Unit of competency details

Descriptor 

This competency unit describes the skills and knowledge required by the Enrolled/Division 2 nurse to perform nursing interventions to assist clients requiring emergency health care

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

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. Work as part of the emergency health care team

1.1 Contribute appropriately to support the role of the health care team in managing the care of clients 

1.2 Contribute to effective team work and supportive group dynamics with health care colleagues

1.3 Establish appropriate professional relationships with other members of the health care team

1.4 Recognise the contributions of emergency service personnel, referring agencies, hospital and community team staff to the care needs of client

2. Assist the registered nurse in the provision of emergency care

2.1 Perform a holistic assessment of the client

2.2 Incorporate an understanding of anatomy and physiology into nursing practice

2.3 Identify and discuss problems and complications with client and/or significant others as appropriate

2.4 Communicate effectively with clients, significant others and health team members

2.5 Clarify the emergency needs of the client

2.6 Use contemporary assessment tools accurately

2.7 Ensure appropriate pre-, intra- and post-diagnostic procedures are undertaken in line with organisation policies and within scope of practice

2.8 Provide nursing care in response to trauma and emergency conditions

2.9 Assist in the preparation of clients for transport by air or road ambulance or by other means such as private car to another health care facility

2.10 Report and document first aid/emergency treatment and client response to the treatment

2.11 Recognise and act upon emergency situations according to organisation policy and procedure and within legal and professional requirements

3. Contribute to the quality and safety of emergency nursing  care in consultation/ collaboration with the registered nurse

3.1 In consultation/collaboration with the registered nurse, use a problem solving framework to plan appropriate nursing management strategies

3.2 Modify nursing interventions  using critical thinking and problem solving approaches, to reflect changes in client's condition

3.3 Assist with processes to evaluate the quality of nursing actions

3.4 Demonstrate ability to rapidly re-prioritise care activities in temporarily changed circumstances

3.5 Participate in organisation risk identification and risk management processes

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:

• Anatomy, physiology and pathophysiology of injuries, poisonings, and emergency medical conditions
• Clinical manifestations of chronic disease states
• Critical thinking and problem solving
• Culturally appropriate health practices
• Diagnostic tests and their meaning
• Emergency and first aid principles
• Evidence based practice
• Legislation related to health care practice, including Workplace health and safety legislation
• Medical terminology
• Organisation policy and procedure
• Participating as a member of the emergency care team
• Principles of health assessment
• Privacy issues including the Medical Records privacy Act, the patients Privacy Act and Local codes of conduct, procedures etc.
• Reflective practice
• Specialised knowledge relating the immobilisation and care of fractures and spinal injuries
• Specialised knowledge relating to care of children and infants
• Specialised knowledge relating to care of older clients

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 clinical nursing skills including:

• basic nursing interventions
• chest pain assessment
• physical assessment skills including neurological function
• specimen collection

• Admission and transfer to acute care facilities
• Apply professional standards of practice:

• ANMC code of conduct
• ANMC code of ethics
• ANMC national Enrolled/Division 2 nurse competency standards
• privacy requirements

• Demonstrate accountability for personal practice
• Discharge to home environment
• Undertake observation and documentation of:

• blood glucose monitoring
• hydration
• neurovascular observations
• nutritional status
• pain scale observations
• respiratory function
• skin integrity

• Use appropriate communication skills (non-verbal, openness, sensitivity, non-judgemental attitudes)
• Use oral communication skills (language competence) required to fulfil job roles as specified by the organisation/service including:

• interviewing techniques
• asking questions
• active listening
• asking for clarification

• Use written communication skills (literacy competence) required to fulfil job roles as specified by organisation/service at a level of skill that includes reading and understanding client documentation
• Use interpersonal skills including working with others, using sensitivity when dealing with people and an ability to relate to persons from different cultural, social and religious backgrounds

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 and have an ability to work with Aboriginal and/or Torres Strait Islander clients and communities
• 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
• Workers should be familiar with their organisation's diversity plans and work in such a manner so as to ensure cultural understanding and inclusion
• All actions must be consistent with State and Territory anti-discrimination legislation

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.

Emergency health care team members could include :

• Client and their significant others
• General Practitioners
• Nurses
• Retrieval teams

Client may include :

• Neonate
• Infant
• Child
• Adult
• Aged person

Legal and ethical issues include :

• Rights of clients
• Consent
• Power of attorney
• Medical Power of attorney
• Advocacy
• Restraint
• Advanced health directives
• Ethical principles
• Privacy

Specific nursing interventions / clinical skills include :

• Basic nursing interventions
• Wound care
• Skin care
• Pain management
• Manual handling

Emergency nursing may include :

• Assisting with:

• resuscitation
• control of bleeding
• alleviation of respiratory distress
• alleviation of cardiac distress
• control of pain
• reduction of swelling
• poisoning symptoms
• dehydration,
• diabetic crises
• eye injury

Diagnostic procedures may include :

• ECG and cardiac monitoring
• BGL
• Specimen collection
• Peak flow meters
• Oxygen saturation levels