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McKenna, B., O'Brien, A. J., Dal Din, T., & Thom, K. (2006). Registered nurses as responsible clinicians under the New Zealand Mental Health (Compulsory Assessment and Treatment) Act 1992. International Journal of Mental Health Nursing, 15(2), 128–134.
Abstract: The objectives of this research were to determine how many registered nurses are working as 'responsible clinicians', under what phases of the legislation they are functioning, and to describe the enabling processes and barriers to nurses undertaking this statutory role. An anonymous descriptive survey was distributed to the 11 nurses who were currently responsible clinicians as well as five senior nurses selected from each of the 21 district health boards and the Auckland Regional Forensic Psychiatry Services (n=121). The response rate was 88.4% (n=107). The survey questioned respondents on statutory roles currently undertaken. Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain it. They were also asked which competencies of the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. Of the approximately 395 responsible clinicians nationally, 11 (2.8%) are nurses. Most nurses viewed the role as legitimate. However, many were unaware of competencies for the role and credentialing processes, and were somewhat ambivalent about achieving the role due to current workload, role conflict and lack of remuneration. Competency deficits were highlighted. The authors conclude that there are grounds to encourage nurses as responsible clinicians given the intent of the legislation. This will require the promulgation of appropriate mental health policy, and a concerted effort by major stakeholders in mental health service delivery.
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McKenna, B., O'Brien, A. J., Dal Din, A., & Them, K. (2006). Responsible clinician role offers opportunities for nurses. Kai Tiaki: Nursing New Zealand, 12(11), 12–14.
Abstract: The authors report on a recent study investigating the statutory role of responsible clinician. Statutory roles under mental health legislation offer mental health nurses a means of having advanced practice skills recognised, as well as contributing to improved access to services. There is a proliferation of roles intended to develop nursing readership, but in most cases they are not primarily clinical roles. The concept of “advanced practice” has become a means of developing clinical leadership roles in nursing. Research on responsible clinician role is presented along with the results of a survey of the 11 Registered Nurses practicing as responsible clinicians, five senior nurses from each of the 21 district health boards, and the Auckland Regional Forensic Psychiatry Services (n = 121). Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain or maintain that role. They were also asked which competencies for the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. A clear majority of the respondents felt the role of the responsible clinician was a legitimate advanced practice role for mental health nurses. Despite this, some respondents expressed ambivalence about taking on the role. The research highlighted deficits in knowledge and skills that could become a focus of education for advanced practitioners seeking appointment as responsible clinicians. Deficits included some assessment skills, knowledge of a range of interventions and knowledge of other legislation affecting mental health legislation.
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Carryer, J. B., & Boyd, M. (2003). The myth of medical liability for nursing practice. Nursing Praxis in New Zealand, 19(4-12), 4–12.
Abstract: This article explores the complex nature of liability in the case of standing orders and vicarious liability by employers, and also when nurses and doctors are in management roles. The authors address misconceptions about medico-legal responsibility for nursing practice with the advent of nurse prescribers and nurse practitioners. They refer to the submission made by the College of Nurses Aotearoa (NZ) on the Health Practitioners Competence Assurance Act (2003), and discuss practice liability and nurse-physician collaboration.
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