Professional Practice, Ethics, and Law
This domain tests judgement about conduct, accountability, and the limits of your role. Know the scope of practice - what you may do, what requires delegation or supervision, and what must be referred. Understand accountability: the nurse remains responsible for delegated tasks and for the standard of care delivered.
Core ethical principles are examined directly: autonomy (respect for the client's informed choice, including refusal), beneficence (acting for the client's good), non-maleficence (avoiding harm), justice (fairness and equitable resource use), and veracity (truthfulness). Apply them to dilemmas such as consent, confidentiality, end-of-life care, and allocation of scarce resources. Informed consent requires capacity, adequate information, and voluntariness; the nurse's role is usually to support and witness, not to obtain surgical consent.
Legal concepts include negligence (duty, breach, causation, harm), duty of care, confidentiality and its lawful exceptions, mandatory reporting, record keeping as a legal document, and professional regulation - registration, fitness to practise, and the role of the council. Know the difference between civil and criminal liability, and between ethical and legal obligations: something may be legal yet unethical, or unethical yet not unlawful.
Traps: choosing 'do nothing' when an error has occurred (the correct path is to assess the client, report, and document honestly); breaching confidentiality to family without consent or legal basis; and accepting a task beyond competence without seeking help. Advocacy is a recurring theme - the nurse speaks for the client's interests, including when the client disagrees with the team.
Rule of thumb - the open-disclosure rule: when something goes wrong, prioritise client safety, then honest disclosure, reporting, and factual documentation. Worked example: you give a drug to the wrong client. Assess the client immediately, inform the prescriber and manager, complete an incident report, and document the facts - not opinions - in the record.