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The Nursing and Midwifery Board of Australia (NMBA) undertakes functions as set by the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law). The NMBA regulates the practice of nursing and midwifery in Australia, and one of its key roles is to protect the public. The NMBA does this by developing standards, codes and guidelines for nurses and midwives in which they are required to practice.
This fact sheet aims to provide clarity regarding the context of practice for nurses and midwives.
The NMBA understands that the existence of separate national registers for nurses and midwives may create confusion as to:
- whether a person can work both as a nurse and a midwife, and
- if the practice of nursing and midwifery is too distinct for overlap.
The NMBA acknowledges that, while some areas of practice that are nursing-specific, and some are midwifery-specific, there may also be common areas of practice.
Definitions of nursing and midwifery practice
The following definitions from the International Council of Nurses (ICN) and International Confederation of Midwives (ICM) help distinguish between the professions of nursing and midwifery. The ICM definition is far more extensive than the ICN definition, however both are included to demonstrate similarities rather than differences.
The ICN definition of nursing states that:
Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles. (ICN 2010).
In Australia, nursing is also defined through the enrolled nurse, registered nurse and nurse practitioner standards for practice, and the code of conduct and code of ethics for nurses in Australia.
The ICM definition of midwifery states that:
A midwife is a person who has successfully completed a midwifery education program that is duly recognised in the country where it is located and that is based on the ICM essential competencies for basic midwifery practice and the framework of the ICM global standards for midwifery education; who has acquired the requisite qualifications to be registered and or legally licensed to practise midwifery and use the title ‘midwife’: and who demonstrates competence in the practice of midwifery.
Scope of Practice (ICM definition)
The midwife is recognised as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labour and the post partum period, to conduct birth on the midwife’s own responsibility and to provide care for the newborn and the infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures.
The midwife has an important task in health counseling and education, not only for the woman, but also within the family and the community. This work should involve antenatal education and preparation for parenthood and may extend to women’s health, sexual or reproductive health and child care.
A midwife may practise in any setting including the home, community, hospitals, clinics or heath units. (ICM2011)
In Australia, midwifery is also defined through the midwifery competency standards and the code of conduct and code of ethics for midwives in Australia.
While nurses provide care to a diverse range of people, the focus of midwifery practice is specific. The NMBA recognises that both sets of practice standards are sufficiently dynamic to be used in the assessment of competence in a range of settings and that certain elements of practice are common to nursing and midwifery.
Examples of shared practices that are common to each profession include a nurse or midwife who:
- functions in accordance with legislation affecting practice
- accepts accountability and responsibility for own actions
- communicates effectively
- promotes safe and effective care
- assesses, plans, provides and evaluates safe effective care
- advocates for clients
- acts to enhance the professional development of self and others, and
- uses research to inform practice and decision making.
The standards for practice further translate into shared areas of practice principles which include
- emotional and physical support to patients and families
- patient education
- wound care and infection control
- pain management
- monitoring vital signs
- emergency response
- interpretation of results
- administration of medicines
- care of gynaecological surgical patients, and
- liaising with other health care professionals to ensure continuity of care.
The NMBA emphasises that this is not a comprehensive list of elements common to nursing and midwifery, and that there is no standard approach. Assessment of applications and the case that a nurse or midwife may present to support their application is assessed on an individual-by-individual basis.
In addition, the NMBA recognises that some similarities exist in the range of issues that nurses and midwives may face. In acknowledgement of the ICN and ICM definitions of nurses and midwives respectively, these similarities should be taken into account in the assessment of nurses and midwives with dual registration.
The NMBA appreciates that a number of roles exist where it may be necessary for a health professional to register both as a nurse and a midwife. An example is work with pregnant women who have drug and alcohol issues.
If an individual is applying to renew their registration as both a nurse and midwife, they must meet the requirements of the NMBA’s mandatory registration standards in both professions. However, the person can make a case on common elements of work and education applicable to nursing and midwifery.