Fact sheet: Registration as a registered nurse and paramedic - dual registration

This fact sheet is for registered nurses (RNs) and paramedics who hold dual registration: that is registration on AHPRA’s Register of practitioners as both a nurse and a paramedic and for students/graduates who intend on holding dual registration in the future. This fact sheet sets out the regulatory requirements for RNs and paramedics who hold dual registration.

The NMBA and Paramedicine Board recognise that nursing and paramedicine are two separate professions and that regulated health practitioners who hold dual registration as an RN and a paramedic are expected to meet the respective professional standards set by the boards for each profession.

The professional standards and capabilities for RNs and paramedics are documented in the registration standards, codes and guidelines for each profession. This means RNs and paramedics with dual registration are required to have recent practice in, and connection to, both the nursing profession and the paramedic profession and must ensure they are safe, competent, confident and current, in each profession’s specific skills and knowledge, relevant to their context of practice. Where an RN also has an endorsement, any additional requirements set by the NMBA related to that endorsement will also need to be met.

If you are registered as an RN and paramedic, you must meet the requirements of the NMBA’ registration standards and Paramedicine Board’s mandatory registration standards to be registered and practice both professions. This means you must complete, and be able to demonstrate, that you have met the recency of practice, continuing professional development requirements and have professional indemnity insurance relevant to your practice as an RN and paramedic.

To work/be employed in an RN and/or paramedic position you must hold the relevant registration with the NMBA and/or the Paramedicine Board. For further information refer to the NMBA Fact sheet: The use of health practitioner protected titles.

The NMBA’s Registered nurse standards for practice (RN standards for practice) provide RNs with a framework for assessing practice. Similarly, the Paramedicine Board’s Professional capabilities for registered paramedics (Paramedic professional capabilities) identify the knowledge, skills and professional attributes needed for safe and competent practice of paramedicine in Australia. To help you determine if you have recent practice as both an RN and a paramedic you can use the RN standards for practice and the Paramedic professional capabilities documents to evaluate your own practice.

The evidence that you keep and present to demonstrate you meet the registration standards, both as a paramedic and an RN are assessed on an individual basis. The NMBA and the Paramedicine Board recognise that there may be certain elements of practice common to both RNs and paramedic practice.

Recency of practice

To demonstrate recency of practice you need to have evidence that shows you have maintained an adequate connection with, and recent practice in each profession that is up-to-date within the context/scope, knowledge and skills in each profession. Connection to a profession can be measured by a range of experience and activities that include:

• extent of practice as relevant to each profession
• extent of education as relevant to each profession
• evidence of ongoing education or professional development
• ability to meet relevant standards for practice/professional capabilities
• evidence of contemporary knowledge relating to practice of the profession

You need to declare annually when you renew your registration, that you have completed the required hours for both nursing and paramedicine. This means that you need to be able to demonstrate that you have met the recency of practice registration standards requirements for both nursing and paramedicine. If your compliance with the recency of practice requirements is audited, you will need to provide evidence of practice in both professions.

Any common elements of practice should be determined within your own context of practice using the respective RN standards for practice and Paramedic professional capabilities. These documents indicate the expected practice standard and provide the framework for assessing your practice. You should use these documents to consider if you meet the requirements for the respective board’s Recency of practice registration standard as both an RN and a paramedic when renewing your registration each year.

Continuing professional development

The continuing professional development (CPD) activities you undertake should be relevant to your context of practice, maintain your competence and build on your knowledge and expertise as both an RN and paramedic. To demonstrate compliance with the respective board’s Continuing professional development registration standard you will need to complete a minimum of 20 hours of CPD related to your RN practice and a minimum of 30 hours of CPD related to your paramedic practice. There may be some CPD hours that can count towards both contexts of practice, but the NMBA and the Paramedicine Board would also expect to see separate activities specific to nursing and specific to paramedicine.

Professional indemnity insurance

Under the National Law, nurses and paramedics must not practise the profession in which they are registered unless they hold appropriate professional indemnity insurance (PII) arrangements in relation to their practice. If you are registered as both a nurse and paramedic, you must have professional indemnity insurance relevant to all aspects of your practice in both nursing and paramedicine to demonstrate compliance with the respective board’s professional indemnity insurance arrangements registration standard.

Context of practice: Context refers to the environment in which nursing is practised, and which in turn influences that practice. It includes:

• the characteristics of the consumer and the complexity of care required by them
• the model of care, type of service or health facility and physical setting
• the amount of clinical support and/or supervision that is available
• the resources that are available, including the staff skill mix and level of access to other health care professionals 

• Visit www.nursingmidwiferyboard.gov.au and www.paramedicineboard.gov.au
  • For profession specific standards, codes and guidelines
  • Contact us to lodge an online enquiry form
• For registration enquiries: 1300 419 495 (in Australia) +61 3 9275 9009 (overseas callers)