NMBI Professional Conduct 2 — Questions and Answers
Question 1: What are the key principles of informed consent in nursing practice?
- The patient must receive adequate information about the treatment, understand it, and give consent voluntarily without coercion, with the capacity to make the decision (Correct answer)
- The patient's family can consent on their behalf at any time
- Written consent is always required for every nursing procedure
- Consent obtained once covers all future treatments
Correct answer: The patient must receive adequate information about the treatment, understand it, and give consent voluntarily without coercion, with the capacity to make the decision
Informed consent requires that the patient has capacity, receives adequate information (including risks, benefits, and alternatives), understands the information, and gives consent voluntarily. Consent can be withdrawn at any time and must be renewed for each new procedure.
Question 2: How should a nurse handle a situation where they are asked to perform a task outside their scope of practice?
- Decline the task, explain that it is outside their scope of practice, and ensure alternative arrangements are made for patient care (Correct answer)
- Attempt the task anyway to help the team
- Perform the task but don't document it
- Ask another nurse to watch while they attempt it
Correct answer: Decline the task, explain that it is outside their scope of practice, and ensure alternative arrangements are made for patient care
Nurses must not practise beyond their scope of competence. Performing tasks outside their scope puts patients at risk and exposes the nurse to professional and legal liability. The nurse should decline, explain the reason, and ensure the task is completed by an appropriately qualified person.
Question 3: What is a 'protected disclosure' under the Protected Disclosures Act 2014 and how does it apply to nurses?
- A report of wrongdoing in the workplace made in good faith, which protects the nurse from retaliation — also known as whistleblowing (Correct answer)
- Disclosing patient information to the media
- Sharing salary information with colleagues
- Disclosing personal health information to an employer
Correct answer: A report of wrongdoing in the workplace made in good faith, which protects the nurse from retaliation — also known as whistleblowing
The Protected Disclosures Act 2014 protects workers (including nurses) who report wrongdoing in the workplace in good faith. This includes reporting patient safety concerns, financial irregularities, or breaches of law. The whistleblower is protected from penalisation.
Question 4: What are the boundaries of the nurse-patient professional relationship?
- The relationship must remain professional and therapeutic, avoiding personal, financial, or romantic involvement with patients or their families (Correct answer)
- Nurses and patients can have any type of personal relationship
- Professional boundaries only apply during working hours
- There are no specific rules about nurse-patient boundaries
Correct answer: The relationship must remain professional and therapeutic, avoiding personal, financial, or romantic involvement with patients or their families
The NMBI Code requires nurses to maintain clear professional boundaries. This means avoiding dual relationships, not accepting gifts of significant value, not entering into financial or romantic relationships with patients, and being mindful of power dynamics in the therapeutic relationship.
Question 5: What is the nurse's obligation regarding professional indemnity insurance in Ireland?
- All nurses practising in Ireland must have professional indemnity insurance, either through their employer or personally arranged (Correct answer)
- Professional indemnity insurance is optional
- Insurance is only needed for private practice nurses
- The NMBI provides automatic insurance to all registrants
Correct answer: All nurses practising in Ireland must have professional indemnity insurance, either through their employer or personally arranged
Under EU requirements and NMBI guidance, all practising nurses must have professional indemnity insurance. Most nurses employed by the HSE or private hospitals are covered by their employer's indemnity arrangements. Nurses in private or independent practice must arrange their own cover.
Question 6: What should a nurse do if they believe a medical order is potentially harmful to a patient?
- Question the order with the prescriber, provide the rationale for their concern, and if unresolved, escalate through the chain of command while refusing to carry out the harmful order (Correct answer)
- Carry out the order regardless — the doctor is always right
- Ignore the order and do nothing
- Carry out the order but document their disagreement
Correct answer: Question the order with the prescriber, provide the rationale for their concern, and if unresolved, escalate through the chain of command while refusing to carry out the harmful order
Nurses have a professional and legal duty to question orders they believe may cause harm. The nurse should discuss concerns with the prescriber, providing evidence. If unresolved, escalate to the nurse manager or clinical lead. A nurse should never carry out an order they believe will harm a patient.
NMBI Professional Conduct 2
What are the key principles of informed consent in nursing practice?