commentary

Victoria Fletcher, RN, MSN, CNM

Sign on the Dotted Line Exploring- Your Professional Contract

ecently my fourteen-year-old son presented me with a contract to sign. He wanted to be com- R pensated for grades on his report card. The con-

tract specified what was to happen if the grades were good, and if some grades were less than desirable. At the end of the document were dotted signature lines for both of us.

“Here Mom, sign on the dotted line,” he said. My son knew that if I signed I would be obligated to adhere to the provisions of the contract. When I recovered my composure, I realized that I had an aspiring Thurgood Marshall on my hands.

Your Contract with Nursing Aside from humor, I think there’s a message for nurses in this story. Ask yourself:

Did you sign on the “dotted line” when you applied for a practical or registered nursing license in your state of residence? Do you know the “provisions” of your contract with the state and the profession? How do you fulfill the “obligations” that you assumed upon entering the practice of nursing?

Based on more than six years of service on the Washington State Board of Nursing, I’m not surprised to find that I have more than a few thoughts on this subject. Every person with a license to practice nursing is obligated to be aware of and abide by the laws and rules governing the practice of nursing in the state where he or she practices. This means being familiar with the Nurse Practice Act, adhering to its provisions, and the provisions of any other laws and rules that per- tain to the practice of nursing.

The second obligation involves maintaining a current knowledge base in your nursing field and specialty. Completion of educational activities and affiliation with professional and specialty associations (such as AWHONN) are just two of the many ways to stay cur- rent. Safety and success in the information age depend on lifelong learning. So does the safe practice of nursing.

Nurses have a third obligation to supervise and dele- gate appropriately. A fourth obligation is, for nurses to

Victoria Fletcher, RN, MSN, CNM, is past chair of the Washington State Nursing Care Quality Assurance Commission (Board of Nursing) and a former member of the AWHONN Lifelines Editorial Advisory Board.

limit patient care activities to what’s within the legal scope of nursing practice, and to limit practice to those areas in which the nurse has received education, has experience, and has demonstrated competency.

Nurses should also report unsafe nursing acts. These last two obligations are perhaps the most important. Every nurse assumes responsibility con- veyed by the public trust of the citizens of the respective state. Nurses must exercise this respon- sibility in their daily practice and advocacy for clients. This includes practicing without discrimi- nation and protecting the privacy rights of indi- viduals in our care.

Every nurse assumes responsibility conveyed by the public trust of the citizens of the respective state. Nurses must exefcise this responsi- b i l i in their daily practice and advocacy for clients. This includes practicing without discrimination and protecting the privacy rights of individuals in our care.

Contract in Effect Am I now going to ask you to sign on the dotted line? Guess what? Your contract is already fully executed, and has been ever since you first entered the practice of nursing. Therefore, take advantage of the resources available to you to meet these obligations. Request a copy of your state’s Nurse Practice Act, review and share it with a colleague. Attend your state board of nursing disciplinary hearings and business meetings. They are open to all. Volunteer to participate on a task force or committee to consider policy and emerging issues. Get involved with the political issues that have an impact on nursing and clients. Contact your legisla- tors and other elected officials and give your opinion on the health issues facing people today. You have nothing to lose, and everything to gain. +

AugustSeptember 1999