Forum recognises NZNO's credentialing experience: NZNO continues to make a valuable contribution to the International Council of Nurses' annual forums on nurse credentialing.

Enabling national nurses' organisations (NNOs) at the cutting edge of credentialing to share information and identify emerging issues are the main aims of the annual International Council of Nurses' (ICN) credentialing forums. A further aim is to move towards an international understanding and congruence on matters relating to credentialing. The 6th annual forum was held in Madrid in November, hosted by the General Council of Spanish Nurses. NZNO president Marion Guy and I represented NZNO. This meeting was followed by the inaugural ICN and International Confederation of Midwives' (ICM) Regulators Forum. Nursing Council chief executive and registrar Marion Clark attended the former meeting as NZNO's guest and represented New Zealand at the latter. Guy and I were observers at the regulators' forum. NZNO was invited to join the forum because of our significant experience in credentialing. This includes our certification process, the practice nurse and diabetes nurse accreditation programmes, and direct involvement with the development and monitoring of over 25 employer professional development and recognition programmes.

Achievements to date

With membership of the credentialing forum being small and relatively stable (approximately 25), work over the years has continued to progress. A major achievement has been the development of a credentialing framework, a central database on the ICN website, which acts as a repository of credentialing-related research internationally and a Lexicon of common terminology for credentialing. This framework assists countries developing credentialing systems and those trying to align credentialing frameworks and standards internationally.

The framework and lexicon were developed to assist in the compilation and structuring of information about different credentialing systems.

This enables speedier comparison and analysis of similarities and differences across countries and between different organisations. The ICN Register of Credentialing Research (ICN-RCR) was developed and trialed by forum members. The use of the register has been promulgated internationally and researchers encouraged to enter their work. Feedback has identified that it is difficult and time-consuming to input and extract data. A new, user friendly system will be implemented this year.

Benefits for NZNO

For NZNO, attendance at this forum has had a number of benefits. It became apparent that NZNO was involved in credentialing matters on an ad hoc basis without a formal policy. In June 2004, the board of directors confirmed a position statement on nurse credentialing to guide current and future work. This is on NZNO's website (via professional/advanced nursing practice). Each country shares its resources at the meetings and the networking is invaluable. Often other projects are mentioned through the course of the three days and this can lead to opportunistic contributions to each organisation's work. Meeting to share the experiences, issues and tensions other nations experience with credentialing matters assists and informs NZNO. Many times, though, it has been NZNO's experiences that have contributed positively towards other countries finding solutions to their issues. For a small country, New Zealand has had significant experience with credentialing.

How much is too much credentialing?

One of the key trends identified at the November forum is related to a question NZNO has been raising for the last three years: how much is too much credentialing and where do we draw the line? The forum identified the dilemma countries such as America and Canada are now facing as nurses clamour for recognition through credentialing of smaller and smaller subspecialties. It is gratifying to see the forum has agreed this will be one of the key topics at this year's meeting (venue yet to be decided). In 2003, the key trend that emerged was the impact of globalisation and mutual recognition agreements on nurse credentialing. Similar issues had emerged at the ICN Regulators Conference held in Australia earlier that year. At the 2003 forum, it was agreed a representative from the regulatory body of each country would be invited to attend the credentialing forum from 2004, as there was a significant overlap in the activities and concerns of both groups.

Recognising registrations

For New Zealand nurses, the Trans-Tasman Mutual Recognition Agreement enables recognition of registrations between New Zealand and Australia. No further testing or examination is required. However, the European Directive 2005/ 36/EC of the European Parliament and of the Council on the Recognition of Professional Qualifications, which came into effect late last year, has had a significant impact on New Zealand nurses seeking registration in the United Kingdom (UK). Simplifying nurses' mobility between European Union countries has resulted in a more complicated and costly process for New Zealand registered nurses, which includes sitting an English Language examination. Clark met representatives of the UK Nursing and Midwifery Council in December to discuss these issues. The regulators also needed an opportunity to meet and discuss regulation matters together, matters that also concern NNOs. So it was agreed that, in 2005, ICN and ICM would host a regulators' forum adjacent to the credentialing forum. Key agenda topics discussed at both meetings included:

* mutual recognition agreements. Clark presented a review of the situation in the Southern hemisphere;

* regulation of unlicensed assistant personnel;

* regulation of advanced practice;

* credentialing and the impact of competence-based education, regulation and career frameworks;

* the impact of mobility and migration on regulation; and

* assessment of continuing competence.

These issues are all very topical for New Zealand nurses. The importance of NNOs and regulators coming together to debate these matters is critical to moving forward positively and cohesively in a nursing world growing ever closer. *

NZNO professional nursing adviser Susanne Trim