New Scope Statement Supports Full Potential Of Enrolled Nurses

Te Kaunihera Tapuhi o Aotearoa The Nursing Council of New Zealand today launched a new Enrolled Nurse Scope Statement, setting the scene for change in Aotearoa New Zealand.

The new statement has been developed in collaboration with the Enrolled Nurse Section of the New Zealand Nurses Organisation (NZNO).

NZNO Enrolled Nurse Section Chair Michelle Prattley says the statement will benefit both nurses and people who use health services in Aotearoa.

"Enrolled Nurses will be able to practice in a wide range of health care services with this less restrictive scope of practice and enrolled nurses have lobbied for these changes."

The new statement has been prepared by a design group including representatives of the Council, Te Poari o Te Rūnanga o Aotearoa, enrolled nurses themselves, and employers and educators of enrolled nurses.

"Enrolled nurses are skilled nursing professionals in their own right," said Catherine Byrne, Chief Executive of the Nursing Council. "They can work across a wide range of possible practice areas and settings, and this statement recognises that."

Key changes in the new statement include stronger recognition of Te Ao Māori, including Te Tiriti o Waitangi and the Kawa Whakaruruhau framework, and moving from listing specific tasks to a flexible description of practice that reflects an EN’s education and experience. The new statement also shifts the relationship between enrolled and registered nurses (RNs) from ‘direction and delegation’ by an RN to a focus on support and guidance.

The development of this new statement is part of a full Review of the Enrolled Nurse Scope of Practice. The next step in this Review will look at the competencies which describe the skills, knowledge, and behaviours needed to be a safe and competent enrolled nurse, and the education standards that govern Enrolled Nurse programmes. The new statement, competencies, and standards will come into full effect at the beginning of 2024.

"With the Pae Ora and vocational education reforms, the systems in which nurses practise and are educated are both experiencing their most dramatic transformation in decades." Said Byrne.

"How we describe Enrolled Nurse practice and learning needs to support this, enabling these nurses to contribute fully to the health and wellbeing of people, their whānau, and communities. Moving to a focus on partnership and collaboration with RNs and the wider health care team is important and should reduce confusion that might have in the past stopped health employers from realising the possible value of enrolled nurses."

Enrolled Nurses are one of three types or ‘scopes’ of nurses in Aotearoa New Zealand, alongside Registered Nurses and Nurse Practitioners. They complete an 18-month Diploma qualification rather than a Bachelors Degree, and are expected to work with the support of a Registered Nurse or other regulated health practitioner. At 31 March 2023 there were 2,409 enrolled nurses representing 3.5% of the nursing workforce.

The Nursing Council regulates nursing practice and education under the Health Practitioners Competence Assurance Act 2003, including managing complaints against nurses. A person must be registered with the Council and maintain an Annual Practising Certificate in order to work as a nurse in Aotearoa New Zealand.

Enrolled Nurse Scope Statement

Enrolled Nursing in Aotearoa New Zealand reflects knowledge, concepts, and worldviews of both tangata whenua and tangata tiriti. Enrolled nurses uphold and enact Te Tiriti o Waitangi ngā mātāpono - principles, based within the Kawa Whakaruruhau framework for cultural safety, that promote equity, inclusion, and diversity.

Enrolled Nurses are accountable and responsible for their nursing practice, ensuring all health services they provide are consistent with their education and assessed competence, legislative requirements, and are supported by appropriate standards. This includes the right of Māori and other population groups to quality services that are culturally safe and culturally responsive.

The Enrolled Nurse works in partnership and collaboration with the health consumer, their whānau, communities, and the wider healthcare team to deliver equitable person/ whānau/ whakapapa-centred general nursing care, advocacy, and health promotion across the life span in all settings. An Enrolled Nurse’s practice is informed by their level of educational preparation and practice experience, and may include a leadership or coordination role within the healthcare team.

Enrolled Nurses partner with health and disability support consumers to initiate care, monitor, and enhance health status through nursing assessments, care planning, implementation, and evaluation of care. Enrolled Nurses 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 midwife, medical practitioner or occupational therapist.:

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