Download a PDF copy of this Enrolled nurses and medicine administration fact sheet (107 KB,PDF)
Since the introduction of the National Scheme1, there are no endorsements for administration of medicines by enrolled nurses.
The National Board changed this to recognise the growing number of enrolled nurses, including all new graduates, who have the required education to administer medicines. In the interest of public protection, it is essential that enrolled nurses must only administer medicines if they have completed the relevant medicine administration education units. Graduates from Board-approved enrolled nurse courses from the Approved programs of study from 2008 onwards have completed relevant medicine administration units, covered as part of the curriculum.
Those enrolled nurses who did not have the requisite education and competence to administer medicines were required to identify themselves to AHPRA and have the notation: ‘Does not hold Board-approved qualification in administration of medicines’ placed on their registration.
This notation will remain in place until the enrolled nurse provides evidence of having completed a Board-approved administration of medicines unit.
See below for information about enrolled nurses with a condition on their registration limiting their practise to mothercraft nursing only.
1The National Registration and Accreditation Scheme
Board-approved programs of study are published under Approved programs of study on the National Board website.
These are programs of study for nursing and midwifery that have been accredited by the Australian Nursing and Midwifery Accreditation Council (ANMAC) and approved by the National Board.
In order to have the notation ‘ does not hold a Board-approved qualification in administration of medicines’ removed, enrolled nurses with a notation must satisfactorily complete two essential Board-approved units of study for administration of medicines:
- Analyse health information HLTAP501C, (previously identified as HLTAP501A or HLTAP501B), and
- Administer and monitor medications in the work environment, HLTEN507C (previously identified as HLTEN507A and HLTEN507B).
These units are delivered within a Board-approved Diploma of Nursing. Education providers offering a Board-approved Diploma of Nursing can deliver the two units to enrolled nurses for removal of the notation.
Note: These Board-approved units of study may have pre-requisite units of study to complete, as well as the two essential units of study. Enrolled nurses should contact the education provider to query eligibility for recognition of prior learning the two essential units of study.
Local state and territory drugs and poisons legislations laws, and relevant policies, specify the routes and schedules of medicines that enrolled nurses are able to administer.
This means that enrolled nurses who are able to administer medicines must adhere to their local laws and practise within their scope of practice.
Employers of enrolled nurses should ensure that:
- the enrolled nurse is familiar with the local drugs and poisons requirements,
- the practice environment enables employees to have and maintain required qualifications and competence to administer medicines.
Through employment arrangement, enrolled nurses must be guided by the principles of determining scope of practice.
All nursing activities must take place in the context of agreed principles of delegation and levels of supervision at the local level.
These should be supported by the policies, procedures and protocols that have been developed in accordance with service needs and intended outcomes of the workplace.
All enrolled nurses are accountable for making decisions about their own practice, and about what is within their own capacity and scope of practice.
Not all enrolled nurses without a notation can administer intravenous (IV) medicines.
This is because the intravenous unit of study ‘Administer and monitor intravenous medication in the nursing environment’ HLTEN519C (previously identified as HLTEN519A and HLTEN519B) is a separate and elective unit in the Diploma of Nursing.
Therefore, an enrolled nurse may lack a notation but may also not have completed the required education.
An enrolled nurse who does not have a notation on their registration can expand their scope of practice to include certain intravenous medicines administration after successful completion of a relevant course.
Enrolled nurses must make sure that they practise within their scope of practice and understand what activities are appropriate for them to undertake.
Employers must ensure that employees have completed approved educational requirements and are qualified for any nursing activity they undertake.
Some Bachelor of Nursing courses in Western Australia and Victoria have approved exit points that allow eligible students to register as enrolled nurses while they complete their undergraduate studies for registration as a registered nurse.
This option, and the point at which it occurs, varies between programs. Students need to discuss this directly with their education provider.
Notation on the register
The notation ‘Does not hold Board-approved qualifications in administration of medicines’ applies to all undergraduate students who undertake an approved Bachelor of Nursing or double degree program with an approved predetermined stage at which they are able to apply for registration as an enrolled nurse.
In Victoria, before being able to register as enrolled nurses, students must:
- undertake the two Board-approved essential units of study, be assessed in a clinical setting to jointly meet the National Enrolled Nurse standards for practice2, and
- have completed a module on the roles and responsibilities of the enrolled nurse
Once these steps have been successfully completed, the education provider can then submit details of the eligible student to AHPRA.
Why units and clinical competencies in a program leading to registration as a registered nurse are not adequate for enrolled nurse registration without a notation
Pharmacology and medication units vary between Bachelor of Nursing programs, and competency is not achieved until the program leading to registration as a registered nurse is completed.
Any pharmacology completed to the approved point for enrolled nurse registration may not be equivalent to the units contained in either the Diploma of Nursing or Certificate IV in Nursing program.
2Previously referred to as Competency standards.
All mothercraft nurses (including Division 5 nurses in Victoria) transitioned to the National Scheme on 1 July 2010 (18 October 2010 in Western Australia) to an enrolled nurse registration with a condition. This condition limited their practice to mothercraft nursing only.
This group of enrolled nurses is not eligible to enrol into a Board-approved medication course and is therefore unable to administer medicines.
Refer to the National Board’s Fact sheet on Mothercraft nurses.