Nursing and Midwifery Practice Standards
Nursing and Midwifery Practice Standards
This domain tests the minimum standard of safe, accountable practice expected of every RN and RM, whatever the setting - ward, theatre, clinic, community or home.
Work within scope. Practise only what you were trained and assessed for. Scope expands through approved post-basic education and supervised competency sign-off, not through years of service or a colleague's instruction. Unqualified staff may assist, but tasks reserved for registered practitioners must not be delegated to them.
Core standards. Use the nursing process - assess, plan, implement, evaluate. Obtain informed consent; keep information confidential; identify patients using at least two identifiers; follow the rights of medication administration; apply standard precautions; document contemporaneously and factually; treat every patient with dignity and without discrimination.
Accountability and escalation. Each nurse is personally accountable for their decisions. A doctor's instruction does not transfer that accountability: if an order is unclear, incorrect or unsafe, clarify it, document the clarification, and escalate. Report unsafe practice, near misses and adverse events through the correct channel; concealment is itself a breach.
Worked example. A doctor verbally orders 10 mg of morphine for an adult when the charted range is 2–4 mg. The nurse does not give it. She repeats the order back, asks the prescriber to review, documents the query and its outcome, and escalates to the nurse-in-charge if the prescriber insists. The reasoning: the nurse is accountable for administration, and a prescriber's order does not make an unsafe dose safe.
Traps. 'The doctor ordered it' is not a defence; 'I will document later' fails the contemporaneous record standard; confidentiality does not end with death or with a family request; consent is a process, not a signature on a form.