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Reflection on Knowledge of Competencies 

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Having recently moved to West Virginia, I was not very familiar with its Nurse Practice Act at all. I had read through Maryland’s Nurse Practice Act when I lived there after I first obtained my nursing license. I learned a lot by reading through my state’s Nurse Practice Act and am glad that we were encouraged to do so for this assignment. I read that nurses must be allowed at least eight hours off after working a 12-hour shift. I also read that nurses are not allowed to work more than 16 hours in a 24-hour period unless in an emergency. I knew this was a rule because we practice it at the hospital where I work, but I did not know it was actually outlined in the Nurse Practice Act.

   I learned that as a nurse, I have the right to refuse to accept an assignment that I feel unprepared or unequipped to accept; however, there may be consequences from the employer or manager. West Virginia’s Nurse Practice Act listed some questions that I can ask myself to assess my readiness to accept an assignment. Such questions include: “Do I have the knowledge and skills needed to meet the responsibilities placed before me?”, “Have I taken care of patients like this before?”, “Have I received sufficient orientation to the unit?”. The Practice Act stated that if my answer is “no” and I still feel uncomfortable with the assignment, I should speak with management and can even use chain of command if needed to reach a safe decision for the patient. I was also reminded of the five rights of delegation: the right task, right person, right directions, right supervision, and right circumstances. This is especially helpful as my unit recently hired CNAs to assist with patient care and responsibilities. I learned the difference between delegation and assignment. Delegation is downward (i.e., RN delegating to CNA), whereas assignment is more lateral (i.e., RN delegating to RN).

   Knowledge provided by state Nurse Practice Acts can improve leadership and management skills by providing a detailed outline regarding nursing care, delegation, safety, and more. Nurse leaders and managers should be aware of what tasks can be delegated to which team members and how to give appropriate assignments. It is always important to ask yourself “check-in” questions outlined in the Nurse Practice Act in order to know our own limitations as leaders and managers and to ensure efficiency and patient safety. It is important to know guidelines for limitations regarding how many hours nurses can work so that nurse leaders and managers can keep track of each nurse’s hours and ensure both their safety and the patient’s safety. I learned many things through reading my state’s Nurse Practice Act and hope to improve my nursing care and leadership skills as a result.

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