Forums familiaris nurses with the HPCA Act: the advent of competency-based practising certificates is still causing concern among many nurses. The recent Nursing Council forums attempted to allay nurses' fears about the new requirements.
Members of NZNO's board of directors attended the Wellington forum. Introducing the day, Council chair Annette Huntington said the new Act, which covers 15 different health professions and a total of 73,000 practitioners, was the biggest change any regulatory authority could go through. The Council had had to change all its policies, there were new scopes of practice and there was the requirement for all health professions to ensure their practitioners were competent to practise. The challenge for the Council, she said, was to find a way of assessing competence white supporting nurses to stay in the workforce.
Huntington stressed that the Council's role was primarily to ensure public safety. She admitted that some in the nursing profession had not easily accepted some of the Council's decisions, particularly around the new scopes of practice. "We knew some would be caught in the changes and that that would be distressing for them. We had to consider all the submissions we received and then make decisions that provided transparency and safety for the public."
Guidelines for competence-based practising certificates were developed in 1999 and reviewed this year, she said. The new definition of "practising" received 95 percent support: "All nurses who are working in a capacity for which a nursing qualification is required in order to practise in direct relationship with clients, or in nursing management and administration, nursing education, nursing research or nursing professional advice or policy development require a practising certificate." The requirements for continuing competence for individual nurses include keeping portfolios with evidence of continuing competence; evidence of a minimum of 60 days' practice in the last three years; evidence of a minimum of 60 hours of professional development in the last three years; and evidence of competence assessment.
Avoiding the term 'portfolio'
Huntington admitted that the requirement to keep a portfolio had alarmed some nurses. "The Council is avoiding the term 'portfolio' now. It's just a collection of material providing a record of practice." Huntington said she did not think the 60 days' of practice requirement over three years was particularly demanding. "That's only four weeks each year and those weeks do not have to done in one block. They need to take place in the particular practice area that is relevant to the individual nurse." Likewise, the 60 hours of professional development over the previous three years had to be relevant to a nurse's particular practice. "There's no list about what is required. It's up to nurses as professionals to know what this is. It could include one-hour seminars, all-day workshops, journal reading or continuing education courses. Nurses have an enormous range of professional development opportunities. They know how to choose what is relevant to their particular practice." Huntington said the requirements were the same for part-timers, enrolled nurses, nurse assistants and nurse practitioners. "We are trying to be as flexible as possible."
Nurses would be assessed against 11 competencies, which were currently being reviewed. Nurses working in management or as consultants would not be assessed on the delivery of direct patient care but would be assessed against other, more relevant indicators. Nurses could choose two out of three competence methods: self assessment; senior nurse assessment or performance appraisal; or peer review or involvement in peer review activities. Nurses were strongly encouraged to enrol in an approved professional development and recognition programme. Nurses on these programmes would not be subject to individual audits.
The Council has the power to review the competence of nurses at any time and will random[y select five percent of nurses a year to audit, ie 2500 nurses each year. If a nurse fails to meet the required standard, the Council may order a nurse to undertake a competence programme, to sit an examination or competence assessment, or to be counselled or assisted. "There are few bad practitioners," said Huntington. "A nurse who fails to provide evidence of competence is most likely coping with other major events or crises in her life. This requires understanding and support, in order to help the nurse remain in practice."
In a session on renewing annual practising certificates (APCs), council chief executive Marion Clark explained that the Council was now faced with a lot more work and would require more time to complete applications. "The issuing of APCs is no longer an automatic process, as each individual application will require scanning. Forms will be issued in early December, and we ask nurses to return them to the Council as soon as possible," she said. New certificates would be issued on a roiling cycle, with some coveting less than a year, depending on a nurse's birth date. Nurses who do not meet requirements fully will be considered on a case-by-case basis and may be issued with an APC or interim APC with conditions.
NZNO board of directors' member Catherine Logan said the forum provided a useful opportunity to hear Huntington's and Clark's perspectives on the HPCA Act changes. However, she regretted there had not been the usual opportunity for more open dialogue and the exchange of ideas on some of the Act's more controversial aspects. "The forum was particularly useful for people who were unfamiliar with the new legislation," she said.
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|Title Annotation:||News Focus; Health Practitioners Competence Assurance Act|
|Publication:||Kai Tiaki: Nursing New Zealand|
|Date:||Nov 1, 2004|
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