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 registration standards, professional codes, guidelines and standards for practice which together establish the requirements for the professional and safe practice of nurses and midwives in Australia.
Registration as an enrolled nurse (EN) means you need to meet the NMBA’s mandatory registration standards. ENs are expected to practise within the relevant NMBA-approved standards for practice and decision-making frameworks.
The following questions answer common queries that you might have about the Enrolled nurse standards for practice (the standards), which will replace the National competency standards for the enrolled nurse and are available on the Professional standards page.
Download a PDF of the Fact sheet - Enrolled nurse standards for practice - August 2016 (59.4 KB,PDF).
The Enrolled nurse standards for practice are the core practice standards that provide the framework for assessing EN practice. The standards:
- communicate to the general public the standards that can be expected of ENs
- determine the eligibility for registration of people who have completed an EN program of study in Australia
- determine the eligibility for registration of ENs who wish to practise in Australia but have completed courses elsewhere
- assess ENs who wish to return to work after being out of the workforce for a defined period, and
- assess ENs who need to show that they are competent to practise.
These standards replace the National competency standards for the enrolled nurse that were first published in 2002 by the Australian Nursing and Midwifery Council (ANMC) and adopted by the NMBA at the start of the National Registration and Accreditation Scheme (the National Scheme) in July 2010 (18 October in Western Australia).
The standards have been developed following an extensive literature review, a survey of ENs, interviews with ENs, observations of ENs in practice, and consultation with consumers and other key stakeholders including education providers.
The Enrolled nurse standards for practice (2015) take effect on 1 January 2016.
- 21 October 2015 - the NMBA Enrolled nurse standards for practice released
- 1 January 2016 - the NMBA Enrolled nurse standards for practice come into effect
- During the transition period - 21 October 2015 to 31 December 2015 - the current National competency standards for the enrolled nurse apply.
Research suggested that confusion existed between the use of the term ‘competency based assessment’ in the vocational education and training (VET) sector and use of the term ‘competency’ in other settings.
You need to familiarise yourself with the standards before 1 January 2016.
During the transition period (21 October 2015 to 31 December 2015), we encourage you to reflect on your practice using the standards, and complete continuing professional development (activities) that will help you identify and address areas of learning.
The standards provide clarity about supervision, delegation and role relationships, including:
- the EN needs to work under the direct or indirect supervision of a registered nurse (RN)
- the EN keeps responsibility for their actions, and
- the EN is accountable in providing delegated care.
Direct supervision is when the supervisor is actually present and personally observes, works with, guides and directs the person who is being supervised.
Indirect supervision is when the supervisor works in the same facility or organisation as the supervised person, but does not constantly observe their activities. The supervisor must be available for reasonable access. What is reasonable will depend on the context, the needs of the person receiving care and the needs of the person who is being supervised.
- It is generally expected that in the case of indirect supervision that the registered nurse and enrolled nurse will be employed by the same organisation. However, in situations where the registered nurse and the enrolled nurse are not employed by the same organisation clearly documented arrangements must be in place regarding supervision arrangements and the registered nurse must be available for reasonable access, or
- In regard to indirect supervision this does not mean that the EN and RN need to be employed by the same organisation however documented arrangements must be in place with the employers of the EN and RN if they are employed by different organisations and the RN must be available for reasonable access.
The Enrolled nurse standards for practice reflect the role of the EN in the current health environment, remaining broad and principle-based, to ensure they are sufficiently dynamic and applicable for a range of practice settings.
These contemporary standards have been revised using the best available evidence to ensure a strong foundation for the education and assessment of ENs into the future. The standards also provide clearer wording about supervision, delegation, and role relationships.
The Enrolled nurse standards for practice have revised the domains as follows:
- professional and collaborative practice
- provision of care, and
- reflective and analytical practice.
The key changes to the domains are described below.
Domain: Professional and collaborative practice
|Professional and ethical practice
||Professional and collaborative practice
- Emphasises that professional practice is also ethical and collaborative.
- Although collaboration is central it also occurs in the other domains as specific indicators.
|Conducts nursing practice in a way that can be ethically justified.
||Practises nursing in a way that ensures the rights of the people are upheld.
Domain: Reflective and analytical practice
|Critical thinking and analysis
||Reflective and analytical practice
- It is expected that ENs reflect on evidence-based practice and ensure currency of essential knowledge and skills.
|Demonstrates critical thinking in the conduct of enrolled nursing practice.
||Provides care that is informed by evidence.
Practices within safety and quality assurance guidelines.
Engages in ongoing development of self as a professional.
Domain: Provision of care
|Management of care
||Provision of care
- Encompasses all aspects of care from assessment to engaging in care, and includes health education and evaluation of outcomes.
|Contributes to the formulation of care plans in collaboration with the registered nurse, individuals and groups.
||Synthesises information from a range of sources in order to plan appropriate care.
|Manages nursing care of individuals and groups within the scope of enrolled nursing practice.
||Collaborates with the healthcare team when developing plans of care.
||Provides skilled and timely care to people receiving care and others while promoting their independence and involvement in care decision-making.
||Uses documentation to inform and report care.
||Removed (covered in other domains)
|Contributes to the promotion of safety, security and personal integrity of individuals and groups within the scope of enrolled nursing practice.
||Removed (covered in other domains).
|Provides support and care to individuals and groups within the scope of enrolled nursing practice.
||Removed (covered in other domains).
|Collaborates with members of the healthcare team to achieve effective healthcare outcomes.
||Removed (covered in other domains).
Under the Enrolled nurse standards for practice an EN needs to practice within their scope of practice, in line with the relevant state drugs and poisons legislation and their own educational preparation and experience. ENs may administer medication if they have completed the required education and are competent to do so. ENs are also expected to work in accordance with the relevant polices of their employer.
Supervision by an RN may be direct or indirect according to the nature of the work delegated to the EN. For further information see the NMBA fact sheet: Enrolled nurses and medicine administration and the NMBA Decision-making framework available on the NMBA website. You may also wish to refer to local protocols approved by your employer/health service.
The scope of practice of an EN and RN are different. An EN must work under the direct/indirect supervision of an RN at all times. An EN should only be carrying out practice that they are appropriately trained and competent to do, and which is within their scope of practice. This does not include working at the level of an RN.
If you are currently enrolled in an NMBA-approved program of study leading to registration as an EN and are due to graduate after 1 January 2016, your program of study is still recognised. The standards will not affect you applying for registration.
Yes. Your program of study is still recognised if you are currently enrolled in an NMBA-approved program of study leading to registration as an EN and are due to graduate after 1 January 2016.
Students will not be disadvantaged in any way by the introduction of the standards. The NMBA encourages you to discuss your individual circumstances with your education provider.
- Audit information on the NMBA website
- Lodge an online enquiry form
- For registration enquiries: 1300 419 495 (in Australia) +61 3 9275 9009 (overseas callers)