The construction and regulation of nursing practice in Australia

The regulation of nursing practice has been shown to be an important component of the accountability which professional nurses are committed to in the delivery of care. A qualitative descriptive study was undertaken of the perception of nurses working in hospitals of the effect of regulation on their ability to practise nursing in the way they expect or desire. A theoretical framework was constructed to enable a description and interpretation of twenty-two female nurses’ perceptions about the nature of their practice in relation to the context of professional regulation and the context of the bureaucratic workplace. Data analysis showed a high degree of agreement among the participants with regard to the social construction of nurses and nursing work. There was however little understanding of the nature of professional regulatory control beyond the initial requirement for licensure to practice. The hierarchical and bureaucratic construction of the modern hospital was seen by participants to affect their ability to carry out the quality of nursing care they expected to be able to implement. And whilst this does not cause them to be disillusioned with nursing itself, it leads to frustration and can contribute to poor practice. The results have implications for consumers of nursing care, the nurse regulatory authorities, and the health care delivery system and for nurses who wish to practice as reflective, accountable and responsible practitioners. Several recommendations arose from the findings in relation to further research and policy making. There should be ongoing assessment of professional competence to practice in the workplace. This assessment could be used, by the nurse, as evidence for maintenance of the license to practice. Collaboration between the regulatory authority, the practising nurse and the managers and employers of nurses could contribute to an in depth explication of nursing practice and contribute to a more informed allocation of scarce resources