Explainer: Early career nurses and midwives and notifications

Early career nurses and midwives and notifications

The Australian Nursing and Midwifery Federation (ANMF) led national Early Career Nurse and Midwife working group aims to support early career nurses and midwives to find meaningful employment and transition support.

Worryingly, the working group recently identified an increase in notifications being made against newly graduated nurses and midwives.

Like other professions, nurses and midwives in their first year of practice need support to transition from student to a nurse or midwife and the time to consolidate theory into practice.

Yet, for some early career nurses and midwives, the lack of effective support has led to a notification.

According to ANMF Federal Profession Officer Julie Reeves, these nurses and midwives are new to the professions and often don’t know who to turn to.

To help graduates navigate notifications, the working group has developed a Fact Sheet: Early Career Nurses and Midwives and Notifications, which provides an overview of the notification process, links to further information and how to access support.

The fact sheet covers:

What is a notification?

A notification is a complaint made about a health practitioner to a National Board, including the NMBA. It can be made when there is a concern identified about a nurse or midwife. The concern could be about a health issue that is affecting a nurse or midwife’s ability to safely practice or a conduct or performance issue.

Under the National Law there are two types of notifications, voluntary and mandatory. They are defined as the following:

⦁ voluntary notification: anyone can make a voluntary notification about a health practitioner.

⦁ mandatory notification: under the National Law, registered health practitioners, employers and education providers must make a mandatory notification in some limited circumstances. There are four concerns that may trigger a mandatory notification, these are:

  1. Impairment
  2. Intoxication while practicing
  3. Significant departure from accepted professional standards
  4. Sexual misconduct

Any person or organisation can raise a concern about a nurse or midwife and for most states and territories, these concerns are assessed and managed by Ahpra and considered by the NMBA. However, Queensland and New South Wales have different arrangements when concerns regarding a health practitioner are made.

Ahpra available resources:

Concerns about practitioners: Australian Health Practitioner Regulation Agency – Concerns about practitioners (ahpra.gov.au)

How can you minimise the risk of having a notification being made about you?

According to the Fact Sheet, to assist in preventing a notification nurses and midwives should:

⦁ Understand and incorporate the NMBA standards for practice, codes, guidelines and frameworks relevant to their registration and apply these to their daily practice;

⦁ Understand and incorporate the NMBA decision-making framework for nursing and midwifery in relation to issues such as delegation, supervision and scope of practice; ⦁ Be clear about the expectations of professional boundaries for nursing and midwifery in relation to issues such as conduct, performance and therapeutic relationships;

⦁ Understand the National Law’s mandatory notification requirements;

⦁ Understand and incorporate legislation and regulation relevant to your practice, eg. medicines;

⦁ Comply with organisational policy and procedure; and ⦁ Document and communicate comprehensively:

What happens if a notification is made about you?

When a notification is made about a health practitioner, the notification is assessed by Ahpra to determine whether it meets the threshold for a notification under the National Law and whether there is a risk basis for regulatory action by the NMBA.

A notification made about an early career nurse or midwife will follow the same processes as a notification made about any other nurse or midwife.

The initial phase of this process is an assessment of the notification which can take up to 60 days. During this period, Ahpra, on behalf of the NMBA, will contact the notifier (the person who has made the complaint) but not always the nurse or midwife concerned in the initial stage.

The assessment will focus on whether the:

⦁ conduct or behaviour of the nurse or midwife appears to have been below standard ⦁ health of a nurse or midwife is impaired to the extent that they might not be making safe decisions for their patients

⦁ reflections and actions of a nurse or midwife in response to an event notified are appropriate, responsible and professional, and

⦁ a nurse or midwife is able to be supported by a workplace to ensure ongoing safety of their practice.

If the notification raises concerns of high risk to the public (as determined by Ahpra/NMBA):

⦁ that has not been appropriately managed or cannot be managed without regulatory intervention, or

⦁ if there are a series of concerns that represent a pattern of behaviour

then the NMBA may take immediate protective action while an investigation occurs. Immediate action could result in the nurse or midwife having their practice restricted. After a process of investigation into the issues that have been raised, which includes providing the nurse or midwife natural justice to provide their response to any allegation, all information will be considered.

The NMBA may decide on a number of different actions including closing the matter, issuing a caution, referring the matter for further investigation, referring the nurse or midwife for a health or performance assessment.

Being prepared for a notification

Where a complaint or notification is made, the notification process usually involves the individual practitioner being contacted by a representative from Ahpra by telephone to advise that they have received a notification.

Ahpra sends a letter requesting documents under s164G of the Health Practitioner Regulation National Law (also known as the National Law). These documents include a CV and CPD records for two registration years.

Ahpra/NMBA may also ask for an information declaration – a form which will be provided to you with the letter of notification.

A response or reflection to the complaint/notification. It is recommended that this be a reflective response on the clinical issues that are raised in the complaint/notification.

Ahpra/NMBA may also seek other documents depending on whether the complaint/notification relates to health, performance or conduct.

When should you seek support from your member organisation?

You are encouraged to contact your union, professional organisation and/or Professional Indemnity Insurance Provider as soon as you are able after receiving a notification.

They are experienced in supporting nurses and midwives going through a notification process and can provide support, resources and access to the legal advice required

Looking after your wellbeing and support networks available

According to the Fact Sheet, having a notification about you made to Ahpra/NMBA can be stressful.

Nurses and midwives who have experienced the process of a notification have described feeling an array of emotions, from being overwhelmed, scared, angry, concerned about their future career, and money, while some have even experienced shame.

Ahpra has provided a number of short clips for health practitioners to view in assisting to understand how other practitioners have experienced a notification process.

These are available here.

It is important that you reach out to your union, professional organisation and colleagues or the independent, Nurse and Midwife Support service to enable you to talk about your concerns and enable these organisations to support you when you need it most

Read the full Graduate Fact Sheet: Early Career Nurses and Midwives and Notifications here

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