Nursing and midwifery in 2023/24

Highlights and issues

A sustainable workforce for the future

In collaboration with the Chief Nursing and Midwifery Officers of Australia, the Nursing and Midwifery Board of Australia (NMBA) funded a review of the current state of Australia’s midwifery workforce to generate information to support policy, regulatory, industrial and educational change.

Midwifery Futures is an in-depth review of Australia’s midwifery workforce we are conducting in partnership with the Macfarlane Burnet Institute for Medical Research and Public Health (Burnet Institute) and colleagues. It aims to set the foundation for the continued growth and sustainability of the midwifery profession.

On 14 March, as part of the project, we hosted the National Midwifery Futures Symposium with our project partners from the Burnet Institute. This event brought together leaders, policy makers, regulators, clinicians and consumers from across Australia.

A final report outlining the current state of Australia’s midwifery workforce and identifying opportunities to strengthen and grow the profession will be published in October.

Our response to the Kruk review

The NMBA is scoping the next phase of work required to support implementation of the recommendations from the Kruk review – the Independent review of Australia’s regulatory settings relating to overseas health practitioners.

We are looking at how the NMBA can contribute to easing workforce pressures through aiding the supply of critically needed safe and competent internationally qualified nurses and midwives (IQNMs).

The work includes exploring evidence-based expedited registration pathways beyond the Board-approved comparable international regulatory jurisdictions, and improving the outcomes-based assessment model to ensure it is responsive to future demands.

Designated RN prescribing

This year has seen significant progress of the NMBA’s proposal to allow registered nurses (RNs) with an endorsement to prescribe scheduled medicines.

The NMBA issued a Consultation regulation impact statement that considered several options for and impacts of a proposed model of designated RN prescribing.

The proposed model will enable RNs with an endorsement for scheduled medicines to prescribe within their level of competence and scope of practice, in partnership with an authorised prescriber such as a medical practitioner or a nurse practitioner.

We recently submitted a Decision regulation impact statement to the Office of Impact Analysis, which was considered compliant. The endorsement and standard were submitted to health ministers for approval.

Accreditation

The NMBA assigned the Australian Nursing and Midwifery Accreditation Council (ANMAC) responsibility for accrediting education providers and programs of study for nursing and midwifery for an additional two years.

ANMAC and the NMBA work together to provide efficient and relevant accreditation services for nursing and midwifery, and engage on other projects to ensure the provision of safe healthcare to all Australians.

Policies, standards and guidelines

Non-surgical cosmetic procedures

The NMBA identified the need to raise the regulatory status of the current Position statement: Nurses and cosmetic medical procedures by consulting on Guidelines for nurses who perform non-surgical cosmetic procedures.

These guidelines will apply to all enrolled nurses, registered nurses and nurse practitioners who work on non-surgical cosmetic procedures.

Privately practising nurses

The NMBA consulted on the introduction of Guidelines for privately practising nurses, developed to be more responsive to the current healthcare environment. The guidelines outline the regulatory requirements within which privately practising nurses must practise.

When implemented, the guidelines will give people accessing the services of a privately practising nurse confidence that they are practising in accordance with their regulatory requirements and are committed to continuously improving the safety and quality of their practice.

RN and EN standards for practice

The Board began a review of the Enrolled nurse standards for practice and Registered nurse standards for practice as part of our regulatory remit to ensure they are nationally fit-for-purpose and evidence based.

Our stakeholders expressed value in aligning the two reviews to strengthen the project and create consistent and connected enrolled nurse (EN) and RN standards for practice based on best international regulatory practice.

Nurse practitioner regulatory framework

In collaboration with ANMAC, the NMBA consulted on our regulatory documents that form part of the nurse practitioner regulatory framework.

The public consultation sought feedback on the NMBA’s Registration standard: Endorsement as a nurse practitioner and Safety and quality guidelines for nurse practitioners and on ANMAC’s Nurse practitioner accreditation standards.

Following a review of the feedback, amendments were put forward that seek to ensure our regulatory documents remain relevant and fit-for-purpose.

Enabling the international workforce

IQNM assessment and registration

In 2020, Ahpra and the NMBA introduced a new assessment and registration model to expedite suitably qualified and experienced internationally qualified nurses and midwives (IQNMs) into the workforce.

As part of a quality improvement review, we evaluated the assessment process, registration process and orientation program designed to introduce IQNMs to a range of concepts relating to Australian healthcare.

Our aim is to make targeted enhancements to improve the experience of IQNMs who go through assessment, registration and orientation in Australia.

Registration standard for IQRNs

The NMBA consulted on a draft registration standard designed to streamline the registration process for eligible internationally qualified registered nurses (IQRNs) who have already been registered to practise as a registered nurse in a Board-approved comparable international regulatory jurisdiction.

Streamlining the registration of IQRNs has the potential to ease workforce pressures across Australia through the supply of critically needed safe, competent and effective practitioners.

The registration standard would mean that IQRNs who are usually required to complete the NMBA’s Stream B outcomes-based assessment pathway would be eligible to apply for general registration with the NMBA.

Supporting nurses and midwives

Nurse and Midwife Support

The NMBA continued to work with Nurse and Midwife Support to provide 24-hour access to confidential advice and referral services for:

• nurses
• midwives
• students
• managers
• employers
• educators
• concerned family and friends.

Online education modules

We contracted the Australian College of Nursing to develop two standardised online education modules for registered nurses, enrolled nurses and midwives who are required to complete education following a notification made about them.

The modules are now live and available on the college’s website.

Fostering culturally safe relationships

In August, the NMBA and the Aboriginal and Torres Strait Islander Health Practice Board of Australia developed a fact sheet to guide nurses and midwives on the collaborative practice role they have with Aboriginal and Torres Strait Islander Health Practitioners.

The new guidance gives nurses and midwives information on working collaboratively with Aboriginal and Torres Strait Islander Health Practitioners to provide culturally safe healthcare and to improve health outcomes for Aboriginal and Torres Strait Islander Peoples.

New IQNM exam location

Ahpra and the NMBA partnered with the Royal Australian and New Zealand College of Obstetricians and Gynaecologists to use their Assessment, Learning and Examination Centre in Melbourne for the assessment of internationally qualified nurses and midwives (IQNMs).

Previously, overseas-trained nurses and midwives who were assessed as holding relevant but not equivalent qualifications had to travel to South Australia to take the Objective Structured Clinical Examinations (OSCE) before they could be registered.

The opening of this second site increased capacity and shortened wait times to sit the examinations.

This partnership meets the commitments made by Ahpra and the National Boards to the National Cabinet to develop options that streamline and accelerate the recognition of health practitioners’ skills and qualifications to support a sustainable health workforce for the future.

Adjunct Professor Veronica Casey AM, Chair