2.7 Professional issues
Scope of practice and supervision
All nurses should work within their scope of practice,
competency level, and the policies established by the individual
general practice.
Nurses working in general practice may be either registered
or enrolled nurses (RN Division 1 and Division 2 in Victoria). Where enrolled nurses are employed, it is the obligation of the
employing general practice to ensure the enrolled nurse is either
directly or indirectly supervised by a registered nurse. The level
of supervision required depends on the abilities, education,
qualifications, scope of practice and experience of the enrolled
nurse and external factors such as geographical setting and size
of the practice. Most state and territories have legislation that
requires enrolled nurses to be supervised by registered nurses.
In South Australia enrolled nurses can apply for exemption from
the requirement of supervision by a registered nurse
(http://www.nursesboard.sa.gov.au/pdf/Enrolled_Nurse_Working_Without_Supervision.pdf).
Further information regarding supervision of the enrolled nurse
can be found at Australian Nursing and Midwifery Council
— Position Statements and Guidelines. http://www.anmc.org.au/research_policy/position_statements.php
Authority to practice as a registered or
enrolled nurse
Each Australian state and territory has a statutory authority
responsible for the registration of nurses and midwives, the
authorisation of nurses and midwives to practice as nurse
practitioners and midwife practitioners respectively, and for the
enrolment of nurses in that state.
Nurses are required to renew their registration or enrolment with
the statutory authority on an annual basis.
The minimum essential qualifications to be held by a nurse employed in general practice are registered nurse and enrolled
nurse. Enrolled nurses are associates to registered nurses and
work under the direction and supervision of registered nurses,
and where appropriate registered midwives.
Registered nurses
A person who has undertaken a bachelor level education
program of not less than three years, or prior to 1985, have
successfully completed a hospital based registered nurse
training program. They must be currently licensed to practice
nursing in an Australian state or territory.
Enrolled nurses
A person who has undertaken a shorter program of education
(usually in a vocational education setting, eg TAFE ), and is
licensed as an enrolled nurse (Division 2 in Victoria) in an
Australian state or territory Nurses Act, to provide nursing care
under the supervision of a registered nurse.
Enrolled nurses working in general practice
Enrolled nurses work under the direction and supervision
of a registered nurse, consistent with the ANMC’s National
Competency Standards for the Enrolled Nurse. Where a medical
practice or any other organisation requires only one nurse, this
should ideally be a registered nurse. If additional nurses are
employed it may be appropriate to employ enrolled nurses. This
would however depend upon the knowledge and skills required
for the particular position, the ability of the registered nurse
to provide adequate supervision, to delegate nursing care, to
undertake an overall assessment of patients’ needs and the
enrolled nurse’s abilities.
How to check a nurse’s authority to practice
Registered nurses, registered midwives and enrolled nurses
are issued certificates of registration and enrolment when they
initially register or enrol. In order to continue in practice, each
year nurses and midwives are required to obtain an authority
to practice for a further year. Nurses and midwives who hold
current registration or enrolment will be able to show a current
authority to practice (card) to an employer or other person
who requests it. This shows the name under which the person
is registered and the period of authorisation to practice.
Employers are advised to sight a potential employee’s or
contractor’s original authority to practice card to ensure it is current,
and to verify the identity of the cardholder. Once employed, this
needs to be sighted annually. It is advised to keep a photocopy
of the nurse’s current authority to practice card in their personnel
file and to replace this annually at the date of renewal.
Any person may contact a registration board to inquire whether a person of a particular name is entered in the Register of
Nurses, Register of Midwives or Roll of Nurses.
Contact:
• Nurses and Midwives Board New South Wales
• http://www.nmb.nsw.gov.au/
• Health Professionals Licensing Authority, Northern Territory
• http://www.nt.gov.au/health/org_supp/prof_boards/prof_licensing_auth.shtml
• Nurses Board of South Australia
• http://www.nursesboard.sa.gov.au/index.html
• Nursing Board of Tasmania
• http://www.nursingboardtas.org.au/nbtonline.nsf/$LookupDocName/home
• Nurses Board of Victoria
• http://www.nbv.org.au/
• Nurses Board of Western Australia
• http://www.nbwa.org.au/
• Queensland Nursing Council
• http://www.qnc.qld.gov.au/home/index.aspx
• ACT Nursing and Midwifery Board
• http://www.nursesboard.act.gov.au/
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