Professional Responsibility: Legal, Ethical and Cultural Foundations of NZ Practice
The framework you must be able to name
Professional responsibility is the legal and ethical scaffold of practice in Aotearoa New Zealand. Know the Health Practitioners Competence Assurance Act 2003 (its purpose is public protection; the Nursing Council is the responsible authority, defines scopes of practice, issues the annual practising certificate and requires continuing competence). Know the Code of Health and Disability Services Consumers' Rights - respect, effective communication, full information, informed choice and consent (Right 7), support persons, the right to complain. Know the Code of Conduct for Nurses, the Privacy Act 2020 with the Health Information Privacy Code, and cultural safety obligations arising from Te Tiriti o Waitangi.
Concepts candidates confuse
- Consent: competence is presumed. A competent consumer may consent, refuse, or use an advance directive; a person with diminished competence keeps rights to the extent of their competence. Emergency treatment may proceed without consent where delay would endanger life or health. A person aged 16 or over can consent; a younger person may consent if competent.
- Confidentiality is not absolute. Disclose with consent, where a serious threat to safety justifies it, or where legislation requires it. Share the minimum necessary and record your reasoning.
- Scope: students and unregulated health care assistants hold no scope of practice; delegation is governed by Nursing Council guidance and the delegator must be satisfied the delegate is competent.
Traps
Questions dress up an everyday situation with an "obvious" answer that breaches a right. A declined injection is not non-compliance; it is an exercise of Right 7. Being short-staffed never justifies a breach of privacy or dignity. Telling the family is not disclosure to the consumer.
Rule of thumb
Before acting, ask: Which right or duty applies? Whose decision is this? Could I defend this to the Health and Disability Commissioner? If information must be shared, apply the minimum-necessary test.