Nursing Council of New Zealand

 

www Nursing Council of New Zealand
 

As the statutory authority, the Nursing Council of New Zealand governs the practice of nurses. The Council sets and monitors standards in the interests of the public and the profession.  The Council's primary concern is public safety.

On 18 September 2004, the legislation governing the Council changed from the Nurses Act 1977 to the Health Practitioners Competence Assurance Act 2003.

 

What's New:

 

Consultation on the competencies and standards for education programmes for the revised enrolled nurse scope of practice.

The Council will be introducing a revised scope of enrolled nurse practice for all second level nurses (see below) and has revised the competencies and the standards for education programmes for consultation. The changes made are based on the feedback the Council received during its consultation on the scopes of practice in 2009. The setting of competencies and standards will enable the transition arrangements for nurses registered in the enrolled nurse and nurse assistant scopes to be confirmed and new programmes to be approved.

All nurses registered in the enrolled nurse and nurse assistant scope of practice of the changes will be informed when transition arrangements have been finalised . In the meantime they can continue practising as usual in their existing scope of practice.

The consultation documents can be downloaded here:

Draft competencies for the enrolled nurse scope of practice

Draft education programmes standards for the enrolled nurse scope of practice

 

How to make a submission

We value the views of nurses and other stakeholders and encourage you to respond. A submission form can be downloaded here.

The closing date for submissions is 15 March 2010.

Please email your submission to Jessica@nursingcouncil.org.nz

Alternatively you may send your submission to:

Jessica Wood
Professional Standards Section
Nursing Council of New Zealand
PO Box 9644
Wellington 6141, New Zealand

 

Revised scope of practice for all second level nurses

  • The Nursing Council has decided on a revised generic scope of practice with the title “enrolled nurse” for all second level nurses.

  • The Council has agreed that an eighteen month programme with at least one third of the programme being at level 5 on the NZQA framework.

  • The Council will Gazette the new scope of practice early in the New Year and meet with stakeholders to ensure implementation can commence as soon as possible.

  • Nurses registered in the existing Enrolled Nurse and Nurse Assistant scopes will have an option to transition into the new scope of practice. Further details of this will be communicated once the new competencies have been developed.

The Council is pleased to make this decision and believes there is support for these changes among the nurses who will be affected and generally within the health sector. The new scope of practice will enable enrolled nurses to make a broader contribution to health services and give greater support to registered nurses. The Council believes that health consumers will ultimately be the beneficiaries of these changes. It will enable enrolled nurses to have a greater role in assessment and to work as part of a team with registered nurses and other health professionals in a variety of settings. It will also enable enrolled nurses to have their nursing skills recognised when working with health care assistants in aged care settings and the community.

 

Revised scope of practice

Enrolled nurses practise under the direction and delegation of a registered nurse or nurse practitioner to deliver nursing care and health education across the life span to individuals in community, residential or hospital settings. Enrolled nurses contribute to nursing assessments; care planning, implementation and evaluation of care for health consumers and/ or families/whanau/aiga potopoto. The registered nurse maintains overall responsibility for the plan of care. Enrolled nurses assist health consumers with the activities of daily living, observe changes in health consumers’ conditions and report these to the registered nurse, administer medicines and undertake other nursing care responsibilities appropriate to their assessed competence.

In acute settings, enrolled nurses must work in a team with a registered nurse who is responsible for directing and delegating nursing interventions. In some settings, enrolled nurses may coordinate a team of health care assistants under the direction and delegation of a registered nurse. In some settings, enrolled nurses may work under the direction and delegation of a registered health professional. In these situations the enrolled nurse must have registered nurse supervision and must not assume overall responsibility for nursing assessment or care planning. Enrolled nurses are accountable for their nursing actions and practise competently in accordance with legislation, to their level of knowledge and experience. They work in partnership with the consumer, and family/whanau/aiga potopoto and multidisciplinary teams.

 

Background

Since the introduction of the Health Practitioners Competence Assurance Act in 2004, there have been two scopes of practice for second level nurses. Enrolled nurses who completed an apprenticeship hospital based programme before 1994 and Nurse assistants who completed a one year level 4 certificate programme through a tertiary provider with a specific focus on an area of practice e.g. aged care.

In March 2009 the Minister of Health requested the Council to work with sector representatives to develop a revised enrolled nurse scope of practice The Council held a series of regional meetings with key stakeholders, seeking their views on a revised scope of practice and education framework. The Council received 460 submissions to a consultation document released in August 2009. (Click here)

The majority of submitters indicate their support for one generic second level nurse scope of practice. The broadening of the scope of practice desired by most submitters was to increase the flexibility of the scope of practice to allow second level nurses to work across health settings, to increase skills in assessment and for second level nurses to be able to lead unregulated workers in some settings.

The main reason given for supporting a second level nurse included the need for the registered nurses to be supported by a regulated worker with appropriate knowledge and skill when working with vulnerable clients.

The title “enrolled nurse” was supported by the majority of submitters.

Most submitters supported the development of the existing nurse assistant programmes into a generic programme with level 5 credits. There was support for lengthening the programme.

 

Analysis of submissions

The Council invites you to read the analysis of submissions which can be downloaded here.

 

Individual submissions

The Nursing Council has decided to make individual submissions publicly available. Some submitters have chosen to not have their response published. Several respondents have accepted this offer and thus the list below is not a complete list of submissions.

 

Submitters

Aoraki Polytechnic

North Haven Hospice

Auckland District Health Board

Nurse Maude Association

Auckland Regional Enrolled Nurse Section, NZNO

Nursing and Midwifery Board of the Northern Territory , Australia

Bay of Plenty District Health Board

Nursing and Midwifery Board of Western Australia

Capital and Coast District Health Board

Nursing Education in the Tertiary Sector

Careerforce (Community Support Services Training Organisation Ltd)

Occupational Therapy Board of New Zealand

Caughey Preston Trust

Older Persons' Health Reference Group, Careerforce (Community Support Services Training Organisation Ltd)

Christchurch Polytechnic Institute of Technology

Otago Community Hospice

College of Nurses Aotearoa

Paediatric Society of New Zealand

Counties Manukau District Health Board

Palliative Care Nurses New Zealand

Critical Care Nurses Section, NZNO

Pharmacy Council of New Zealand

District Health Boards New Zealand

Primary Health Care Nurses Advisory Council, NZNO

Diabetes Nurse Specialist Section, NZNO

Private Community Service Provider

District Health Board

Radius Residential Care

Education Provider

Royal New Zealand Plunket Society

Hawke's Bay District Health Board

South Canterbury District Health Board

Health Care Development and Primary Health Care Nursing Clinical Governance Council, Mid Central District Health Board

Southern Cross Hospitals Ltd

Hurst Holdings Ltd

Southern Institute of Technology

Kites Trust (Mental Health Community Development Trust)

Southern Region Enrolled Nurse Section, NZNO

MercyAscot Hospital

Taranaki District Health Board

Ministry of Health

Te Ao Maramatanga- New Zealand College of Mental Health Nurses

Ministry of Women's Affairs

Te Runanga o Aotearoa, NZNO

National Enrolled Nurse Association of Australia

The Office of the Health and Disability Commissioner

National Enrolled Nurse Section, NZNO

Unitec, Department of Nursing

National Residential Disability Providers Group

Universal College of Learning , School of Nursing

Nelson Marlborough District Health Board

Waiariki Institute of Technology

New Zealand Aged Care Association

Wairarapa District Health Board

New Zealand College of Midwives

West Coast District Health Board

New Zealand Institute of Rural Health

West Coast Enrolled Nurses Section, NZNO

New Zealand Nursing Organisation

Whanganui District Health Board

New Zealand Private Surgical Hospitals' Association

Whanganui Regional Primary Health Organisation

New Zealand Public Service Association

 

Submitters

Enrolled Nurse 1

Enrolled Nurse 31

Enrolled Nurse 2

Enrolled Nurse 32

Enrolled Nurse 3

Registered Nurse 1

Enrolled Nurse 4

Registered Nurse 2

Enrolled Nurse 5

Registered Nurse 3

Enrolled Nurse 6

Registered Nurse 4

Enrolled Nurse 7

Registered Nurse 5

Enrolled Nurse 8

Registered Nurse 6

Enrolled Nurse 9

Registered Nurse 7

Enrolled Nurse 10

Registered Nurse 8

Enrolled Nurse 11

Registered Nurse 9

Enrolled Nurse 12

Individual Nurse 1

Enrolled Nurse 13

Enrolled Nurse Group 1

Enrolled Nurse 14

Enrolled Nurse Group 2

Enrolled Nurse 15

Registered Nurse Group 1

Enrolled Nurse 16

Registered Nurse Group 2

Enrolled Nurse 17

Individual Nurse Group 1

Enrolled Nurse 18

Individual Nurse Group 2

Enrolled Nurse 19

Individual Nurse Group 3

Enrolled Nurse 20

Individual Nurse Group 4

Enrolled Nurse 21

Individual Nurse Group 5

Enrolled Nurse 22

Nurse Assistant Student Group 1

Enrolled Nurse 23

Example representing 85 shortened submission forms

Enrolled Nurse 24

Shortened Submission forms- Group 1

Enrolled Nurse 25

Shortened Submission forms- Group 2

Enrolled Nurse 26

Shortened Submission forms- Group 3

Enrolled Nurse 27

Shortened Submission forms- Group 4

Enrolled Nurse 28

Shortened Submission forms- Group 5

Enrolled Nurse 29

Shortened Submission forms- Group 6

Enrolled Nurse 30

 

Nursing Council's role in keeping you safe

The Nursing Council has published a pamphlet with information for the public, to view a copy please click here.

 

Important notice from the Nursing Council of New Zealand

It is a requirement that all information provided by an applicant in support of his/her application for registration must be true and accurate. Where false or misleading information is submitted the application will not be processed. This may affect any subsequent application and the appropriate authorities may be notified.

If the applicant obtained registration by making a false or misleading representation or declaration or was not entitled to be registered the Council may order the cancellation of the applicant’s registration.

 

Consultation on the registered nurse scope of practice under the Health Practitioners Competence Assurance Act (2003) (Expanded practice)

The Council is aware that, in a rapidly moving practice environment, nurses are increasingly being required to perform extended practice roles. The Council has completed a consultation with the sector on an appropriate framework for ensuring the safety of the public in an environment where practice is expanding and is increasingly complex and diverse.

The Council’s consultation (please click here to download the consultation document) sought feedback on whether the registered nurse scope of practice should be extended, whether another scope of practice for registered nurses performing these types of roles is required, whether a credentialing framework is implemented (and if so, by whom) or whether authorisation of individual scopes of practice is appropriate.

The Council received over 150 submissions. The Council thanks all the individuals and organisations who made a submission. Many of the submitters agreed to the placement of their submission on the website. These can be found below.

The submissions have been analysed and there is no clear direction on which option is most supported. The Council is aware that this is an important decision for the safety of the public and for individual nurses. It will be taking time to consider all the issues before making a decision in 2010. This will include further discussions with key stakeholders. The Council invites you to read the analysis of submission which can be downloaded here. Analysis of submissions and Executive summary.

The Council is aware that some nurses may have concerns that they are practising outside of their scope of practice. While these decisions are being considered they should be reassured that the Council will not take any measures to limit their activities but they have a professional responsibility to ensure they are competent.

The Council will keep the sector informed of any decisions in the coming months.

 

Individual submissions

The Nursing Council has decided to make individual submissions publicly available. Some submitters have chosen to not have their response published. Several respondents have accepted this offer and thus the list below is not a complete list of submissions.

 

 

Submitters

Australian and New Zealand College of Anaesthetists

New Zealand Society of Physiotherapists Inc and The New Zealand College of Physiotherapy

Atawhai Assisi Home & Hospital Hamilton

Nurse and Midwives Board of New South Wales, Australia

Auckland District Health Board

Nurse Educators in the Tertiary Sector

Australian Nursing and Midwifery Council

Nurse Executives of New Zealand

Bay of Plenty District Health Board

Nurse Maude

Capital & Coast District Health Board

Nurse Practitioner Advisory Committee of New Zealand

Caughey Preston Trust

Nurse Practitioners New Zealand

Centre for Postgraduate Nursing Studies, University of Otago Canterbury

Nurses for a Smokefree Aotearoa / New Zealand

College of Nurses Aotearoa

Nursing & Midwifery Board of the Northern Territory, Australia

Counties Manukau District Health Board

Nursing Education Advisory Committee, Eastern Institute of Technology

Critical Care Nurses Section of NZNO

Otago/Southland District Health Boards

Dietitians Board

Palliative Care Nurses New Zealand Society Inc.

District Health Boards New Zealand

Pharmacy Council of New Zealand

Faith Community Nurses’ Association

Primary Health Care Nurse Leaders Steering Group

General Practice Nursing Alliance

Royal New Zealand Plunket Society

Health and Disability Commissioner

Rural Canterbury Primary Health Organisation

Hutt Valley District Health Board

South Canterbury District Health Board

Lakes District Health Board

Southern Cross Hospitals Ltd

Medical Council of New Zealand

Tairawhiti District Health Board

MidCentral Health

Taranaki District Health Board

Midwifery Council of New Zealand

Te Ao Maramatanga ( New Zealand College of Mental Health Nurses)

National Residential Intellectual Disability Providers

Te Pou (National Centre of Mental Health Research, Information and Workforce Development)

Nelson Marlborough District Health Board

Te Rau Matatini (Aotearoa Māori Mental Health Workforce Development)

Nelson Marlborough Institute of Technology

Te Tai Tokerau Primary Health Care Nurse Leadership Group

New Zealand College of Midwives

The Nurses Board of South Australia

New Zealand College of Practice Nurses

The Royal New Zealand College of General Practitioners

New Zealand Institute of Rural Health

University of Auckland

New Zealand Medical Association

Waitemata District Health Board

New Zealand Nurses Organisation

Wellington Section of Peri-Operative Nurses College

New Zealand Private Surgical Hospitals Association

West Coast District Health Board

New Zealand Public Service Association Te Pūkenga Here Tikanga Mahi

Western Institute of Technology at Taranaki

New Zealand Rural General Practice Network

Whanganui District Health Board

New Zealand Society for the Study of Diabetes

Whanganui Regional Primary Health Organisation

New Zealand Society of Anaesthetists Submission / Letter

Wharangi Ruamano (Māori Nurse Educators Group)

 

 

Submitters

Registered Nurse 1

Registered Nurse 21

Registered Nurse 2

Registered Nurse 22

Registered Nurse 3

Registered Nurse 23

Registered Nurse 4

Registered Nurse 24

Registered Nurse 5

Registered Nurse 25

Registered Nurse 6

Registered Nurse 26

Registered Nurse 7

Registered Nurse 27

Registered Nurse 9

Registered Nurse 28

Registered Nurse 10

Registered Nurse 29

Registered Nurse 11

Registered Nurse 30

Registered Nurse 12

Registered Nurse Group 1

Registered Nurse 13

Registered Nurse Group 2

Registered Nurse 14

Registered Nurse Group 3

Registered Nurse 15

Registered Nurse Group 4

Registered Nurse 16

Registered Nurse Group 5

Registered Nurse 17

Registered Nurse Group 6

Registered Nurse 18

Registered Nurse Group 7

Registered Nurse 19

Registered Nurse Group 8

Registered Nurse 20

Registered Nurse Group 9

 

Revised Nurse Practitioner Guidelines

The revised Nurse Practitioner application package and information is now available on the website. Please click here for further information.

 

Evaluation of the continuing competence framework

The Council began a major research project in July 2009 to determine if the way we currently measure continuing competence – through practice hours, professional development hours and peer assessment of competence are the best ways to determine continuing competence. These measures reflected the best thinking when the Health Practitioners Competence Act (2003) was introduced and five years on a review is appropriate. There has been very little research anywhere in the world with regard to the measurement of continuing competence and the findings of this project will be of international interest.

We are pleased to announce that Rachael Vernon the Head of School, Nursing, at the Eastern Institute of Technology (EIT) Hawke’s Bay has been awarded the research contract. Rachael is currently undertaking her doctoral studies through the University of Sydney. Rachael’s research team includes Professor Mary Chiarella (Professor of Nursing & Chair, Australian Nursing & Midwifery Council, University of Sydney), Dr Elaine Papps (Professor of Nursing, EIT Hawke’s Bay) and Professor Denise Dignam (Associate Dean, University of Technology, Sydney).

The study will include seeking feedback from nurses on current continuing competence requirements, via an on–line survey which will be undertaken during November 2009. The project is expected to be concluded in March 2010.

 

Revised First Surgical Assistant Guidelines

The revised First Surgical Assistant application package and information is now available on the website. Please click here for further information.

 

Nursing Council or Nurses Organisation

Know the difference, please click here for further information

 

Internationally qualified nurses applying for registration in New Zealand

Since 1 January 2009, all international applicants from all countries (except Australia) are required to sit an English Language assessment before submitting an application.

The assessment can be either the International English Language Testing (IELTS) Academic Test, or the Occupational English Test (OET).

(click here for further information)

 

Returning to nursing practice

If you have not been practising as a nurse within the last five years, either in New Zealand or overseas, you will be required to complete a competence assessment programme before being issued an annual practising certificate.

Please contact a competence assessment programme provider (click here for further details) regarding the course and the cost.

 

Approval of nurse entry to practice expansion programmes

The Nursing Council approves and audits these programmes under contract to the Clinical Training Agency (CTA). These programmes are an expansion of the Nurse Entry to Practice programmes to include newly graduated nurses working in non-DHB community based providers such as primary health care, aged care services, rehabilitation providers, Maori health care providers.

The programmes are delivered collaboratively between the DHB and service providers. The approval and audit process requires programme providers to demonstrate that the processes and systems they have in place meet the standards of the Nursing Council and CTA.

The approval process follows the same steps as the auditing of the Nurse Entry to Practice programmes. A comprehensive toolkit has been compiled by DHBNZ that contains information about the programme and explains the steps in the audit process, the audit tool, desk audit requirements and suggested site visit timetable.

The various forms can be downloaded from this document (click here for the toolkit).

All audits must be completed by May 2009. Programme co-ordinators are requested to contact Lyn Dyson , Education Nurse Advisor on lyn@nursingcouncil.org.nz to arrange an audit date

 

First surgical assistant and nurse colposcopist roles (click here for further information)

 

NEW Nurse practitioner competencies
 
The Nursing Council has considered submissions on the draft Competencies for the nurse practitioner scope of practice. A total of 47 submissions were received, with several submissions representing either groups of nurses or nursing organisations. The Council is pleased to announce that the nurse practitioner competencies were approved at their September 2008 meeting. Applicants for approval to the nurse practitioner scope of practice after 30 September 2009 are required to meet the new competencies. The Nursing Council is working with NPAC NZ to update the guide to assist applicants in the approval process.

Click here for Nurse practitioner competencies

 

  • Nursing Council of New Zealand fees
    Click here to see the Council's new fees.
  • Definition of practising for the purposes of the Health Practitioners Competence Assurance Act 2003

    Introduction
    The Council is required to define practising, for the purposes of the Health Practitioners Competence Assurance Act 2003 (“the Act”), because it must:
    • determine whether a nurse has maintained the required standard of continuing competence pursuant to section 27(a) of the Act
    • determine whether or not a nurse has lawfully practised nursing in the 3 years preceding the date of application for a practising certificate (section 27(f) of the Act)
    • decide whether or not a nurse has practised without a practising certificate (sections 8(1) and 100(1)(d) of the Act).

    In the 20 months since the Act came into force, the sector has provided the Council with valuable feedback on the current definition of practising. The Council has carefully considered this feedback and has re-worded the definition to ensure that it fulfils its purpose of protecting the health and safety of members of the public by ensuring that nurses are competent and fit to practise.

    New definition
    Nursing practice is using nursing knowledge in a direct relationship with clients or working in nursing management, nursing administration, nursing education, nursing research, nursing professional advice or nursing policy development roles, which impact on public safety.

    Explanatory note
    • This means that if a person has the responsibilities of a nurse as defined by the Nursing Council scopes of practice and is using his or her nursing knowledge in a direct relationship with clients he or she should hold a practising certificate.
    • If a nurse is employed in one of the other roles set out in the definition he or she may not require a practising certificate unless his or her role impacts on public safety.

    Purpose of the definition
    The purpose of this definition is to ensure that nurses who are in a direct nursing relationship with clients or whose role impacts on public safety are required to comply with the mechanisms put in place by the Act to ensure that nurses have maintained the required standard of competence to protect public safety, such as ongoing professional development and completing hours of practice.

    It is not intended to include nurses who no longer have nursing responsibilities but who choose to continue working in the health care sector. The definition may include some practitioners who are working as nurses but whose employers have not previously required them to hold practising certificates.

    Eligibility
    There may be some nurses on the register who did not fit within the previous definition of practising who may wish to make new applications for practising certificates. Applications for practising certificates are always considered on an individual basis. If you have any questions regarding your eligibility or whether you require a practising certificate in your current role, please contact the registration section of the Nursing Council.

  • Nursing entry to practice programmes
    Click here to read information for district health boards intending to apply for Council approval for nurse entry to practice programmes.

  • Professional development and recognition programmes
    Click here for a list of professional development and recognition programmes.
  • Nurse practitioner prescribing
    Requirements for education and continuing competence for nurse prescribers were gazetted 10 November 2005 and came into force on 8 December 2005. Click here to read the gazette notice.
  • New competencies and standards
    New competencies have been approved for the nurse assistant, enrolled nurse and registered nurse scopes of practice.

    New education programme standards have been approved for the nurse assistant and registered nurse scopes of practice.

    They may be downloaded by clicking on the links in the previous paragraphs.

    The following implementation plan has been developed taking into account that institutions with approved programmes have internal processes to complete before they are able to implement the standards and competencies into existing curricula:

    The competencies for the registered nurse, nurse assistant and enrolled nurse scopes of practice were implemented for the purpose of assessment of continuing competence from August 2006.
  • Health Practitioners Competence Assurance Act 2003
    For a general overview please click here .

  • Scopes of practice
    To read about the scopes of practice, click here

  • Public register
    For information about the public register click here

  • Competence provisions Read about competence reviews click here

  • Changing the condition on a scope of practice
    Click here if you are a registered nurse who wants to change the condition in your scope of practice?

  • Nurse practitioners
    For more information click here

  • Nurse assistants
    For more information click here

 

For further news, please go to our news and issues page.

The Nursing Council of New Zealand would be pleased to receive feedback on your use of this website, and ideas on information which would assist you to complete your inquiry.

 

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Site last updated 9 February 2010

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