Where to for RN scope of practice?(NEWS AND EVENTS)(registered nurses)

The Nursing Council has put forward four options on how to regulate registered nurses (RN) practising in expanded rotes. Its consultation document on the RN scope of practice, released last month, outlines four options for expanded rotes: amending the current scope of practice to allow RNs to perform activities traditionally outside the scope; nurses undertaking expanded practice activities are credentialled by other organisations; nurses undertaking expanded practice activities are authorised to do so by the Council; and a new scope of practice for those practising in expanded roles.

Council chief executive Carolyn Reed said the RN scope of practice had not changed in the five years since its introduction but practice was constantly changing. "The Council has concerns that some expanded rotes do not fit within the present scope. The Council needs to be assured that nurses performing expanded rotes have the required education and skills," she said.

NZNO's professional services manager Susanne Trim said NZNO welcomed the consultation and appreciated its "appropriate timeframe for robust discussion and input".

The consultation document outlines some of the changes in health over the last 10 years that have affected nursing practice. These include hearth policy with its focus on innovation, including a greater contribution by nursing, workforce issues and increased specialisation in nursing. "Nurses take on a range of new practices and decision making responsibilities, with greater risks attached," the paper states.

It outlines different international approaches to regulating expanded practice: restrictive, where activities or rotes are authorised by the regulator; credentialing, where another body accredits or authorises the nurse in a specialty area of practice; and permissive where the regulator does not determine the limits of practice but leaves it up to the individual nurse.

In New Zealand, there is no consistent approach to decisions on expanding an individual nurses' scope of practice. "Decisions are made by individuals, employers, the Accident Compensation Corporation or the Ministry of Hearth and may be a response to medical staff shortages, development of new service delivery models, changing hearth priorities, specialty interest groups or individual practitioner preferences," the consulation paper states.

"Are we just concerned with technical procedures or are we wanting to frame expanded practice more holistically, including advanced assessment, diagnosis and treatment?" the paper asks.