Nursing and Midwifery Board of Australia NMBA, legislated Registration Standards.
These is what determines whether an applicant, a student or registrant meets to be registered. They apply to registered midwives and nurses and to all applicants who desires registration with an exception of all registered students and those who have registered but are not into practice. It consists of five standards that have to be met for one to be able to practice.
This is a standard that started being effective on July 1st 2015. It enables NMBA decide if a health care provider history of crime is of any relevancy to their profession, that is, the health practitioner regulation national law. It apply to all applicants excluding the students. There are ten factors that the NMBA takes into consideration so as to decide if the applicant is to practice.
a. They look into the nature and the gravity of the crime and its relevance to the health sector/ practice. Offences against humanity caries high weight. The higher the weight an offence caries the higher the likelihood of it affecting health practice.
b. The time span since the offense was committed.
Recent offenses are viewed by the board with a high weight.
c. Was there conviction on the offense? Was one charged? Is the charge still pending?
The board considers offense to be of relevancy in the following descending order: convicted, guilty, pending and non-convicted.
d. The sentence that was charged
The weight goes on the significance of the sentences given.
e. The age of the applicant when the offence was committed.
Less consideration when the offence occurred at 18 years and below.
f. If the offence that the applicant committed has been decriminalized.
Less weight on those offenses that are no longer viewed as offenses.
g. The behavior of the applicant since they committed the offense.
If the applicant has kept a good conduct since then, the board places less weight on the offense.
h. The possibility of the offence to be a threat to a patient in future.
The higher the likelihood the higher the weight of the offence.
i. Information given by the applicant
j. Any other thing that the board considers relevant.
From all the above it is significant for an enrolled student to know so that they can avoid having problems when it comes to registration. They can avoid crimes as they can destroy their professional practice.
This is done to initial applicants. It tests their skills in English language. Tests are given by the board although for those whose first/ primary language is English they are just asked for papers to prove it. For example they should have attended and passed in recognized schools that taught and assessed in English for at least 6 years in primary and secondary.
This information is very important to a student who wishes get enrolled after the course. This makes him/her know that English language is a requirement so they will polish on it and if it is their primary language they will get papers ready to prove it.
This standard for registration was effective from June 1st 2016. It laid out the minimum requirements, which the enrolled nurses, registered midwives and nurses have to meet for them to make any continual developments in their professions.
For one to meet these standards they are required to have completed a minimum of 20 hours of the continuing professional development by the time they are registering. Those who have an endorsement/ have been recommended in diagnostic investigation, medicine administration and referrals they need to have an additional of 10 hours in their CPD, making their hours 30.
This is significant to a student as they will be knowing what will be knowing what is required of them when the time comes to be registered for continuing development. With this knowledge they will be able to attain the minimum requirement.
This means that the midwife or the nurse has kept an adequate touch/connection with/ and upcoming/emerging practices in the field of nursing for them to be able to be registered.
For the applicant to meet this they are required to be either registered, have knowledge on nursing and midwifery or have a postgraduate qualification on an area of nursing. For nurses already in practice they need to have a minimal of 450 hours of practice in the field, have been assessed and approved by NMBA and have completed a period of practice while being supervised by NMBA.
This is relevant to a nursing student as it guides them on what will be required of them to get recency of practice.
This standard sets out the requirements of either enrolled nurse or a registered nurse or midwife to be given professional indemnity insurance PII.
When applying to be registered they are required to declare that they will not practice unless they get PII. It is also a requirement by the national law. At renewal of registration, NMBA checks if the nurse have been practicing the professional as per the required by the registration standards.
This helps a student who will be registered and enrolled in future to know what will be required of them so as to get PII. They also get assured that they will be insured and covered during practice.
The number one role of the national board of Australia is to ensure that only the suitable and competent nurses are registered. This is done so as to protect its people. The Nursing and Midwifery Board of Australia, NMBA, has come up with frameworks, guidelines and codes. This guides the nurses and midwifes. They help them understand requirements and expectations of NMBA and they provide the right path for them to achieve the requirements. There is a national framework for development of decision making tools for midwifery and nursing practices.
The first thing I will do after being assigned the procedure is to determine whether the procedure is in the current contemporary scope as a nursing practice. Is it in the professional legislation and standards? Being an enrolled nurse and having been taught how to do the procedure, for sure it is in my scope. The second step will be assessing and considering the quality and risk management frameworks of the hospital. I should also consider its staff capacity and access to health professional just in case of an emergency. The third step will be evaluating myself. Am I capable? I will be able to answer this question by asking myself the following questions: what’s the current health status of the patient? What’s the complexity of the care required by the patient? From the professional guidelines who should perform the procedure? A registered nurse or an enrolled nurse? Is there a commonwealth legislation indicating a nurse should perform the procedure? The organizational guidelines, do they specify whether a registered nurse or an enrolled nurse should be the one to perform the procedure? If the nurses to all the above questions dictates that an enrolled nurse can perform the procedure then I will perform the procedure.
Developments and learning occurs daily in a nurses’ life. Continuous professional development helps maintain, broadens and improve the competence of midwifes and nurses. This makes nurses and midwifes able to provide safe, ethical, effective and competent services. For me perform the procedure safely and to the required standards, I should have knowledge on:
i. The client’s condition. My procedure is inserting an NG tube, but to who? Which condition is he/she suffering from? At the moment what is their current health status? Are they stable or comatose?
ii. Should be knowing the risks and benefits of inserting a nasogastric tube. An NG tube aids the patient in feeding, can be used to drain aspirates. It is dangerous as during insertion it can cause injuries and also it is a media of infection. Knowing this I be careful and septic when inserting it.
iii. The resources available to support the procedure and for managing possible risky outcomes. The resources can be in terms of professionals, suctions machines just in case of an emergency. This adds my confidence and gives the patients an assurance that in case something goes wrong it will be handled promptly.
The skills I require so as to be able to give the patient standard, quality and safe care. Having read and practiced the procedure in school, I should freshen up my skills on nasogastric insertion. This will be by going through the procedure in the current nursing manual. This will give me an update on how the procedure should be done as per the standards. Most hospitals do have their procedure manual guidelines. I should ask for it and refer. In case I still feel not competent enough I should ask a nurse who is free to assist me perform the procedure.
I should identify my deficits / limitations so as to be able to improve on them as per the standard. Discussing the plan with my peers, mentor or supervisors. Will be the best way to learn my limitations.
Should be able to notice the red signs. The danger signs when inserting it. For example if the tubes causes trauma or starts chocking the patient. I should know how to respond to that. Should have a skill on how to reverse/ manage emergences.
This will be achieved through continuous professional development. Being my area of interest, I should prioritize it, as a learning need. This should be after considering the results from my reflection, that is, the deficits, so as to strengthen those weak areas. When I practice this procedure I should be able to achieve the standards so as to consider myself to have perfected. I should also identify a learning plan. This could be through observation, partial participation or/ and performing the procedure by myself. Observing the patients feedbacks after the procedure. After prioritizing, developing a plan and learning the crucial part will be reflecting the value of these learning on my profession. Did it improve my service delivery? Did it improve on my competence and efficiency? If yes I have perfected on the procedure. The CPD specifies a certain amount of hours for one to be registered with it. Having been working for 10 weeks I should have seen/ done the procedure for 5 or more hours. This is not true in my case as this is my first. Since the next registration group is between 3-6 months requiring 10 or more hours I should ensure I have achieved that so as to be declared competent in that field.
Decision making and continuous professional development are very essential in the clinical area. It improves nurses and midwives services delivery, their efficiency and their competence. The national framework gives us the framework on decision making in nursing and midwifery. There are guidelines on the continuous professional development. When a nurse is encountered with a situation that requires critical thinking and decision making. The nurse should reflect on their abilities to perform the procedure and plan on it.
References
Ryan, D., 2009. Registered nurses-standards and criteria for the accreditation of nursing and midwifery courses leading to registration, enrolment and endorsement, nursing and midwifery board of Australia.
Milson, S., Higgins, I., 2003. The scope of enrolled nurse practice, contemporary nurses by Taylor and Francis.
Pearson, A., Fitzgerald, M., Walsh, K., 2002. Continuing competence and the regulation of nursing practice, Journal of Nursing, Wiley online library.
Hendry, C., Launder, W., 2007. The dissemination and uptake of competency framework, Journal of Research, obtained from journals.sagepub.com
Vernon, R., 2010. Evaluation of the continuing competence framework, nursing council of New Zealand.
Pearson, A., 2002. The competent nurse? International journal of nursing practice, Wiley online library
Bryant, R., 2005. Regulation, roles and competency development, international council of nurses
Chiarella, M., Thom’s, D., Mclnnes, E., 2008. An overview of the competency movement in nursing and midwifery, obtained from Elsevier
Gardner, G., Middleton, S., Gardener, A., 2010. The work of nurse practitioners, Journal of advanced nursing. Wiley library.
Jacob, E., Sellick, K., McKenna, L., 2012. Australian registered and enrolled nurses: is there a difference? International journal of nursing. Wiley online library.
Jacob, R., Barnett, A., Sellick, K., 2013. Scope of practice for Australian enrolled nurses: Evolution and practice issues, contemporary nurse.
Kenny, A., Bish, M., Nankervis, K., 2008. Enhancing the scope of practice for the second level nurse: A change process to meet growing demands in nursing. Contemporary nursing by Taylor and Francis
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