Unit of competency details

Descriptor 

This competency unit describes the skills and knowledge required by Enrolled/Division 2 Nurses to address requirements of an extended role in the assessment and management of clients and their significant others experiencing loss and grief

This unit emphasises the importance of recognising and managing personal, workplace and professional stress of self and colleagues in caring for those experiencing loss and grief

Application 

The knowledge and skills described in this competency unit are to be applied within jurisdictional nursing and midwifery regulatory authority legislative requirements

Enrolled/Division 2 nursing work is to be carried out in consultation/collaboration with registered nurses and under direct or indirect supervisory arrangements in line with jurisdictional regulatory requirements

Pre-requisite units 

This unit must be assessed after successful achievement of pre-requisites:

• HLTEN514B Apply research skills within a contemporary health environment
• HLTEN516B Apply understanding of the Australian health care system
• HLTEN606B Assess clients and manage client care

Employability Skills 

This unit contains Employability Skills

Elements define the essential outcomes of a unit of competency.

The Performance Criteria specify the level of performance required to demonstrate achievement of the Element.

ELEMENT 

PERFORMANCE CRITERIA 

1. Assess the needs of those experiencing loss and grief

1.1 Identify the effects of grief on the physical, emotional, cognitive, behavioural, social and spiritual domains of a person's experience

1.2 Review knowledge of client  and their significant others in relation to the client's condition, management requirements and therapies

1.3 Recognise determinants impacting or potentially impacting on the experience of grief of the client and their significant others

1.4 Recognise potential or actual manifestation of a complicated grief reaction

1.5 Assess needs of client and significant others experiencing loss and grief in consultation/ collaboration with the Registered Nurse and health care team

2. Plan management of clients and significant others experiencing loss and grief

2.1 Use a reflective, problem solving approach to analyse the assessment of grief status of client and significant others

2.2 Develop an individualised plan to provide ongoing care, support and education to the client and/or significant others within the health care facility and on discharge in consultation/collaboration with Registered Nurse and health care team

2.3 Analyse, evaluate and modify care plan according to clients progress in consultation/collaboration with the Registered Nurse and health care team

3. Implement strategies to manage the grief of clients and significant others

3.1 Use counselling skills to encourage clients and/or significant others to verbalise grief experience

3.2 Support client and/or significant others experiencing loss and grief

3.3 Use specific communication skills in the event of having to break adverse news or assist a health care team member to break adverse news to a client and/or significant others

3.4 Implement critical incident strategies in the event of a crisis situation

3.5 Implement support and safety and welfare measures in the event of a complicated grief reaction

3.6 Identify and access as required relevant additional resources related to loss and grief

3.7 Discuss available resources with client and/or significant others

4. Develop and implement strategies to manage own stress

4.1 Identify specific personal and workplace stressors within the context of the nursing profession

4.2 recognise and respond appropriately to physical, behavioural, interpersonal and attitudinal symptoms of professional carer burnout

4.3 Identify, access and incorporate into daily routine relevant resources/activities to relieve stress and prevent professional carer burnout

5. Provide support for peers and colleagues

5.1 Recognise symptoms of stress and professional carer burnout in peers and colleagues

5.2 Implement appropriate support and safety and welfare measures for peers and colleagues

REQUIRED SKILLS AND KNOWLEDGE 

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge 

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

• Attitudes
• Cultural and spiritual beliefs
• Customs
• Ethical and legal dimensions
• Health terminology
• Manifestations of loss and grief and the effect on health care clients, their family and friends
• Practices
• Regulations and legislation
• Self and colleague care
• Social and community support systems
• Symptoms of professional carer burnout
• Theoretical frameworks
• Values

Essential skills 

It is critical that the candidate demonstrate the ability to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

• Apply professional standards of practice:

• ANMC code of conduct
• ANMC code of ethics
• ANMC national Enrolled/Division 2 nurse competency standards
• State/territory Nurse Regulatory Nurses Act
• State/territory Nursing and Midwifery Regulatory Authority standards of practice
• Scope of nursing practice decision making framework
• NBSA Standard on Therapeutic Relationships and Professional Boundaries
• NBSA Standard on authorisation for an Enrolled/Division 2 Nurse to practise without the supervision of a Registered Nurse
• Nurses Act 1999
• Consent to Medical Treatment and Palliative Care Act 1995
• Guardianship and Administration Act 1993
• Powers of Attorney and Agency Act 1984

• Apply advanced communication skills
• Apply counselling skills
• Apply knowledge of various models of grief in practice
• Assess a client at risk of a complicated grief reaction
• Formulate a strategy to care for the safety of a client at risk of a complicated grief reaction
• Formulate strategies for communicating with and caring for clients experiencing grief
• Formulate strategies to reduce occupational stress
• Locate and utilise resources related to loss and grief
• Respond appropriately to a range of clients in a range of loss and grief contexts
• Work as an effective member of a multi-disciplinary team
• Work within a reflective practice and problem solving framework

EVIDENCE GUIDE 

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit :

• The individual being assessed must provide evidence of specified essential knowledge as well as skills
• Observation of performance in a work context is preferred for assessment of this unit
• Consistency of performance should be demonstrated over the required range of workplace situations and should occur on more than one occasion and be assessed by a registered nurse

Context of and specific resources for assessment :

• This unit is most appropriately assessed in the clinical workplace or in a simulated clinical work environment and under the normal range of clinical environment conditions prior to assessment in the workplace
• Where, for reasons of safety, access to equipment and resources and space, assessment takes place away from the workplace, simulations should be used to represent workplace conditions as closely as possible

Method of assessment 

• Observation in the work place
• Written assignments/projects
• Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice.
• Questioning - verbal and writing
• Role play/simulation

Access and equity considerations :

• All workers in the health industry should be aware of access and equity issues in relation to their own area of work
• All workers should develop their ability to work in a culturally diverse environment
• In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people
• Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

RANGE STATEMENT 

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Clients may include 

• Children
• Adolescents
• Adult
• Older adult
• Professional colleagues
• Client family members
• Client friends
• Client carers
• Professional peers and colleagues

Age and gender considerations could include 

• Maturation and psychlogical development
• Self esteem
• Gender specific coping strategies

Health care settings may include 

• Acute
• Chronic
• Rehabilitation
• Aged care
• Respite
• Mental health
• Community
• Clinic
• Prison

Health considerations could include 

• Physical health
• Psychological health

Cultural considerations could include 

• Religious beliefs
• Cultural beliefs and practices ( including non ethnic definitions of culture)
• Views on loss and grief
• Culturally appropriate nursing actions
• Need for interpreter/support services