Nursing and Midwifery Board of Australia - 2021/22 annual summary

2021/22 annual summary

Nursing and midwifery in 2021/22

Snapshot nursing

All nurses

469,986 nurses (including those also registered as midwives)

  • Up 2.5% from 2020/21
  • 55.1% of all registered health practitioners
  • 28,095 also hold registration in midwifery

1.4% identified as Aboriginal and/or Torres Strait Islander

88.3% female; 11.7% male

Nurse-only registered

441,891 nurses

  • Up 2.9% from 2020/21
  • 51.8% of all registered health practitioners

87.7% female; 12.3% male

Age

All nurses, including those also registered as midwives

Age: <25 6.4%, 25-34 25.9%, 35-44 22.7%, 45-54 19.3%, 55-64 18.5%, 65-74 6.8%, >75 0.4%

Divisions, dual registration and endorsements

Nurses by division

74,100 enrolled nurses
10,970 enrolled nurses and registered nurses
356,821 registered nurses
441,891 total

Nurses and midwives, dual registered

113 enrolled nurses and midwives
97 enrolled nurses and registered nurses and midwives
27,885 registered nurses and midwives
28,095 total

Nurses with endorsements

2,425 nurse practitioners
1,299 scheduled medicines (rural and isolated practice)
3,724 total

Regulating

Notifications

1,940 notifications lodged with Ahpra about

1,593 nurses

  • 2,970 notifications about 2,357 nurses made Australia-wide, including HPCA and OHO data
  • 0.5% of the profession

Sources of notifications

Sources of notifications: 29.7% Patient, relative or member of the public, 20.1% Employer, 17.5% Other practitioner, 5.9% Health complaints entity, 2.4% Board initiated, 24.4% Other

Most common types of complaint

Most common types of complaint: 16.7% Clinical care, 11.1% Health impairment, 10.8% Offence against other law, 8.2% Medication, 7.4% Behaviour, 6.9% Communication, 5.3% Breach of non-offence provision - National Law, 3.6% Boundary violation, 3.4% Confidentiality, 3.1% Documentation, 23.5% Other

199 immediate actions taken

 451 mandatory notifications received

  • 193 about professional standards

Notifications closed

Notifications closed: 1,896 notifications closed 9.4% conditions imposed on registration or an undertaking accepted, 5.2% cautioned or reprimanded, 1.9% registration suspended or cancelled, 9.6% referred to another body or retained by a health complaints entity, 74.0% no further action

Monitoring

754 practitioners monitored for health, performance and/or conduct during the year

1,567 cases being monitored at 30 June:

  • 121 for conduct
  • 244 for health
  • 69 for performance
  • 227 for prohibited practitioner/student
  • 906 for suitability/eligibility for registration

Criminal offence complaints

53 criminal offence complaints made

  • 48 about title protection
  • 3 about practice protection
  • 2 about advertising breaches
  • 1 directing or inciting unprofessional conduct/professional misconduct

62 closed

Referred to an adjudication body

60 matters decided by a tribunal

No matters decided by a panel

Appeals

17 appeals lodged

Snapshot midwives

All midwives

35,256 midwives (including those also registered as nurses)

  • Down 2.2% from 2020/21
  • 4.1% of all registered health practitioners
  • 28,095 also hold registration in nursing

1.5% identified as Aboriginal and/or Torres Strait Islander

98.7% female; 1.3% male

Age

All midwives, including those also registered as nurses

Age: <25 3.7%, 25-34 19.8%, 35-44 17.6%, 45-54 18.8%, 55-64 27.8%, 65-74 11.5%, >75 0.7%

Midwife-only registered

7,161 midwives

  • Up 5.5% from 2020/21
  • 0.8% of all registered health practitioners

99.7% female; 0.3% male

Dual registration and endorsements

Midwives and nurses, dual registered

113 midwives and enrolled nurses
97 midwives and registered nurses and enrolled nurses
27,885 midwives and registered nurses
28,095 total

Midwives with endorsements

1 midwife practitioner
860 scheduled medicines
861 total

Regulating

Notifications

113 notifications lodged with Ahpra about 99 midwives

  • 147 notifications about 131 midwives made Australia-wide, including HPCA and OHO data
  • 0.4% of the profession

Sources of notifications

Sources of notifications: 34.5% Patient, relative or member of the public, 15.0% Other practitioner, 10.6% Employer, 9.7% Board initiated, 5.3% Health complaints entity, 24.8% Other

Most common types of complaint

Most common types of complaint: 36.3% Clinical care, 13.3% Medication, 9.7% Communication, 6.2% Health impairment, 6.2% Offence against other law, 4.4% Breach of non-offence provision - National Law, 2.7% Documentation, 2.6% Behaviour, 1.8% Confidentiality, 16.8% Other

4 immediate actions taken

 17 mandatory notifications received

  • 11 about professional standards

Notifications closed

Notifications closed: 1,896 notifications closed 9.4% conditions imposed on registration or an undertaking accepted, 5.2% cautioned or reprimanded, 1.9% registration suspended or cancelled, 9.6% referred to another body or retained by a health complaints entity, 74.0% no further action

Monitoring

23 practitioners monitored for health, performance and/or conduct during the year

42 cases being monitored at 30 June:

  • 3 for conduct
  • 4 for health
  • 6 for performance
  • 3 for prohibited practitioner/student
  • 26 for suitability/eligibility for registration

Criminal offence complaints

4 criminal offence complaints made

  • 3 about title protection
  • 1 about practice protection

5 closed

Referred to an adjudication body

No matters decided by a tribunal

No matters decided by a panel

Appeals

No appeals lodged

From the Chair

This year

Nurses and midwives show strength during difficult times

Our inspiring nurses and midwives led us through another pandemic-affected year. As frontline responders, nurses and midwives stepped forward and encouraged the roll-out of the COVID-19 vaccination. We also watched as retired nurses and midwives quickly returned to the workforce through the pandemic sub-registers – more than 1,800 midwives and 15,000 nurses were on the sub-registers during the year. These nurses and midwives were crucial to the nation’s vaccination efforts and supported our hospitals through these challenging times.

The Nursing and Midwifery Board of Australia (NMBA) and I also wish to recognise the continued strength and resilience shown by our nurses and midwives who are experiencing ongoing personal and professional pressure, not only related to the pandemic response but also due to the challenges caused by recent natural disasters across Australia. In these extreme circumstances, nurses and midwives continue to meet their responsibilities to their work and support their communities in the times when they need it the most. Thank you for all that you do.

Registration fee freeze

The NMBA approved a registration fee freeze for the second year in support of our nurses and midwives. We also acknowledged the significant amount of professional development nurses and midwives have done while navigating COVID-19 in clinical settings, by minimising the need for reporting the continuing professional development (CPD) of nurses and midwives at registration renewal.

New Board members

We welcomed two new community members, Ms Sonja Ilievska and Mrs Gemma Martin, to the NMBA, both with wide-ranging backgrounds in public health services. Professor Catherine Chamberlain, a midwife, educator and Trawlwoolway woman, also joined the NMBA as our newest practitioner member. With a combination of public and practitioner board members, the NMBA ensures its regulatory priorities remain fit for purpose and community focused.

Nurse & Midwife Support

The NMBA continues to work closely with Nurse & Midwife Support, a 24/7 national support service for nurses and midwives that provides confidential advice and referral. The NMBA made a commitment to a new suite of services to further support nurses and midwives:

  • Notification navigator: free, accessible, professional, confidential, compassionate and individualised support throughout the notification process
  • Interactive, guided wellbeing resources: evidence-informed resources to support the mental health and wellbeing of nurses and midwives
  • New graduate support: resources to support the transition to independent practice/graduate years, and a mentoring program connecting early career professionals with experienced nurse and midwife mentors.

The NMBA acknowledges this unprecedented era in healthcare and its effect on nurses and midwives across the country.

Policy in nursing

Working in cosmetic procedures

With a critical lens on the standard of care across the medical cosmetic industry, the NMBA released a position statement for nurses working or wishing to work in the area of cosmetic medical and surgical procedures. The purpose of this statement is not to impose further regulation but rather to clarify a nurse’s scope of practice in certain medical and surgical procedures.

This position statement includes guidance for:

  • all nurses working in the area of cosmetic medical procedures, including specific advice for enrolled nurses, registered nurses and nurse practitioners
  • cosmetic injections – detailed expectations of prescribers and the role of the registered nurse and enrolled nurse
  • supervision requirements for enrolled nurses
  • registered nurses with a sole qualification in mental health nursing, paediatric nursing or disability nursing wanting to practise in the area of cosmetic medical procedures. Ahpra and the Medical Board of Australia are conducting a separate review into cosmetic surgery.

The NMBA may amend the Position statement: Nurses and cosmetic medical procedures in future based on the recommendations of that review.

Retiring the RIP endorsement

The NMBA and health departments are ending the Endorsement for scheduled medicines for registered nurses (rural and isolated practice) (RIP endorsement), allowing rural and isolated practice registered nurses (RNs) to supply and administer certain scheduled medicines under local medicines and poisons legislation, policies and protocols without needing an endorsement.

Most states and territories in Australia already regulate the safe use of medicines by RNs through drugs and poisons legislation, local regulations and health service policies and/or protocols.

The two states that relied on the RIP endorsement within their legislation (Victoria and Queensland) have finalised alternative regulatory mechanisms for RNs to obtain, supply and administer certain scheduled medicines in rural and isolated practice settings. These changes enable RIP-endorsed RNs to continue their medicines practice without requiring an endorsement from the NMBA.  

By removing the endorsement, the NMBA aims to minimise any overregulation and streamline the process for rural nurses to administer scheduled medicines.

Policy in midwifery

Health Ministers have agreed to extend the professional indemnity insurance (PII) exemption for privately practising midwives (PPMs) until 31 December 2023. For PPMs to be eligible for the exemption from PII for providing intrapartum care for home births, they must meet the Safety and quality guidelines for privately practising midwives.

These guidelines provide PPMs with clarity and support to practise their role with safety and quality, while facilitating workforce flexibility and access to services. The guidelines also apply to PPMs who provide care in discrete areas such as postnatal care, antenatal care and/or specialist lactation services. The NMBA has started a review of these guidelines and will consult with midwives in the review process.

Adjunct Professor Veronica Casey AM

 
 
Page reviewed 16/12/2022