Download a PDF of this Fact sheet - Context of practice for registered nurses and midwives (103 KB,PDF)
The Nursing and Midwifery Board of Australia (NMBA) regulates nurses and midwives in Australia. The purpose of this page is to give advice to nurses and midwives, employers and the community on the context of practice for registered nurses and midwives.
The NMBA does not regulate scope of practice. The extent of a nurse or midwife’s scope of practice is determined by the individual’s education, training and competence. The extent of an individual’s scope of practice is then authorised in the practice setting by the employer’s organisational policies and requirements.
The NMBA acknowledges that, while some areas of work are nursing specific, and some are midwifery specific, there may also be common areas of practice.
Definitions of nursing and midwifery practice
To help distinguish between the professions of nursing and midwifery are the following International Council of Nurses (ICN) and International Confederation of Midwives (ICM) respective definitions. 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 competencies, 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 registered midwife competencies 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 National Board 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 National Board 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 National Board 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 National Board 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 for renewal of registration as both a nurse and midwife, they must meet the requirements of mandatory registration standards as a nurse and a midwife. However, the person can make a case on common elements of work and education applicable to nursing and midwifery.
Further information on registration standards is available on the National Board website. Frequently asked questions on recency of practice and continuing professional development (CPD) are also published on the website.
The following documents set out requirements for re-entry to practice:
Applicants for registration can make a case on common elements of work and education applicable to nursing and midwifery.
Non practising registration enables a nurse or midwife to continue to use their nursing or midwifery title. This type of registration is only applicable to registered nurses, registered midwives and enrolled nurses. The applicant would need to meet all mandatory registration standards in order to be reinstated onto the relevant practising register.
An applicant is responsible for providing sufficient evidence to support their application for registration as a nurse and/or midwife.
Refer to the fact sheet for non-practising registration on the National Board website.