Fact sheet: Maternal, child and family health nurses and midwives in Australia. A regulatory perspective.

The report told us:

Foundational education

• The NMBA Registered nurse standards for practice, NMBA Midwife standards for practice and the NMBA-approved accreditation standards suggest foundational knowledge and skills for the novice/beginning role of a MCFH registered nurse and/or midwife,
• it is unlikely that graduates of nursing and midwifery entry to practice programs have experienced a paediatric or MCFH service placement, and
• to practise safely and effectively in MCFH both RNs and midwives require additional specific MCFH knowledge and skills.

MCFH postgraduate education

• The quality of current postgraduate MCFH programs vary considerably,
• midwives don’t need a tailored postgraduate MCFH qualification that addresses any nursing knowledge/skills gaps, and
• there are insufficient postgraduate MCFH programs available for midwives to enter

Employment

• Changes in employment have occurred and where there are no legislative/regulation requirements for dual registration as an RN and midwife, midwives are being employed in MCFH services,
• where midwives are employed in MCFH services, job descriptions and position titles have been revised to be inclusive of their midwifery scope of practice,
• there is insufficient orientation and support for RNs transitioning into MCFH roles in some jurisdictions impacting on midwives moving into a MCFH role, and
• employers have a shared regulatory responsibility to ensure newly employed RNs and midwives have a professional development program to support their transition into MCFH services as a safe novice MCFH registered nurse and/or midwife.

Regulation

• Midwives, working in MCFH that have a postgraduate MCFH qualification are adequately prepared to practise in the MCFH area and should not require any additional regulatory intervention.

The NMBA will continue the provision of right touch health regulation for nurses and midwives who work in the MCFH area.

We propose:

NMBA regulation

• For midwives that do not hold nursing qualifications there is no evidence to suggest any current regulatory risk for the public that warrants changes to the existing regulation in place for MCFH as it is sufficient to protect the public,
• recognise that practice in the MCFH area can be attributed as both nursing and/or midwifery practice. A midwife (working only in MCFH) would meet the requirements of the NMBA’s Registration standard: Recency of practice for annual renewal of midwifery registration, and
• the annual nursing and midwifery workforce survey includes MCFH as an area of practice for midwives to inform future workforce analysis.

Opportunities were also identified from the research for the tertiary education providers of MCFH courses, professional association; the Maternal Child and Family Health Nurses Association (MCaFHNA) and employers. 

Education providers

• Standardisation of curricular for postgraduate MCFH programs based on the National Standards of Practice for MCFHNs in Australia produced by MCaFHNA, and
• a flexible approach to admission criteria to increase access to postgraduate MCFH courses for both RNs and midwives to meet future demands for course entry.

MCaFHNA

• The National Standards of Practice for MCFH nurses developed by MCaFHNA are broadened to reference the NMBA Midwife standards for practice, and
• potential development of entry to practice standards for the MCFH context of practice.

Employers

• Ensure there are professional development programs to support RNs and midwives as they transition from the novice/beginning level of a MCFH registered nurse and/or midwife for safe service delivery.

The NMBA‘s approved registration standards, codes, guidelines, and standards for practice together form the Professional Practice Framework (PPF). The PPF determines the requirements and expectations which guide the professional practice of nurses and midwives in Australia.

The NMBA recognises that nurses and midwives obtain and develop qualifications and expertise through the course of their careers. It is an expectation that nurses and midwives are educated and competent in their specific area of practice and hold the requisite skills required to meet the needs of their client group. The public has an expectation that nurses and midwives provide safe, person-centred, and evidence-based care in all areas of MCFH practice.

Nurses and midwives are responsible for making professional judgements about when an activity is or is not within their scope of practice − for initiating consultation and collaboration with, or referral to, other members of the healthcare team. They are also responsible for ensuring their qualifications meet the employment requirements within a MCFH service as this may vary between jurisdictions.

The NMBA has fact sheets on the Scope of practice and capabilities of nurses and Scope of practice and capabilities of midwives to guide nurses and midwives in their practice. They also guide employers, private and public health services, and other health practitioners, on the varying roles and scope of practice of nurse and midwives.

If you are a midwife, you do not need to have dual registration as a nurse to work in the area of MCFH services in Australia, except for Victoria. Victoria has legislation and policies that require qualifications and registration in both nursing and midwifery to work in MCFH services. You must ensure you expand your scope of practice in accordance with the fact sheet on the Scope of practice and capabilities of midwives, and the Decision making framework for nursing and midwifery.