Adjunct Professor Veronica Casey AM, Chair of the Nursing and Midwifery Board of Australia (NMBA), reflects on an important year for the Board as it slowly returned to face-to-face engagements and maintained the steady growth of the professions.
It was great to meet with nurses and midwives across Australia again. Representatives of the NMBA and I were fortunate to attend or speak at a number of national and international conferences, including the Australian College of Midwives’ National Conference, Australian College of Nursing National Nursing Forum, CRANAplus, Australian College of Nurse Practitioners’ National Conference, the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) National Conference and many more. We were also able to host the NMBA’s national conference once again to support the professional development of Board members and Ahpra staff, and to improve the regulation of the nursing and midwifery professions. I find events such as these incredibly important as we get to engage with colleagues, nurses and midwives. I also want to acknowledge the incredible commitment of nurses and midwives to deliver safe and quality care to the public.
This year we’ve hit the ground running with the start of several projects to support the growth of safe and competent nursing and midwifery workforces. This can be seen through our commitment to a full review of the policy on re-entry to practice, facilitating the assessment of internationally qualified nurses and midwives through the outcomes-based assessment model, improving our engagement with employers, and creating a high-level scope-of-practice document for the professions and those working with and being treated by nurses and midwives.
An update was made to the Re-entry to practice policy, which provides nurses and midwives who have been out of practice for between 10 and 15 years the opportunity to complete an NMBA-approved re-entry-to-practice program based on an assessment of their application. This interim solution was put in place while a full review of the policy identifies what works with the current approach and what opportunities there are to amend re-entry strategies to improve the timeliness of the process and the quality of nurses and midwives re-entering the workforce.
With the borders well and truly open, we are seeing larger numbers of internationally qualified nurses and midwives (IQNMs) interested in getting registered and working in Australia. This has seen more IQNMs progressing through the online self-checks, portfolio creation and examinations. Fortunately, we have been able to maintain a steady assessment of IQNMs, with qualification assessments averaging 10 business days and waiting lists for Objective Structured Clinical Exams (OSCE) effectively cleared. The NMBA has also committed to the establishment of a second OSCE site and the development of an accessible and affordable online OSCE preparatory course for internationally qualified registered nurses (IQRNs), which will provide critical information about safe and quality practice in the Australian healthcare context and support IQRNs through the OSCE process.
We worked with consultants at Nous Group to conduct a survey and workshops with employers of nurses and midwives across the country, which assessed the current level of engagement that the NMBA and Ahpra have with employers of practitioners. The project reviewed our current methods of communicating with employers and also assessed the understanding of roles and expectations the NMBA, Ahpra and employers have of each other. Nous developed an engagement strategy to improve trust and engagement between employers, the NMBA and Ahpra, and to create an opportunity for the three to work together to support an environment for safe and competent care by nurses and midwives.
The NMBA requested a review of education conditions being imposed on nurses’ and midwives’ registration following a notification. The review found that the education topics varied, including the number of hours and topics, and the timeframe for completion, even though the issues raised in the notifications were similar. The review further identified significant challenges for nurses and midwives in sourcing appropriate education, in terms of both a provider and relevant or ‘fit for purpose’ topic content.
The NMBA has approved a third party to develop and host standardised education topics. The units will be targeted, flexible, fit for purpose and provide profession-specific education modules that address the main deficits identified in the notifications review process.
In response to continuing feedback from employers, the professions and public who were unsure of what to expect from the differing roles and education of nurses and midwives, the NMBA released two fact sheets: Scope of practice and capabilities of nurses and midwives and What do nurses and midwives do? The fact sheets provide an overview of the varying roles and core activities of midwives, registered nurses, enrolled nurses and nurse practitioners, and provide information for practitioners, employers and the general public on the different education, knowledge, skills and responsibilities expected of each group. The fact sheets outline the foundational aspects of what nurses and midwives do – throughout their careers, their scope continues to develop, based on their ongoing education, training and competence.
In addition to extended pandemic services, the NMBA has worked with Nurse & Midwife Support to develop a new suite of resources to support nurses and midwives. These services include the Notification Navigator and the Graduate mentorship pilot program. The Notification Navigator provides nurses and midwives who are the subject of a notification with accessible, professional, confidential, compassionate and individualised assistance throughout the notification process. The mentorship program focuses on building nurturing and collaborative relationships to support new graduates during their initial phase of entering the workforce. The program aims to enhance early career wellbeing, ultimately improving retention, which will help us maintain stable nursing and midwifery workforces. More information about these services is available at Nurse & Midwife Support on 1800 667 877.
The Aboriginal and Torres Strait Islander Health Practice Board and the NMBA agreed to a joint project to explore and develop strategies to better inform and educate nurses and midwives about the role of Aboriginal and Torres Strait Islander Health Practitioners.
To inform the development of the draft guidance document, workshops were held at the NMBA National Conference in October. A series of focus groups identified the areas where nurses, midwives and Aboriginal and Torres Strait Islander Health Practitioners work in partnership.
In early June, the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) and the NMBA committed to a landmark agreement to strengthen our commitment to improve the quality and safety of contemporary nursing and midwifery practice to further influence culturally safe care for Aboriginal and Torres Strait Islander Peoples.
The NMBA and CATSINaM signed a partnership investment agreement that will support the delivery of the strategies and recommendations made in the Gettin’ em and keepin’ em and growin’ em report (GENKE II). This includes addressing systemic racism and enhancing cultural safety, as well as empowering the next generation of Aboriginal and Torres Strait Islander nurses and midwives, engagement with education providers, an analysis of pathways and strengthening community.
The agreement is designed to create systemic, lasting change, and will enable collaboration, innovation and shared decision-making to achieve this.
Recent updates have been made to the NMBA’s position statement Nurses and cosmetic medical procedures. These aim to ensure that arrangements are in place for post-procedural care and that nurses comply with the requirements of the Therapeutic Goods Administration to use products only for their intended and approved use.
A comprehensive review and revision of the nurse practitioner (NP) regulatory framework has begun, including an internal analysis, external literature review and input from expert stakeholders. This has informed the revision of the NP registration standard and guidelines, which will soon be consulted on.
The NMBA has undertaken a preliminary consultation on a proposed registration standard, General registration for internationally qualified registered nurses. This proposes two new pathways designed to streamline processes for eligible internationally qualified registered nurses, who have already been registered and have practised as a registered nurse in an NMBA-approved comparable international regulatory jurisdiction.
We conducted a full review of the Safety and quality guidelines for privately practising midwives, which ensures they remain contemporary and reflect the current safety and quality expectations for privately practising midwives (PPMs). Once an advance copy of the updated guidelines was published, we supported several educational webinars for PPMs to learn about any changes and how they may affect their practice.
We have committed to leading a comprehensive review of the Australian midwifery workforce, which will deliver a full report and includes broad stakeholder consultation. It will also include a review of the registration standard Endorsement for scheduled medicines for midwives, to ensure it aligns with current public and practitioner expectations. Our aim for this project is to enable the continuous development of a flexible, responsive and sustainable Australian midwifery workforce that can meet the needs of our communities.
Adjunct Professor Veronica Casey AM, Chair