Hon David Cunliffe
Minister of Health

10 September 2008

Enrolled nurses reinstated

Minister of Health David Cunliffe announced today that Government has acted to reinstate the scopes of practice and qualification of “enrolled nurses” for 137 second level nurses.

The nurses began training or graduated as enrolled nurses between 2000 and 18 September 2004 but whose title was changed to “nurse assistant” under the health practitioners scopes of practice notice gazetted in 2004.

"The issue is one where a group of nurses, through no fault of their own, were caught out by a decision which changed their job title and their scope of practice to something different from what they intended when they signed up for a course of study,” Mr Cunliffe said.

The Nursing Council had considered the issue and consulted widely on a proposal to allow this group who trained for enrolled nurses to retain that job title and original scope of practice, but it declined to amend the scopes of practice notice pending a wider review of the role of second level nurses and how they work with other health professionals.

Mr Cunliffe said he understood the Council's reasons for not acting, but believes that further delay is unfair to these nurses who have been waiting for action on the issue for a number of years.

"Parliament's Regulations Review Committee last year decided this situation was unfair and unwarranted. When a committee of Parliament makes such findings after careful deliberations, government must pay attention. Other than in very exceptional circumstances, I expect the Committee’s recommendations to be acted on."

BACKGROUND
Parliament has amended the Nursing Scopes of Practice established by the Nursing Council under S9 of the Regulations (Disallowance) Act 1989.

The amended Scope of Practice is then published by the Chief Parliamentary Counsel under S4 of the Acts and Regulations Publication Act as a regulation.

This is the first time the Regulations (Disallowance) Act 1989 has been used to amend a regulation.

The newly amended regulation states:

"Scope of Practice - Enrolled Nurse

Enrolled nurses practise under the direction of a registered nurse or midwife to implement nursing care for people who have stable and predictable health outcomes in situations that do not call for complex nursing judgement. The responsibilities of enrolled nurses include assisting clients with the activities of daily living, recognising the changing needs of the clients and performing delegated interventions from the nursing or midwifery care plan. There may be conditions placed on the scope of practice of some enrolled nurses limiting them to a specific area of practice according to their qualifications or experience.

Qualification
Successful completion of a programme approved by the Nursing Council of New Zealand and a pass in the specified examination leading to registration as an enrolled nurse. The programme must be completed prior to 31 December 2004.

This scope of practice is not open for any further new applicants from New Zealand who completed a programme after 31 December 2004 or new applicants from overseas who have applied after 18 September 2004. Applicants from that date will be registered as Nurse Assistants."

The key difference is that Enrolled Nurses work in a wide range of areas but can only deal with stable and predictable situations whereas Nurse Assistants are not restricted to only these stable situations but are only allowed to work in a specific area of practice - so far there are two such areas: care of the elderly, and long-term care and rehabilitation.

ENDS

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