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Enrolled nurses here to stay - finally.

NZNO's decade-long struggle to cement the position of enrolled nurses (EN) in the country's nursing workforce is over with the Nursing Council's decision on an expanded generic scope of practice and EN the title for all second-level nurses. Its decision, announced just before Christmas, came after extensive consultation, which elicited 460 submissions.

NZNO welcomed the decision and said it would ensure patients' differing needs were met through an appropriate nursing ski[[ mix.

The Council has decided on an 18-month programme with at least one third of it at level 5 on the New Zealand Qualifications Authority framework. The new scope has been gazetted and the Council has started meeting education and health providers and organisations to ensure implementation begins as soon as possible. Current ENs and nurse assistants (NAs) will have an option to transition into the new scope of practice, once competencies have been developed.

The Council believes the changes are supported among nurses affected and within the health sector generally but there is some notable opposition. The College of Nurses, Aotearoa, in its submission, stated the re-establishment of the EN position and title would be "an unfortunate step with prolonged and wide-spread consequences". The college's Maori caucus believes the new scope "will reactivate the inappropriate direction of Maori students towards such a role rather than to the BN degree." The college believed questions posed in the Council's consultation document limited the scope of feedback and provided some sense of foregone conclusion, which was "unfortunate".

Outgoing Health and Disability Commissioner (HDC) Ron Paterson, in his submission, canvassed some HDC cases involving ENs and said where there were staff shortages, there was a risk second-level nurses would be required to work outside their scope of practice. "Accordingly, I consider that second-level nurses should not work in acute mental health units and other acute areas," he said.

In its submission, the District Health Board New Zealand's Nursing and Midwifery Workforce Strategy Group wanted a generic broad-based scope with no exclusions. It wanted a "flexible approach to matching nurses with individual patients depending on their care needs rather than automatically excluding the EN role from particular clinical settings" Ultimately employers and clinical leaders would chose the staff mix that best matched their preferred model of care and patterns of patient complexity and acuity.

The new scope enables ENs to have a greater role in assessment and to work as part of a team with RNs and other health professionals in a variety of settings. It will also enable ENs to have their nursing skills recognised when working with health care assistants in aged-care settings and the community.

It has been a tortuous, confusing and protracted journey to secure the place of ENs in the nursing workforce, including, since 2004, two titles and two scopes of practice for second-level nurses. The Council's decision "finally resolves ongoing uncertainty about the second-fever nurse and their place in the health service," NZNO professional nursing adviser Suzanne Rolls said. "It also reflects the reality of health service provision and provides clarity for the public. NZNO looks forward to working with the Council on implementing the new scope and education programme," she said.

Over the years, NZNO's national EN committee has been a dogged campaigner on behalf of its constituents. Current chair Robyn Hewlett thanked Health Minister Tony Ryall and former Chief Nurse Mark Jones for their support. "I believe their support was significant because there were a number of influential submitters opposed to an expanded scope and the EN title."

She believes the certainty the decision brings, along with the expanded scope and education programme, will attract many to the role.

Hewlett hopes to transition to the new scope once the competencies are finalised.

The EN new scope of practice and submissions can be viewed on the Council's website: www. nursingcouncil.org.nz.
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Title Annotation:NEWS AND EVENTS
Publication:Kai Tiaki: Nursing New Zealand
Geographic Code:8NEWZ
Date:Feb 1, 2010
Words:636
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