Appendix C – Definition of nurses and nursing

The Nursing and Midwifery Board of Australia (NMBA) regulates the practice of nursing in Australia by developing standards, codes and guidelines which together establish the requirements for the professional and safe practice of nurses. This includes students of nursing enrolled in a recognised nursing program. 

Qualifications

The qualification to become an enrolled nurse (EN) is a Diploma of Nursing – minimum 18 months, gained in the vocational education sector such as TAFEs and private training organisations. To become a registered nurse (RN) requires a Bachelor of Nursing (degree) – three years, or Master of Nursing – two years, gained through higher education providers and registered training organisations at a university. To become a nurse practitioner (NP) requires registration as a RN and completion of a Master of Nurse Practitioner – minimum 18 months, gained at a university. The foundational education of a RN, EN and NP captures the breadth of the scope of the profession at graduate level. 

Scope of practice⁷⁴

The scope of practice of individual nurses is influenced by the settings in which they practise and is not restricted to the provision of direct clinical care. Nursing practice extends to any paid or unpaid role where the nurse uses their nursing skills and knowledge. This includes working in a direct non-clinical relationship with clients, working in management, administration, education, research, advisory, regulatory, policy development roles or other roles that impact on safe, effective delivery of services in the profession and/or use of the nurse’s professional skills.

Registered nurse practice⁷⁵

RNs determine, coordinate and provide safe, quality nursing. This includes comprehensive assessment, development of a plan, implementation and evaluation of outcomes. As part of practice, RNs are responsible and accountable for supervision and the delegation of nursing activity to ENs and others.

Enrolled nurse practice⁷⁶

The EN works with the RN as part of the healthcare team. Core practice generally requires the EN to work under the direct or indirect supervision of the RN - which is critical for consumer safety. At all times, the EN retains responsibility for their actions and remains accountable in providing delegated nursing care.

Nurse practitioner practice⁷⁷

The NP scope of practice is built on the platform of the RN scope of practice. NPs can manage and are accountable for, complete episodes of care including wellness-focused care, as the primary provider of care or part of a care team. NPs can independently request and interpret any diagnostic and/or screening investigations within their scope of practice to facilitate diagnosis and/or screening processes. Care can include nursing interventions that involve initiation, titration or cessation of any medicines in their scope. NPs take responsibility for following up on any components of care initiated.

Assistant in nursing (AIN) practice

AINs have an important role in the delivery of nursing care. AINs work under the direction and supervision of ENs, RNs and NPs. AINs are part of the nursing career pathway as many go on to complete further study to become an EN or RN. These workers have various titles e.g. Personal Care Workers. NMBA regulation does not extend to AINs, however, those employed in aged care are subject to a Code of Conduct. 

Sectors

Nurses work in many settings. For the supply and demand modelling⁷⁸ completed by the Australian Government Department of Health, Disability and Ageing, nurses are assigned to a sector based on the individual respondents reported job role, job area and job setting in the annual survey at the time of renewal of annual registration. These sectors represent different healthcare settings. They are:

1. Aged care nurses – provide care to older people in areas such as community settings, in-home settings, residential aged care facilities and hospitals. 
2. Acute care nurses – provide care to people with acute conditions predominantly in hospitals. 
3. Primary healthcare nurses – work in a variety of roles in non-hospital settings such as general practices, community health services and Aboriginal health services. 
4. Mental health nurses – provide care to people with mental ill health and disorders. They work in various settings including hospitals, community and residential health services, drug and alcohol services and correctional services. 
5. Other – includes all other nurses such as those working in education, government departments and professional associations.