Nursing Council of New Zealand Enrolled Nurse Scope of Practice and Prescribed Qualifications Amendment Notice 2024
Pursuant to sections 11(1) and 12(1) of the Health Practitioners Competence Assurance Act 2003 (“Act”), the following notice is given.
(1) This notice may be cited as the Nursing Council of New Zealand Enrolled Nurse Scope of Practice and Prescribed Qualifications Amendment Notice 2024.
(2) This notice comes into effect on 20 January 2025.
(3) On 20 January 2025, this notice revokes and replaces the Notice of Replacement Scope of Practice and Related Qualifications Prescribed by the Nursing Council of New Zealand for Enrolled Nurses published in the New Zealand Gazette, 13 May 2010, No. 55, page 1540.
Dated at Wellington this 12th day of November 2024.
CATHERINE BYRNE, Registrar, Nursing Council of New Zealand.
Under sections 11 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 enrolled nurse scope of practice. The Council had received consistent feedback that the enrolled nurse scope was too limiting, did not enable optimum contribution to the health workforce, and was a barrier to effective deployment of enrolled nurses.
The new scope provides a shift from describing tasks and activities to a flexible scope description clearly linked to an enrolled nurse’s educational preparation and practice experience. The scope removes the requirement for enrolled nurses to practise under the direction and delegation of a registered nurse or nurse practitioner. It emphasises collegiality, stating that an enrolled nurse must always have access to support from a registered nurse (or other appropriate registered health practitioner) and has an obligation to seek guidance when appropriate. A significant focus of the new scope is the addition of clear reference to te ao Māori and culturally safe practice. The scope also references general nursing functions to enable enrolled nurses to undertake functions referred to in other legislation.
The review was undertaken in partnership with the Enrolled Nurse Section of the New Zealand Nurses Organisation and with guidance from Te Poari o Te Rūnanga o Aotearoa. A design group was established to work on this review. Members of the design group were drawn from the Nursing Council, the Enrolled Nurse Section, Te Poari and educators and employers of enrolled nurses. The concepts proposed by the design group were tested with a broader sector reference group comprising representatives from a wide range of stakeholders. To support the review, the Council also analysed relevant academic literature, reports, and requirements in other jurisdictions.
From December 2022 to February 2023, the Council consulted widely on the proposed scope. Overall, there was clear support from across the sector. There was recognition that the new statement provided a broader, more flexible and future-focused scope with opportunities to develop enrolled nursing to better meet population health needs, with a specific focus on equitable outcomes for Māori across diverse health settings.
The Council decided to publish this new scope of practice in the New Zealand Gazette once new education standards and standards of competence were developed to support enrolled nurse practice.
Enrolled nurses in Aotearoa New Zealand reflect knowledge, concepts and worldviews of both tangata whenua and tangata tiriti. Enrolled nurses uphold and enact ngā mātāpono – principles of Te Tiriti o Waitangi, based on the Kawa Whakaruruhau framework and cultural safety, promoting equity, inclusion, diversity, and rights of Māori as tangata whenua. These concepts also relate to Pacific peoples and all population groups to support quality services that are culturally safe and responsive.
Enrolled nurses are accountable and responsible for their nursing practice, ensuring that all health care provided is consistent with their education, assessed competence, relevant legislative requirements, supported by relevant practice standards, and is guided by the Nursing Council of New Zealand’s standards for enrolled nurses.
The enrolled nurse works in partnership and collaboration with individuals, their whānau, communities, and the interprofessional healthcare team, to deliver equitable person/whānau/whakapapa-centred nursing care, including advocacy and health promotion, across the life span in all settings. An enrolled nurse’s practice is informed by their educational preparation and practice experience and may include a leadership or coordination role within the healthcare team.
Enrolled nurses partner with people receiving health and/or disability support services to initiate and monitor care through nursing assessments, care planning, implementation and evaluation of care. Enrolled nurses must work with access to, and seek when appropriate, guidance from a registered nurse or other registered health practitioner.*
*A health practitioner is a person who is registered under the Health Practitioners Competence Assurance Act 2003 – for example, a nurse practitioner, midwife or medical practitioner.
For the avoidance of doubt in other legislation where nurse is defined, this scope of practice includes general nursing and nursing functions.