Pursuant to section 12(1) of the Health Practitioners Competence Assurance Act 2003 (“Act”), the following notice is given.

Notice

Title and Commencement

(1) This notice may be cited as the Nursing Council of New Zealand Registered Nurse Scope of Practice and Prescribed Qualifications Amendment Notice 2023.

(2) This notice comes into effect on 4 December 2023.

(3) On 4 December 2023, this notice revokes and replaces the Notice of Replacement and Revocation of Notices for Registered Nurses 2021 published in the New Zealand Gazette, 5 October 2021, Notice No. 2021-gs4210.

Dated at Wellington this 25th day of October 2023.

CATHERINE BYRNE, Registrar, Nursing Council of New Zealand.

Explanatory Note

Introduction

Under sections 11(2) and 12 of the Health Practitioners Competence Assurance Act 2003, the Nursing Council of New Zealand (“Council”) is required to describe the scopes of practice for nursing in New Zealand and prescribe the qualifications for each scope of practice.

The Council undertook a significant review of the registration process and prescribed qualifications for internationally qualified nurses (IQNs) to become registered in New Zealand. A specific focus was how the Council assessed the competence to practise of IQNs. The Council proposed a model that focused on outcomes and directly assessing competence. The model proposed was for IQNs to sit a theory exam and an objective structured clinical exam (OSCE). It was also proposed that there be a structured learning programme to educate IQNs about Te Tiriti O Waitangi, cultural safety and to enable applicants to orientate to the New Zealand healthcare context.

From 4 April 2022 to 16 May 2022, the Council consulted widely on the proposals. A number of organisations submitted feedback as well as individuals (the Council received approximately 395 responses). Overall, the responders were supportive of the proposals. Feedback included support for introducing a more standardised, consistent, robust and rigorous approach to competence assessment, specifically through the use of an OSCE. Professional organisations noted their support for this approach in terms of aligning with our international counterparts, in particular Australia, the United Kingdom and other countries.

The proposal for the education programme for IQNs also garnered positive views on the whole, and there was support for the proposed focus on Te Tiriti o Waitangi and cultural safety education.

The Council has replaced the Competence Assessment Programme (CAP) by prescribing qualifications requiring a pass in a theory exam, OSCE and to successfully complete a ‘Welcome to Aotearoa New Zealand’ programme of education.

The Council has further set a prescribed qualification for 1800 hours post-registration nursing practice, which will ensure that IQN applicants have prior experience working as a registered nurse. This is a reduction on the previous requirement of 2 years’ practice within the last 5 years. The rationale for the reduction is that an IQN’s competence to practise will be more directly and robustly measured through the theory exam and OSCE, rather than through work experience. The requirement for post registration experience is to align with the post registration experience New Zealand graduates receive.

Scope of Practice

Registered Nurses

Registered nurses utilise nursing knowledge and complex nursing judgment to assess health needs and provide care, and to advise and support people to manage their health. They practise independently and in collaboration with other health professionals, perform general nursing functions, and delegate to and direct enrolled nurses, health care assistants and others. They provide comprehensive assessments to develop, implement, and evaluate an integrated plan of health care, and provide interventions that require substantial scientific and professional knowledge, skills and clinical decision making. This occurs in a range of settings in partnership with individuals, families, whānau and communities. Registered nurses may practise in a variety of clinical contexts depending on their educational preparation and practice experience. Registered nurses may also use this expertise to manage, teach, evaluate and research nursing practice. Registered nurses are accountable for ensuring all health services they provide are consistent with their education and assessed competence, meet legislative requirements and are supported by appropriate standards. There will be conditions placed in the scope of practice of some registered nurses according to their qualifications or experience limiting them to a specific area of practice. Some nurses who have completed the required additional experience, education and training will be authorised by the Council to prescribe some medicines within their competence and area of practice.

The Nursing Council Competencies for Registered Nurses describe the skills and activities of registered nurses.

Prescribed Qualifications

New Zealand Graduates

1. A bachelor’s degree in nursing approved by the Nursing Council of New Zealand (“Council”); or
2. a graduate nursing qualification at Level 7 on the New Zealand Qualifications Framework approved by the Council; or
3. a postgraduate nursing qualification at Level 9 on the New Zealand Qualifications Framework approved by the Council; and
4. a pass in an assessment of Council Competencies for Registered Nurses by an approved provider; and
5. a pass in an Examination for Registered Nurses set by the Council.

Registered Nurses from Overseas

1. Current nursing registration with an overseas regulatory authority; and
2. a nursing degree or qualification, assessed as being equivalent to a prescribed qualification for New Zealand Graduates listed at a-c above, that led to overseas nursing registration as a Registered Nurse; and
3. at least 1800 hours of post-registration practice as a Registered Nurse; and
4. successful completion of a ‘Welcome to Aotearoa New Zealand’ programme accredited by the Council; and
5. as directed by the Council, a pass in a Nursing Theory Examination for Registered Nurses set by the Council; and
6. as directed by the Council, a pass in an Objective Structured Clinical Exam (OSCE) for Registered Nurses, approved by the Council, in Aotearoa New Zealand.