Lance:
We all want to do a good job, be really helpful, but sometimes we try to do too much, even stuff that’s not part of our job maybe just because someone asks us to. That might sound good but in aged care if we do this we might be putting clients in danger, even putting ourselves in danger. That’s why we’ve got to stop and think. We’ve got to work within our scope of practice. What’s scope of practice? Let me show you. Let’s watch Samuel helping old Jack. Jack, he has dementia, and sometimes he needs help with his medication.
Jack:
Hey. You going to help me take these here medicine. Here.
Samuel:
Okay I guess.
Jack:
You just push them out there, put them here. That Lance, he does that for me.
Samuel:
Okay.
Lance:
Hey. Wait up there Samuel. What you doing?
Samuel:
Giving Jack his tablets like he asked me.
Lance:
Remember when you asked about working in aged care and I said you have to have special training to give out medicine?
Samuel:
But this here medicine, it’s in a packet, so I don’t need to measure anything out.
Lance:
You think because medicine is in a pack that it’s safe for you to help old Jack with it?
Samuel:
Well yeah. Isn’t it?
Lance:
No it isn’t. To start with this isn’t even Jack’s tablets. That’s one of the first things you learn when you do the medication training. Make sure you’ve got the right person’s medicine. Give out the wrong one and you can make someone really sick.
Samuel:
Oh sorry. So I’ve got to learn to make sure I’ve got the right medication pack? I can do that.
Lance:
Well there’s a lot more than just that. You’ve also got to learn about things that can go wrong, like if you give old Jack his tablets and he isn’t sitting upright he might choke. You’ve got to stay watching him while he takes them, making sure he doesn’t have any problems. You’ve got to also make sure that he takes the right tablets at the right time. Like you can’t give him his night time tablets in the morning. And we always have to make sure he’s had his breakfast before we help him with his tablets because the nurse said he has to have food in his stomach or else the tablets will make him feel real bad.
Samuel:
So there’s a bit more to learn then.
Lance:
Yeah. You’ve got a lot more to learn and you’ve got to go study and get a Certificate before you can do any of this. Judith and me, we done that study and we’ve still got to go and do a refresher every year that helps remind us the right way to do things.
Samuel:
So now you’re trained does that mean you and Judith can give needles?
Lance:
No. We haven’t been trained for needles. We only help people with their tablets. That’s all our scope of practice covers.
Samuel:
Scope of practice? What’s that?
Lance:
Scope of practice is like the fence around your job. It says how far you can go and what you’re allowed to do when you’re helping people. Go past that fence and you’re working outside your boundaries.
Samuel:
Aha.
Lance:
All jobs here have boundaries to protect you, the clients and others like me and Judith. We can tell people to take their medicine but we can only help them when their medicine is in these packs. And we can’t do injections or give out medicines. That job belongs to the nurse at the clinic. And that Sonia in the kitchen, she’s been employed as the cook here. She’s done some training as a health worker years ago and she used to give injections to people then but she can’t do that here. That’s not her job. It’s not in her scope of practice. She’s just got to do cooking like in her job description.
Samuel:
So my scope of practice, that’s like a fence I don’t go over?
Lance:
Yep. That’s right. You keep working here, you increase your scope of practice. You can be like Judith and me. Get more training, more Certificates, more experience and skills.
Samuel:
Right. But what if someone asks me for help and you’re not around?
Lance:
You tell them ‘I’m not allowed to do that. I might do something wrong and make you sick’. You tell them to wait for me or Judith. That’s the right way. And if anyone tries to make you do different you tell Enid. She’ll help you.
Samuel:
Okay.
Lance:
Well we best get back to helping these old fellas and I’ll go find Jack’s medication pack.
Jack:
Hey young fella. When are you going to help me take that medicine?
Samuel:
I can’t do that Jack. I’m not trained to give medicine. That’s Lance’s job. He’s gone to get it for you now.
Jack:
Okay.
Samuel:
That wasn’t so hard to say. I want to make sure I help people, not do things the wrong way. I know now I’ve got to work to my scope of practice. What’s your scope of practice?
Care staff need to understand the parameters of their job role. Going beyond their scope of practice can place a person receiving care in danger and may be working outside the law.
Use this facilitator guide to support discussion about the concept of scope of practice in aged care.
Stories, people and places are based on individuals from different communities in East Arnhem Land. For cultural appropriateness, names have been changed.