Diploma of Nursing Report: Regulatory Bodies, Standards, and Scenarios

This report provides a comprehensive overview of the Nursing and Midwifery Board of Australia (NMBA) and the Australian Nursing and Midwifery Federation (ANMF), detailing their respective functions in regulating and supporting nursing practice in Australia. It explores the NMBA's registration standards, including continuous professional development, criminal history checks, English language proficiency, professional indemnity insurance, and recency of practice. The report also examines the Enrolled Nurse Standards for Practice, outlining key domains and standards. Furthermore, it presents a scenario where a graduate enrolled nurse faces a challenge related to a nasogastric tube replacement, analyzing the decision-making process based on the NMBA framework. The analysis emphasizes the importance of seeking guidance, assessing one's competence, and engaging in continuous professional development to ensure safe and effective patient care, adhering to ethical and professional responsibilities.

Running head: DIPLOMA OF NURSING
Diploma of nursing
Name of the student:
Name of the University:
Author’s note

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Introduction:
Australia is a multicultural nation where meeting health care needs and safety of
people is a critical responsibility of the health care system. The performance and
standards of nursing care is regulated in Australia by the NMBA and the ANMF. The
report gives insight into the role of NMBA and ANMF in improving nursing practice and
making care safe, affordable and accessible to people. It also gives idea about different
registration standards that nurses or midwives must adhere to prevent cancellation of
registration. This includes recency of practice, criminal history, continuous professional
development, professional indemnity, English language and Enrolled Nurse Standards
for Practice. As nurse are often faced with several dilemma during the clinical practice,
the decision making framework has also been provided by NMBA to support nurses to
identify the best action needed in specific scenario. The decision making framework has
also been used in relation to a scenario to decide the best strategy that nurse can take
to engage in decision making during their placement.
Part A:
1.
Function of NMBA: The Nursing and Midwifery Board of Australia (NMBA) is the
regulatory board established in each state and territory of Australia to carry out all work
set up by the Health Practitioner Regulation National Law. It mainly deals with
establishing regulatory, ethical, legal and professional practice standards for nurse and
midwives and promote the health and safety of patient. It also plays key role in
registering nursing and midwifery students, handling discipline hearing and approving
accreditation standards for nurses (Nursing and Midwifery Board of Australia – About,
2017).
Function of ANMF: The Australian Nursing and Midwifery Federation is a strong union
of nurses and midwives that believes in improving the professional and industrial status
of its member. They stand up for all Australians to provide universal healthcare and high
quality patient care. It members work in every health setting such as nursing home,
hospital, GP clinic and community health practice in rural and urban Australia. They

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strive to provide good quality affordable and accessible care to every Australians.
Currently, it is the largest union in Australia with about 2, 59, 000 members (Australian
Nursing & Midwifery Federation, 2017).
2. Summary of the following NMBA registration standards:
Registration standard: Continuous Professional Development: The NMBA registration
standard for continuous professional development provides guidance to EN, RN and
midwives regarding the minimum requirement for CPD. The first requirement to meet
registration is standard is to complete minimum 20 hours of CPD. However, for nurses
who hole an endorsement or those who are nurse practitioner, they need to complete
additional 10 hours of CPD apart from the minimum 20 hours. In addition, the additional
10 hours of CPD is also applicable for midwives who hold an endorsement (Nursing and
Midwifery Board of Australia - Continuing professional development, 2017). As I am
going to register as a nurse soon, this registration standard is important for my
preparedness and knowing the time needed for me to engage in continuous
professional development.
Registration standard: Criminal history
To develop suitable and safe practice environment within health care
organization in Australia, the NMBA sets out standard to check applicant’s criminal
history during the registration process. All nurses and midwives must inform NMBA if
 They are charged with an offence that is punishable by 12 months imprisonment
 They are convicted or found guilty of an offence
The NMBA also considers the following regarding criminal history of applicants:
 Nature and gravity of offence and its impact on health care practice
 Time elapsed since the offence and records of guilty or conviction due to the
offence
 Type of sentence imposed for the offence and age of health practitioner at the
time of offence

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 Changes in health practitioner’s behavior since the offence and chances of risk to
patient from the nurse or midwives
 Explanation given by the applicant regarding their criminal history (Nursing and
Midwifery Board of Australia - Criminal history, 2017).
The knowledge about criminal history is relevant to my professional practice as I am
going to register for nursing practice soon and I must be aware of disclosing this
information if applicable to ensure that the registration process is smooth.
Registration standard: English language
NMBA focus a lot on English language competency skills of nurses and
midwives. They need to demonstrate their English language competence by showing:
 English as primary language by studying it for at least six years of primary and
secondary education OR
 Getting relevant professional communication in English in one of the recognized
countries OR
 All registered nurse, EN and midwives need to provide proof of completing 5
years of education in English OR
 Candidates must achieve minimum score in language test like IELTS, OET or
PTE Academic (Nursing and Midwifery Board of Australia - English language
skills, 2017).
Registration standard: Professional indemnity: The NMBA minimum requirement for
professional indemnity insurance (PII) for nurse, EN and RN defines the following:
 All nurse/midwife must cover their own or third party professional indemnity
arrangement for aspects of practice, location or working part time or full-time
 The PII cove must include civil liability, retroactive cover and
 Candidate must not practice if any practice area is excluded from PII
 Individual PII arrangement must also be in place to cover any practice (Nursing
and Midwifery Board of Australia - Professional indemnity insurance
arrangements 2017).

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Knowledge about PII arrangement is essential for me as it will me to secure and get
certain PII coverage.
Registration standard: Recency of practice
NMBA has defined the criteria for nurse and midwife to maintain recency of
practice. Meeting the minimum requirements for recency is necessary not just to fulfill
professional and ethical responsibilities in care, but it is also necessary to maintain
limits of competence and provide safe and effective care. The recency requirements
can be fulfilled by nurses and midwives by demonstrating completion of minimum 450
hours of practice in the past 5 years or successful completion of NMBA approved
assessment. Another option is successful completion of supervised practice (Nursing
and Midwifery Board of Australia - Recency of practice, 2017). The knowledge about
this registration standard will be useful for me in the future to understand my criteria to
fulfill recency requirements of NMBA.
Enrolled Nurse Standards for practice: This standard provides a framework to assess
the practice of Enrolled Nurse (EN). The key domain on the basis of which the practice
of EN is evaluated includes professional and collaborative practice, provisions of care
and reflective and analytical practice. The key standards in professional and
collaborative practice include:
 EN must practice accordance with law, policies and procedures
 They must ensure confidentiality, dignity, rights and respect of patient during
care
 They must be accountable for their action
Major standards in the domain of provisions of care include:
 Interpretation of health care information from range of sources to plan care
 Collaboration with RN and other members of the team during care planning
 Involving patients in care decision making and providing efficient and timely care
 Documents and reports care to relevant members
The reflective and analytical practice standards for EN are:

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 Provide evidence-based nursing care
 Engages in continuous professional development
 Practice according to safety and quality improvement standards (Standards for
practice: Enrolled nurses (2017)
Part B: Written analysis of scenario:
1. After placement in clinical practice, nurses often encounter challenges where
decision making becomes a difficult process. Similar challenge was also faced by
me when I started my new position as a Graduate Enrolled Nurse in a major
metropolitan hospital. I was asked to replace a blocked nasogastric tube.
However, the dilemma for me was that although I never learnt about the skills
and knowledge required for inserting and replacing nasogastric tube. The
immediate action for me in this scenario would be to consult my senior nurse and
make them aware that I do not have practical knowledge in conducting
nasogastric intubation for patients and doing it without any supervision might lead
to error or hazardous outcome for patient. Hence, consulting other health care
team or seeking supervision from senior members is the most appropriate action
that I need to take in such scenario. This action is also professionally allowed
because according to the NMBA decision making framework, it is necessary that
nurse be accountable for making professional judgment. According to this
criteria, it is critical that nurses assess their education preparedness, experience
and confidence to perform any activity safely (National decision-making
framework, 2017). I also did similar assessment and identified that nasogastric
intubation was outside my capacity of practice. Hence, I decide to start
consultation with other members of the health care team according to the
decision making framework.
2. To safely perform the activity of replacing and inserting blocked nasogastric tube,
I have identified that I need learning or supervision in the following areas:
 Firstly, I need to consult my seniors regarding the medical equipment and
devices that I need to perform the nasogastric intubation.

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 Secondly, the process of inserting nasogastric tube is a skilful activity
where nurses must have knowledge about appropriate insertion technique
and proper position of patients. I need to learn these techniques too.
There are certain techniques for easier insertion of the tube too which
needs to be learned by me.
 The most critical learning need is the method of replacing the blocked tube
without causing discomfort to patient. The challenges in the process of
removing nasogastric tube is also reduced of patients cooperate and
understand the process of intubation (Cason et al., 2015). Hence,
communicating with patient will also enable completing the activity safely.
3. The above scenario makes it necessary for me to seek educational opportunities
to learn about nasogastric tube intubation. Engaging in learning activity to
enhance my competence in nasogastric intubation is also important for me to
continuous evolved in my professional practice and gain the confidence to do the
same task in the future. This action is also professional important for me because
according to the NBMA registration standard, it is necessary for nurses and
midwives to maintain a minimum hours of continuous professional development
to renew their registration as a nurse. Hence, the opportunity of learning
nasogastric intubation will add up to my CPD period and enable me to learn and
grow as a confident nurse in the future.
Conclusion:
From thee summary of different registration standards for nurses, midwives or
EN and the response of nurse during complex decision making, it is understood that
different NMBA standards are there to support nurse to enhance and promote safe
nursing practice. The decision making framework is also useful for nurses as it provides
adequate step that nurses can use to be accountable and responsible while providing
care to patients.

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Reference
Australian Nursing & Midwifery Federation. (2017). Anmf.org.au. Retrieved 5 November
2017, from http://anmf.org.au/pages/about-the-anmf
Cason, M. L., Gilbert, G. E., Schmoll, H. H., Dolinar, S. M., Anderson, J., Nickles, B.
M., ... & Schaefer, J. J. (2015). Cooperative learning using simulation to achieve
mastery of nasogastric tube insertion. Journal of Nursing Education.
National decision-making framework. (2017). Retrieved 5 November 2017, from
http://file:///C:/Users/User00/Downloads/Nursing-and-Midwifery-Board---Codes-
and-Guidelines---National-framework-for-decision-making---September-
2007%20(1).PDF
Nursing and Midwifery Board of Australia - About.
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http://www.nursingmidwiferyboard.gov.au/About.aspx
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http://www.nursingmidwiferyboard.gov.au/Registration-Standards/Continuing-
professional-development.aspx
Nursing and Midwifery Board of Australia - Criminal history.
(2017). Nursingmidwiferyboard.gov.au. Retrieved 5 November 2017, from
http://www.nursingmidwiferyboard.gov.au/Registration-Standards/Criminal-
history.aspx
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(2017). Nursingmidwiferyboard.gov.au. Retrieved 5 November 2017, from
http://www.nursingmidwiferyboard.gov.au/Registration-Standards/English-
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Nursing and Midwifery Board of Australia - Professional indemnity insurance
arrangements. (2017). Nursingmidwiferyboard.gov.au. Retrieved 5 November

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2017, from
http://www.nursingmidwiferyboard.gov.au/Registration-Standards/Professional-
indemnity-insurance-arrangements.aspx
Nursing and Midwifery Board of Australia - Recency of practice.
(2017). Nursingmidwiferyboard.gov.au. Retrieved 5 November 2017, from
http://www.nursingmidwiferyboard.gov.au/Registration-Standards/Recency-of-
practice.aspx
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Enrolled-nurse-standards-for-practice.aspx