Nursing in an International Context

This paper provides a comparison and contrast of the Australian and Chinese nursing system. It explores the differences and similarities in nursing practice and the implications for nursing management, research, clinical practice, and nursing education.

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Nursing in an International Context
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Introduction
The nursing practice differs from one country to the other. At the same time, there still
exist similarities between nations with respect to nursing practice. These differences and
similarities are often thought to pose a multitude of implications for nursing management,
affecting research, clinical practice, and nursing education. In this paper, the comparison and
contrast of the Australian and Chinese nursing system are provided. The Australian regulation
requires that all nurses abide by the minimum criterion of CPD standards in order to get
renewed. They are also required to keep CPD documentation as evidence that they have
completed the minimum hours per year. In contrast, China has no CPD requirements dictating
renewal of nurse memberships. Additionally, while nurses in China are only allowed to work in
certain cities or regions as per the awarded licenses, nurses in Australia can practice across
territories and states. More detailed analysis and comparison of the two countries is done in this
paper.
Nursing in Australia
The Australian territory and state governments introduced the National Registration and
Accreditation Scheme in 2010 for the purposes of registering health care practitioners including
nurses (NRAS, 2014, n.d.). The Health Practitioner Regulation National Law is concerned with
governing this scheme (HPRNLQ, 2010, n.d.). Ideally, NRAS is dedicated to protecting the
interests of the general public through guaranteeing that only the qualified nurses enter the
Australian health care system. The Australian Nursing and Midwifery Accreditation Council
generally ensure health safety of all Australians by ascertaining that nursing and midwifery
programs offered are of the required quality (ANMAC, 2015, n.d). Upon successfully
completing the educational programs endorsed by the ANMAC, midwives and nurses are

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considered competent and can, therefore, seek membership in the Nursing and Midwifery Board
of Australia. Additionally, they are required by the professional code of conduct to offer health
care that is safe and competent across all nursing practice domains. The national law mandates
the NMBA to regulate and register midwives and nurses. In simpler terms, for one to get
registered and enrolled as a nurse in Australia, a person should complete a degree or diploma
nursing program which is approved by the ANMAC and seek membership with the NMBA,
which is ideally done through the Australian Health Practitioner Regulation Agency. Essentially,
the Australian nursing registration system is comprised of three levels, which include an Enrolled
Nurse (EN), Registered Nurse (RN), and Nurse Practitioner (NP). To get a Diploma of Enrolled
Nursing in the country, one needs to complete a 12 to 18 months course, either studying full-time
or part-time. Under a registered nurse’s supervision, an EN offers health care services to patients
within a diverse array of clinical environments (Jacob, Sellick and McKenna, 2012 p. 305). After
finishing an ANMAC endorsed the program, an EN can thereafter become a registered nurse.
Notwithstanding, recognition of EN’s comes before learning and experience.
A registered nurse needs to pursue a Bachelor of Nursing for 3 to 3.5 years, either full-
time or part-time. Some of the major responsibilities of a registered nurse include offering direct
care to patients, engaging in research and offering education services, staff management,
promotion of health, and coordination of care (Birks et al., 2013, p.28). A registered nurse has
multiple avenues of career advancement, including the potential to specialize in advanced
practice roles. A nurse practitioner essentially a registered nurse with in-depth knowledge and
experience and has completed a master’s degree in the relevant field. A nurse practitioner can
operate independently and/or work as a team in a more advanced clinical role (Wand et al., 2012,
p 153). Some of the prime responsibilities of a nurse practitioner include management and

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assessment of patients through application of skills such as medication prescriptions, patient
referral to other clinicians, and ordering diagnostic investigations. For the NMBA registration to
be renewed and continued seamlessly, nurses ought to abide by the standards of the Continuing
Professional Development (CPD). Such a requirement ideally sets the registered and enrolled
nurses’ minimum requirements needed for the purposes of registration and renewal of the
registration. Each year, it is generally required that all nurses engage in not less than 20 hours of
nursing professional development. Also, the national law dictates that nurse practitioners should
finish an additional 10 hours annually in education correlated with their respective endorsements.
CPD documentation is required to act as evidence of successful completion of these hours, and
this applied to registered nurses, enrolled nurses and nurse practitioners. All registered nurses are
required to reregister by 31st May every year, and the Nursing and Midwifery Board of Australia
(NMBA) sends an email as a remider.
Nursing in China and Chinese Healthcare System
On the other hand, registered nurses in China are required to acquire civil conduct and
also, they need to have a sober mind based on the General Principles as stated in the Chinese
Civil Law. Nurses in China must be highly qualified by completing the appropriate vocational
education. In China, there are Master of Nursing programs that focus on preparing nurses to
achieve advanced skills that are required in clinical practice. Moreover, China has Doctoral
programs for nurses that seek to equip them with management, research, and educational skills
(Parker and Hill, 2017 p.201). Additionally, there are diploma programs that equip Chinese
nurses with technical skills. The Chinese Nursing Registration Board demands nurses to ensure
that they renew their registration after a period of five years to maintain their relevance in the
Chinese Healthcare Systems. China’s most significant goal is to establish its advanced and

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specialized programs for nurses locally to ensure that the nurses are highly equipped (Wang,
2016 p.3).
Comparison
Nursing in the Australian Healthcare System compares and contrasts with that of China
in various ways. To start with, the registration system in the Australian healthcare system is
endowed by legislation and laws that are designed to offer guidance. Based on the Australian
registration, there are various nursing levels that outline different responsibilities and
requirements in the practice, focus, and training levels. It is important to note that various
registration levels and practices in Australian healthcare system recognize various focuses and
needs of patients care. On the other hand, in China nursing in the healthcare system is seen as of
late starter (Wang, Whitehead and Bayes, 2016 p.131). Previously, nursing constituted only the
diploma qualification as the level of registration in China but it has evolved with time.
Currently, the tertiary level of nursing compares in Australia and China and also, it has
expanded rapidly. Precisely, the nursing requirements and qualifications have evolved from
diploma to degree, Masters and doctoral programs. The Chinese Ministry of Health indicates that
the tertiary nursing level constitutes 30% of nurses (Zhou et al., 2016 p.2).
Notably, globalization in both countries contributes to significant implications for nursing
management. Globalization impacts nursing research, clinical practice, and nursing education
thus there is increased demand for nurses in both Australia and China. Additionally, there is an
urgent demand for the establishment of nursing education among nurses to achieve an effective
and safe workforce.
Contrast

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In contrast, the Australian healthcare system requires nurses to fulfil the minimum
qualifications based on the CPD standards to retain their relevance in the nursing profession
(Halcomb et al., 2016 p.1193). The EN, RN, and NP must have a detailed record of CPD that
shows evidence that a nurse has completed the CPD within minimal hours annually. This
requirement ensured that there is progressive evidenced-based in the nursing profession (Cheng,
Feng and Hu, 2017 p.27). However, China does not have CPD requirements that require nurses
to renew their registration.
Additionally, the Australian healthcare system gives nurses an opportunity to engage in
nursing practice in various territories and states. Moreover, it ensures that all Australians receive
standardized nursing care regardless of their residential areas. In contrast, in China, the nurses
only engage in nursing practice in particular provinces or cities in which they are issued licenses.
Moreover, the Chinese nurses experience difficulties because of a complicated transfer process
that is involved in case they want to register for other cities or provinces.
Challenges Faced by Nursing in China
However, nursing in China is faced by various challenges such as lack of state
registration thus nurses are limited in terms of movement from a single city to another.
Registered nurses who wish to engage in nursing practice in a different city or state must apply
for the nursing registration that is transferred before they move to the new geographical area.
Another challenge facing nursing in China is that there lacks unity that paves a way for
confusion and development of discussions about nursing education. Additionally, nursing in
China is clinically oriented in Masters and Doctoral levels thus there lacks advanced clinical
practice for nursing students.
Conclusion

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To summarize, the local conditions have significant impacts on the nursing profession in
China and Australian healthcare systems. Due to the prevailing differences of nursing in the
Chinese and Australian healthcare systems, it is difficult for them to be transplanted because of
various factors such as quality that will be compromised. This is because the healthcare systems
are established based on the prevailing government structure, national objectives, and economic
factors of respective countries. In this case, registration of nurses offers insights about the
establishment of strategies to overcome the ever-changing demand for nurses in the healthcare
systems.

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