August 2020

Contents

• Message from the Chair
• Call for applications
• NMBA news          
  • Last chance to have your say in consultations   
  • Updates from the June and July NMBA meetings
• Registration
  • Victorian nurse practitioners no longer need notation to prescribe
• Students and graduates
  • Graduating soon? Here’s what you need to know
• Nursing and midwifery regulation at work: notification case studies
  • Nurse disqualified for two and a half years for professional misconduct
• National Scheme news
  • Changes in regulatory practice since Independent review of the use of chaperones to protect patients
• Keep in touch with the NMBA

Message from the Chair

The Nursing and Midwifery Board of Australia (NMBA) recognises that nurses and midwives are doing vital work under extreme challenges during the COVID-19 pandemic.

We sincerely thank you for your commitment and the professional care you provide.

As the regulator we will support you to provide safe, flexible care where it is needed.

Provision of care and scope/context of practice

We recognise that in these challenging circumstances, there may be a need for you to adjust established procedures and work in different contexts to provide appropriate care to people.

Some will be called on to work in unfamiliar situations where their knowledge and experience are needed most. We are aware of the flexibility required in your context or scope of practice when working outside your usual clinical roles during this emergency. Professional judgement is critical to continue to practise safely when resources are limited and demand intense.

We encourage you to work with your colleagues, supervisors and health services and use your professional judgement to assess risk. Safe care should be informed by relevant evidence and guidelines, as well as the values and principles set out in the professional standards and code of conduct for your profession.

I encourage you to review the new NMBA fact sheet Nurses and/or midwives changing their clinical context of practice in response to COVID-19.

Please also visit the NMBA's COVID19 guidance for nurses and midwives and Ahpra's Responding to COVID 19 hub for the latest guidance.

Look after your own health

We also encourage you to take steps to look after your health, like seeking professional health advice when needed. Remember, all nurses and midwives have access to a free, confidential health support service. Nurse & Midwife Support is available 24/7 on 1800 667 877.

The NMBA does not expect you to place yourself in harm’s way while providing care. We urge you to ensure effective use of personal protective equipment and follow relevant infection control requirements and public health advice. If you have pre-existing health conditions that increase your risk of infection, you should actively manage this, such as by discussing it with your colleagues, employer or place of work.

Follow public health advice

It is also vital that during this rapidly evolving situation, everyone follows national public health directions and guidance. If you know or suspect you are infected you should follow current public health advice including self-isolating.

Thank you again for your service to your communities during this pandemic.

Associate Professor Lynette Cusack, registered nurse and midwife
Chair, Nursing and Midwifery Board of Australia

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Call for applications

Community member vacancies on the ACT Board

The Australian Capital Territory (ACT) Board of the NMBA is seeking two community members. Community members must not currently be, or previously have been, registered as a nurse or a midwife. Applications close on 27 August 2020. More information.

Applications open for exam committee

The Nursing and Midwifery Accreditation Committee (NMAC) is calling for applications for appointment to the registered nurse Objective Clinical Structured Exam Examination Committee. Please note that most members will need to hold current NMBA registration as a registered nurse. Applications close on 31 August 2020. More information.

NMBA news

Last chance to have your say in consultations

Don’t miss your chance to have your say on two important standards of the professions – the Registration standard: Recency of practice and the Nurse practitioner standards for practice.

The proposed Registration standard: Recency of practice gives practitioners more flexibility to meet the recency of practice requirements: these can now be met over two, three or five years.

Changes to the Nurse practitioner standards for practice include updates to key definitions such as ‘advanced practice’ and ‘nurse practitioner.’

To have your say on these changes, please visit the Current consultations section of the NMBA website to read the consultation papers before responding to the feedback questions via the online survey link. The consultation closes on Monday 31 August 2020.

Updates from the June and July NMBA meetings

In June, the NMBA approved the proposed revised Registration standard: Recency of practice, Guidelines: Recency of practice and Nurse practitioner standards for practice for public consultation.

In response to the COVID-19 pandemic, the NMBA approved the Temporary modification to an English language skill registration standards pathway: COVID-19 response which is available on the Ahpra website. The policy applies to people who wish to use the English language test pathway and extends the time for applicants to combine the results from two sittings to nine months. The policy took effect on 22 July 2020.

The NMBA has established the Nurse Practitioner Advisory Group (NPAG). The NPAG will comprise nurse practitioner members of the NMBA and its state and territory boards, as well as nominations from key stakeholder organisations with expertise in nurse practitioner practice and advanced practice. The NPAG will provide advice to the NMBA on advanced practice in nursing (relevant to regulation), as well as nurse practitioner regulatory and policy matters. The NPAG’s first meeting is planned for September.

The NMBA has reinstated the requirement for both direct and indirect supervision for nurses and midwives who are required to complete a period of supervised practice for re-entry to practice.

Each month the NMBA makes decisions on approved programs of study leading to registration and endorsement. To see the up-to-date, searchable list of approved programs, please visit the Approved programs of study section of the NMBA website.

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Registration

Victorian nurse practitioners no longer need notation to prescribe

Due to legislative changes gazetted on 23 July 2020, Victorian nurse practitioners (NPs) will no longer need a notation to authorise them to prescribe a specific list of medicines.

The legislative changes mean that NPs practising in Victoria are now able to obtain, use, sell or supply (prescribe) any Schedule 2, 3, 4 or 8 poisons in the lawful practice of their profession within their scope of practice or area of expertise.

We are writing to all impacted nurse practitioners to let them know we are removing the notations on their endorsement from the National Register.

For more information, please see the health.vic website.

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Students and graduates

Graduating soon? Here’s what you need to know

Ahpra’s planning for this year’s graduate registration campaign is underway. As we all know, this year is unlike any we’ve had before. The COVID-19 pandemic has affected many aspects of our lives including clinical placements for students. We are taking COVID-19 into account as we plan for this year’s campaign.

Avoid delays with your application

Once registration is open, check out the resources on the Graduate applications page of the Ahpra website before you submit your application. This will help ensure your application is complete, so we don’t have to come back to you seeking clarification or more information. We can then get you registered as soon as we receive your graduate results.

Customer experience survey and improvements to our service

Last year Aphra conducted the first ever survey of new graduates to hear about their experience registering for the first time. We contacted just over 24,000 graduates and had a great response rate of over 15 per cent to the voluntary survey.

We’re very grateful to those graduates who participated, their feedback will help us improve the experience for this year’s graduates. Some of the improvements we plan to make for this year’s campaign include:

• more guidance on how to correctly certify identity documents
• emailing graduates with updates to complement the online application tracker and give more detail about where your application is at in the assessment process.

We hope this will make first-time registration a smoother, less stressful experience.

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Nursing and midwifery regulation at work: notification case studies

The NMBA publishes summaries of tribunal decisions about nurses and midwives as professional learning case studies. All information in these summaries has been made publicly available by the relevant tribunal before the NMBA publishes its summary.

Nurse disqualified for two and a half years for professional misconduct

A tribunal has disqualified a nurse for two and a half years for criminal conduct and working under the influence of illicit drugs.

Please read the news item.

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National Scheme news

Changes in regulatory practice since independent review of the use of chaperones to protect patients

An independent report has found reforms of the regulatory management of allegations of sexual misconduct have had a profound impact.

Ahpra and the Medical Board of Australia (MBA) commissioned the author of the ground-breaking 2017 Independent review of the use of chaperones to protect patients in Australia, Professor Ron Paterson, to assess what had been achieved and identify what more could be done to improve their handling of sexual misconduct allegations.

Professor Paterson, Professor of Law at the University of Auckland and Distinguished Visiting Fellow at Melbourne Law School, found that Ahpra and the MBA have fully implemented ‘nearly all’ his recommendations and made significant changes to regulatory practice.

The report notes the huge changes since 2017 to community and media discussion of sexual misconduct arising from the #Metoo movement and as a result of the Royal Commission into Institutional Responses to Child Sexual Abuse.

The report finds that the National Registration and Accreditation Scheme (National Scheme) compares favourably with international health practitioner regulators on this issue and is ‘highly advanced in how it operates in this complex and demanding area’.

Major changes to regulatory practice made by the MBA and Ahpra since 2017 to improve the handling of allegations of sexual boundary violations include:

• abandoning the use of mandated chaperones and only rarely imposing practice-monitor restrictions
• centralising the expertise and handling of allegations of sexual boundary violations, and
• extensive specialised education and training for decision-makers and investigators handling these matters.

Ahpra and the MBA have accepted all Professor Paterson’s recommendations to ensure continuous improvement, including by:

• improving communication with notifiers and practitioners and reducing timelines
• improving support for notifiers (especially when cases go to tribunals), and for decision-makers and staff, and
• applying new ministerial ‘public interest’ guidance to sexual boundary notification decisions.

Professor Paterson’s report notes the ongoing use by tribunals of chaperones as a mechanism to protect the public, despite the recommendations of his initial report.

‘These decisions suggest that the thinking of tribunals about alleged sexual misconduct by health practitioners is still evolving and may not yet reflect changing community expectations,’ he writes.

Sexual boundary violations have a devastating impact on patients. Highlights of Ahpra’s action plan to address Professor Paterson’s recommendations include:

• piloting a new support service for notifiers, to provide practical and emotional support during the regulatory process
• considering options for expanding the specialised approach to deciding sexual boundary cases to other professions
• strengthening and expanding expert training for staff handling sexual boundary notifications
• Ahpra-wide work to reduce timelines for notifications management, and
• developing guidance on physical examination.

For more information, read the media release.

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Keep in touch with the NMBA

• Visit the NMBA website for registration standards, codes, guidelines and FAQ.
• Lodge an online enquiry form.
• For registration enquiries, call 1300 419 495 (from within Australia) or +61 3 9275 9009 (for overseas callers).
• Address mail correspondence to: Associate Professor Lynette Cusack RN, Chair, Nursing and Midwifery Board of Australia, GPO Box 9958, Melbourne, VIC 3001.

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