No images? Click here Need to KnowJune 2024 Welcome to the latest edition of Need to Know - the newsletter for Nurses and Midwives A word from the PresidentWelcome to the June 2024 edition of the Nursing and Midwifery Council of NSW’s Newsletter. In my many roles as President of the Council, regulator, academic and clinician I am acutely aware of the numerous demands on the nursing and midwifery profession. I have held a number of conversations with colleagues, peers and Council stakeholders about the role of the Council, the expectations of the public and practitioners, and our obligations as practising health professionals. As a regulator, I appreciate the significant role the Council plays in protecting the public and in maintaining high standards of patient care. Intervention by the regulator is sometimes necessary, but feel it is important to emphasise the Council is not here to be punitive. We work within a protective area/power, which means that any regulatory decision or action taken by the Council is done so purely to ensure safe practice, thereby protecting the public. You will note from the following graph that the vast majority of complaints received by the Council result in no regulatory action being taken. And while the numbers within each category vary slightly from year to year, the overall outcomes are generally the same.* Before the Council reaches a decision regarding a complaint, practitioners are given the opportunity to respond to the complaint and make further submissions. This means any Council decision is not based simply on the information received within the complaint. A number of practitioners who have provided feedback to the Council, have reflected that after receiving a complaint and managing the inevitable stresses, the experience has enabled valuable reflection on the professional standards resulting in a positive impact on their clinical practice. You will read more about the importance of self-reflection in the article later in the newsletter on the successful completion of this year’s Regulation in Leadership Program, which was supported by the Council. We also read later of a case study from a practitioner who went through the complaints process and how during this experience she gained a better understanding of the professional standards and Code of conduct for nurses which had positive benefits and enabled them to deliver the best possible outcome for their patients. Three of the current Council Members are coming to the end of their terms this month – 9 years - I am delighted we have the reflections from two of our “leavers” on their work for the Council and how it has impacted their own work practices. May I take this opportunity to thank each of the retiring Council Members for their hard work and dedication during their terms of office. You will be missed! We hope you enjoy reading this edition of the newsletter and do let us know at the link below if you have any comments or suggestion about this edition. Regards, Adjunct Professor Greg Rickard OAM FACN ![]() Nurse and Midwife SupportNurse & Midwife Support is for all nurses and midwives, nursing and midwifery students, employers, educators and concerned family and friends. They provide confidential advice and referral, promote better health for nurses, midwives and students, and safer care for the public. Whether you want to chat to a counsellor, email a quick query or find a service — they have an option for you. Find out more on the link below. International Nurses/Midwives DayIn May 2024 midwives and nurses celebrated International Day of the Midwife (IDM) and International Nurses Day (IND). IDM enables midwives to celebrate their profession and for all of us to recognize their work and contribution to maternal and newborn health (NSW Health). The 2024 theme ‘Midwives: A Vital Climate Solution’, recognises climate change as the greatest challenge of our time and the recognition that continuity of midwife care leads to optimal and safe outcomes by using fewer resources, resulting in a reduced ecological footprint (https://internationalmidwives.org/idm-theme-announcement). The Nursing and Midwifery Council recognises the vital contribution midwifery care provides for women, babies and families. We also acknowledge the practice challenges and successes navigated by midwives every day in their pursuit for best outcomes, informed by evidence and woman-centred practice. The IND 2024 theme is 'Our Nurses. Our Future. The economic power of care'. The reasoning behind the theme is to highlight the financial constraints and societal undervaluation of nursing internationally. It is time to shift this perspective and demonstrate how strategic investment in nursing can bring considerable economic and societal benefits. The International Council of Nurses’ vision is that the global community recognizes, supports, and invests in nurses and nursing to lead and deliver health for all. The NMC recognises changes across health creates challenges for all committed to ensuring safe and quality care. The flexibility of nurses to reinvigorate in a time of reshaping healthcare, is applauded and your contribution to enabling your communities to live healthier lives is recognised. The Nursing and Midwifery Council contributes to the protection of the health and safety of the public through regulation. Appropriate regulatory systems support the provision of safe, competent, and ethical nursing and midwifery care for all members of our society. Your personal and professional commitment to regulation, engenders strength and integrity within our professions. Regulation in Leadership Program (RiLP)![]() Photo (L to R):Greg Rickard, NMC Council President; 2024 RiLP participant Maria Ferguson; 2021 RiLP participant Kristen Bennie; 2024 RiLP participant Travis Brown The 2021 Nightingale Challenge, launched by the Burdett Trust for Nursing, asked every health employer around the world to create and promote leadership and development opportunities for emerging nurse and midwife leaders. Responding to this call, the Nursing and Midwifery Council of New South Wales launched its regulation and leadership program with two emerging leaders joining the team on a supernumerary basis for a three month period. Feedback from the program's participants was overwhelmingly positive, returning to their workplaces, equipped with a deep understanding of professional practice, sharing their knowledge across their teams and organizations. Due to the success of the 2021 program, the Council decided to offer the three month paid program again in 2024, with successful participants Maria Ferguson and Travis Brown engaging in a wide range of activities covering all aspects of the council's role in managing complaints and notifications about the health, performance and conduct of nurses, midwives and students in both professions. "One thing the program has made me feel more confident about as a leader is understanding how to support practitioners and indeed my colleagues. When I go back to my workplace I will share my knowledge with my stream managers, nurse managers and Director of Nursing about what I've learned and how we might be better improve on support for our practitioners through the work that we do, and also to illustrate the importance of the professional practice framework. (Travis) "I've got a very simple take home message to take back to my practice, and that is to constantly revise the standards for practice and the code of conduct and frameworks. I'm also not going to underestimate the power of self-reflection and using it as a great tool to inform my future learning and development within my own nursing career". (Maria) Read here Maria and Travis's further thoughts on the program as they came to the end of their secondment with the Nursing and Midwifery Council. We are hoping to run another Regulation in Leadership Program early in 2025 and further information will be sent out to all nursing and midwifery practitioners nearer the time. In the meantime, please enjoy the short video below outlining the work undertaken during the Project. My experience as a Council memberIn this issue we are very grateful to hear from two retiring Council members about their experiences over the last nine years and what they will take away from their time with the Nursing and Midwifery Council. ![]() Ms Karen Hay (above)Enrolled NurseCouncil Member of the Nursing and Midwifery CouncilServed on the Council from July 2015 - June 2024![]() Dr Elisabeth Black (above)Registered Nurse and Non-Practicing MidwifeDeputy President of the Nursing and Midwifery CouncilServed on Council from July 2015 - June 2024What does the Nursing and Midwifery Council do? Karen: The Council acts as a co- regulator for the N&M professions. Its aim is to uphold professional standards, policies and guidelines, and of course the law and to reduce harm in the interest public safety. Lis: The Council’s focus is on safe and professional nursing and midwifery practice, maintaining public safety and minimising risk. The Council has an obligation to act to prevent unsafe practice in nursing and midwifery and has been granted legal powers under the National Law to regulate our profession. As regulators, Council members are not investigators but assessors of risk and as such make decisions that ensure significant risks are mitigated. We have to be proportionate, consistent, transparent in our decision making and accountable to the legislators and public of NSW. Working as a regulator has been very interesting and at times challenging work to be involved with over the last nine years. I have evolved a deep understanding of the importance of regulation not only for the community but also for our profession. Whilst complaint numbers aren’t large, we do have practitioners who, for many varied reasons find themselves in some kind of professional difficulty over their clinical practice, conduct or health. Working collaboratively to maintain standards and being able to guide and counsel practitioners is rewarding work when you care deeply about the difference best nursing and midwifery practice can make to our patients and their health outcomes. Equally rewarding is being able to assist practitioners, with compassion and understanding, to find a pathway through the process with insight and reflection and get them back to safe professional practice as soon as possible. How did you get involved with the Council? Karen: A friend and colleague was a member of the previous State Board/NMC and knew of my interest in the law and practice development so she encouraged me to apply back in 2014/2015. Fortunately, I was successful and have completed the 3 terms allowable under the law. It’s fascinating, no two days are the same. Lis: Initially I was nominated to Council due to my role as a Fellow of the Australian College of Nursing, and I was asked to be their representative on Council. I was subsequently re-nominated for additional terms. What is your professional background? Karen: I’ve worked as an Enrolled Nurse in the perioperative setting for around 35 years. (30 of them at the same place) and have at some point during those years worked in all areas .(ie: Anaesethics, Instrument/Circulating, PACU and a stint in Pain Management. I’ve had the privilege of sitting on a Board of Directors for a specialty nursing college, an executive committee for a professional association and have travelled overseas to participate in regulatory /enforcement forums, not only nursing, but for a variety of professional and vocational workforces. Lis: I am a registered nurse and non-practising midwife with a career long interest in specialty and advanced professional practice, models of care, nursing and multidisciplinary education. I have worked in a variety of clinical, managerial and leadership roles, and have always been committed to leading and influencing activities that deliver an evidence-based, best practice approach to care. Regulation and the maintenance of professional standards aligns closely to my other interests so working on Council has been a good ‘fit’ for me. It is very meaningful work with purpose! What did you learn during your time with the Council, and how did it change the way you practice? Karen: I don’t think I can sum that up in a few lines. There is so much. Some things are sad, some are so enlightening and powerful. I don’t think the question should ‘how it changed’ but instead ‘Did it change’ and the answer would be a resounding yes. Lis: I’ve learnt so much but probably the most significant insight my time on Council has given me is the importance of workplace culture on practice. Workplaces are constantly evolving and are becoming increasingly complex environments for registrants to practice within. A positive and learning workplace culture with a focus on safety supports nurses and midwives to do their best work so I have always tried to ensure that within my circle of influence, we work collaboratively to achieve it as best we can. What would be your advice to the nursing and midwifery profession? Karen: Be kind to yourself and to others. Take a few minutes a day and look at the good things you have achieved. Talk to others and if it’s necessary seek help with your well-being whether it be physical, emotional or mental health or your practice. There is no harm in “Standing on the Shoulders of Giants” occasionally to get a better view of yourself. Lis: Be familiar with the standards that guide your practice and the professional practice framework that we must all work within. The benefits of reflective practice should never be underestimated and, never rely on your colleagues to keep your practice safe- only you can do that! Social media guidelines update![]() Ahpra have devised a guidance for all registered health practitioners to understand and meet their obligations when using social media. While recognising the freedom of expression and right to communicate for practitioners, Ahpra and the National Boards have collated examples, based on real cases, as a guide to practitioners to ensure their activities do not involve the abuse or discrimination of others, or present a risk to the public. Please take time to refresh yourself of your obligations under the Nursing and Midwifery Board's code of ethics and professional conduct. Case Study - Gina's experience of indirect supervisionTRUST such an important word and is integral to our profession, from clinicians to the governing bodies who guide and regulate our profession. As professionals working in a healthcare environment, trust helps us build therapeutic and professional relationships with our patients, their families, work colleagues, managers, and stakeholders. Such a little word which has so much meaning and importance, as it influences how we think, our understandings, our behaviours, and our reputations. What happens when you trust the cultural practices in your workplace rather than the Standards of Practice, Codes of Conduct, and policies for your profession? This lesson was the turning point for Gina* a registered nurse who had just completed a Transition to Practice Program earlier in the year. Gina was working a night shift with a very experienced Nurse in Charge who directed how the work would be completed with the expectation that you did not question the practice. The culture of the unit supported this practice. Read here to learn what happened when Gina was subject to a notification to Aphra and the subsequent conditions placed on her registration. The Standards for practice, Code of Conduct and Code of Ethics can be found via the Nursing and Midwifery Board website here. *name has been changed to maintain confidentiality Connection, collaboration and learning at inaugural HPCA and NSW Councils Conference![]() Friday 12 April saw the Health Professional Councils Authority (HPCA) and NSW Heath Professional Councils (the Councils) successfully deliver their first joint all Councils Conference. A diverse collection of speakers and panellists across health regulation came together in Sydney to discuss and explore the latest regulatory themes, challenges and opportunities in the NSW co-regulatory landscape. “Thank you to all presenters, panel members and attendees for participating in the inaugural HPCA and NSW Councils Conference, and to everyone involved in making this event a success. The opportunities provided by this conference to engage with a broad range of stakeholders will surely assist us in maintaining public safety and confidence in the practice of regulated professions in NSW,” said Ameer Tadros, Director, HPCA. Working as a Nurse in the Cosmetic/Aesthetic industry![]() In NSW currently, 1.7% of all notifications to the Nursing and Midwifery Council are related to cosmetic/ aesthetic nursing practice. Notification themes are highlighting concerns beyond those conventionally expected within the regulatory conduct, health and performance pathways. They raise issues regarding business processes, competitive practices, client expectations often seeking arbitration, advertising and social media. These are often provided to the regulator with 'before and after' photos in the hope that the regulator may intervene and assist with gaining financial compensation for the notifier. Read our Case Study about Ava*, a registered nurse who opened a business specialising in cosmetic injectibles. *name has been changed to maintain confidentiality For nurses working or thinking about practicing in cosmetic/aesthetic practice, it is imperative you are aware of regulatory updates. A good starting place is the NMBA position statement on Nursing and cosmetic medical procedures and the Poisons and Therapeutics Goods Act 1996. If there is a notification made about your practice in this setting, you will be asked to provide further information on how you comply with these requirements. Within this document you will find links to the NMBA’s standards, codes and guidelines which set the regulatory requirements within which nurses working in the area of cosmetic medical procedures must comply, to ensure ongoing competence and safe practice. Additionally, there is a link to the Medical Board of Australia’s (MBA) Guidelines for registered medical practitioners who perform cosmetic medical and surgical procedures (MBA guidelines). All nurses working in cosmetic medical procedures should be aware of the MBA guidelines. Update from AhpraJoint statement on professional responsibilities for prescribing and dispensing medicinesAhpra and the Medical, Nursing and Midwifery, and Pharmacy Boards of Australia have released a Joint statement on professional responsibilities for prescribing and dispensing medicines. It is in response to the rise in telehealth models of care prescribing predetermined medicines often in closed-loop arrangements with pharmacies, without adequate patient assessment, management or follow-up. Whilst it does not specify products, they are referencing weight loss medicines (e.g. semaglutide) and products for sleep and anxiety (e.g. medicinal cannabis). The statement reminds practitioners of their responsibilities and obligations under the relevant Code of Conduct and urges health practitioners to think carefully before practising in any business and ensure that the framework for practice is consistent with their professional obligations. How can we improve this newsletter?This newsletter aims to provide content that is relevant and timely for nursing and midwifery practitioners in NSW. It is designed to inform your practice and shed light on your regulatory responsibilities as they evolve over time. We would appreciate you spending a couple of minutes to share your feedback, which will help us stay on track. We acknowledge that we are located on the traditional lands of the Eora Nation and pay our respects to Elders past, present and future. |