Nursing and Midwifery Board of Australia - December 2021

December 2021

Contents


Message from the Chair

On behalf of the NMBA, I thank each of you for your contribution to the health and wellbeing of your communities in 2021. Nurses and midwives have led the way, not only in clinical care provision but in providing a diverse range of knowledge and skills across our large nation during the pandemic. I wish you a happy and safe festive season. 

I encourage anyone needing professional and personal support during the busy festive season to get in touch with Nurse & Midwife Support which is available 24/7. 

I want to thank our departing Board members, Melodie Heland, Max Howard, Nicoletta Ciffolilli and Allyson Warrington, for their dedication and service to the public and the professions.

We welcome two new community members, Sonja Ilievska and Gemma Martin and practitioner member, Professor Catherine Chamberlain to the Board. You can read more about Sonja and Gemma in this newsletter. 

Adjunct Professor Veronica Casey, registered nurse and midwife

Chair, Nursing and Midwifery Board of Australia

Veronica Casey   

Call for applications 

The Australian Nursing and Midwifery Accreditation Council is recruiting for an Associate Director (Accreditation). If you a registered nurse or midwife with experience in undergraduate clinical education you may be interested in applying for the role, which is advertised on Seek

Ahpra will soon be advertising for a Senior Policy Officer to join the internationally qualified nurse and midwife outcomes-based assessment team. When recruitment opens, the vacancy will be advertised on the Ahpra careers site

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NMBA news

Introducing two new NMBA community members

We are pleased to welcome new community members Sonja Ilievska and Gemma Martin to the NMBA. We look forward to introducing new practitioner member Professor Catherine Chamberlain in the next newsletter. 

Sonja Ilievska

Sonja Ilievska, Community member Victoria

I am a managing partner in a risk management and auditing consultancy firm advising industry and local community on the prevention of Legionnaires' disease. I have held various committee and advisory roles at both state and local government level and in the not-for-profit sector. 

I come from a culturally diverse background and my experience in disability, healthcare, aged care, and community services provides me with deeper insights into the importance of inclusive, accessible and culturally safe mainstream services for all. 

My experience and background have shaped my desire to ensure public protection and confidence in the health workforce of the future. I’m looking forward to bringing a community lens to the regulatory landscape in which the Board navigates.

Gemma Martin

Gemma Martin, Community Member, Western Australia

I have 15 years of experience in the community services and healthcare field with 12 years spent in the Perth metropolitan area and regional WA. I have worked in both government and non-government sectors in roles such as Regional Manager of Mental Health Services, Senior Social Worker and Carer Services Manager. 

As a community member I will endeavor to represent the views and opinions of our community to ensure high-quality nursing and midwifery standards are maintained.

Retirement of the Endorsement for scheduled medicines for registered nurses (rural and isolated practice) (RIP endorsement)

The NMBA and health departments are transitioning from the RIP endorsement to enabling 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. 

Why is the RIP endorsement being retired?

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. In these states and territories, there is no need for additional regulation by the NMBA through an endorsement.

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.

What does this mean for me?

The NMBA recognises the vital role RIP endorsed RNs have played since the current endorsement came into effect in 2010. RIP endorsed RNs have successfully provided timely, localised nursing care in rural and isolated practice settings where access to other health professionals may have been limited.

If you are a RIP endorsed RN, it’s important to know that your day to day practice will not change and you do not need to take action at this time.

For further information on these changes, please visit the NMBA website, speak with your health service manager/local health department or email the NMBA at info@nursingmidwiferyboard.gov.au.

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Updates from recent NMBA meetings

The NMBA has established a National Special Committee which will consider all registration and notification issues related to COVID-19 matters for nurses and midwives. The committee will have the power to take immediate action and refer nurses and midwives to a tribunal. 

The NMBA finalised the Position statement: Nurses and cosmetic procedures, which it will release soon on the NMBA website. It contains important information for nurses currently working and wanting to work in this area of practice.  

The NMBA has also updated its Fact sheet: Nurses with a sole qualification in mental health nursing, paediatric nursing or disability nursing which provides further clarity about registered nurses who hold these qualifications.

Each month the NMBA makes decisions on approved programs of study leading to registration and endorsement. To see the up-to-date, searchable list of approved programs, please visit the Approved programs of study section on our website.

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Registration

Considering a break from practising in your profession? Your registration options

If you’re considering a break from practising as a nurse or a midwife, you have several registration options to consider. 

Keep your registration 

If you are planning to return to the profession, for example after maternity leave or a sabbatical, it may be beneficial to keep your general registration with the NMBA. This will make it straightforward to return to practice. You will need to continue to meet the registration standards while you take leave, for example by completing the minimum number of hours of CPD each registration period and ensuring you meet the recency of practice requirement for 450 hours of practice over the previous five years. 

Non-practising registration

Another option is to apply non-practising registration. You cannot practise in any context if you hold non-practising registration. Non-practising registration is generally only suitable for nurses and midwives who are likely to be permanently retiring from the professions but would like to continue to use the title ‘nurse’ or ‘midwife.’ 

While non-practising registration has a lower annual registration fee than general registration, it’s important to note that if you wish to return to practice later you will be required to show you meet all the registration standards, including recency of practice. The process to reapply for general registration will be more involved that simply renewing your registration. 

Letting your registration lapse

You can also choose to let your registration lapse during the registration renewal period or to surrender your registration prior to renewal (there is no refund available).

It’s important to note as above, if you reapply for general registration later and can’t meet the Recency of practice registration standard, you may need to meet the NMBA re-entry to practice policy.  

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Students and graduates

Graduating soon? Apply now and be ready to work

Once you are registered with the NMBA, you can work as a midwife or a nurse anywhere in Australia.

If you're set to complete your course within the next three months – apply for registration now. We'll start assessing your application while we wait for your graduate results.

How do I apply?

Create your account using the online services portal and complete your application

Upload your documents and pay the required fees. Check that you have provided all required documentation to prove you’ve met the registration standards, including certified copies of your photo ID.

Wait for your education provider to send your graduate results to Ahpra

Once we’ve received your graduate results from your education provider and we are satisfied that you have met all the requirements for registration, we will finalise your application.

When you are registered, we will publish your name to the Register of practitioners, and you can start working as a nurse or a midwife!

Get your application right

Check out Ahpra’s graduate video to help you get your application right.

You’ll find helpful advice, tips for avoiding common causes of delay and downloadable information flyers on the Graduate applications page of the Ahpra website.

Photo ID

It's important that you provide correctly certified photo ID documents with your application – the wording is very specific.

‘I certify that this is a true copy of the original and the photograph is a true likeness of the person presenting the document as sighted by me.’

To get it right the first time, download the guide Certifying documents and take it with you to the authorised officer.

Who can certify documents?

In addition to JPs, registered health practitioners, public servants, teachers, lecturers and members of the legal profession can certify photographic ID documents. For the full list of authorised officers see the guide.

How long does it take to assess my application?

We can’t finalise your application until we receive your graduate results from your education provider.

If you’ve submitted everything you need to prove you’ve met the requirements for registration, we aim to finalise your application within two weeks of receiving your graduate results.

Clinical placement delayed? When to apply

We know for some your final clinical placement may be delayed.

To help you get registered as soon as possible we recommend you apply three months before you expect to finish your final placement or complete your course. 

We will assess your application while we wait for your final results. 

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National Scheme news

Annual report: Registered health practitioner numbers grow with paramedics leading the charge

A continued growth in the registered health workforce is highlighted in Ahpra’s 2020/21 Annual report

While it was another year dominated by the challenges of the COVID-19 pandemic, the work of regulation continued and adapted to the impacts of the pandemic. A particular aim was to ensure that students were able to graduate with sufficient clinical experience despite placement delays. National Boards also looked to greater flexibility in some regulatory requirements, while maintaining their focus on patient safety.

Snapshot of nurses 

  • 458,506 nurses
  • Up 3.0% from 2019/20
  • 29,248 also hold registration in midwifery
  • 1.3% identified as Aboriginal and/or Torres Strait Islander
  • The number of nurse-only registered is up 3.3% from 2019/20
  • Nurses, including dual registered, 88.4% female; 11.6% male
  • Nurse-only registered, 87.8% female; 12.2% male

Snapshot of midwives

  • 36,033 midwives
  • Down 0.03% from 2019/20
  • 6,785 hold registration as a midwife only
  • The number of midwife-only registered is up 7.5% from 2019/20
  • 1.4% identified as Aboriginal and/or Torres Strait Islander
  • Midwives, including dual-registered, 98.5% female; 1.5% male
  • Midwife-only registered, 99.6% female; 0.4% male

Growth across the professions

As at 30 June 2021, there were 825,720 registered health practitioners across 16 regulated professions, 24,061 more than last year. This includes 26,595 health practitioners on the 2020 pandemic sub-register which offers a surge workforce for the health system response to COVID-19. Overall, 75% of registered practitioners are women.

The largest growth in registrants was paramedics (up 8.3% on 2020).

Registered health practitioners have done exceptional work in very challenging times. It is very encouraging to see the continued growth in the number of health practitioners over the past year. 

Aboriginal and Torres Strait Islander representation

Only 8,311 (1.1%) of all health practitioners identify as Aboriginal and/or Torres Strait Islander. This is well short of the 3.3% Aboriginal and Torres Strait Islander representation in the general population.

Ahpra and the National Boards are working closely with Aboriginal and Torres Strait Islander leaders and organisations to increase the participation of Aboriginal and Torres Strait Islander Peoples across all registered health professions and to promote cultural safety and the elimination of racism in healthcare.

Top 10 facts from this year's report 

  • Ahpra dealt with 84,607 new applications for registration; 41,548 applications were from new graduates, including nearly 23,300 nursing applications.
  • Ahpra renewed the annual registration of 738,659 practitioners.
  • 189,786 students were studying to be a registered health practitioner in over 860 accredited and approved programs of study delivered by more than 130 education providers. These programs of study provide graduates with the qualification they need for registration.
  • 10,147 notifications about 7,858 practitioners were received by Ahpra; this was 0.9% fewer than in 2019/20 and 8.7% more than in 2018/19.
  • The top three reasons for a notification were clinical care, medication issues and communication.
  • The overall percentage (1.6-1.7%) of health practitioners with a notification stayed around the same in 2020/21.
  • We received 568 notifications involving a possible failure to maintain appropriate professional boundaries, which is an increase on previous years. These can range from comments made by a practitioner to a patient during a consultation to inappropriate sexual relationships. The serious nature is reflected in the outcomes with regulatory action taken more often about boundary notifications.
  • 121 matters about professional misconduct were determined by independent tribunals: 96.7% resulted in disciplinary action.
  • Ahpra completed 16 successful proceedings in the courts. All resulted in findings of guilt against the defendant on one or more charges, with penalties imposed ranging from a good behaviour bond to fines of up to $30,000.
  • 3,516 practitioners were monitored by Ahpra to ensure health, performance and/or conduct requirements were being met during the year.

To view and download the 2021/21 annual report, visit the Annual report webpage.

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Changes to notifications management in Queensland

Queensland has introduced joint consideration of all notifications about health practitioners between Ahpra, the National Boards and the Office of the Health Ombudsman (OHO).

The changes aim to speed up the initial assessment of notifications, which will benefit registered health practitioners and notifiers.

All notifications about nurses and midwives in Queensland will continue to be received by the OHO. Currently, the OHO deals with the most serious matters it receives and refers most of the remaining notifications to Ahpra and the NMBA.

From December, all notifications received by the OHO about nurses and midwives will be shared with Ahpra and the NMBA when they are received. Ahpra and the OHO will review each notification at the same time and agree on which agency should manage the matter. All notifications that raise a concern about a practitioner’s performance will be reviewed by a nursing or midwifery clinical advisor.

The changes provide greater opportunity for earlier closure of concerns that do not need a regulatory response.

Relevant changes to Queensland legislation took effect on 6 December 2021 and all notifications from this date will be subject to joint consideration. 

For more information on how notifications are managed, see Ahpra's website.

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Alert

Independent review into patient safety in cosmetic practice

Ahpra and the Medical Board of Australia have commissioned an independent review of patient safety issues in the cosmetic sector, including how to strengthen risk-based regulation of practitioners in this increasingly entrepreneurial part of the profession.

Key points

  • Independent review into patient safety issues in cosmetic sector to start in 2022
  • Weak safety and reporting culture in cosmetics under the microscope
  • Focus on improving communication in system of checks and balances

Some worrying features of the cosmetic industry set it apart from conventional medical practice, including corporate business models which are alleged to place profit over patient safety, no medical need for cosmetic procedures, limited factual information for consumers and exponential growth in social media that emphasises benefits and downplays risks. 

There are also concerns that there may be a weak safety and reporting culture in cosmetic surgery. While it’s a good thing that there are doctors, nurses and other health professionals who are picking up the pieces when cosmetic procedures go wrong, we need to understand why these practitioners are not always sharing their patient safety concerns with us in a timely way.  

The independent review will ensure that the specific regulatory responsibilities of Ahpra and National Boards are effectively protecting the public, in our part of the system of checks and balances in place for cosmetic surgery. State and territory health authorities have a major regulatory role in licensing facilities. 

The review will:

  • assess communication and cooperation between agencies involved in the current system of checks and balances in cosmetic surgery
  • examine how to strengthen risk-based regulation of practitioners in the industry
  • ensure our regulatory approach keeps pace with rapid changes in the cosmetic surgery industry, and
  • recommend actions to better protect the public.

The review will be led by outgoing Queensland Health Ombudsman, Andrew Brown. Public consultation will begin in early 2022.

Read more, including the review’s terms of reference, in the news item on the Ahpra website.

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Ahpra welcomes consultation on surgeon title

Ahpra has welcomed the announcement by Health Ministers to review the use of the title ‘surgeon’. 

Currently, any registered health practitioner can use the title ‘surgeon’ as it is not protected under the National Law.

Health ministers, as part of a collaborative nationwide consultation, are seeking feedback from the public about whether the current framework should be changed or if other options should be considered to help the public better understand medical practitioner qualifications.

‘Ahpra and the National Boards welcome this important review, and we look forward to having the opportunity to provide input during the consultation phase,’ Ahpra CEO Martin Fletcher said.

Public consultation material, including FAQs, are available on the Engage Victoria website. The consultation opens soon, and submissions will be accepted until April 2022.

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Keep in touch with the NMBA

  • Visit the NMBA website for registration standards, codes, guidelines and FAQs.
  • Lodge an online enquiry form.
  • For registration enquiries, call 1300 419 495 (from within Australia) or +61 3 9285 3010 (for overseas callers).
  • Address mail correspondence to: Adjunct Professor Veronica Casey AM, Chair, Nursing and Midwifery Board of Australia, GPO Box 9958, Melbourne, VIC 3001.

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Page reviewed 28/04/2022