Clarification on nurse assistant scope of practice imminent.

After a four-month delay, a clarification of the nurse assistant (NA) scope of practice is imminent. As Kai Tiaki Nursing New Zealand went to press, the Ministry of Health's chief nursing adviser Mark Jones and Nursing Council chief executive Marion Clark said they were collaborating on the issue and hoped a statement would be issued "in the near future".

Four months ago, the Nursing Council hosted a forum on NAs, with clarification of the role and scope of practice of NAs a significant outcome. Speaking after the forum, Nursing Council chair Annette Huntington said the Council and the Ministry would work together to "re-iterate clearly the scope of practice of the regulated NA".

The need for the clarification arose from the confusion caused by a 2003 letter to district health boards (DHB) signed by Clark and the Deputy Director General of the Ministry's clinical service directorate, Colin Feek. That letter had affected the employment of enrolled nurses (ENs) and NAs, with many ENs removed from acute care as a result. Speaking after the June forum Huntington admitted the letter had caused ambiguity and the Council needed to address that. Clark said the delay in issuing the clarification had been caused by heavy workloads.

Frustration at delay

The delay has frustrated NZNO's chief executive Geoff Annals and the chair of NZNO's national EN committee, Robyn Hewlett. "It is utterly frustrating that it has taken so long for any clarification to be forthcoming. Everyone at the forum agreed the 2003 letter needed to be updated and the Council gave a clear undertaking to do that," Annals said.

Hewlett shares this frustration. "If that clarification had been available, it might have saved the jobs of two experienced ENs working in acute mental health at Dunedin Hospital who were recently made redundant because of the 2003 letter," she said. They had been allowed to remain working until 2006.

Otago DHB chair Richard Thomson has said the board should have ignored the 2003 letter. Quoted in the Otago Daily Times early this month, he said the board had paid $60,000 in severance to the two nurses and would now have to pay other staff overtime to cover the gap.