Nursing NZ - Enrolled Nurse

Competency 1.1 Accepts responsibility for ensuring that their nursing practice and conduct meet the standards of the professional, ethical and relevant legislated requirements

• Indicator: Demonstrates knowledge of relevant legislation pertaining to the delivery of health consumer care.
• Indicator: Ensures practice is within the scope of practice and adheres to legislated requirements and relevant ethical codes, policies and procedural guidelines.
• Indicator: Accepts responsibility for actions and decision making within the enrolled nurse scope of practice.
• Indicator: Identifies breaches of law that occur in practice and reports them to the registered nurse/manager.

Competency 1.2 Demonstrates the ability to apply the principles of the Treaty of Waitangi/Te Tiriti o Waitangi to nursing practice.

• Indicator: Understands the Treaty of Waitangi/Te Tiriti o Waitangi and its relevance to the health of Māori in Aotearoa/New Zealand.
• Indicator: Applies the principles of the Treaty of Waitangi/Te Tiriti o Waitangi to nursing practice.
• Indicator: Demonstrates knowledge of differing health and economic status of Māori and nonMāori and how this impacts on health outcomes.

Competency 1.3 Demonstrates understanding of the enrolled nurse scope of practice and the registered nurse responsibility and accountability for direction and delegation of nursing care.

• Indicator: Recognises and acts in accordance with the enrolled nurse scope of practice, organisational policy and own level of competence.
• Indicator: Demonstrates understanding of the registered nurse’s role to direct, delegate, monitor and evaluate nursing care.
• Indicator: Consults with the registered nurse to ensure that delegated tasks and responsibilities are commensurate with own level of competence.
• Indicator: Seeks guidance from a registered nurse when encounters situations beyond own knowledge, competence or scope of practice

Competency 1.4 Promotes an environment that enables health consumer safety, independence, quality of life, and health.

• Indicator: Identifies and reports situations that may impact on the safety of health consumers or staff.
• Indicator: Adjusts the physical and social environment in order to maximise health consumer wellbeing.
• Indicator: Adheres to standards and procedures related to restraint minimisation, infection control, safe handling, pressure area prevention and the administration of medicines.
• Indicator: Initiates appropriate interventions in emergency situations.
• Indicator: Supports the right of health consumers to maintain independent lifestyles with dignity in their own environment.

Competency 1.5 Participates in ongoing professional and educational development.

• Indicator: Undertakes regular review of own practice by engaging in reflection and identifying ongoing learning needs.
• Indicator: Takes responsibility for own professional development and maintenance of competence.
• Indicator: Takes opportunities to learn with others contributing to health care.

Competency 1.6 Practises nursing in a manner that the health consumer determines as being culturally safe.

• Indicator: Demonstrates ability to provide culturally safe care to meet health consumers’ individual needs, beliefs and values.
• Indicator: Reflects on own practice and values that impact on cultural safety.
• Indicator: Takes opportunities to gain feedback from health consumers to determine own practice is culturally safe.
• Indicator: Avoids imposing prejudice on others and reports any observed occurrences of prejudice to the registered nurse.
• Indicator: Appropriately challenges practices that compromise health consumer safety, rights, privacy or dignity

Competency 2.1 Provides planned nursing care to achieve identified outcomes.

• Indicator: Contributes to the development of care plans in collaboration with the registered nurse and health consumers, and clarifies responsibilities for planned care with the registered nurse.
• Indicator: Promotes independence while assisting health consumers to undertake activities of daily living, such as nutrition, hydration, elimination, mobility, social functioning and personal hygiene.
• Indicator: Uses nursing knowledge and problem-solving skills when carrying out professional responsibilities.
• Indicator: Prioritises and manages time.
• Indicator: Carries out procedures competently and safely.
• Indicator: Administers nursing interventions and medications within legislation, codes, scope of practice and according to prescription, established organisational policy and procedures.

Competency 2.2 Contributes to nursing assessments by collecting and reporting information to the registered nurse.

• Indicator: Completes assessment tools as delegated by the registered nurse.
• Indicator: Uses a range of data gathering techniques including observation, interview, physical examination and measurement.
• Indicator: Assists with routine examinations and routine diagnostic investigations.
• Indicator: Applies understanding of the different developmental stages of the life span.

Competency 2.3 Recognises and reports changes in health and functional status to the registered nurse or directing health professional.

• Indicator: Observes for changes in health consumers’ health and functional status in the course of nursing practice.
• Indicator: Communicates observations to the registered nurse and appropriate members of the health team.
• Indicator: Reports changes in health status in a timely manner and is aware of procedures for responding to concerns which are escalating in the health care setting.

Competency 2.4 Contributes to the evaluation of health consumer care.

• Indicator: Monitors and documents progress towards expected outcomes.
• Indicator: Contributes to the review of care plans in collaboration with the registered nurse

Competency 2.5 Ensures documentation is accurate and maintains confidentiality of information.

• Indicator: Observes, reports, records and documents health status.
• Indicator: Records information in a systematic way that is in line with organisational policy and procedures.
• Indicator: Ensures written communication is comprehensive, logical, legible, clear and concise, using only accepted abbreviations.
• Indicator: Maintains confidentiality of documentation/records and interactions with others.

Competency 2.6 Contributes to the health education of health consumers to maintain and promote health.

• Indicator: Provides accurate and culturally appropriate education to health consumers or groups to maintain or promote health in consultation with the registered nurse.
• Indicator: Determines consumer understanding by seeking feedback on information given.
• Indicator: Demonstrates an understanding of how health and disease are affected by multiple and interconnected factors.

Competency 3.1 Establishes, maintains and concludes therapeutic interpersonal relationships.

• Indicator: Establishes rapport and trust with the health consumer and or family/whānau.
• Indicator: Demonstrates respect, empathy and interest in the health consumer.
• Indicator: Is able to establish relationships and effectively and culturally appropriately communicate with health consumers.
• Indicator: Appropriately terminates therapeutic relationships.
• Indicator: Understands therapeutic relationships and professional boundaries.

Competency 3.2 Communicates effectively as part of the health care team.

• Indicator: Communicates orally and in writing appropriately and effectively.
• Indicator: Demonstrates understanding of the need for different communication styles and approaches in different situations.
• Indicator: Engages with colleagues to give and receive constructive feedback that enhances service delivery to health consumers.
• Indicator: Contributes to a positive working environment.

Competency 3.3 Uses a partnership approach to enhance health outcomes for health consumers.

• Indicator: Understands and applies the principles of a recovery centred1 approach to nursing care within different health care settings.
• Indicator: Understands the impact of stigma and discrimination on health outcomes for health consumers and is able to implement nursing interventions that enhance fairness, equality and self determination.
• Indicator: Understands and uses the resources in the health consumer’s community to improve health outcomes.

Competency 4.1 Collaborates and participates with colleagues and members of the health care team to deliver care.

• Indicator: Understands and values the roles, knowledge and skills of members of the health care team in relation to own responsibilities.
• Indicator: Supports the therapeutic activities of other team members in the provision of health care.
• Indicator: Provides other members of the team with accurate and relevant information to assist in decision making and provision of care.
• Indicator: Contributes to discussion related to nursing practice, systems of care planning and quality improvement.

Competency 4.2 Recognises the differences in accountability and responsibility of registered nurses, enrolled nurses and healthcare assistants.

• Indicator: Clarifies enrolled nurse role and responsibilities in the context of health care settings.
• Indicator: Acts as a resource and role model for nurse students and health care assistants.
• Indicator: Prioritises the delivery of nursing care to health consumers as guided by the registered nurse.
• ndicator: Co-ordinates provision of care by health care assistants within the team as delegated by the registered nurse.

Competency 4.3 Demonstrates accountability and responsibility within the health care team when assisting or working under the direction of a registered health practitioner who is not a nurse.

• Indicator: Understands the enrolled nurse role and boundaries in relation to the scopes of practice of other registered health practitioner.
• Indicator: Practises within legislative requirements, organisation policy and refers issues outside scope to a registered nurse supervisor.
• Indicator: Works under the direction of an identified health practitioner and reports observations, changes in health status and escalates concerns to that health practitioner.