Nursing regulation in australia.

 All registered health practitioners must read and adhere to their respective National Boards codes and guidelines in full: Nurses should refer to the Nursing and Midwifery Board of Australia’ guidelines, standards and codes of conduct. Nurses and midwives must be registered with the Nursing and Midwifery Board of Australia (NMBA) and meet the NMBA’s professional standards to practice in Australia. 

Professional standards define the practice and behaviour of nurses and midwives and include:

o codes of conduct 

o standards for practice; and

o codes of ethics.

It is the responsibility of the individual nurse or midwife to maintain professional standards, competence and ethics. It is the responsibility of the individual nurse or midwife to maintain and inform their scope of practice with ongoing education and competence (1).

Enrolled Nurse (EN)

The EN works with the registered nurse (RN) as part of the health care team and demonstrates competence in the provision of person-centred care. Core practice generally requires the EN to work under the direct or indirect supervision of the RN. At all times, the EN retains responsibility for his/her actions and remains accountable in providing delegated nursing care. The need for the EN to have access to a named RN at all times and in all contexts of care for support and guidance is critical to patient safety (2).

· Enrolled Nurse | Standards for Practice 

Registered Nurse  

RN practice is person-centred and evidence-based with preventative, curative, formative, supportive, restorative and palliative elements. RNs work in therapeutic and professional relationships with individuals, as well as with families, groups and communities. These people may be healthy and have a range of abilities or have health issues related to physical or mental illness and/or health challenges. These challenges may be posed by physical, psychiatric, developmental and/or intellectual disabilities (3).

Registered Nurse | Standards for Practice 

Midwife

The midwife is responsible and accountable for maintaining their capability for midwifery practice that may include: 

o providing women’s health support, care and advice before conception, during pregnancy, labour, birth and the postnatal period,  

o promoting normal physiological childbirth and identifying complications for the woman and her baby via consultation with and referral to medical care or other appropriate assistance, and  

o implementing emergency measures (4).

Using the principles of midwifery continuity of care, primary health care and cultural safety, the midwife provides health counselling and education, which may include preparation for childbirth and parenthood. The midwife’s practice may extend to women’s health, reproductive and sexual health, and child and family health care (5). 

· Midwife | Standards for Practice 

Nurse Practitioner 

Nurse Practitioners (NP) can manage, and are accountable for, complete episodes of care including wellness-focused care and as the primary provider of care or part of a care team. NPs collaborate and consult with health consumers, their families and community, and other professionals, including health personnel, to plan, implement and evaluate integrated care that optimises outcomes for recipients, their progression through the health system and access to relevant systems of care. 

As part of providing care, NPs can independently request and interpret any diagnostic and/or screening investigations within their scope of practice to facilitate diagnosis and/or screening processes. This informs diagnosis and care planning. Care can include nursing interventions that involve initiation, titration or cessation of any medicines within their scope of practice. NP practice encompasses technical and procedural skills that are applied as part of their responsibility in initiating and managing complex healthcare requirements. NPs take responsibility for following up on any components of care initiated. They are accountable for care provided and self-monitor their work (6).

· Nurse Practitioner | Standards of Practice 

References

1. AHPRA (2023) Nursing and Midwifery Board. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

2. AHPRA (2023) Nursing and Midwifery Board. Enrolled nurse standards for practice. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/enrolled-nurse-standards-for-practice.aspx

3. AHPRA (2023) Nursing and Midwifery Board. Registered nurse standards for practice. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

4. International Confederation of Midwives (2005) Philosophy and Model of Midwifery Care. https://www.internationalmidwives.org/assets/files/general-files/2020/07/cd0005_v201406_en_philosophy-and-model-of-midwifery-care.pdf
 

5. AHPRA (2023) Nursing and Midwifery Board. Midwife standards for practice. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/Midwife-standards-for-practice.aspx
 

6. AHPRA (2023) Nursing and Midwifery Board. Nurse Practitioner standards for practice. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/nurse-practitioner-standards-of-practice.aspx