roles;
• functions and responsibilities; and
• decision making capacity.

The scope of nursing practice is influenced by government legislation and policy, level of educational preparation, practice context and the health needs of the population. A sound risk management, professional, regulatory, and legal framework is required to enable the nurse’s decision making capacity. It should be seen as an enabling process for nurses to work within their scope of practice and not merely the addition of tasks and activities.[2]

The ANMC Code of Professional Conduct for Nurses in Australia states that:1

A nurse must be aware that undertaking activities that are not within their scope of practice may compromise the safety of an individual. The scope of practice is based on each nurse’s education, knowledge, competency, extent of experience and lawful authority.

The scope of practice represents only core practice skills within the defined level of nursing practice and is restricted to what the law permits based on specific experience and educational qualifications. It does not however, reflect further knowledge and/or skills acquired through professional development activities and/or experience.  Further knowledge and/or skills can be reflected within individual professional portfolios.

ACTIVITIES APPROPRIATE TO THE NURSES ROLE ARE DETERMINED BY THE:

• The registering authority’s licence to practice.
• Extent of educational preparation.
• Relevant legislation, standards, codes and ethical practices, and context of care.
• Organisational policies and clinical practices, and legal requirements and policy directives.
• Level of clinical competence and clinical judgment required.

The scope of practice provides a measure to guide a nurse’s professional growth and development. It assists the nurse unit manager/centre manager and the nurse to appropriately judge the nurse’s performance, areas of strength, practice development requirements and/or the need for additional education and support. Used in conjunction with a professional portfolio it guides the nurse in providing evidence of educational and professional nursing activities that support the nurse’s claims of competence to practice nursing.

ENROLLED NURSE (Parentcraft)

Enrolled Nurses (ENs) at Tresillian Family Care Centres have a key role in contributing to tertiary level child and family health services. These services are delivered using a framework of the Tresillian Model of Care with consideration of the context of care.  The EN is an associate to the registered nurse who demonstrates competence in the provision of care for individuals who have stable and predictable health outcomes in situations that do not call for complex nursing judgement. ENs provide family-centred care as specified by the registering authority’s licence to practise and educational preparation. As per the Australian Nursing and Midwifery Council (2007) 4 it is the responsibility of the CFHN to delegate activities and provide direct or indirect supervision according to the nature of the delegated task. All delegated tasks must be within the framework of the nurse’s knowledge, skill, education, experience and the context of the nursing care to be provided.  At all times, the EN is accountable for his/her own actions and to the CFHN for all delegated functions.[3]

QUALITIES OF AN EN INCLUDE THE CAPACITY/ABILITY TO:

• Practice within legal, ethical, and professional guidelines pertinent to EN practice.
• Demonstrate knowledge of organisational policies and procedures pertinent to EN practice.
• Accept accountability and responsibility for own actions within EN practice.
• Conduct nursing practice in a way that respects the rights of individuals and groups.
• Use family partnership skills to communicate appropriately with families, significant others and colleagues.
• Collaborate with clients and colleagues to ensure consistent, safe, effective care.
• Contribute to the formulation of care plans / pathways in collaboration with the CFHN, individuals and groups.
• Manage nursing care of individuals and groups within the scope of EN practice.
• Use reflective, critical, and analytical thinking to facilitate creative and flexible nursing practice.
• Work within the context of a multidisciplinary health care team to apply primary health care principles.
• Contribute the promotion of safety, security and personal integrity of individuals and groups within the scope of EN practice.

CORE KNOWLEDGE AND SKILLS APPROPRIATE TO THE EN:

• Demonstrates an understanding of the role of the EN as a valued member of the multidisciplinary team.
• Understands the Tresillian Model of Care and works within the principles of practice, organisational policies and clinical practice guidelines.
• Understands the core principles or features of early child growth and development, the key developmental tasks or challenges faced by children including: 
  • achieving physical, social and emotional milestones;
  • forming attachments;
  • acquiring self-regulation;
  • developing communication and learning skills; and
  • learning how to relate to peers, and managing the key transitions in their lives.
• Understands the importance of the establishment and maintenance of healthy parent-child relationships.
• Understands the core basic needs of all children – including establishment and maintenance of feeding, sleeping, rest, play and limit setting of behaviour, safety, and hygiene.
• Understands the unique needs of the individual child and family-including the need to be culturally sensitive and accepting of individual and family differences.
• Understands the legal rights of children and families.
• Understands the importance of effective communication skills [principles of working in partnership with families and colleagues].
• Understands the impact of personal values, attitudes, qualities on the ability to work with families and young children.
• Understands the principles and application of universal precautions and the use of personal protective equipment.
• Recognises that critical and reflective thinking skills contribute to decision making which includes reporting changes in health and functional status and individual responses to health care interventions.
• Understands and implements ongoing maintenance of a safe workplace through involvement in the implementation of safe systems of work in accordance with Occupational Health and Safety policies and procedures.
• Recognises the need for and participates in continuing self / professional development.
• Literate and competent in the use of specific child and family health care technology and related activities (e.g. use of electronic scales, documentation).

CORE ACTIVITIES IDENTIFIED WITHIN THE ENS SCOPE OF PRACTICE:

• Assist in the establishment, enhancement and / or maintenance of healthy parent-child relationships.
• Ensure and maintain an effective supportive, safe and welcoming learning environment for children and their parents.
• Participate in the admission physical assessment of an infant/child under the delegation/supervision of a registered nurse.
• Recognise the needs of the child and family and responds appropriately by supporting the implementation and evaluation of the child’s Care Plan and the Care Pathway of the parent/carer.
• Recognise normal and abnormal parameters during assessment, intervention and evaluation of individual health and functional status.
• Contribute to the nursing assessment, management and evaluation of progress toward expected outcomes; including the development of discharge summaries.
• Undertake tasks (e.g. infant feeds) accurately according to policy and clinical practice guidelines.
• Support the maintenance of breastfeeding and healthy lifestyles of the family, by providing education and guidance.
• Use partnership skills to assist and support parents in the care of their young children, including establishment and maintenance of feeding, sleeping, rest, play and limit setting of behaviour, safety and hygiene.
• Under the supervision and guidance of a registered nurse, contributes to the health education of individuals or groups to maintain and promote health, including  planning and implementation of education (opportunistic or planned) sessions:
• Infant feeding – supporting parents in the dinning room;
• Demonstration of formula and food preparation;
• Play and development;
• Behaviour management.
• Plan, organise, implement, guide and evaluate play and age-appropriate learning experiences for young children, encouraging parents to participate.
• Observe and report on the children’s health, behaviour and development, and in collaboration with the registered nurse participate in the implementation of flexible intervention strategies that meet the family’s needs.
• Monitor the impact of nursing care and maintains ongoing communication with the registered nurse regarding the health and functional status of individuals.
• Ensure reporting and documentation is timely and accurate.
• Organise workload to facilitate planned nursing care for individuals and groups.
• Carry out cleaning activities associated with client care. This includes cleaning of toys, making cots/beds, changing linen and rubbish bags as necessary.
• Recognise parenting behaviours that indicate concern related to the level of risk to a child and report concerns immediately to the registered nurse.
• Record information on care plans, in the medical records as per the Tresillian Documentation Clinical Practice Guidelines.  
• Maintain  and respects confidentiality of each client including appropriate storage of medical records; 
• Participate in the clinical handover processes and staff team meetings.
• Assist  in the monitoring and ordering unit stock and equipment.
• Participate in the orientation of new staff to the unit.
• Foster and facilitate appropriate interpersonal relationships with families, relatives, visitors and colleagues.
• Ensure that the environment is safe for staff, clients and visitor.
• Provide  support to students e.g. providing demonstrations of care within the  ENs scope of practice
• Collect urine and/or faecal specimens if requested.
• If required provide basic emergency life support and cardiopulmonary resuscitation.
• Work collaboratively with the CFHN in administration activities such as replacing staff on the roster.
• Maintain the professional knowledge and skills base related to child and family health and be responsible for own professional development.
• Check and or administer prescribed medicines in accordance with their educational preparation and organisational policy.

ENROLLED NURSE (MOTHERCRAFT) 

The enrolled nurse list B (Mothercraft prior to July 2010), practice under the direct or indirect supervision of a CFHN.[4] As per the Australian Nursing and Midwifery Council (2007) 4 it is the responsibility of the CFHN to delegate activities and provide direct or indirect supervision according to the nature of the delegated task. All delegated tasks must be within the framework of the nurse’s knowledge, skill, education, experience and the context of the nursing care to be provided. At all times, the nurse remains accountable for their own actions and is responsible to the CFHN for all delegated functions.[5],[6]  

QUALITIES OF AN EN INCLUDE THE CAPACITY/ABILITY TO:

• Practice within legal, ethical, and professional guidelines pertinent to EN (Mothercraft) practice.
• Demonstrate knowledge of organisational policies and procedures pertinent to EN (Mothercraft) practice.
• Accept accountability and responsibility for own actions within EN (Mothercraft) practice.
• Conduct nursing practice in a way that respects the rights of individuals and groups.
• Use family partnership skills to communicate appropriately with families, significant others and colleagues.
• Collaborate with clients and colleagues to ensure consistent, safe, effective care.
• Contribute to the formulation of care plans / pathways in collaboration with the CFHN, individuals and groups.
• Manage nursing care of individuals and groups within the scope of EN practice.
• Use reflective, critical, and analytical thinking to facilitate creative and flexible nursing practice.
• Work within the context of a multidisciplinary health care team to apply primary health care principles.
• Contribute to the promotion of safety, security and personal integrity of individuals and groups within the scope of EN (Mothercraft) scope of practice.

CORE KNOWLEDGE AND SKILLS APPROPRIATE TO THE EN (MOTHERCRAFT) 

• Demonstrates an understanding of the role of the EN (Mothercraft) as a valued member of the multidisciplinary team.
• Understanding of the core principles of child development and the key developmental tasks.
• Understanding of social factors that support or undermine the capacity of families to parent young children.
• Understanding of the importance of the establishment and maintenance of healthy parent-child relationships.
• Understanding of the core basic needs of all children – including establishment and maintenance of feeding, sleeping, rest, play and limit setting of behaviour, safety, and hygiene.
• Understands the unique needs of the individual child and family-including the need to be culturally sensitive and accepting of individual and family differences.
• Understands the legal rights of children and families.
• Understands the importance of effective communication skills [principles of working in partnership with families].
• Understands the importance of effective communication skills  [principles of working in partnership with families and colleagues].
• Understands the impact of personal values, attitudes, qualities on the ability to work with families and young children.
• Understands the principles and application of universal precautions and the use of personal protective equipment.
• Understands and implements ongoing maintenance of a safe work place through involvement in the implementation of safe systems of work in accordance with Occupational Health and Safety policies and procedures.
• Recognises the need for and participates in continuing self/professional development.

CORE ACTIVITIES IDENTIFIED WITHIN THE EN (Mothercraft) SCOPE OF PRACTICE:

• Assist in the establishment and maintenance of healthy parent-child relationships.
• Ensure and maintain an effective supportive, safe and welcoming learning environment for children and their parents.
• Participate in the admission physical assessment of an infant/child under the delegation/supervision of a registered nurse.
• Perform demonstrations of formula and food preparation.
• Use partnership skills to assist and support parents in the care of their young children, including establishment and maintenance of feeding, sleeping, rest, play and limit setting of behaviour, safety and hygiene.
• Recognise the needs of the child and family and respond appropriately by supporting the implementation and evaluation of the child’s Care Plan and the Care Pathway of the parent/carer in consultation with the registered nurse and family.
• Observe and report on the children’s health, behaviour and development, and in collaboration with the registered nurse participate in the implementation of flexible intervention strategies that meet the family’s needs.
• Carry out cleaning activities associated with client care. This includes cleaning of toys, making cots/beds, changing linen and rubbish bags as necessary.
• Plan, organise, implement, guide and evaluate play and age-appropriate learning experiences for young children, encouraging parents to participate.
• Participate in the assessment process of the Care Plan / Care Pathway with the registered nurse through reporting and discussing all issues or concerns.
• Participate in the development of discharge summaries.
• Recognise parenting behaviours that indicate concern related to the level of risk to a child and report concerns immediately to the registered nurse.
• Record information on care plans, in the medical records as per the Tresillian Documentation Clinical Practice Guidelines.
• Maintain and respect confidentiality of each client including appropriate storage of medical records.
• Participate in the clinical handover processes and staff team meetings.
• Assist in monitoring and ordering unit stock and equipment.
• Participate in the orientation of new staff to the unit.
• Foster and facilitate good interpersonal relationships with families, relatives, visitors and colleagues;
• Ensure that the environment is safe for staff, clients and visitor.
• Maintain a professional knowledge and skills base related to child and family health and be responsible for own professional development.
• Collect urine and/or faecal specimens if requested.
• If required provide emergency basic life support and cardiopulmonary resuscitation;
• Assist the registered nurse in replacing staff on the roster.

 

Providing support to student child and family health nurses e.g. providing demonstrations of care within the mothercraft scope of practice

 

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