All Nurses & Midwives
Nurses and midwives undergo educational preparation to register as a nurse and/or midwife. It is expected that all nurses and midwives are cognisant of their own scope of professional practice and are aware of the professional standards and organisation policies and procedures which are relevant for their practice.
Nurses and midwives are accountable for making professional judgements about when an activity is beyond their capacity or scope of practice and for initiating consultation with or referral to other members of the health team when this occurs.
Credentialing verifies qualifications, experience and professional standing – see Nursing and Midwifery Credentialing page for further information.
Classification of roles within nursing and midwifery occurs in alignment with the enterprise agreement requirements.
Decision Making Framework
The Nursing and Midwifery Board of Australia (NMBA) provides nurses and midwives with tools to assist practice decisions.
A profession’s scope of practice is the full spectrum of roles, functions, responsibilities, activities and decision-making capacity that individuals within that profession are educated, competent and authorised to perform.
An individual’s scope of practice is that which the individual is educated, authorised and competent to perform – which may be more specifically defined than the scope of practice of the profession. To practice within the full scope of practice of the profession, individuals may be required to update or increase their knowledge, skills or competence.
The NMBA’s Decision-making framework for nursing and midwifery provides guidance and principles that underpin decision-making for nursing and midwifery practice. The principles support the provision of safe, person-centred/woman-centred and evidence-based care and, in partnership with the person/woman, promote shared decision-making and care delivery in a culturally safe and respectful way.
Decision-making within a sound risk management, professional, regulatory and legislative framework is a considered, rational process that enables nurses and midwives to work to their full and potential scope of practice. The Framework provides direction to nurses, midwives and others about processes that will help to ensure that safety is not compromised when making decisions about scope of practice, about whether to delegate activities to others and for supervision support.
Extended or Advanced Practice and Nurse Practitioners
Extended Practice roles (advanced nursing practice) are specific to an individual within their context of practice where clinical practice is undertaken that is not traditionally within the scope of the profession or requires advanced skills to complete.
All extended or advanced nursing practice roles require a defined scope of practice based on their position description, clinical service requirements and the required scope of practice.
Any extended or advanced nursing practice roles must be authorised by the Nursing and Midwifery Scope of Practice and Credentialing Committee and positions must be approved by the Nursing and Midwifery Executive prior to recruitment and commencement of the role.
A robust application process must be followed with re-credentialing occurring at specific timelines. See resources listed in the side bar.
Nurse Practitioner and Nurse Practitioner Candidate Roles
Western Health currently has Nurse Practitioner and Nurse Practitioner Candidate roles within the following areas:
- Adult Emergency Services
- Aged Care Community
- Dementia
- Dialysis and Transplant
- Drug & Alcohol Services
- ICU Liaison
- Kidney Disease
- Mental Health & Wellbeing
- Paediatric Emergency Services
- Pain Management
- Stroke Services
- Urgent Care
Extended practice roles are also employed in the following areas:
- Emergency Plaster Nurse
- Nurse Endoscopist
- Nurse Immunisers
- Ultrasound Amniotic Fluid Index for Midwives – Level 1 and 2A
Clinical Supervision
Clinical supervision is a contemporary method of professional support provision which has a long-standing presence within a variety of healthcare professions. The art of effective clinical supervision includes:
- peer review (participating actively in peer practice review),
- coaching (collaborative processes to enhance learning),
- mentoring (longer-term nurturing of knowledge, behaviours and skills),
- practice development (outcomes gained through professional development translate into improved health outcomes).
Clinical supervision is an important component of practice development and can potentially be the driver of change.
At Western Health, clinical supervision is conducted using the Driscoll model of reflective practice, who describes clinical supervision as a process of guided reflection where a supervisor supports and guides the supervisee(s) through the process.
Western Health’s Clinical Supervision for Nurse Practitioners and Clinical Supervision for Nurse Practitioner Candidates guides have been developed to inform and enhance clinical supervision outcomes for our advanced practice nurses.
Delegation and Supervision
A fundamental component of a professional registered nurse and midwife’s roles and responsibilities is delegation and supervision of nursing and midwifery tasks and activities. With team-based models of care, registered nurses and midwives are working collaboratively with enrolled nurses, Registered Undergraduate Students of Nursing (RUSONs), Registered Undergraduate Students of Midwifery (RUSOMs) and unregulated care providers (e.g. Health Care Workers, personal care workers / assistants, assistants in nursing) to provide necessary care to our patient groups.
Delegation and supervision of tasks and activities to health care providers within a team allows an enhanced opportunity to facilitate delivery of safe, effective and efficient nursing and midwifery care. To ensure this occurs, nurses and midwives need to have a clear understanding of the requirements of delegation and supervision.
The Nursing & Midwifery Board of Australia (NMBA) Decision-making framework for nursing and midwifery 2020 also guides to decision-making that relates to delegation, including whether to delegate activities to others and the supervision and support requirements.