Professional Role and Practice
What to know
Professional practice rests on the nurse practice act, scope and standards, ethics, and legal accountability. Know autonomy, beneficence, nonmaleficence, justice, fidelity, and advocacy. Informed consent is obtained by the provider; the nurse witnesses the signature, verifies voluntariness, and clarifies understanding. Confidentiality, mandatory reporting, chain of command, evidence-based practice, quality improvement, and interprofessional collaboration are testable. Assignment differs from delegation: assignment distributes work, while delegation transfers a specific task with accountability retained by the RN. Certification maintenance and continuing competence also fall here.
Traps
- Believing the nurse obtains informed consent.
- Accepting an order that is outside scope or unsafe; use the chain of command.
- Confusing advocacy with confrontation: advocacy is voicing the patient's concern through appropriate channels.
- Documenting a refusal as noncompliance rather than informing the provider and documenting the patient's choice.
- Discussing patients on social media or in public areas.
Worked example
Before surgery, a patient says, "I still don't understand what they will remove." The nurse should not have the patient sign yet. Notify the provider, arrange interpretation or clarification, and document. Rule: consent requires capacity, information, and voluntariness; the nurse validates understanding, not the procedure's risks and benefits.