Retired: Framework: Assessment of nursing and midwifery applicants for re-entry to practice

In accordance with the Health Practitioner Regulation National Law as in force in each state and territory (the National Law), the Nursing and Midwifery Board of Australia (National Board or NMBA) has approved a number of registration standards, two of which are the Recency of practice and the Continuing professional development (CPD) registration standards for nurses and midwives.

The NMBA Recency of practice registration standard applies to all nurses and midwives when they apply for renewal of registration each year. Previously registered nurses and midwives in Australia who have not practised in their respective profession for a period of between five (5) and 10 years will be required to undergo an individual assessment of their application. The Re-entry to practice policy (implemented on 19 March 2012) was developed to set out the processes to be followed when nurses and/or midwives do not meet the re-entry to practice requirements.

It is the relevant state or territory board or registration committee of the NMBA that, on the merits of each case, makes individual decisions about whether a person applying for re-entry to the profession who has not practised for a period of between five and ten years needs to be directed to either:

• a Board-approved period of supervised practice or 
• a Board-approved re-entry to practice program.

However, as part of the policy implementation and to assist with national consistency, the NMBA undertook to develop a set of principles to assist the decision-making of state and territory boards and registration committees. These principles incorporate consideration of three key elements – professional competence, confidence and capability. The main underlying principle for re-entry decisions is the safety of the health practitioners to practise in the profession.

This document elaborates the principles that underpin re-entry decisions. It is focused solely on assisting determinations for applicants who have not practised for a period of time between five and ten years. It is based on three considerations: the individual, their experience in the preceding five to ten years, and their plans for the future. These three considerations should be looked at as a whole, not judged in isolation. The document includes an explanation of the principle and the type of evidence that might assist in demonstrating the principle (see Table 1). It also provides a case study/exemplar for each end of the spectrum.

Table 1: 

Principles for determining whether an applicant who has not practised for five (5) to 10 years ought to undertake either a NMBA- approved period of supervised practice or a re-entry to practice program

The NMBA considers that applicants who have not practised for a period of time between five and ten years will sit along a continuum. At one end of the spectrum will be those who appear to have maintained competence and are probably safe, and thus will simply need to demonstrate this fact through supervised practice; and at the other end of the spectrum will be those who are not able to demonstrate that they have maintained competence and thus for safety will need to undertake a NMBA-approved re-entry to practice program to re-establish and confirm competence.

It is important to note that supervised practice and re-entry to practice programs cannot be considered equivalent to each other. The NMBA is of the view that an applicant must likely be safe in order to undertake supervised practice. Supervised practice is intended to consolidate and confirm existing knowledge; if it is determined that the applicant has insufficient current knowledge they should be directed to complete a re-entry to practice program.

(1) An ideal candidate for a period of supervised practice

Ideal candidate for a NMBA-approved period of supervised practice (documented evidence provided of maintenance of competence but applicant is required to demonstrate the competence)

1. Extensive experience in nursing and/or midwifery practice prior to lapse in professional practice. 
2. Relevant, contemporary and appropriate postgraduate education with a period of consolidation in professional practice. 
3. Relevant, contemporary and appropriate engagement in continuing professional development activities. 
4. Able to clearly demonstrate that they can meet the relevant competencies for nursing and/or midwifery. 
5. Able to clearly demonstrate that their previous experience is relevant to their application. 
6. A smaller proportion of the person’s previous 5 to 10 years of work experience was spent non-practising. 
7. Able to provide evidence and forethought about contemporary practice in the profession/s. 
8. Able to provide evidence of an offer of employment.

(2) An ideal candidate for re-entry to practice program of study

1. Minimal experience in nursing and/or midwifery practice prior to lapse in professional practice. 
2. Little or no relevant, contemporary and appropriate postgraduate education with little or no period of consolidation in professional practice. 
3. Little or no appropriate engagement in relevant and contemporary continuing professional development activities. 
4. Unable to demonstrate that they can meet the relevant competencies for nursing and/or midwifery. 
5. Unable to demonstrate that their previous experience is relevant to their application. 
6. A larger proportion of the person’s previous 5 to 10 years of work experience was spent non-practising. 
7. Unable to provide evidence of forethought about contemporary practice in the profession/s. 
8. Unable able to provide evidence of an offer of employment.

Supervised practice means a period of practice under direct supervision, equivalent to the minimum amount of practice required to demonstrate recency of practice (three months’ full-time equivalent). Where supervised practice is required, it is the responsibility of the applicant to arrange a placement that meets the requirements of the NMBA.

Supervised practice must take place in a health setting that provides clinical experience placements for education providers delivering Board-approved programs of study leading to registration as a nurse or midwife.

Re-entry to practice program means a program of study accredited by the Australian Nursing and Midwifery Accreditation Council (ANMAC), and approved by the NMBA. It prepares nurses and midwives for re-entry to the register after a lapse in practice for a period exceeding the requirement in the Recency of practice registration standard. It contains both a theoretical and a clinical experience component.