Download American Nurses Association Scope and Standards of Nursing

Running head: AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
American Nurses Association Scope and Standards of Nursing Practice
Jenna Winters
Ferris State University
1
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
2
American Nurses Association Scope and Standard of Nursing Practice
The American Nurses Association [ANA], (2010), has set standards that are expected to
be followed competently by all nurses in the profession. These standards are used to guide
nursing practice in all aspects of care. There standards will be used for a self-assessment of
practice as well as goals to maintain or obtain competence in the standards.
ANA Scope and Standards of Nursing Practice
Standards of Practice
Assessment. The first step in the nursing process is assessment. The nurse is responsible
for collecting comprehensive data that is pertinent to the patient’s health and medical condition
(American Nurses Association [ANA], 2010). This information may include, but is not limited
to, physical, cognitive, functional, emotional, sexual, psychosocial, cultural, environmental, and
spiritual/transpersonal (ANA, 2010). This standard has been met in a variety of settings from
class room activities, to hospital rooms and in patient homes.
By using the skills learned in the classroom setting, as well as on the floor in the hospital,
one can become confident in performing a complete head-to-toe assessment on any patient. In
one situation encountered at the hospital, a patient was on neurological checks every two hours
after a stroke. As the student nurse assigned to this patient, it was important to complete
neurological checks on time and document accurately to ensure that if patient status changes, it is
acknowledged and responded to accordingly.
Diagnosis. Using the data gathered during the assessment, the nurse is responsible for
determining the diagnosis primary issue for each patient (ANA, 2010). Diagnosing the patient is
an important standard to be competent in because the rest of the nursing process closely relies on
the diagnoses. This standard has been partially met by the example given below. However,
ensuring to choose the priority diagnosis is something that still needs practice. The paperwork
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
3
required for clinical is used to prepare the student nurse in making nursing diagnoses by
recognizing what the priority diagnosis is for each individual patient. Knowledge deficit may be
a priority diagnosis for one patient that came into the emergency room with a blood glucose level
of 559. The patient had stopped giving himself insulin injections related to lack of appetite and
not eating. After diagnosis of the patient with knowledge deficit, a care plan can be made. The
patient needs to understand the importance of checking blood sugars regularly, especially when
not feeling well, and giving insulin based on the readings.
Outcomes Identified. Nurses are responsible for identifying outcomes for a plan of care
that is individualized for each specific patient (ANA, 2010); the outcomes include the patient,
family, healthcare providers and other outside sources as appropriate. In the classroom setting,
student nurse received practice on assessing a patient, diagnosis, then identifying outcomes. The
outcomes provide both the healthcare providers and the patient with a goal and something to
strive for, pertaining to the patients overall health and well-being.
As a student nurse, this outcome is not achieved to the fullest. However, when working
with a patient post-ileostomy, outcomes identified were the patients’ acceptance of the
procedure, involvement in ostomy care, and ultimately independent care of the ostomy. These
outcomes were identified while working with the patient, student nurse, and registered nurse. In
the hospital setting a trained nurse in ostomy care came in and worked one on one with this
patient to ensure the patient was accurately and safely providing care for the ostomy.
Planning. After obtaining outcomes, the nurse is responsible to develop a plan of
strategies to achieve the outcomes identified (ANA, 2010). The plan is individualized and should
include the patient, patient’s family, and others considering the patient’s characteristics or
situation. Values, beliefs, spiritual and health practices, preferences, choices, developmental
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
4
level, coping style, culture and environment as well as available technology are all to be
considered when developing a plan (ANA, 2010). This standard has been partially met by the
student nurse.
Forming an individualized plan is something that requires a lot of knowledge and
experience. As a student nurse, there are not as many instances of developing a plan as one
would like. In clinical paperwork, one plan that was developed was to encourage ambulation,
oral fluids, and the administration of stool softeners as prescribed for the patient that was at risk
for constipation post-surgery. Understanding the situation, outcome, and goal will ensure the
nurse is able to establish a plan of care for his/her patient.
Implementation. With the patient, family, significant other, and any caregivers the nurse
will implement the identified plan in a safe, realistic and timely manner (ANA, 2010). According
to the ANA (2010), advocating for healthcare, utilizing technology, using evidence-based
interventions and treatments, as well as utilizing community recourses and systems for
implementing the plan are examples of some of the responsibilities the registered nurse in this
standard of care should be competent in.
This standard has been met many times in clinical practice. Patients in hospital settings
are at an increased risk of blood clots. It is important for the nurse to acknowledge this potential
threat and ensure an intervention is in place to prevent clot formation. Lovenox, Heparin,
sequential compression devices (SCDs), and/or ambulating are used every day to prevent the
development of blood clots in patients. This student nurse has given both Lovenox and Heparin
prophylactically as well as encouraged patients to wear SCDs and assist with ambulation.
Evaluation. After a goal is set and implementation begins, the nurse is responsible for
evaluating the progress toward the outcome (ANA, 2010). This process is ongoing and
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
5
systematically based on the prescribed plan of care and timeline that is decided upon with the
nurse and patient. Collaboration with the patient and others involved in care is used in this
process. Ongoing assessment data is collected and used to review and change diagnoses,
outcomes, plan and implementation as needed for each individual patient (ANA, 2010).
This standard is partially met with an example of pain medication. After administration of
Dilaudid for pain, the student nurse is required to re-evaluate the patient’s pain level and
response to the medication and chart accordingly. The administration of blood or blood products
also requires the nurse to re-evaluate the patient frequently to ensure there is no sign of an
adverse reaction to the infusion. Vitals are taken before transfusion begins, then again 15 minutes
later and frequently throughout the transfusion. If any sign of reaction occurs the nurse is to stop
the transfusion immediately and follow facility policy.
Standards of Professional Performance
Ethics. It is the obligation of each nurse to ensure their practice is ethical (ANA, 2010).
The ANA published a Code of Ethics for Nurses with Interpretive Statements in 2001 to help
guide ethical practices. The nursing profession is one that is held to very high standards in
regards to ethics. As a nurse it is imperative to provide care in a method that will protect and
preserve the patients’ autonomy, rights, beliefs, values, and dignity. This standard includes
confidentiality, and maintaining a therapeutic and professional relationship with the patient while
maintaining appropriate boundaries (ANA, 2010).
This standard has been met a number of times during clinical rotation as a student nurse.
Each patient is treated with dignity and respect while guaranteeing confidentiality through
standardized lawful regulations. Establishing permission from the patient before disclosing
patient information to family members or patient friends is critical in maintaining confidentiality.
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
6
During a clinical rotation, one patient’s daughter wanted to be informed when a time was set for
a magnetic resonance imaging (MRI) test; because the patient gave permission for medical
information to be shared with the daughter, the student nurse called the daughter and disclosed
what time the procedure was going to take place. Therapeutic relationships are established with
each patient however, more practice will promote how therapeutic the nurse is.
Education. Current and up-to-date nursing practice is essential for the all nurses to
obtain. This standard assures the nurse attains knowledge and is competent in current practice
(ANA, 2010). Participating in ongoing educational activities, committing to lifelong learning,
seeking new learning experiences, and identifying learning needs will ensure the nurse to be
competent in this standard (ANA, 2010). This standard is not completely met. As a student nurse
the most current education is learned in the classroom and clinical setting. It is important that the
student nurse take control of their education and learn everything they can while still in the
educational setting. After graduation, the nurse is responsible for continuing to learn and grow as
a nurse to be able to give their patients the most accurate, up-to-date, and safe evidence-based
care.
Evidence-Based Practice and Research. “The registered nurse integrates evidence and
research findings into practice” (ANA, 2010, p. 51). Registered nurses are to share current
research findings with colleagues, allow the research to guide practice and use that evidence
when initiating changes to nursing practice (ANA, 2010). At this point of nursing school, this
standard has not been met to its fullest. The student nurse has learned the importance of research
and how to locate research findings that may be needed or used to initiate changes to practice.
The student nurse has shared research findings with colleagues multiple times in the classroom
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
7
setting in the form of research presentations and papers, but has not yet used research to initiate a
change in practice.
Quality of Practice. This standard requires the registered nurse to contribute to quality
nursing practice (ANA, 2010). To establish competency in the standard, the nurse is responsible
for documenting the nursing process in a responsible, accountable and ethical manner; use
creativity and innovations to improve care and contribute to quality improvement (ANA, 2010).
This standard has been partially met. The student nurse documents the application of the nursing
process in a responsible, accountable and ethical manner on each patient in the clinical setting.
Creativity was used when working on the pediatric floor with a young patient who was
afraid of the sphygmomanometer and stethoscope. The student nurse allowed the young patient
to use the stethoscope and sphygmomanometer on her stuffed animal prior to taking vitals on the
patient. This calmed the patient’s fears and allowed the student nurse to obtain assessment data
and document accurately in a timely manner. With more clinical experience, the student nurse
will be able to use creativity and innovations to contribute to quality of care. The student nurse
uses criticism from current registered nurses and the clinical instructor to improve documentation
and interventions.
Communication. Communication is to be used by all individuals in the nursing
profession effectively in every area of practice to meet this standard (ANA, 2010). Assessing
communication style and skills of oneself is the first step for the nurse to be able to communicate
effectively with patients, families, and other healthcare providers (ANA, 2010). This is an
important standard when working with not only patients but the entire interdisciplinary team.
Disclosing important patient information that promotes safe and accurate treatment to improve
the patient’s condition relies on strong and effective communication. This standard has been met,
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
8
but it is important to “seek continuous improvement of communication and conflict resolution
skills” (ANA, 2010, p.54).
As the student nurse, relaying information to the nurse that has been learned during the
assessment or anytime when interacting with the patient is important. The most common thing
the student nurse relays is the patient’s request for pain medication. Student nurses are only
allowed to give medication under the supervision of a registered nurse, so reporting the patients
request in a timely manner is important for the comfort of the patient. This information can be
communicated in both written and verbal communication. In the clinical setting the student nurse
also communicated verbally to another department in the hospital when the student nurse called
Interventional Radiology (IR) to determine what time the patient’s procedure was scheduled. The
student nurse then communicated with the registered nurse, the patient, and the nurse aid to
confirm all parties were aware of the time and ensure the patient would be ready to go on time as
to not backup other procedures in IR.
Leadership. To establish competency in this standard the nurse is to demonstrate
leadership in the practice setting and in the profession as a whole (ANA, 2010). Overseeing care
given by others, commitment to lifelong learning, mentoring colleagues, participating in
professional organizations, and seeking ways to advance nursing autonomy are a couple of
examples to demonstrate the nurse is competent in this standard (ANA, 2010). This standard has
not been met by the student nurse at this point. During simulations in the classroom setting, the
student nurse has taken charge and became a leader in the simulation. However more practice is
needed to become competent in the clinical setting in regards to delegating tasks, mentoring
colleagues, and becoming a leading in the profession of nursing.
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
9
Collaboration. Nurses are responsible to collaborate with patients, families, and other
members of the interdisciplinary team when conducting the nursing process (ANA, 2010).
Patient-centered care is being used to improve patient outcomes and the experience of patients in
the hospital setting. The nurse communicates with many other people in regards to patient care
and the nurse’s role in the delivery of care (ANA, 2010). There are many departments in the
hospital that are used to improve patient outcomes including but not limited to orthopedics,
neurosciences, urology, therapy, surgery, rehabilitation, radiology, as well as heart and vascular.
This standard has been partially met by the student nurse when calling to Interventional
Radiology to determine the time for the patients procedure as well as being a part of rounding
with the colorectal team.
The student nurse also collaborates with registered nurses and nurse aids on a daily basis
in the clinical setting to guarantee all patient care is completed in a timely manner. For example,
the student nurse worked with the registered nurse to administer medication, perform an
assessment, complete a bed bath, and change a wound dressing on a patient who was completely
dependent and on bed rest. This information was then documented timely and accurately
allowing other members of the interdisciplinary team to read the nursing notes and assessment
data when reviewing the patient’s progress. The wound assessment in this case was especially
important to chart because back surgery was being held off until the wound and infection healed.
Close collaboration and communication with the physician will make sure the patient is not
waiting longer than needed to have surgery.
Professional Practice Evaluation. “The registered nurse evaluates his or her own
nursing practice in relation to professional practice standards and guidelines, relevant statutes,
rules, and regulations” (ANA, 2010, p.59). For the nurse to be competent in this standard he/she
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
10
must provide age-appropriate and developmentally appropriate care, self-evaluate ones practice
regularly, obtain feedback from peers, provide peers with constructive feedback, and interact
with peers to enhance nursing practice (ANA, 2010). This standard is partially met; each week
the student nurse is required to submit a weekly self-evaluation of the care given. This paper is
also a self-assessment of the student nurse’s practice in regards to the ANA standards of practice,
standards of professional performance and code of ethics. For this paper, the student nurse will
also give constructive feedback to a peer, meeting another portion of this standard.
Resource Utilization. Using appropriate resources to plan and provide nursing care that
is safe, effective, and financially responsible are the nurse’s responsibilities under this standard
(ANA, 2010). The nurse is to assess individual patient needs and available resources, delegate
care as appropriate, advocate for resources that enhance practice, modify practice to promote
positive interaction between patient, care providers and technology, and assist patients and
families in decisions regarding costs, risks, and benefits of treatment and care (ANA, 2010). This
standard has not been fully met. When collecting a blood sample from a peripherally inserted
central catheter (PICC) line, the student nurse drew the blood right into the sample tube instead
of drawing it into a syringe then placing it into the sample tube which saves one syringe and
nursing time for each blood draw.
Environmental Health. The nurse should ensure he/she is practicing in an
environmentally healthy and safe manner at all times (ANA, 2010). Competencies for this
standard include communicating environmental health risks and exposures, using evidence to
determine if treatment is an environmental threat, reduce environmental risk for workers and
patients, and implementing environmental health strategies (ANA, 2010). When self-evaluating,
the student nurse has partially met this standard. Ensuring all sharps are placed into appropriate
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
11
containers and placing medications and wrappers in proper disposal boxes are examples in which
the student nurse has worked to meet the competencies of this standard. While drawing up
Dilaudid into a filter needle, the student nurse pays close attention to the vial and the needle that
was used and ensures they both go into the sharps container as soon as possible to eliminate
potential risks. In the clinical setting, it is important for the nurse to pay close attention to proper
disposal of items in the hospital to reduce risk for workers and patients.
Code of Ethics
Ethics is an important part of the nursing profession. According to the American Nurses
Association (2001), the code of ethics serves the following purposes: “it is a succinct statement
of the ethical obligations and duties of every individual who enters the nursing profession; it is
the profession’s nonnegotiable ethical standard; and it is an expression of nursing’s own
understanding of its commitment to society” (American Nurses Association [ANA], 2001, p.23). It is important that all registered nurses know the standards and code of ethics when
practicing. As a novice nurse in this profession, it is imperative to pay close attention not only to
the standards of practice, but also the code of ethics when interacting with patients, families, and
other members of the interdisciplinary team. Below is a short description of each provision with
a self-assessment.
Provision 1. Nurses are to practice with compassion and respect for the dignity, worth,
and uniqueness of each patient (ANA, 2001). Respect for human dignity, relationships to
patients, the nature of health problems, the right to self-determination, and relationships with
colleagues and others are the subcategories of provision 1. Respect is to extend to all patients
who require nursing services (ANA, 2001). This provision has been met. One patient was in the
hospital and on comfort care. As the student nurse, respect was given during the entire
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
12
assessment and assistance with activities of daily living (ADL) even though the patient was close
to death and not verbal. Another example is respecting the patient’s decision to refuse to wear
SCDs after the student nurse educated the patient about what they are used for and the
importance of SCDs.
Provision 2. The nurse’s main commitment is to the patient; the patient could be an
individual patient, family, group, or community (ANA, 2001). This category is broken into
primacy of the patient’s interests, conflict of interest for nurses, collaboration, and professional
boundaries (ANA, 2001). After a self-assessment, it is clear that more practice is needed for this
provision, though there is an example where the student nurse is working to meet the provision.
Each week the student nurses develop a plan of care for a patient. Some patients have the same
medical diagnosis and similar assessment data and outcomes. However, the student nurse took
into consideration the uniqueness of the patient and tailored the plan of care to be effective for
that specific patient.
Provision 3. As a nurse, it is ones responsibility to promote, advocate for, and strive to
protect the health, safety, and rights of all patients (ANA, 2001). Provision 3 is broken into 6
subcategories: privacy, confidentiality, protection of participants in research, standards and
review mechanisms, acting on questionable practice, and addressing impaired practice (ANA,
2001). The student nurse has partially met this provision. In the clinical setting, the nurse
provides privacy as much as possible for all patients. For example, ensuring the door and curtain
is closed when performing any assessment or nursing skill is an advised practice of patient
privacy. The nurse also ensures patient confidentiality by only speaking to other healthcare
professionals who are also working with the patient, and not disclosing any patient information
to family or friends without permission from the patient first.
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
13
Provision 4. “The nurse is responsible and accountable for individual nursing practice
and determines the appropriate delegation of tasks consistent with the nurse’s obligation to
provide optimum patient care” (ANA, 2001, p. 8). Acceptance of accountability and
responsibility, responsibility for nursing judgment and action, and the delegation of nursing
activities are all subcategories of provision 4 (ANA, 2001). Delegation is an important part of the
job description of the registered nurse. The student nurse has not met this provision. As a student
nurse, most of the responsibility and tasks completed for each patient are accomplished by the
student nurse, from medication administration to helping with patient ADLs or toileting.
Provision 5. This provision is broken into morals, self-respect, professional growth and
maintenance of competencies, wholeness of character, and preservation of integrity (ANA,
2001). Under provision 5, “the nurse owes the safe duties to self as to others, including the
responsibility to preserve integrity and safety, to maintain competence, and to continue personal
and professional growth” (ANA, 2001, p. 9). The student nurse has started to become competent
in this provision from the first day of nursing school. Professional growth is important for all
nurses and requires the commitment of lifelong learning. Furthermore, increasing knowledge
and skill base will allow the nurse to give the best patient care he/she can give.
Provision 6. “The nurse participates in establishing, maintaining, and improving health
care environments and conditions of employment conducive to the provision of quality health
care and consistent with the values of the profession through individual and collective action”
(ANA, 2001, p 11). This includes the influence of the environment on moral virtues and values,
influence of the environment on ethical obligation, and the responsibility for the healthcare
environment (ANA, 2001). This provision has not been fully met. The student nurse does
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
14
contribute to a moral environment by encouraging respectful interaction between peers while
treating peers fairly.
Provision 7. Provision 7 explains that the nurses should partake in advancement of the
nursing profession through contributions to practice, education, administration and knowledge
development (ANA, 2001). The three subcategories include: advancing the profession through
active involvement in nursing and in health care policy, advancing the profession by developing,
maintaining, and implementing professional standards in clinical, administrative, and educational
practice, and advancing the profession through knowledge development, dissemination, and
application to practice (ANA, 2001). This standard has not been met; as a novice nurse, it is
important for the student to use their education to develop a large knowledge base that may be
used in the future to participate in the advancement of practice.
Provision 8. The nurse will work with other healthcare professionals and the public to
promote community, national, and international efforts to meet health needs (ANA, 2001). To be
competent in this provision, the nurse must meet the two subcategories: health needs and
concerns, and responsibilities to the public. As a nurse it is important to be knowledgeable about
specific health needs, but also the larger picture, for example, world hunger, lack of fresh water
or lack of access to healthcare. While collaborating with other professionals, the nurse is
responsible to educate the public and support initiative to address barriers to health care (ANA,
2001). This standard has been met. The student nurse has done some collaboration with peers for
a public health project addressing pregnant mothers who smoke, as well as developing a plan for
children to attend during summer vacation to combat childhood obesity. The student nurse also
traveled abroad to Guatemala to bring health care and supplies to an area that is underserved.
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
15
Provision 9. “The profession of nursing, as represented by associations of their members,
is responsible for articulating nursing values, for maintaining the integrity of the profession and
its practice, and for shaping social policy” (ANA, 2001, p13). This provision is broken down into
four sections: assertion of values, the profession carries out its collective responsibility through
professional associations, intraprofessional integrity, and social reform (ANA, 2001). This
standard has not been met. The student nurse has not had an opportunity to bring about changes
in the health care environment. This provision ensures all nurses work in agreement with the
code of ethics for nurses, standards of nursing practice, ongoing development of nursing
knowledge derived from theory, educational requirements, certification and mechanisms for
evaluating the effectiveness of professional actions (ANA, 2001). The student nurse is abiding
by the law, rules and regulation set for nursing students and registered nurses.
Professional Development Plan
Goals
The standards of practice, standards of professional performance, and the code of ethics
have a thorough description and examples to determine if nurses are competent in all areas and
eligible to be a registered nurse. All standards and provisions above have not yet been met by the
student nurse. By committing to lifelong learning; advancing in the nursing profession,
specifically as a nurse practitioner; and joining a professional nursing organization within the
hospital or a national group, the student nurse will be able to meet the standards and provisions
not yet achieved, and maintain competence in the areas that have been met. Reviewing the
standards and provisions frequently will ensure the student nurse is gaining competence in all
areas and retaining competencies already met.
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
16
Action Plan
Lifelong learning is very important in the nursing profession. Technology is constantly
growing and improving the healthcare field. Staying up-to-date with most recent technology and
interventions will ensure the student nurse is knowledgeable and able to give the most effective
and safe care to his/her patients. As a new registered nurse, the student plans to work on a
medical-surgical floor for at least one year to obtain a solid foundation of nursing practice and
skills before advancing into a more specific area of practice. It will also be beneficial for the
student nurse to find a mentor in the work setting that fosters novice nurses and guides them to
become the best nurse they can be. Reading policies and procedures of the organization for
which the nurse works will ensure one is providing the best care he/she can to their patients.
Along with reading policies, looking at the evidence-base for specific practices and why it is
done a specific way will allow the novice nurse to understand the procedure more fully or begin
a process for improvement if the evidence does not have a strong foundation.
The decision to go back to school is not one that should be taken lightly. Masters and
doctorate programs are very difficult, nevertheless, very rewarding. Obtaining either of these
graduate degrees will advance the scope of practice of the nurse dramatically. The nurse will be
able to work in education and/or as a nurse practitioner. This again, is an example how lifelong
learning will be reached. After working as a registered nurse for two years, the nurse is going to
begin the process of advancing ones educational level in order to increase the knowledge level of
the nurse and be able to assist patients in a way that is not in the scope of practice as a registered
nurse.
Joining an organization, for example the ANA, the student nurse will be in touch with
other nursing professions across the country, have access to the Online Journal of Issues in
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
17
Nursing. This will contribute to lifelong learning and the possibility to change policies for high
quality and safe practice. The ANA and similar organizations may allow nurses to gain
knowledge that improve patient care and influence decisions that impact nurses on both a state
and national levels. The student nurse will begin to look for organizations of interest and the
benefits to each before joining.
Reviewing the standards described above frequently, while in nursing school and after
graduation, and completing a self-assessment similar to this paper while asking for constructive
criticism from peers will be great tools in the professional development and growth of oneself as
a nurse. It is also the responsibility of the nurse to be accountable and responsible for one’s own
actions while keeping ethical standards in mind and assuring the patient’s rights and
confidentiality are present.
Evaluation of Plan
Lifelong learning is a continuous goal which will have to be evaluated frequently to
ensure the nurse is working toward ones goal. Staying up-to-date with technology, reading
policies and procedures, and attending conferences regarding the nursing profession is how one
will evaluate if the goal is being met. Every week the nurse will read at least one policy and/or
procedure relevant to ones patients.
If the student nurse graduates from the nursing program, that will be the first step in the
educational goal. A Bachelor’s degree must be earned before one can move on and start a
graduate program. In the next five years, the nurse will begin a graduate program for education
or to become a nurse practitioner. This goal will be fully met after the graduation from a graduate
level nursing program.
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
18
If the nurse is accepted into a nursing organization in the next year, this goal will be
completed and aid in nurses in becoming competent in the standards and provisions described
above. Finally, the nurse will evaluate oneself frequently throughout her career to ensure the
competencies are maintaining to be met.
Conclusion
The ANA has a specific set of standards that have been established to ensure the nursing
profession is competent in all the duties required (ANA, 2010). A Code of Ethics for Nurses with
Interpretive Statements has also been developed from the ANA, to act as a “guide for carrying
out nursing responsibilities in a manner consistent with quality in nursing care and ethical
obligations of the profession” (ANA, 2001, p. 1). The standards and provisions written by the
ANA are used on a daily basis in the healthcare setting as a nurse. This self-assessment of the
standards of care and code of ethics gives the student nurse a picture of competencies that have
not yet been met and a goal and plan in how the student nurse will become competent in the
standard or provision before graduation and entering the workforce. When these standards and
provisions are met, the student nurse will be ready to use his/her knowledge learned over the past
years to provide quality care in a safe manner to all patients while collaborating and
communicating with a variety of other individuals required to promote and achieve health and
wellness.
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
19
References
American Nurses Association (2001). Code of ethics for nurses with interpretive statements.
Silver Spring, MD: American Nurses Association.
American Nurses Association (2010). Nursing: Scope and standards of practice (2nd ed.). Silver
Spring, MD: American Nurses Association.
AMERICAN NURSES ASSOCIATION SCOPE AND STANDARDS
20