Fact sheet: Enrolled nurse standards for practice

The Enrolled nurse standards for practice are the core practice standards that provide the framework for assessing EN practice. The standards:

• communicate to the general public the standards that can be expected of ENs
• determine the eligibility for registration of people who have completed an EN program of study in Australia
• determine the eligibility for registration of ENs who wish to practise in Australia but have completed courses elsewhere
• assess ENs who wish to return to work after being out of the workforce for a defined period, and
• assess ENs who need to show that they are competent to practise.

These standards replace the National competency standards for the enrolled nurse that were first published in 2002 by the Australian Nursing and Midwifery Council (ANMC) and adopted by the NMBA at the start of the National Registration and Accreditation Scheme (the National Scheme) in 2010.

The standards have been developed following an extensive literature review, a survey of ENs, interviews with ENs, observations of ENs in practice, and consultation with consumers and other stakeholders including education providers.

• 21 October 2015 - the NMBA Enrolled nurse standards for practice released
• 1 January 2016 - the NMBA Enrolled nurse standards for practice come into effect
• During the transition period - 21 October 2015 to 31 December 2015 - the current National competency standards for the enrolled nurse apply.

Research suggested that confusion existed between the use of the term ‘competency based assessment’ in the vocational education and training (VET) sector and use of the term ‘competency’ in other settings.

The standards provide clarity about supervision, delegation and role relationships, including:

• the EN needs to work under the direct or indirect supervision of a registered nurse (RN)
• the EN keeps responsibility for their actions, and
• the EN is accountable in providing delegated care

The standards have the following domains:

• professional and collaborative practice
• provision of care, and
• reflective and analytical practice.

Direct supervision is when the supervisor is physically present at all times and personally observes, works with, guides and directs the person who is being supervised.

Indirect supervision is when the supervisor works in the same facility or organisation as the supervised person but does not constantly observe their activities. The supervisor must be available for reasonable access. What is reasonable will depend on the context, the needs of the person receiving care and the needs of the person who is being supervised.

• It is generally expected that in the case of indirect supervision that the registered nurse and enrolled nurse have the same employer. There may be situations where the registered nurse and the enrolled nurse may not have the same employer but work in the same facility or organisation. In these situations clearly documented arrangements between the employers, supported by the registered nurse/s and the enrolled nurse/s, must be in place. These documented arrangements should include details of all aspects of the supervision arrangements (including insurance) and describe how the registered nurse will be available for reasonable access to ensure effective timely direction and supervision so that the delegated practice is safe and correct and public safety is ensured.

The Enrolled nurse standards for practice reflect the role of the EN in the current health environment, remaining broad and principle-based, to ensure they are sufficiently dynamic and applicable for a range of practice settings.

Under the Enrolled nurse standards for practice an EN needs to practice within their scope of practice, in line with the relevant state or territory drugs and poisons legislation and their own educational preparation and experience. ENs may administer medication if they have completed the required education and are competent to do so. ENs are also expected to work in accordance with the relevant polices of their employer.

Supervision by an RN may be direct or indirect according to the nature of the work delegated to the EN. For further information see the NMBA's fact sheet: Enrolled nurses and medicine administration and the NMBA Decision-making framework for nursing and midwifery. You may also wish to refer to local protocols approved by your employer/health service.

No, the scope of practice of an EN and RN are different. An EN must work under the direct/indirect supervision of an RN at all times. An EN should only be carrying out practice that they are appropriately trained and competent to do, and which is within their scope of practice. This does not include working at the level of an RN.

• Enrolled nurse standards for practice
• Audit information on the NMBA website
• Lodge an online enquiry form
• For registration enquiries: 1300 419 495 (in Australia) +61 3 9275 9009 (overseas callers)