Professional Ethics, Law, Nursing Regulation and Communication
Professional practice questions test the legal and ethical framework of Cambodian nursing, plus the communication skills that keep patients safe.
Framework
The Nursing Council regulates registration and licence renewal under Ministry of Health guidance; scope of practice is defined by law and ministerial regulation (prakas). Know the four principles - autonomy, beneficence, non-maleficence and justice - and apply them to concrete situations. Negligence requires a duty of care, a breach of that duty, harm and a causal link. Documentation is the legal record: if it is not written, it did not happen.
Consent and confidentiality
Valid consent must be informed, voluntary and given by a competent person; for a minor, by a parent or guardian. Keep information confidential except where disclosure is required or permitted - a reportable communicable disease, or a serious risk to the patient or others.
Worked example
A competent adult with severe anaemia refuses a blood transfusion after being told the risks. Reasoning: autonomy and the right to refuse outweigh the nurse's wish to help, provided the patient is competent and informed. Action: confirm the explanation was understood and documented, involve the doctor, offer alternatives, continue monitoring, and record the refusal and the advice given. Do not obtain a signature from a relative instead.
Communication
Use SBAR for handover: situation, background, assessment, recommendation. Speak the patient's language or use a trained interpreter; a family member is not a neutral interpreter for sensitive information.
Traps
Signing a record for a colleague; discussing a patient in a public area; telling a relative a diagnosis before the patient; describing an error as the patient's fault instead of reporting it honestly.