Enrolled nurses’ scope of practice to be reviewed this year — Nursing Council

May 18, 2022

NZNO’s enrolled nurses (ENs) say they are looking forward to working closely with the Nursing Council to review their scope of practice, after a 2019 survey found ENs preferred not to work “under the direction” of nursing colleagues.

The Nursing Council announced this week plans to fully review the EN scope of practice this year — a year earlier than the previously signalled time-frame of 2023.

This follows two years’ of lobbying from the NZNO Enrolled Nurses Section (ENS) over a requirement ENsĀ  work “under the direction” of registered nurses (RNs).

Robyn Hewlett

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ENS chair Robyn Hewlett said the section was looking forward to working collaboratively with the Nursing Council to define a “forward-focused” scope which recognised ENs’ distinctive role as one in “partnership” with RNs rather than under their direction.

The EN role differed from that of an unregulated health worker, she said.

The ENS had originally requested a change in wording of the EN scope, from working “under the direction and delegation of the registered nurse (RN) or nurse practitioner (NP)” to “works in collaboration and partnership” with nursing colleagues.

However, reviewing the entire scope was a good idea, “as we can look at what works well, what is not working well, how can we improve it, so no EN is disadvantaged”, Hewlett said.

‘This new EN scope of practice statement needs to be future-focused for nursing in New Zealand and allow ENs to be able to do more and work collaboratively with the RN or NP rather than under direction and delegation.’

“We don’t want it to be task-orientated. This new EN scope of practice statement needs to be future-focused for nursing in New Zealand and allow ENs to be able to do more and work collaboratively with the RN or NP rather than under direction and delegation.”

Nursing Council director of policy, research and performance Nyk Huntington said the review would have two stages. Firstly, it would revisit the current scope statement to ensure it fully represented the current nature and future potential of EN practice. The second stage would look at the competencies underpinning the scope, and the education standards — which set out the council’s expectations for EN education.

Nyk Huntington

The review was in the planning stages but was expected to begin within the next few months, Huntington said. Details on how the council would work with the nursing profession on reviewing the scope would be released as it progressed.

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Council members decided while setting the strategic plan that revising the EN scope should be a priority, given it was last reviewed 10 years ago and “the council’s commitment to enabling high quality EN practice”.

Huntington said the council wanted to look at the role of the EN “holistically”, rather than just focusing on “the long-standing issue of the ‘direction and delegation’ terminology”.

However, the review did not mean everything would be changed, he said. “We will be asking what currently works well, what doesn’t work well, and what is missing.”

Huntington hoped the first stage would be completed within six months.

A 2019 NZNO survey found ENs felt the requirement to work “under the direction and delegation” of colleagues such as RNs was too restrictive. The section wanted the wording changed to reflect a more collaborative “partnership” between ENs and their nursing colleagues, Hewlett said at the time.