Download Annual Report for year ending 30 June 2003

N E W S O U TH W A LE S
N U R S ES
R E G IS T R A T IO N B O A R D
A N N U A L R E P O R T FO R TH E YE A R E N D E D
3 0 JU N E 2 0 0 3
CONTENTS
CHARTER
1
AIMS AND OBJECTIVES: FUNCTIONS
1
CLIENTELE OF THE BOARD
2
ACCESS
3
MANAGEMENT AND STRUCTURE
Membership
3
Meetings of the Board
5
Attendance at Meetings
5
Code of Conduct for Members
5
Disciplinary Matters
Conduct Committee
7
Statistics
8
Psychiatric Assessment
9
Professional Standards Committees
Nurses Tribunal
9
11
Committee Structure
Research and Development Committee
22
Health Committee
22
HUMAN RESOURCES
Administrative Staffing
23
REVIEW OF OPERATIONS
Activities
24
Consultation Forums - Education of Enrolled Nurses
24
Seminars for Nurses
25
Course Accreditation
25
Assessment of Applicants from Other Countries
26
Portfolios for Registered Nurses and Enrolled Nurses
26
Registration, Enrolment, Authority to Practise Midwifery
26
Mutual Recognition
27
Statistics
28
Requests for Information from Interstate Registering Authorities
28
Overseas Nurse Applications
29
Nurses Registration Board Education and Research Account
Research and Development Scholarships
30
31
Nurse Education Inspections
33
Recognised Institutions
33
Leading to Registration on List A
33
Leading to authorisation as a Nurse Practitioner
34
Leading to an Authorisation to Practise Midwifery
34
Leading to Enrolment on List A
36
CODES OF CONDUCT
Code of Professional Conduct
41
Code of Conduct for Members of the Nurses Registration Board
and Committees of the Board
42
NURSES REGISTRATION BOARD PROJECTS: SPECIAL INITIATIVES
Strategic Plan
42
"Board Works" Newsletter
43
Internet Web-Site
43
PUBLICATIONS
43
Information Leaflets
43
Reports
43
Circulars and Policy Documents
CONSUMER RESPONSE
44
44
TIME FOR PROVISION OF SERVICES
Applications
44
Annual Renewal of Registration/Enrolment
44
GENERAL
Fees Payable - List of fees and comparison between years 2002/2003
45
Costs of Administration of the Board
46
Metal Badges
46
ETHNIC AFFAIRS PRIORITY STATEMENT
Key Strategies
47
Overseas Qualified Nurses - Recognition of Qualifications
48
Interpreter and Translation Services
49
HEALTH PROFESSIONALS REGISTRATION BOARDS
Administration - Management and Structure
49
Overseas Travel
50
Administrative Staff - Code of Conduct
51
NSW Government Action Plan for Women
57
Waste Reduction And Purchasing Policy (WRAPP)
58
Freedom of Information
59
Legislative Change
59
Consultancies
59
Organisational Chart
60
FINANCE
Finance and Budget
61
Auditor-General's Certificate
64
Statement of Accounts
66
INDEX
74
1.
CHARTER
The Nurses Registration Board of NSW was established by an Act of the NSW Parliament in 1926.
Presently the NSW Nurses Registration Board operates under the Provisions of the Nurses Act 1991
(as amended) to exercise the powers, authorities, duties and functions prescribed by the Act.
2.
AIMS AND OBJECTIVES
2.1
Functions
•
To maintain the Register of legally qualified registered nurses.
•
To maintain the Roll of legally qualified enrolled nurses.
•
To grant registration and enrolment to nurses with the appropriate qualifications.
•
To grant authority to practise midwifery to nurses with the appropriate qualifications.
•
To hold examinations and to determine the character, subjects and conduct of those
examinations.
•
To appoint examiners and supervisors in respect of examinations.
•
To appoint places and times at which examinations shall be held.
•
To determine applications for registration as a nurse, for authorisation to practise
midwifery and for enrolment as enrolled nurses.
•
To issue certificates of registration to registered nurses, certificates of authorisation to
practise midwifery to registered nurses authorised to practise midwifery and certificates
of enrolment to enrolled nurses.
•
To issue authorities to practise as a registered nurse or enrolled nurse.
•
To grant recognition to hospitals, nursing homes and educational and other institutions
offering courses for the training of nurses, midwives and enrolled nurses.
•
To grant recognition to the curricula for such courses.
•
To grant recognition to the diplomas, certificates and other qualifications awarded to
those persons who successfully complete those courses.
•
To investigate the conduct of a registered nurse, enrolled nurse or certified midwife
where a complaint is received or where the Board decides that it is desirable to do so.
1
•
To promote and maintain professional standards of nursing practice in New South
Wales.
•
To promote the education of nurses and educational programs relating to nursing.
•
To advise the Minister on matters relating to the registration and enrolment of nurses,
standards of nursing practice and any other matter arising under or related to the Act or
the Regulations.
•
To publish and distribute information concerning the Act and the regulations to nurses
and other interested persons.
•
To impose requirements or conditions for or relating to registration as a nurse,
authorisation to practise midwifery or enrolment as an enrolled nurse or enrolled nurse
(mothercraft).
•
To grant to persons in prescribed circumstances or cases exemptions from a requirement
or condition for or relating to registration as a nurse, authorisation to practise midwifery
or enrolment as an enrolled nurse.
•
To make recommendations to the Minister for Health for appropriate amendments to the
Act and Regulations.
The Board is empowered
3.
•
To terminate as it considers appropriate any appointment of examiners and to vary the
place and times of examinations.
•
To withdraw, or vary the conditions of, any recognition or exemption granted.
•
In accordance with the Act, to cancel or suspend any registration as a nurse,
authorisation to practise midwifery or enrolment as an enrolled nurse or, where
appropriate, to restore any such registration, authorisation or enrolment.
CLIENTELE OF THE NSW NURSES REGISTRATION BOARD
•
All Registered and Enrolled Nurses in NSW
•
Any member of the public who has cause to enquire regarding the regulation of nursing or
complain of the professional actions of Registered and Enrolled Nurses.
•
Employers of Registered and Enrolled Nurses.
•
Hospitals and other Health Care Facilities.
2
4.
ACCESS
The NSW Nurses Registration Board is located at the following address:Level 2
28-36 Foveaux Street
SURRY HILLS
SYDNEY 2010
Hours of Business
Postal Address:
8.30 am - 4.30 pm
PO Box K599
Monday to Friday
HAYMARKET
Telephone: (02) 9219 0222
1238
Facsimile: (02) 9212 7126 Mutual Recognition
Facsimile: (02) 9281 2030
Rural Access: 1800 241 220
5.
MANAGEMENT AND STRUCTURE
5.1
Membership
Membership of the Board is prescribed under Section 9 of the Nurses Act 1991 and consists
of 13 members who are appointed by the Governor, of whom
From 1 July 2002 to 30 June 2003
Three (3) are registered nurses elected in the prescribed manner by registered nurses who are
eligible to vote at elections held for the purpose:
Dale Sutton, RN,CM, BHlth Sc (Nursing) Grad Cert Critical Care, appointed under
section 9(2)(a)
Tara Walker, RN, Dip Hlth Sc (Nursing), B Hlth Sc (Nursing), B Hlth Sc (Hons),
PhD, MRCNA, appointed under section 9(2)(a)
Lynette Taylor, RN, B Nursing(Deakin), Oncology Cert, Counselling Cert,
MRCNA, appointed under section 9(2)(a)
One (1) is an enrolled nurse or enrolled nurse (mothercraft) elected in the prescribed manner
by the enrolled nurses and enrolled nurses (mothercraft) who are eligible to vote at elections
held for the purpose:
David Cathie, EN, AMRCNA, appointed under section 9(2)(b)
One (1) is a registered nurse nominated by the New South Wales Nurses' Association:
Brett Holmes, RN, CM, Certificate in Psychiatric Nursing, appointed under section
9(2)(c)
One (1) is a registered nurse nominated by the New South Wales College of Nursing:
Joan Englert, AM, RN, CM, MSc Soc, BHA, DNA, COTM, FCN(NSW), FRCNA,
MINA, FAIM, appointed under section 9(2)(d)
3
One (1) is a registered nurse who is an officer of the Department of Health, an Area Health
Service, the Ambulance Service of NSW or the Corporation, nominated by the Minister:
Judith Louise Meppem, RN, CM, BHA (NSW), COTM, FRCNA, FCN (NSW),
FINA (NSW and ACT), AFAIM, appointed under section 9(2)(e)
(resigned September 2002)
One (1) is a registered nurse who is an educator of nurses jointly nominated by the Minister
for School Education and Youth Affairs and the Minister for Further Education, Training
and Employment:
Jill White, RN, CM, BEd, MEd, FRCNA, FCN(NSW)
One (1) is a barrister or solicitor nominated by the Minister:
Yvonne Grant, BA, Bachelor of Law, Master of Law (London), Diploma of Air &
Space Law (London), appointed under section 9(2)(g)
Two (2) are persons nominated by the Minister as a representative of consumers:
Chris Guest, B.Ec (I), Monash University 1975, MA (Econ, Hons. I), University of
Melbourne 1980, M.App.Fin. Macquarie University 1987, appointed under section
9(2)(h)
Amanda Cornwall LLB (Adelaide), appointed under section 9(2)(h)
(resigned November 2002)
One (1) is a registered nurse authorised by the Board to practise midwifery who is elected in
accordance with the regulations by registered nurses who are eligible to vote at elections
held for the purposes of this paragraph:
Kate Dyer, RN, CM, Grad Dip Community Nursing (Syd Uni), M Midwifery
(UWS), appointed under section 9(2)(b1) (1)
One (1) is to be a registered nurse who is nominated by the Minister who practises nursing in
the area of mental health:
Charles Linsell, RN, BA, Dip.Ed, Grad.Dip. Of Business Studies (Industrial
Relations) appointed under section 9(2)(f1)
Of the members of the Board, one who is a registered nurse is appointed as President and
one (who may or may not be a registered nurse) is appointed as Deputy President, by the
Governor.
President
Joan Englert, AM, RN, CM, MSc Soc, BHA, DNA, COTM, FCN(NSW), FCNA, MINA,
FAIM
Deputy President
5.2
Kate Dyer, RN, CM, Grad Dip Community Nursing (Syd Uni), M Midwifery (UWS)
Meetings of the Board
4
The Board met on 11 occasions during the reporting period, usually on the first Thursday of
each month between 1 July 2002 to 30 June 2003.
5.3
Attendance at Meetings
Number of meetings attended
Board Members
J Englert
11
K Dyer
11
D Cathie
8
A Cornwall
(resigned November 2002)
2
Y Grant
8
C Guest
3
B Holmes
8
C Linsell
10
J Meppem
(resigned September 2002)
2
D Sutton
10
L Taylor
8
T Walker
6
J White
7
CODE OF CONDUCT FOR MEMBERS OF THE NURSES REGISTRATION BOARD
AND COMMITTEES OF THE BOARD
Introduction
The Nurses Registration Board is established and functions in accordance with provisions of the Nurses
Act 1991. The functions of the Board are set down in Section 10 of the Nurses Act 1991. The Board is
subject to the control and direction of the Minister for Health in the exercise of its functions.
Section 12 of the Act provides for the establishment of committees to assist the Board in connection with the
exercise of any of its functions. The majority of committee members must be registered nurses or enrolled
nurses.
Purpose
The following Code of Conduct has been developed by the Nurses Registration Board to guide members
of the Board and committees in fulfilling their obligations. The Code outlines fundamental values and
principles that define expected standards of behaviour.
Principles of Conduct
Members must adhere to standards of conduct and ethics that maintain public confidence and trust.
Public confidence means that the public has the right to expect the highest integrity and competence in the
fair, reasonable and equitable treatment of all members of the community.
Members are expected to perform functions with integrity, impartiality, honesty, conscientiousness, care,
skill, diligence and loyalty to the public interest.
Principle 1 - Responsibility
5
Members must comply with, and operate within, the provisions of the Nurses Act and other relevant
legislation. They should have an understanding of their public duty and must act for the proper purpose and
without exceeding their powers. They should understand their role and the role of the Minister in relation to
the functions of the Nurses Registration Board.
Having accepted appointment to the Board or a committee, members should properly prepare for and attend
all meetings.
Principle 2 - Impartiality and Respect for People
Members of the public and colleagues are to be treated fairly and consistently, in a non-discriminatory
manner with proper regard for their rights and obligations.
Members should perform their duties in a professional and responsible manner. Decisions and actions should
be reasonable, fair and appropriate to the circumstances, based on a consideration of the relevant facts, and
supported by adequate documentation.
Principle 3 - Honesty Integrity and Public Interest
Members should always act honestly and in the public interest, rather than in their private interest. In
performing their duties they must promote confidence in the integrity of public administration.
Acceptance of gifts and benefits can place a public official in a position where they feel obliged to act
contrary to rules of integrity, impartiality and honesty.
Board and committee members must not accept gifts or benefits that could place them under an actual or
perceived financial or moral obligation to other organisations or to individuals. Money or gifts offered to
obtain benefit is illegal.
Principle 4 - Economy and Efficiency
Members should ensure the efficient and responsible expenditure of public funds and look to improve
organisational performance and standards of public administration.
Principle 5 - Confidentiality
Members must not use or disclose confidential information or documents acquired as a consequence of
membership of the Board or committee other than is required by law or when the member has been given
proper authority to do so.
Principle 6 - Conflicts of Interest
Members must disclose a perceived or real conflict of interest. A member’s interests include those of an
associate or close relative. Disclosure and management of conflicts of interest are detailed in schedule 1
clause 7 of the Nurses Act 1991. In summary, this requires that members absent themselves and not take part
in any discussion or decision relating to the matter, unless the Minister or the Board determines otherwise.
6
Principle 7 - Corrupt Conduct
Members must not engage in corrupt conduct.
Corrupt conduct can be generally understood as the non impartial or dishonest exercise of public official
functions. It may also involve the conduct of non-public officials which adversely affects the honest and
impartial exercise of a public official’s functions.
Principal officers are required to report corrupt conduct or suspected corruption to the Independent
Commission Against Corruption (Section 11 of the Independent Commission Against Corruption Act).
Principal officers include the President of the Board and chairpersons of committees. Suspected corrupt
conduct should be reported, in the first instance, to the principal officer.
Members can also report directly to the following investigative bodies. Disclosures concerning:
•
Corrupt conduct should be made to the Independent Commission Against Corruption
•
Maladministration should be made to the NSW Ombudsman
•
Serious and substantial waste of public money should be made to the NSW Auditor General
Relevant Legislation
Relevant legislation which relates to above principles is recorded below:
•
•
•
•
•
•
•
Anti Discrimination Act 1977
Freedom of Information Act 1989
Independent Commission Against Corruption Act 1989
Nurses Act 1991
Ombudsman Act 1974
Protected Disclosures Act 1994
Public Finance & Audit Act 1983
5.4
DISCIPLINARY MATTERS
(a)
Conduct Committee
The Conduct Committee has been established by the Board to review all issues
dealing with disciplinary matters or professional misconduct/ unsatisfactory
professional conduct complaints sent to the Board. All matters referred from
individuals, the courts, the Health Care Complaints Commission, other nurse
registering authorities, hospitals, Health Department Regional and Area Offices,
Pharmaceutical Services Section (Health Department) concerning the professional
conduct of registered/enrolled nurses are considered by the Conduct Committee.
Those persons making application for registration or enrolment as a nurse who
make declaration that they had a felony, misdemeanour/criminal convictions prior
to application were reviewed by the Conduct Committee.
7
The Conduct Committee met on 11 occasions during the reporting period.
Members
J Englert
K Dyer
C Linsell
Observers
A Adrian, Commissioner
Health Care Complaints Commission
Alternate members
T Walker
D Sutton
(a)(i) Statistics
From 1 July 2002 to 30 June 2003 the following types of complaints were made to
the Nurses Registration Board concerning the conduct of registered/enrolled nurses
and considered by the Conduct Committee.
Complaint/Offence Total
Misappropriate Hospital Property/Prescriptions
University related matter
Sexual relationship with client/staff
Sexual assault patient/non patient
Breach of Confidentiality
Patient care and work standards/competence
Providing False Information
Drug related offence
Assault Patients
Drug Authority withdrawn
Drug Authority restored
Complaints re character
Driving Offence
Holding out to be a Nurse
Fraud
Complaints relating to non-registrant, false claims re qualifications
Inaccurate patient drug allocation
Other
TOTAL
3
1
5
3
56
8
19
4
11
8
2
2
2
11
135
Notifications
Advice from other Boards about Registration
Impairment (Physical)
Impairment (Mental)
Impairment (Drug & Alcohol)
Court Convictions
151
3
16
15
23
TOTAL
208
Disclosures/Information relating to applicants for registration/enrolment
8
Assault charges
Traffic offences / Speeding/DUI/PCA
Drug Related Offence
Physical/Mental Impairment
Breach of AVO
Offensive Conduct
False Declarations
Stealing
Shoplifting
University related matter
Larceny
Other
TOTAL
6
61
6
15
4
1
2
5
16
3
7
126
(a)(ii) Psychiatric Assessment
The Conduct Committee directed that a number of nurses attend for psychiatric
examination under s.45(5) of the Act.
(b)
Professional Standards Committees
These Committees are independent of the Nurses Registration Board.
When the Board decides to refer a complaint or is informed by the Director-General
of Health of his decision to refer a complaint to a Committee, the Board appoints
three persons to sit as the Committee for the purpose of conducting an inquiry into
the complaint.
The Chairperson and members of these Committees are appointed to sit on a
particular Inquiry by the President of the Board, delegated to perform this function
by the Nurses Registration Board. The members are drawn from a panel of Board
approved nurses and a panel of lay persons approved by the Minister for Health.
The Committee is composed of two registered nurses with appropriate
qualifications, depending on the case to be heard, and one lay person who does not
have nursing qualifications.
Professional Standards Committees may only conduct inquiries which do not
provide grounds for the suspension or cancellation of the nurse's accreditation to
practise. However these Committees are empowered to place conditions on a
nurse's registration if a complaint is proved.
Status of matters before Professional Standards Committees
Three (3) matters were finalised by the Professional Standards Committees.
Professional Standards Committee Inquiries (Section 50)
Matter 1
9
Complaint
The nurse administered Morphine to 2 patients at a Nursing Home without a witness and made false entries in
the Drug Register by writing a signature in the column requiring signature of the person supervising,
authorising or witnessing the administration of the drug.
Orders
The nurse was reprimanded by the Professional Standards Committee.
The reprimand dealt with the necessity to maintain the correct and legal procedures when handling,
administering and accounting for schedule 8 medications.
Matter 2
Complaint
While employed by an Area Health Service Community Health Service, the nurse on visiting a patient: a. Failed to protect the bed linen of Patient A whilst using saline solution to an abdominal wound and
failed to change Patient A's wet bed linen;
b. Failed to apply an appropriately thick dressing to an abdominal wound as requested by Patient A;
c. Failed to adequately communicate with Patient A or her daughter and asked questions relating to
private conversations between Patient A and other parties.
Further in relation to Patient B, the nurse failed to identify herself on visiting the patient, was inappropriately
attired and of an unkempt appearance and did not appropriately communicate with Patient B. Additionally,
the nurse failed to observe and maintain adequate infection control whilst dressing a wound.
In a further complaint it was alleged the nurse suffered an injury requiring hospitalisation as a result of a
motor vehicle accident and subsequently the behaviour of the nurse was observed to have changed to the
detriment of her nursing practice. It was observed that the nurse was prone to mood swings and she failed to
comply with a notice given by the Nurses Board to undergo a medical examination, which in terms of the Act
was evidence “that the nurse lacked sufficient mental or physical capacity to practice nursing”.
Committee's Decision to Terminate the Inquiry
The Committee having considered all the evidence, records and documentation were comfortably satisfied
that particulars of the Complaint were made out and that the Complaint was proven. The Committee was also
satisfied that the nurse suffered from a mental impairment or disorder which is likely to detrimentally affect
the nurse's mental capacity to practice nursing. On hearing the evidence of the Board approved psychiatrist
and other oral evidence, the Committee formed the view that the Complaints could provide grounds for the
suspension or cancellation of the nurse's accreditation and therefore the Inquiry should be terminated in
accordance with s.54 of the Act.
Orders
10
1. This Inquiry is hereby terminated and the Complaint referred to the Nurses Tribunal;
2. A copy of this Reason for Decision document and the transcript of the evidence of the Inquiry be
provided to the Nurses Tribunal.
Matter 3
Complaint
The nurse while employed at a Residential Aged Care Facility:
1
2
3
4
5
Inserted a naso-gastric tube into the lung and not the stomach of a patient.
Failed to follow the protocol of aspirating gastric fluid and testing it with litmus paper to assess the
placement of the naso-gastric tube.
Failed to follow the protocol of auscultation of the stomach to assess the placement of the naso-gastric
tube.
Proceeded to commence a gravity feed into the incorrectly sited naso-gastric tube.
Failed to remove the naso-gastric tube when the patient indicated he was experiencing discomfort.
Findings on the particulars as listed above:
The Committee was not comfortably satisfied that any of the particulars had been proved.
The Committee was critical of the nurse for:
•
•
Not having read or become familiar with the procedure at the facility for the insertion of naso-gastric
tubes OR
Having read the procedure, failing to comply with that procedure by not having a second nurse
present to confirm the position of the naso-gastric tube and for not flushing the tube with water prior
to commencing the feed.
The Committee expressed a general concern about the quality of clinical notes demonstrated by the extract
received from the resident’s file.
From the evidence heard the nurse had a limited command of English which the Committee believed could
contribute to the quality of her note keeping and the care provided to her patients particularly those with
impaired communication ability.
Outcome
The Complaints were dismissed as not proven.
(c)
The Nurses Tribunal
The Nurses Tribunal was established by the Nurses Act 1991.
The Nurses Tribunal is a statutory authority independent of the Nurses Registration
Board.
Complaints which may provide grounds for the suspension or cancellation of a
nurse’s accreditation must be referred to the Nurses Tribunal.
11
The Governor appoints the Chairperson and Deputy Chairperson who have the
appropriate legal qualifications as specified by the Act.
For the purpose of conducting an Inquiry or Hearing an appeal, the Tribunal
consists of:
(a)
(b)
(c)
a Chairperson
two accredited nurses drawn from a panel of nurses, having such
qualifications as may be prescribed, and who are appointed by the Board
one lay person is appointed by the Board, drawn from a panel of persons
nominated by the Minister. Lay persons do not have nursing qualifications.
Chairperson:
Irving Wallach
Deputy Chairpersons:
Cedrick Vass
Suzanne Jamieson
STATUS OF MATTERS BEFORE THE NURSES TRIBUNAL
The Nurses Tribunal finalised sixteen (16) matters.
Section 61 Inquiries
Matter 1
Complaints
The complaints concerned issues of drug dependence with the nurse admitting the use of marijuana, ecstasy
and speed. The nurse was admitted to a major Sydney hospital with a drug overdose.
The Complaints related to unusual behaviour while on duty; including sleeping and being absent while
rostered on duty. Further complaints of failing to attend interviews with an Impaired Nurses Panel were
lodged. Additionally the nurse left his workplace without informing colleagues and therefore leaving patients
exposed to unacceptable risk.
Orders
1. That the nurse’s name be removed from the Register of Nurses
2. That the accredited nurse not be permitted to apply for restoration for a period of two (2) years.
(The nurse is required to apply to the Tribunal to have the Tribunal consider his application to restore to the
Register)
Matter 2
Complaint
That the nurse, while employed at a health centre as a community nurse, accepted and self administered
fifteen endone (morphine) tablets given to her by a patient. The nurse stole blank pharmaceutical prescription
12
forms then forged and presented them for the purpose of obtaining prohibited drugs. The nurse
inappropriately used patient names on prescription forms to obtain prohibited drugs and inappropriately used
pension numbers to defraud the Commonwealth by obtaining prohibited drugs at a reduced cost.
Orders
1. The registration and enrolment of the nurse be suspended for a period of two years;
2. Following that period of suspension it is a condition on practice that the nurse not recommence
practice until she has ceased use of Methadone;
3. The nurse is to undergo urinalysis for drug usage for a period of twelve months as per the protocol of
the Nurses Registration Board. The period is to commence six months prior to her commencing
practice and is to continue for a period of six months after she commences practice as an accredited
nurse;
4. For a period of twelve months from commencing practice as a registered and/or enrolled nurse, the
nurse is to supply the Board within seven days of commencing employment, the name and address of
her employer.
Matter 3
Complaint
That the registered nurse physically assaulted a young person of moderate to severe intellectual disability in a
hospital setting by striking the patient's head with various objects.
Orders
1. The registered nurse was reprimanded;
2. That the registered nurse within three years successfully complete a bachelor of nursing conversion
course approved by the Nurses Registration Board;
3. The prerequisite for commencing that course is for the nurse to complete employment as an assistant
in nursing for six months full time;
4. The nurse to advise the Nurses Registration Board of commencement of employment as an assistant
in nursing and advise the Board of the name and address of his workplace and the name of his
Director of Nursing;
5. The Nurses Registration Board is to obtain a report from the Director of Nursing on the nurse's
practice.
13
The Tribunal made these Orders on the basis that the inappropriate behaviour and assaults occurred
approximately twelve years earlier and the registered nurse concerned had not worked in that capacity for all
that period.
Matter 4
Complaint
The complaints related to inappropriate sale of glucose monitors, devices for injection of insulin and blood
sugar level books to clients of a diabetes education centre.
The complaint also related to the nurse not following official receipting procedures and accounting practices
in that money from the sales was banked in her personal bank account and she did not seek approval from her
supervisor/employer for her activities.
Outcome
The Tribunal found that the majority of the particulars were found proved however, the Tribunal found no
demonstrated dishonesty on the part of the nurse and no demonstrated personal benefit to her.
The complaints were found not proved. No Orders were made.
Matter 5
Complaint
The complaint related to a boundaries issue.
The female patient concerned in the case was a vulnerable person placed in a health institution due to a
mental illness.
The male nurse was alleged to have engaged in sexual misconduct with the female patient and also to have
engaged in an inappropriate emotional relationship with the patient.
The behaviour included holding the patient's hand, dancing with her while she was a patient in a health
facility, permitting the patient to hug him, buying her gifts of an intimate nature (i.e. a nightdress). It was
also alleged that he was present in her bedroom at her home while she was undressed. The patient also
claimed that the nurse tried to hug and kiss her in her home.
Following an Inquiry the Tribunal made the Orders as listed.
Orders
1. That the name of the nurse be removed from the Register of Nurses;
2. That the nurse not be eligible to apply for accreditation for a period of two years.
(The nurse is required to apply to the Tribunal to have the Tribunal consider his application to restore to the
Register)
Matter 6
14
Complaint
The complaint related to a psychiatric impairment in that the nurse was alleged to suffer from a paranoid
mental illness that had been in existence since at least 1997. The nurse had been the subject of voluntary and
involuntary admissions to psychiatric units between 1997 and 2000. The nurse breached a community
treatment order and was admitted as an involuntary patient to a psychiatric unit. While in the Impaired
Nurses Program the nurse complied with some conditions on registration but not others.
Between August 2001 and April 2002, the nurse was diagnosed with a paranoid psychiatric illness where a
Board approved psychiatrist recommended she should not be working as an accredited nurse. That doctor
advised that the nurse suffers from delusional ideation, which is very entrenched. Further, the psychiatrist
believed the nurse would be in danger of involving patients with her delusional concerns and this could be
detrimental to the nurse and her patients.
The nurse did not believe she was suffering from a mental illness and was resistant to psychiatric treatment.
Following an Inquiry into complaints lodged by the Health Care Complaints Commission, which
particularised the issues detailed above the following Orders were made:
Orders
1. The name of the nurse be removed from the Register of Nurses;
2. The nurse not be permitted to reapply until a period of twelve (12) months has elapsed.
(The nurse is required to apply to the Tribunal to have the Tribunal consider her application to restore to the
Register)
Matter 7
Complaint
Whilst employed at a major public hospital in Sydney the nurse became involved in an emotional
relationship, which was inappropriate with a male patient and allegedly crossed the boundaries of what would
be expected of a registered nurse in her relationship with a patient. The nurse visited the patient in various
hospital settings where she was not his carer.
She attended a Mental Health Review Tribunal while the patient was in a hospital as an inpatient. (The nurse
was not attending in her professional capacity).
The nurse paid for the patient's accommodation whilst outside the hospital setting when she knew he had
absconded from a health facility where he was detained as an involuntary patient.
15
Orders
1.
The name of the accredited nurse be removed from the Register of Nurses for the State of New
South Wales.
2.
That the accredited nurse not be permitted to reapply for accreditation for a period of 18 months.
(The nurse is required to apply to the Tribunal to have the Tribunal consider her application to restore to the
Register)
Matter 8
Complaint
It was alleged that the female registered nurse while employed in the Corrections Health Service had an
inappropriate personal and sexual relationship with a male patient who was in prison. The activities
complained of included the registered nurse writing letters and cards to the inmate, sending her underwear to
the patient, engaging in sexual activity and taking heroin with the patient.
Further, it was alleged that the registered nurse wrote a reference, which presented a dishonest account of the
patient's period in the methadone program at the Correctional Centre and also provided false and misleading
statements in the reference about the patient's progress in the methadone program.
Additionally it was alleged that the nurse knew the reference was contrary to policy and contained false and
misleading statements in relation to the patient.
Orders
1.
The name of the registered nurse be removed from the Register of Nurses of New South Wales.
2.
That a period of three years is fixed before which the respondent nurse may apply for
accreditation.
(The nurse is required to apply to the Tribunal to have the Tribunal consider her application to restore to the
Register)
Matter 9
Complaint
In a complaint lodged against the nurse it was alleged that during the period of admission of a patient the
nurse failed to ensure the patient received proper nursing care for:
a.
i. pressure areas
ii. wounds
iii. oral hygiene
iv. fluid intake and dietary assistance
16
Further it was alleged the nurse:
b.
authorised inappropriate restraint of the patient.
c.
failed on receipt of a registered nurse’s report noting a significant deterioration in the patient’s
condition, to refer the patient to the medical officer.
d.
failed to ensure that the registered nurses under her supervision maintained adequate and appropriate
documentation of the care provided to the patient.
Orders
1.
2.
3.
Within a period of (2) two years the nurse successfully complete courses in Nursing
Management, Documentation, and record keeping as approved by the Nurses Registration
Board.
Within (2) two years to provide evidence of satisfactory completion of such courses.
It is a condition of practice that until successful completion of the courses the nurse may not
practice as a Director of Nursing or Nurse Manager.
Matter 10
Complaint
Whilst employed as a registered nurse at the Hospital for Women in Sydney, the nurse inappropriately
requested another registered nurse to remove a quantity of Narcan, a schedule 4 drug, and some syringes from
the hospital's drug cabinet and forward them to the nurse.
The nurse proposed to administer the Narcan to a female friend (Patient A) who was not at that time, a patient
of the hospital and the nurse had neither medical authority, nor a prescription for Narcan contrary to the
Poisons and Therapeutic Goods Act.
The nurse failed to seek appropriate medical attention or call an ambulance for Patient A.
Orders
1. That the nurse successfully complete a course of study entitled "Practice Interactions" of one
semester duration at the University of Technology, Sydney or such equivalent course at university
level which may be approved by the Nurses Registration Board in the event that this course is not
available;
2. The course of study is to be completed by the nurse at no cost to the Nurses Registration Board;
3. The Tribunal reprimands the nurse;
4. It is a condition on the practice of the nurse that until she successfully completes the course, she is
not to handle or dispense drugs listed in schedule 4 and schedule 8 of the Poisons and Therapeutic
Goods Act.
17
Matter 11
Complaint
The nurse, while employed as a senior nurse manager at a suburban Sydney hospital, committed multiple
drug administration violations in that he: •
•
•
•
Administered Pethidine without a medical order;
Breached the Poisons Act Regulations by making a false record on the Drug Register (i.e. altering
time of administration and witnessing the administration time himself);
Also breached the above regulation in that he administered the drug otherwise than on the direction
of a medical practitioner;
Dispensed a schedule 8 drug from the drug cabinet without a valid medical order.
The nurse similarly falsified or breached regulations and policies in relation to twelve identified patients.
Orders
The Tribunal made the following Orders: 1.
Directed that the name of the nurse be removed from the Register of Nurses of New South Wales;
2.
Directed that a period of three (3) years is applicable before the nurse may apply for accreditation
as a registered nurse.
(The nurse is required to apply to the Tribunal to have the Tribunal consider his application to restore to the
Register)
Section 68 Application for Restoration to the Register
Matter 12
Original Complaint
Following an Inquiry before the Nurses' Tribunal in 2000 the nurse's name was removed from the Register of
Nurses and it was specified that he could not apply for accreditation until a period of twelve months had
elapsed.
The Complaint related to: 1. The nurse forging or causing to be forged signatures in his clinical experience record for training for
a graduate diploma in midwifery;
2. In his application to the Nurses Registration Board for authorisation to practise midwifery, the nurse
claimed to have been awarded a graduate diploma of midwifery when he knew or ought to have
known that the claim was false.
18
Application under s.68
The nurse applied in 2002 to have his name restored to the Register in New South Wales following
deregistration for a period of twelve months. A new Tribunal heard his application to restore but was not
convinced by his submissions in relation to how his character had rehabilitated in the intervening period of
time.
Orders
The Tribunal did not grant his application and the nurse remains deregistered.
Section 49 Appeal Against Conditions imposed on Registration by the Nurses Registration Board
Matter 13
Complaint Background
Following a serious complaint about the male registered nurse's behaviour towards female patients, which
involved alleged inappropriate sexual contact, when the patients were recovering from anaesthesia following
surgery. The Nurses Registration Board imposed the following conditions on his registration under s.48 of the
Act. Following consultation with the Health Care Complaints Commission the complaint was referred to the
Commission for investigation and report.
Conditions – S48
1. That the registered nurse is to notify any employers of the condition on his registration.
2. That the registered nurse not provide nursing care for female patients without direct supervision.
The registered nurse appealed these conditions to the Nurses Tribunal, under s 49 of the Act however, when
advised of the processes before the Tribunal i.e. that he would have to provide evidence to convince the
Tribunal to lift the conditions the registered nurse withdrew his appeal.
Outcome
Following the withdrawal the Tribunal ordered the confirmation of the conditions imposed on the
registered nurse by the Nurses Registration Board.
The matter of original complaint continued to be investigated by the Health Care Complaints
Commission, which will provide a report and recommendation for consideration by the Nurses
Registration Board.
Matter 14
The nurse appealed to the Tribunal under section 49 following the imposition by the Board of conditions on
registration under section 48 of the Act.
The Board imposed s 48 condition was:
That the nurse not provide direct patient care
19
The complaints related to patient care issues and the nurses’ interaction with staff and patients. The matter
concerned the use of language and what the nurse found acceptable and what other employees and patients
considered acceptable. This led to difficulties of interaction on many occasions with work colleagues and
patients particularly during assessment programs conducted by the College of Nursing to improve and test the
skills of the nurse.
Orders
1. The Tribunal revoked the conditions imposed on registration of the nurse by the Nurses Registration
Board;
2. The Tribunal ordered that the nurse is: (a)
not to provide patient care beyond the level as may be lawfully provided by an enrolled
nurse;
(b)
the nurse must be supervised by a registered nurse while on duty;
(c)
only to be employed as an accredited nurse at an aged care facility.
Section 64 (3) Inquiries (Application alteration of Orders)
Matter 15
The Nurses Tribunal made Orders in relation to the nurse’s practise in November 2000 following an Inquiry,
which related to issues concerning his midwifery practise. The complaint related specifically to a boundaries
issue in that he inappropriately maintained a personal relationship with a female patient while he was
providing nursing services and inappropriately met with the patient after her discharge from hospital. The
inappropriate behaviour related to intimate and sexual contact during his treatment of the female patient.
The nurse made application to the Tribunal for guidance since having attempted many times to gain
employment in a midwifery unit for a six month period as approved by the Nurses Registration Board; no
institution was willing to employ the nurse in a midwifery unit. Therefore, the nurse was unable to fulfil this
condition on his registration.
Orders following application for alteration
The nurse could not comply with Order 3 concerning employment in a midwifery setting and the Tribunal
made the following subsequent Orders: 1. that before 30 November 2003 the nurse complete the equivalent of six (6) months full time
employment in a non-supervisory position in the fields of midwifery/gynaecology at a hospital with a
recognised facility in those fields as approved by the Nurses Registration Board;
2. that in the event that the nurse has not complied with the proceeding Order, he is not to practise in
the fields of midwifery and gynaecology.
20
Matter 16
Original Complaint
On 12 May 1998 the Tribunal made Protective Orders in relation to the practise of the accredited nurse. The
Tribunal had previously made a finding of professional misconduct arising out of complaints referred to the
Tribunal.
The finding by the Tribunal was that the respondent nurse had been involved in striking a resident at
Kenmore Hospital where he was employed. The Tribunal further found he subsequently acquiesced in and
took part in a course of conduct in which the striking of the resident was covered up, not reported and not
properly documented.
Orders relating to original complaint
The Tribunal at that time made the following Orders: 1. The nurse to satisfactorily complete twelve months full time employment at a general teaching
hospital or in a psychiatric unit of a schedule 2 hospital;
2. The nurse satisfactorily complete a course in gerontology.
Both Orders were to be completed within two years of May 1998.
Application for alteration of Orders
The nurse made application for alteration of Orders due to his inability to complete the required course in
gerontology within the required period. The Tribunal accepted the nurse's explanations as to why the course
had not been completed and consequently the Tribunal in September 2002 made the following Orders: New Orders
1.
The Tribunal finds that the respondent has breached Order 2(b)(ii) of the Orders made
concerning him on 12 May 1998.
2.
It is a condition of practice for the accredited nurse as follows: (a) In 2003 the respondent is to commence a graduate diploma course in gerontology at
the University of New England or such other course in gerontology as approved by
the Nurses Registration Board;
(b) By March 2005 the nurse is to produce to the Nurses Registration Board, written proof
of his satisfactory completion of the graduate diploma course in gerontology at the
University of New England or such other course in gerontology as approved by the
Nurses Registration Board;
(c) The respondent nurse is to complete this course without cost to the Nurses
Registration Board.
3.
In order to comply with Order 2, the respondent may, until March 2005, practise as a
registered nurse in the field of gerontology.
4.
If the respondent nurse fails to comply with Order 2, he may only practise as a registered nurse
in a general teaching hospital not occupying a supervisory position.
21
5.
The Tribunal recommends to the Nurses Registration Board that, if the respondent nurse
satisfactorily completes Order 2 herein, it remove any notation to his authority referring to
conditions of registration.
5.5
COMMITTEE STRUCTURE
A number of Committees have been established by the Board to facilitate the decision
making process and to ensure that advice is received from representatives of professional
groups, consumers, government departments and other interested parties on matters which
are addressed by the Board in accordance with the Nurses Act 1991.
In recognition of the diverse nature of the Board's responsibilities, committees have been
established to report on professional issues and scholarship matters.
(a)
Research and Development Committee
The Research and Development Committee is responsible for the scholarship
program currently offered by the Nurses Registration Board for eligible registered
and enrolled nurses in NSW. The functions of this committee include review of
applications, the conduct of interviews and making recommendations to the Board
regarding the granting of scholarships.
Membership
Members of the Board
Prof J White
Dr T Walker
D Cathie
L Taylor
Y Grant
External Members
Prof E Chang
S Carpenter
Prof J Daly
Prof J Donoghue
Prof M Fitzgerald
Prof R Griffiths
M Hinchliffe
Prof D Keatinge
J Kingston
Prof S McKinley
Prof M McMillan
Prof S Nagy
Assoc Prof J Stein Parbury
The Committee invites external members to attend as required.
The Committee met on 10 occasions during the reporting period to review
scholarship applications.
(b)
Health Committee
Amendments to the Nurses Act 1991 relating to impairment matters commenced on
6 December 1996. These amendments provide for the referral of matters to an
Impaired Nurses Panel when the Board considers that an accredited nurse suffers
from an impairment. If the Board refers a matter to an Impaired Nurses Panel, three
(3) persons must be appointed as the Panel to deal with the matter. The panel must
consist of at least one (1) registered nurse and at least one medical practitioner.
22
The Health Committee of the Board has met on eleven (11) occasions and thirtyseven (37) matters were referred to a Panel for inquiry. An Impaired Nurses Panel
is to inquire into any matter referred to it by the Board.
Members
Ms Y Grant
Ms T Walker
Mr C Linsell
Ms D Sutton
6.
HUMAN RESOURCES
Administrative Staffing
Registrar:
Ronald Keith Dwyer
Executive Director:
Jan Dent, RN, CM, DNE, Cardio Thoracic Cert., BA (Ed)
Associate Executive Director:
Michael Cleary, RN, DNE, BA, MHP, FCN (NSW)
Nursing Officers:
Janet Brooks, RN, CM, Cardio Thoracic Cert., Neurology Cert., DNE, BA
(retired)
Alan Brown, RN, BH, A&E Cert., M.Ed, MCN (NSW), JP
(commenced November 2002)
Anna
Kettle,
M.Management
RN,
CM,
B.Econ.,
Dip.Ed.,
Maureen Giddins Blues, RN, CM, Paed.Cert., BA
Maureen Dean, RN, DNE, MHEd, MN
(part-time)
Heng Ang, RN, DNE, MRIPHH
(part-time)
Communications Development Officer:
Maureen McGrath, BA,(ANU), RN, CM, FCN(NSW)
(part-time)
Marian Borland, RN,CM,BA
(part-time)
Deputy Registrar:
Ron Lazucki, BA, Dip.Ed. (Sydney) JP
23
MA(Ed),
Manager Registrations:
Michael Jaques, A.Dip.Health Admin. JP
Stenographers: Margaret Jarosz, BEd,MEd, JP
Donna Sullivan
Registrations, Enrolments, Restorations and Telephone Enquiries:
Jan Lardner-Smith
Veronika Morgan
Carolyn Broadhead JP
Vivienne Sheekey
Lauraine McKenzie
Registrations Clerk:
Elaine Harrop JP
Mutual Recognition Clerk:
Anna Fenech JP
Impaired Nurse Programme Clerk:
Virginia Kristiansen JP
Enquiry Counter Staff:
Suzan Dardass JP
Christine Gursen
Frances Timpano JP
Karen Carrett JP
Kristen Miller
Plus 12 full-time and 6 part-time support staff serving the Health Professional Registration
Boards in the areas of:
Finance
Computer Operations
Cashiering
Office Administration
Word processing/Stenography Mailing
7.
REVIEW OF OPERATIONS
7.1
Activities
As well as professional liaison and practice committees the Board convenes committees
and meetings to consult on a range of issues and to review policies and guidelines
regarding professional practice, education, research initiatives, communication strategies
and requirements in relation to the functions of the Board.
(a)
Consultation Forums - Education of Enrolled Nurses
Last year the Board received recommendations, in regard to the education of
enrolled nurses, from a meeting of a Professional Liaison Committee.
24
The Board noted that other organisations were undertaking reviews and
foreshadowed further consultation on completion of two Commonwealth
government reviews into nursing and nursing education, and completion of the
Australian Nursing Council’s investigation on the future role of the enrolled
nurse and the revision of enrolled nurse competency standards.
Two major forums were held, on 14 November 2002 and 20 June 2003.
Representation was invited from education providers, public heath services,
private hospital employers, aged care employers, community services,
professional organisations and nurses in clinical practice.
The first forum provided strong recommendations to the Board in regard to
education for enrolled nurses to administer medications. Guidelines for the
education of enrolled nurses to administer medications were issued in December
2002 and courses have been submitted for approval by the Board; it is anticipated
these courses will be conducted in the coming year.
A report, regarding other aspects of enrolled nurse education, from the second
forum is awaited for consideration by the Board.
(b)
Seminars for Nurses
Seminars continue to be organised by the Board to inform registered and enrolled
nurses of the functions of the Board, professional practice responsibilities,
professional conduct (including processes, scenarios and outcome exemplars) and
to provide a forum to enable members of the nursing profession to inform the
Board of the issues relevant to professional practice and management within the
Board’s jurisdiction. The issues raised by accredited nurses are considered in
regard to development of strategies and key focus areas for strategic planning
purposes.
Seminars were held at Tamworth (September 2002), Broken Hill (November
2002) , Dubbo (March 2003), Wagga Wagga (May 2003) and Albury (May
2003).
(c)
Course Accreditation
The Nurses Registration Board is responsible for the accreditation of courses
leading to registration, enrolment and authorisation to practise midwifery as well
as courses developed at masters level for the purpose of authorisation as a nurse
practitioner, in this jurisdiction.
Currently, twenty-five (25) courses leading to registration have been approved by
the Board including enrolled nurse bridging courses which enable enrolled nurses
to receive credit towards completion of approved bachelor of nursing programs
leading to registration.
Enrolled nurse education courses continue to be conducted by the New South
Wales Technical and Further Education Commission in conjunction with
participating hospitals as approved by the Board. One other organisation has
submitted a course for the education of enrolled nurses and final approval of this
course is pending.
25
There are seven (7) approved programs leading to authorisation to practise
midwifery, including one four-year double degree program leading to both
registration as a nurse and authorisation to practise midwifery.
Four (4) masters level courses have been approved by the Board for the purposes
of authorisation as a nurse practitioner subject to meeting other essential criteria.
(d)
Assessment of Applicants from Other Countries
Persons who have been educated as nurses in other countries are able to apply for
registration under the Nurses Act 1991. The education completed in another
country is compared with the requirements for nurses in New South Wales.
Information about the process and requirements is available on the Board’s website and an information sheet is available from the Board’s office. The required
documents may be submitted for assessment by mail or in person.
A number of applicants, who have been educated as nurses outside of Australia
are required to demonstrate safe practice and the competencies for
registration/enrolment/authority to practise midwifery. This is undertaken
through participation in an approved assessment program conducted by the
College of Nursing (formerly known as the New South Wales College of
Nursing).
(e)
Portfolios for Registered Nurses and Enrolled Nurses
Portfolios, containing documents to assist nurses as they enter practice, are
provided free to new registrants and may be purchased, at cost, by other
interested persons. Documents in portfolios include the code of conduct, various
guidelines issued by the Board and some relevant NSW Health Department
policies relating to infection control and the administration of medications.
7.2
Registration, Enrolment and Authority to Practise Midwifery
The Board has maintained the Register and the Roll of Nurses in NSW as required under the
provisions of Section 16 and Section 26 respectively of the Nurses Act 1991.
Total number of Registered Nurses as at 30 June 2003 79244
Total number of Enrolled Nurses as at 30 June 2003
16200
Total number of Midwives as at 30 June 2003
18988
Total number of Nurse Practitioners as at 30 June 2003
17
Midwives are already registered on List A or List B and are therefore already
counted in figures for List A or B. (ie, already included in the figure of the total
number of registered nurses).
The Register and the Roll are subdivided into:-
26
Register of Nurses
List A:
78903
List B:
341
List A:
15820
List B:
438
*List A & B
+
+
-
Roll of Nurses
*
7.3
15820
438
58
An enrolled nurse may be listed on both List A and List B, hence the number so listed is
subtracted from the total of List A and List B, to obtain the total number of enrolled nurses.
Mutual Recognition
(a)
Under the principle of mutual recognition, nurses registered/enrolled in one
Australian State/Territory or New Zealand are entitled to be registered/enrolled in
another State/Territory of Australia, or New Zealand providing certain conditions,
as outlined in the mutual recognition legislation are met.
In accordance with the Mutual Recognition Act 1992, the Nurses Registration
Board, between 1 July 2002 and 30 June 2003, has
Registered
Enrolled
1042
209
registered nurses
enrolled nurses
In accordance with the Trans Tasman Mutual Recognition Act 1997 the Nurses
Registration Board, between 1 July 2002 and 30 June 2003 has:
Registered
Enrolled
208
17
registered nurses
enrolled nurses
27
(b)(i)
Statistics
Statistics concerning States/Territories from which nurses are applying to
NSW under mutual recognition legislation From 1 July 2002 to 30 June 2003
Authority
Registered
Nurse
Aust
Registered
Nurse
Overseas
Enrolled
Nurse
Aust
Enrolled
Nurse
Overseas
Authority to
Practise
Midwifery
Overseas
12
Authority to
Practise
Midwifery
Aust
25
Queensland
220
118
29
6
Northern Territory
28
19
9
-
2
2
ACT
43
7
22
1
9
1
Victoria
213
122
107
1
29
5
Tasmania
26
4
7
-
1
1
South Australia
68
16
17
1
8
4
Western Australia
64
79
8
1
8
6
New Zealand
1
205
-
17
1
7
663
570
199
27
83
38
Totals
Total Registered Nurses
1233
Total Enrolled Nurses
226
(b)(ii) Requests for Information from Interstate Registering Authorities
1 July 2002 - 30 June 2003
ACT
N.T
QLD
S.A
TAS
VIC
WA
NZ
TOTAL
JULY
25
37
2
14
3
41
31
17
170
AUG
18
28
1
5
14
31
36
9
142
SEPT
18
39
1
4
8
40
35
19
164
OCT
24
32
0
7
4
28
43
19
157
NOV
25
20
1
8
9
20
33
15
131
DEC
12
29
0
11
8
21
18
15
114
JAN
22
42
0
15
15
79
23
18
214
FEB
28
27
0
9
2
76
53
17
212
MAR
19
44
0
12
7
58
49
26
215
APR
17
27
0
5
13
49
40
18
169
MAY
17
56
0
5
9
44
60
26
217
JUNE
13
41
0
9
3
30
61
14
171
TOTAL
208
422
5
104
95
517
482
213
2076
28
(c)
Overseas nurse applications
Statistics
The following statistics relate to persons who were educated as nurses in other countries and
who were registered or enrolled in New South Wales under the Nurses Act or one of the two
mutual recognition acts. (Some applicants may be required to demonstrate competence and
safe practice prior to registration).
Country
No. of RNs
List A
Austria
Belgium
Brazil
Canada
China
Czechoslovakia
Denmark
Fiji
Finland
France
Germany
Ghana
Holland
Hong Kong
India
Iran
Ireland
Italy
Japan
Jordan
Korea
Lebanon
Malaysia
Malta
Nepal
Netherlands
New Zealand
Nigeria
Norway
Pakistan
Papua New Guinea
Persia
Philippines
Rhodesia
Romania
Singapore
South Africa
South Korea
Spain
Sri Lanka
Sweden
1
1
1
56
5
1
5
20
53
3
15
2
3
8
30
1
282
3
6
1
13
2
3
1
1
3
154
2
2
1
1
1
73
1
1
26
126
4
1
1
25
29
No. of RNs
List B
1
5
2
1
1
Switzerland
Taiwan
Thailand
United Kingdom
United States of America
Western Samoa
Yugoslavia
Zambia
Zimbabwe
6
2
1
1084
57
2
2
1
157
Total
2251
Country
7.4
No. of ENs
List A
Canada
Croatia
Czechoslovakia
India
Iran
Malani
Macedonia
Nepal
New Zealand
Philippines
Romania
Russia
Serbia
Slovakia
South Africa
Switzerland
Thailand
United Kingdom
United States of America
Yugoslavia
2
1
1
1
1
1
1
1
22
8
1
2
1
1
3
1
1
14
4
3
TOTAL
70
97
107
No. of ENs
List B
Nurses Registration Board Education and Research Account
This account was established pursuant to Section 76 of the Nurses Act 1991. In accordance
with the terms of that Section, the account may be used by the Board for education,
including post graduate education, and research in nursing or any public purpose connected
with the profession of nursing.
During the year 1 July 2002 to 30 June 2003 an amount of $219,956 was expended for
scholarships, research, etc. The total amounts spent on individual items is reflected in the
account at the back of this report.
(a)
Research and Development Scholarships
30
The Nurses Registration Board continues to provide scholarships for registered and
enrolled nurses. In this financial year the sum of $350,000 was allocated for this
purpose.
Recipients of scholarships to support research, study projects or attendance at a
conference are required to submit a written report to the Board. These reports are
available, on application to the Registrar.
The following categories of scholarships were offered for the period 1 July 2002 to
30 June 2003.
Categories
1.
to complete the final year of study leading to an academic award
2.
for a recognised education programme, or the final year of a programme,
which does not lead to an academic award
3.
for a study project in a specific nursing field
4.
attendance at an international, national or local conference, or seminar, etc.
5.
to undertake research in the discipline of nursing
6.
to support the completion of a thesis for doctoral studies relevant to
nursing.
Scholarships offered by the Board promote and maintain standards of practice by
providing valuable support for the extension of nursing knowledge through
education of individual nurses, promotion of nursing research and attendance of
nurses at national and international conferences.
The Board awarded 56 scholarships:
Category 1/2 Scholarships
Category 3 Scholarships
Category 4 Scholarships
Category 5 Scholarships
Category 6 Scholarships
28
Nil
20
5
3
31
2002 - 2003 Scholarship Recipients were Category 1/2
Aguas, J
Bartley, B J
Cohen, R M
Cope, J L
Dalag, C M
Davidson, K A
Ellery, J M
Elmes, J
Foster, V L
Ingram, S J
Jensen, T L
Kenny, E M
Kruse, J A
Markocic, S
McEnroe, A M
Pang, S
Perks, J K
Schumaker, M D
Stokes, J D
Summersby, G V
Taylor, A M
Tosh, A J
Turner, J C
Vasilakis, N
Wade, J M
Wilson, K V
Woodman, P E
Wright, J H
Category 3
NIL
Category 4
Burgeois, S
Bradbury, J
Catling-Paull, C
Curtis, K A
Erjavec, S
Fry, A J
Fulton, L M
Ganly, H E
Hollis, M
Johnston, K
Jones, K M
Maraun, M
Mate, J A
Morritt, M L
Murphy, C L
Russell, M
Thornton, C E
Whitton, A M
Wilson, I
Yong, G L
Category 5
Connolly, S M
Frotjold, A J
Lawler, J
Whaites, M J
White, K
Category 6
Fisher, M J
Kwok, T Y C
Raymond, L M
7.5
Nurse Education Inspections
32
In June 2003, two hundred and sixty nine (269) health institutions had current approval to
provide clinical experience for enrolled nurse education, with fifty four (54) of these
facilities also approved to provide clinical experience for student midwives undertaking an
approved midwifery program conducted by a recognised tertiary institution. During the
period July 2002 to June 2003, forty (40) of these health institutions were inspected in
relation to the education of enrolled nurses and /or midwifery education.
Enrolled nurse education: Thirty three (33) inspections were related to continued approval
for clinical experience for enrolled nurse education and thirty eight (38) were new requests
to be involved in the education of enrolled nurses in conjunction with one or more Colleges
of Technical and Further Education.
Midwifery education: Seven (7) inspections were related to continued approval for clinical
experience for student midwives and two (2) inspections were new requests to be involved
in the education of student midwives undertaking an approved midwifery program
conducted by a recognised tertiary institution.
Comments: As in previous years, inspection reports have identified that medication charts
and drug registers do not always comply with the requirements of the guidelines to the
poisons legislation provided by the NSW Department of Health. The Directors of Nursing
of these facilities have been requested to provide a report to the Board of action taken and
outcomes achieved in relation to the issues of non-compliance with the guide to the poisons
regulations.
7.6
Recognised Institutions
(a)
N.S.W. TERTIARY EDUCATION INSTITUTIONS RECOGNISED BY THE NURSES
REGISTRATION BOARD OF NEW SOUTH WALES TO CONDUCT APPROVED
NURSING PROGRAMS WHICH MEET THE LEGISLATIVE REQUIREMENTS
LEADING TO REGISTRATION AS A NURSE IN NEW SOUTH WALES
Australian Catholic University, New South Wales Division (PO Box 968, North Sydney NSW
2059)
Avondale College, Wahroonga (PO Box 19, Cooranbong NSW 2265)
Charles Sturt University:
(PO Box 789, Albury NSW 2640)
(Private Bag 29, Bathurst NSW 2795)
(Locked Bag 49, Dubbo NSW 2830)
(PO Box 588, Wagga Wagga NSW 2650)
Southern Cross University (PO Box 157, Lismore NSW 2480)
University of New England (Armidale NSW 2351)
University of Newcastle (University Drive, Callaghan, NSW 2309)
University of Sydney (Sydney NSW 2006)
University of Technology, Sydney (PO Box 123, Broadway NSW 2007)
University of Western Sydney (Locked Bag 1797 Penrith South DC NSW 1797)
University of Wollongong (Wollongong NSW 2522)
(b) TERTIARY EDUCATION INSTITUTIONS RECOGNISED BY THE NURSES
REGISTRATION BOARD OF NEW SOUTH WALES TO CONDUCT APPROVED
33
MASTERS LEVEL PROGRAMS LEADING TO AUTHORISATION AS A NURSE
PRACTITIONER IN NEW SOUTH WALES
Applicants for nurse practitioner authorisation who have completed an approved Masters level
qualification are required to submit evidence of completion, verified by the University, with other
required documents as listed in the information booklet.
The following courses have been approved by the Board for the purpose of authorisation of nurse
practitioners:
Institution
Recognised course(s)
Area of practice
Avondale College
Wahroonga
Master of Advanced Practice
in Nursing (High Dependency
Nursing)
and
Master of Advanced Practice in
Nursing (Honours)(High
Dependency Nursing
high dependency nursing
University of Southern
Queensland,
Toowoomba
Master of Advanced Nursing
Practice (Rural and Remote)
community health nursing
University of Newcastle
Master of Nursing (Nurse
Practitioner)
*maternal & child health
nursing
*high dependency nursing
*mental health nursing
*rehabilitation/habilitation
nursing
*medical/surgical nursing
*community health nursing
University of Western
Sydney
Master of Nursing (Mental
Health-Nurse Practitioner)
mental health nursing
(c) INSTITUTIONS RECOGNISED BY THE NURSES REGISTRATION BOARD OF NEW
SOUTH WALES FOR THE PURPOSE OF CONDUCTING OR PARTICIPATING IN
APPROVED MIDWIFERY PROGRAMS WHICH MEET THE LEGISLATIVE
REQUIREMENTS LEADING TO AN AUTHORISATION TO PRACTISE MIDWIFERY IN
NEW SOUTH WALES
Armidale Health Service Armidale 2350
Auburn District Hospital, Auburn 2144
Bankstown Hospital, Bankstown 2200
Bathurst Base Hospital, Bathurst 2795
Belmont District Hospital, Belmont 2280
Blacktown-Mt Druitt Health Service, Blacktown 2148
Calvary Heath Care-Riverina Wagga Wagga 2650
Canterbury Hospital, Campsie 2194
Christo Road Private Hospital, Newcastle
Coff’s Harbour Base Hospital, Coff’s Harbour 2450
34
Cowra Health Service, Cowra 2794
Dubbo Base Hospital, Dubbo 2830
Fairfield Hospital, Fairfield 2165
Glen Innes Health Service, Glen Innes 2370
Gosford Hospital, Gosford 2250
Grafton Base Hospital, Grafton 2460
Griffith Base Hospital, Griffith 2680
Hornsby and Kuring-gai Hospital & Community Health Services, Hornsby 2077
Illawarra Private Hospital Figtree 2525
Inverell Health Service, Inverell 2360
John Hunter Hospital, Newcastle 2310
John Hunter Children’s Hospital New Lambton 2299
Kareena Private Hospital, Caringbah 2229
Leeton District Hospital, Leeton2705
Lismore Base Hospital, Lismore 2480
Lithgow Community Private Hospital, Lithgow 2790
Lithgow Health Service Lithgow 2790
Liverpool Hospital, Liverpool 2170
Macarthur Health Service: Campbelltown Hospital 2560
Macarthur Health Service: Camden Hospital 2570
Maitland Hospital, Maitland 2320
Manly District Hospital, Manly 2095
Manning Base Hospital, Taree 2430
Mona Vale Hospital, Mona Vale 2103
Moree Plains Health Service, Moree 2400
Nepean Health Service, Penrith 2750
Nepean Private Hospital, Kingswood 2747
North Gosford Private Hospital, North Gosford 2250
North Shore Private Hospital, St Leonards 2065
Orange Base Hospital, Orange2800
Parkes Health Service, Parkes 2870
Port Macquarie Base Hospital, Port Macquarie 2444
Prince of Wales Private Hospital Randwick 2031
Royal Hospital for Women, Randwick 2031
Royal North Shore Hospital, St Leonards 2065
Royal Prince Alfred Hospital, Camperdown 2050
Ryde Hospital, Eastwood 2122
Shellharbour Hospital, Shellharbour 2529
Shoalhaven District Memorial Hospital, Nowra 2541
St George Hospital, Kogarah 2217
St George Private Hospital, Kogarah 2217
Sutherland Hospital, Caringbah 2229
Sydney Southwest Private Hospital, Liverpool 2170
Tamworth Base Hospital, Tamworth 2340
The Hills Private Hospital, Baulkham Hills 2153
The Wollongong Hospital, Wollongong 2500
Wagga Wagga Base Hospital, Wagga Wagga 265
Westmead Hospital, Westmead 2145
Wingecarribee Health Service, Bowral 2576
Wodonga Regional Health Service Wodonga (Victoria)
Wyong Hospital, Wyong 2259
Tertiary Education Institutions:
35
Charles Sturt University, Riverina (External Course)
University of Newcastle
University of Sydney
University of Technology, Sydney
University of Western Sydney
University of Wollongong
(d) LIST OF INSTITUTIONS RECOGNISED BY THE NURSES REGISTRATION BOARD
OF NEW SOUTH WALES FOR THE PURPOSE OF CONDUCTING ENROLLED NURSE
COURSES IN ASSOCIATION WITH TECHNICAL AND FURTHER EDUCATION
INSTITUTIONS
Aminya Centre for Aged Care, Baulkham Hills 2153
Anglicare Chesalon Aged Service, Beecroft 2119
Armidale Private Hospital Armidale 2350
Bankstown Health Service, Bankstown 2200
Bathurst Base Hospital, Bathurst 2795
Belmont District Hospital, Belmont 2280
Bega District Hospital, Bega 2550
Blayney Health Service, Blayney 2799
Bombala District Hospital, Bombala
Boorowa District Hospital, Boorowa
Bourke Health Service, Bourke 2840
Broken Hill Base Hospital, Broken Hill 2880
Bushland Place Nursing Home, Taree 2430
C.A. Brown Anglican Village, Booragul 2284
Caloola Centre for Aged Care, Wagga Wagga 2650
Calvary Health Care – Riverina, Wagga Wagga 2650
Canowindra Soldiers Memorial Hospital, Canowindra 2804
Cape Hawke Community Private Hospital, Forster 2428
Carey Bay Nursing Home, Carey Bay 2283
Carlingford Centre for Aged Care, Carlingford 2118
Castlecrag Private Hospital, Castlecrag 2068
Central Coast Area Health Service, Gosford 2250
Participating Institutions:
Central Coast Community Health Services
Home Flexi-Care-Central Coast (BCS)
Gosford Hospital
Kincumber Health Centre
Long Jetty Healthcare Centre
Woy Woy Hospital
Wyong Hospital
Central Sydney Area Health Service Enrolled Nurse School, Camperdown 2050
Participating Institutions:
Balmain Hospital, Balmain
Canterbury Hospital, Campsie
Concord Repatriation General Hospital
Royal Prince Alfred Hospital, Camperdown
Rozelle Hospital, Rozelle
Strathfield Private Hospital, Strathfield
Cessnock District Hospital, Cessnock 2325
36
Condobolin Health Service, Condobolin 2877
Cooma Health Service, Cooma 2630
Cootamundra Nursing Home Cootamundra 2590
Cowra Health Service, Cowra 2794
Crookwell District Hospital, Crookwell 2583
Delegate Multi-Purpose Service, Delegate 2633
Elizabeth Lodge Nursing Home, Willoughby 2068
Eurobodalla Shire Nursing Home, Dalmeny 2546
Fairfield Health Service, Fairfield 2165
Forbes Health Service, Forbes 2871
Goulburn Base Hospital, Goulburn 2580
Greater Murray Area Health Service, Wagga Wagga 2650
Participating Institutions:
Albury Base Hospital
Berriquin Nursing Home, Finley
Cootamundra Hospital
Corowa Hospital
Deniliquin Hospital
Finley Hospital
Griffith Base Hospital
Gundagai District Hospital
Holbrook Hospital
Home Flexi-Care-Riverina (BCS)
Junee District Hospital
Leeton District Hospital
Narrandera District Hospital
Temora and District Hospital
Tumut Hospital
Wagga Wagga Base Hospital
Greenwich Hospital, Greenwich, 2065
Grenfell Multi-Purpose Health Service, Grenfell 2810
Gunnedah Nursing Home, Gunnedah 2380
HarbisonCare, Burradoo 2576
Harbourside Haven Retirement Village, Shoal Bay 2315
H.N. McLean Retirement Village, Inverell 2360
Hornsby and Kuring-gai District Hospital, Hornsby 2077
Hunter Residences, Stockton Centre, Stockton 2295
Illawarra School of Nursing, Port Kembla 2505
Participating Institutions:
Bulli District Hospital
Coledale Hospital
Coniston Nursing Home
Culburra Nursing Home
Illawarra Private Hospital, Figtree
John & Helen Robinson Nursing Home, Gerringong
“Kalparrin” Community Residential Facility, Dapto
Lawrence Hargrave Private Hospital, Thirroul
Mount Warrigal Nursing Home, Warilla
Nowra Private Hospital
Port Kembla Hospital
Queen Beatrix Nursing Home Albion Park Rail
Sarah Claydon Nursing Home, Milton
37
Shoalhaven Rehabilitation, Aged & Extended Care Service
Shellharbour-Kiama Hospital and Community Health Service
Shellharbour Private Hospital, Warilla
Shoalhaven District Memorial Hospital, Nowra
The Wollongong Hospital
Towradgi Park Nursing Home
Woonona Nursing Home
James Milson Nursing Home, North Sydney 2060
John Hunter Hospital, Lambton 2310
Kara Centre for Aged Care, Mayfield 2304
Kurri Kurri District Hospital, Kurri Kurri 2327
Lady Davidson Private Hospital, Turramurra 2074
Lady Gowrie Nursing Home, Gordon 2072
Lake Cargelligo Multi-Purpose Health Service, Lake Cargelligo 2672
Leighton Lodge Nursing Home, North Turramurra 2074
Leumeah Nursing Home Castle Hill 2154
Liverpool Health Service, Liverpool 2170
Macarthur Health Service: Camden Hospital, Camden 2570
Macarthur Health Service: Campbelltown Hospital, Campbelltown 2560
Macarthur Health Service: Queen Victoria Memorial Hospital, Picton 2571
Macquarie Hospital, North Ryde 2113
Macquarie Area Health Service, Dubbo 2830
Participating institutions:
Coonamble Health Service
Dubbo Base Hospital
Gilgandra Health Service
Lourdes Hospital, Dubbo
Mudgee Health Service
Narromine Hospital and Community Health Service
Nyngan District Hospital
Warren Health Service
Wellington Health Service
Maitland Hospital, Maitland 2320
Manly Hospital, Manly 2095
Maroba Nursing Home, Waratah 2298
Marsfield Centre for Aged Care, Marsfield 2122
Mater Private Hospital, North Sydney 2060
Mayo Private Hospital, Taree 2443
Mercy Care Centre, Young 2594
Metro West Residences, Westmead 2145
Metro West Residences, Rydalmere 2116
Mid North Coast Area Health Service, Taree 2443
Participating institutions:
Autumn Lodge Nursing Home, Macksville
Coff’s Harbour Health Campus
Community Health Service-Southern Network
Fyson Nursing Home, Kempsey
Gloucester Soldiers Memorial Hospital
Kempsey District Hospital
Lourdes Nursing Home, Port Macquarie
Macksville and District Hospital
Manning Base Hospital, Taree
Wauchope District Memorial Hospital
Wingham District Hospital
38
Mid Western Mental Health Service, Orange 2800
Mona Vale Hospital, Mona Vale 2103
Morisset Hospital, Morisset 2264
Moruya District Hospital, Moruya 2537
Mosman Private Hospital, Mosman 2088
Mount Wilga Private Hospital, Hornsby 2077
Murrumburrah-Harden District Hospital 2587
Muswellbrook Hospital, Muswellbrook 2333
Narrandera Nursing Home, Narranderra 2700
Neringah Hospital, Wahroonga 2076
New England Area Health Service, Tamworth 2340
Participating Institutions:
Armidale Health Service
Barraba Health Service
Gunnedah Health Service
Guyra Health Service
Inverell Health Service
Manilla Health Service
Moree Plains Health Service
Narrabri Health Service
Quirindi Health Service
Tamworth Base Hospital
Tenterfield Health Service
Tingha Health Service
Walcha Health Service
Niola Centre for Aged Care, Parkes 2870
North Shore Private Hospital St Leonards 2065
Northern Rivers Area Health Service, Lismore 2480
Participating institutions:
Ballina District Hospital
Casino and District Memorial Hospital
Crowley Care Centre, Ballina
Ex-Services Home, Ballina
Grafton Base Hospital, Grafton
Lismore Base Hospital
Maclean District Hospital
Murwillumbah District Hospital
Pinehaven Nursing Home, Suffolk Park
The Cedars Nursing Home, Casino
Tweed Heads District Hospital
Oberon Health Service, Oberon 2799
Orana Centre for Aged Care, Point Clare 2250
Orange Base Hospital, Orange 2800
Pacific Care Transitional Centre, Newcastle 2300
Parkes Health Service, Parkes 2870
Pambula District Hospital, Pambula 2549
Peak Hill Health Service, Peak Hill 2869
Poplars Private Hospital, Epping 2121
Port Macquarie Base Hospital, Port Macquarie 2444
Port Macquarie Private Hospital, Port Macquarie 2444
Queanbeyan Health Service, Queanbeyan 2620
Royal Newcastle Hospital, Newcastle 2300
Royal North Shore Hospital, St Leonards 2065
39
Royal Rehabilitation Centre Sydney, Ryde 2112
Ryde Hospital, Eastwood 2122
Rylstone Health Service, Rylstone 2849
Scott Memorial Hospital, Scone 2337
Singleton District Hospital, Singleton 2330
South-Eastern Sydney Area Health Service, Kogarah 2217
Participating institutions:
Frenchman’s Lodge Nursing Home, Randwick
Garrawarra Centre, Waterfall
Kareena Private Hospital, Caringbah
Prince Henry Hospital, Little Bay
Prince of Wales Private Hospital, Randwick
Prince of Wales Hospital, Randwick
Royal Hospital for Women, Randwick
St George Hospital, Kogarah
St George Private Hospital, Kogarah
Sutherland Hospital, Caringbah
Sydney Children’s Hospital, Randwick
Sydney Hospital
Southern Area Mental Health Services, Goulburn 2580
Southern Highlands Private Hospital, Bowral 2576
St Anne’s Nursing Home, Hunters Hill 2110
St John of God Health Care, Goulburn 2580
St Joseph's Home, Sandgate 2304
St Michaels Home for the Aged, Casino 2470
St Vincent's Hospital, Darlinghurst 2010
St Vincent’s Private Hospital, Sydney 2010
Sydney Adventist Hospital, Wahroonga
The Mater Private Hospital, North Sydney
Toronto Nursing Home, Toronto 2283
Warabrook Centre for Aged Care, Warabrook 2304
Wahroonga Nursing Home, Wahroonga 2076
Walgett Health Service, Walgett 2832
Wentworth Area Health Service, Penrith 2750
Participating Institutions:
Blue Mountains District Anzac Memorial Hospital, Katoomba
Catholic Health Care Bodington, Wentworth Falls
Governor Phillip Nursing Home, Penrith
Hawkesbury Hospital, Windsor
Nepean Health, Penrith
Division of Community Health Services
Nepean Private Hospital, Kingswood
Our Lady of Consolation Nursing Home, Rooty Hill
Wesley Gardens Georgian Aged Care, Belrose 2085
Western Sydney Area Health Service, Westmead 2145
Participating institutions:
Auburn Hospital & Community Health Services, Auburn
Blacktown-Mt Druitt Health Service
Greater Parramatta Mental Health Service, Cumberland Hospital
Lottie Stewart Hospital, Dundas
St Joseph's Hospital, Auburn
Westmead Hospital
Wingecarribee Health Service, Bowral 2576
40
Woodlands Nursing Home, Cherrybrook 2126
Young District Hospital, Young 2594
Colleges of the Technical and Further Education Commission Participating in the
Enrolled Nurse Program
Hunter Institute of Technology, Newcastle Campus
Illawarra Institute of Technology, Shellharbour College of TAFE
New England Institute of TAFE, Gunnedah College of TAFE
Northern Sydney Institute of TAFE, Meadowbank College of TAFE
Northern Sydney Institute of TAFE, North Sydney College of TAFE
Riverina Institute of TAFE, Cootamundra Campus
South Western Sydney Institute of TAFE, Wetherill Park College of TAFE
Southern Sydney Institute of TAFE, St George College of TAFE
Sydney Institute of Technology, Ultimo
Western Institute of TAFE, Dubbo Campus
Western Sydney Institute of TAFE, Werrington College of TAFE
8.
CODES OF CONDUCT
(a)
Code of Professional Conduct
Section 43 of the Nurses Act 1991 states "The Board may establish codes of professional
conduct setting out the rules of conduct which should be observed by accredited nurses
in carrying out the practice of nursing."
In April 2003 the Nurses Registration Board adopted the Code of Professional Conduct
for Nurses in Australia 2003 which was developed by the Australian Nursing Council.
The code states:
A nurse must:
1.
Practise in a safe and competent manner.
2.
Practise in accordance with the agreed standards of the
profession.
3.
Not bring discredit upon the reputation of the nursing profession.
4.
Practise in accordance with laws relevant to the nurse's area of
practice.
5.
Respect the dignity, culture, values and beliefs of an individual
and any significant other person.
6.
Support the health, well being and informed decision-making of an
individual.
7.
Promote and preserve the trust that is inherent in the privileged
relationship between a nurse and an individual, and respect both the person and
property of that individual.
41
(b)
8.
Treat personal information obtained in a professional capacity as
confidential.
9.
Refrain from engaging in exploitation, misinformation and
misrepresentation in regard to health care products and nursing services.
Code of Conduct for Members of the Nurses Registration Board and Committees of the
Board
This code was developed by the Nurses Registration Board and outlines principles of
conduct to guide members of the Board and its committees.
The principles addressed within the code relate to
• Responsibility
• Impartiality and Respect for People
• Honesty Integrity and Public Interest
• Economy and Efficiency
• Confidentiality
• Conflicts of Interest
• Corrupt Conduct
The code is available from the Board’s web-site or from the Board’s office. Members of
the Board and members of Board committees are requested to confirm in writing that
they will adhere to the code.
9.
NURSES REGISTRATION BOARD PROJECTS: SPECIAL INITIATIVES
(a)
Strategic Plan
The Nurses Registration Board of New South Wales Strategic Plan for 2002 - 2004.
Key focus areas include:
Safe Practice
Promotion and maintenance of standards of nursing
practice
Education
The promotion of nursing education
Communication
Publication and distribution of information to the
community and nursing profession.
In developing the strategic plan the Nurses Registration Board identified guiding principles
and values to provide vision and direction in the achievement of objectives and in fulfilling
its statutory responsibilities. These are:
•
The public will be served through establishing, maintaining and reviewing
standards of nursing practice.
•
Professional nurses will be supported and promoted through establishing,
maintaining and reviewing education standards and regulatory processes.
42
•
(b)
Changing societal needs and the health care environment will inform
regulation, the development of standards and educational processes.
‘Board Works’ Newsletter
The Nurses Registration Board Newsletter is distributed to all accredited nurses, providing
them with information on their professional responsibilities and the activities of the Board.
As foreshadowed last year, the frequency of publication has been increased from twice to
three times each year.
(c)
Website
The Nurses Registration Board Website continues to be updated to include information to
guide accredited nurses in their professional practice. Also included on the website are
research projects commissioned by the Nurses Registration Board related to standards of
nursing practice. The website is accessible to nurses in a range of practice contexts, and to
members of the public.
10.
PUBLICATIONS
Information Leaflets
Professional Conduct "A Case Book of Disciplinary Discussions Relating to Professional Conduct
Matters".
Procedures for assessment of interstate or overseas trained nurses seeking registration or enrolment in
New South Wales.
Payment of Annual Practising Fee
Amendments/changes to Register and Roll since November 1987
Guidelines and Information on the operation of Mutual Recognition in NSW
Nurse Practitioner Information Package
Guidelines for Applications for Scholarship
Reports
Annual Report
Circulars and Policy Documents
A range of specific information circulars detailing changes to Board policy/procedures or advising
new information or procedures is available in hard copy and on the Board’s website.
11.
CONSUMER RESPONSE
The main areas of complaint involved registered/enrolled nurses not wishing to pay the balance
restoration fee of $10 for late payment of annual renewal fees. The Act specifically
43
states that registered/enrolled nurses must have current financial status with the Board to be able to
practise in the capacity of a registered/enrolled nurse. The Board issues a written reminder 6 weeks
prior to the renewal date to the last known address specified by the registered/enrolled nurse and the
Board considers that following the issuing of the reminder notice the individual nurse has the
responsibility to finalise payment by the due date. The requirement to make payment by the due date
is highlighted on each year's renewal notice and is also specified in an Information Leaflet issued to
each nurse when he/she first registers/enrols with the Board.
12.
TIME FOR PROVISION OF SERVICES
(a)
Applications
Applications for registered/enrolled nurses and midwives from Australian applicants
received by mail require a standard average time of approximately 5 working days to finalise
the issuing of a certificate or letter of advice.
The processes are as follows:
•
•
•
•
•
opening of mail and receipting of money
allocation of documents and applications to the appropriate officer
assessment of documents and application form
obtaining signatures of approval
issuing a formal certificate of registration/enrolment/authority to practise midwifery or
issuing of a letter detailing which requirements are still outstanding.
Applicants from Australia who present in person with all required documents can be
finalised and issued with a certificate within a standard time of 5 to 20 minutes.
Standard times relating to applicants from overseas countries cannot be specified as each
application is assessed individually on its merits. However, Board staff are committed
to providing a fast and efficient service within the constraints of staff numbers and
volume of applications.
(b)
Annual Renewal of Registration/Enrolment
Annual renewal of registrations can be accomplished within 2 to 10 minutes for those
presenting in person. Standard times for renewals arriving by mail is 3 to 10 working days
for a receipt to be issued, depending on the volume of mail.
Continuing efforts are being made to maximise the allocation of staff resources to expedite
the return of the annual practising receipt in the shortest timeframe possible. Computerised
systems are updated on an ongoing basis to provide a more efficient customer friendly
service.
As in previous years, the Board is concerned at the large number of registered/enrolled
nurses who fail to renew their annual registration and pay the renewal fee by the due date.
In some cases, this is due to oversight or failure to notify the Board of a change of address.
44
The names of registered/enrolled nurses who fail to maintain current
registration/enrolment are automatically removed from the Register and/or Roll once
the due date has expired.
13.
GENERAL
13.1
Fees Payable
Under the Nurses Act 1991, registered and enrolled nurses are required to pay an annual fee,
currently $35.00, to the Board to remain on the Register/Roll. Fees collected are mainly for
registrations and renewals, paid into an administration account created for administration
purposes. An amount as determined by the Minister from time to time is transferred to the
Education and Research Account of the Board.
Other fees payable to the Board which also assist in meeting the administrative costs of the
Board are -
1.
2.
3.
4.
5.
6.
7.
8.
2002
$
2003
$
For examination of candidate for
registration as a nurse.
21.00
21.00
For registration as a nurse of a person
who has completed training in
Australia, the issue of a certificate of
registration and the practising fee for an
authority to practise as a nurse during the
prescribed period.
45.00
45.00
For registration as a nurse of a person who
has completed training outside
Australia, the issue of a certificate of
registration and the practising fee for an
authority to practise as a nurse during the
prescribed period.
50.00
50.00
The practising fee for an authority to practise
as a registered nurse during the prescribed
period.
35.00
35.00
For restoration of name to the Register and the
practising fee for an authority to practise as
a nurse during the prescribed period.
45.00
45.00
The application fee for an authority to practise
midwifery.
15.00
15.00
For enrolment as a nurse, the issue of a
certificate of enrolment and the practising fee
for an authority to practise as an enrolled nurse
or enrolled nurse (mothercraft) during the
prescribed period.
45.00
45.00
The practising fee for an authority to practise
as an enrolled nurse or an enrolled nurse
(mothercraft) during the prescribed period.
35.00
35.00
45
9.
For restoration of name to the Roll and the
practising fee for an authority to practise
as an enrolled nurse or enrolled nurse
(mothercraft) during the prescribed period.
45.00
45.00
10.
For duplicate certificate of registration
20.00
20.00
11.
For duplicate certificate of enrolment
20.00
20.00
12.
For duplicate certificate of authority to practise
midwifery
20.00
20.00
The badge fee for a nurse whose name is on the
Register or the Roll
15.00
15.00
14.
For duplicate badge
15.00
15.00
15.
For inspection of Register or Roll
10.00
10.00
16.
For recording in the Register of additional
qualifications
12.00
12.00
For issue of verification of registration
to registering authorities outside Australia
15.00
15.00
For examination of candidate for enrolment
as a nurse
21.00
21.00
For issue of verification of enrolment to
registering authorities outside Australia
15.00
15.00
20.
For issue of a certificate of temporary registration
45.00
45.00
21.
Fees for a Nurse Practitioner
13.
17.
18.
19.
13.2
150.00
Costs of Administration of the Board
These costs are set out in the audited Statement of Accounts embodied in this report.
13.3
Badges (Metal) Issued
Registered Nurse
Enrolled Nurse
14.
1106
307
ETHNIC AFFAIRS PRIORITY STATEMENT
The Nurses Registration Board is one of nine health professional boards administered by the
Health Professionals Registration Board (HPRB) on behalf of the Health Administration
Corporation. The Board in conjunction with the HPRB undertakes a number of initiatives to
support our culturally diverse population under the key result areas of social justice, economic
and cultural opportunities.
These initiatives include to:
(i)
promote the recognition and registration of overseas trained health
professionals.
46
(ii)
assist overseas trained applicants to register.
(iii)
increase the number and range of bilingual health professionals employed by HPRB.
(iv)
ensure ethnic media is used in any information sponsored by the Board.
(v)
ensure the Board receives advice on matters relating to people of culturally diverse
backgrounds.
(vi)
promote use of culturally diverse workforce.
(vii)
ensure the Board is aware of the Government=s commitment to implementing the
principles of multiculturalism as set out in section 3 of the Community Relations
Commission and Principles of Multiculturalism Act 2000.
Key Strategies
The EAPS statement developed through a consultative process includes initiatives relating to the Nurses
Registration Board under the key result areas of social justice, community harmony, economic and
cultural opportunities.
Within the legislative framework pathways for the registration of overseas trained professionals were
applied.
The main initiatives of the existing statement remain the key strategies for 2003 - 2004.
These are to:(i)
promote the recognition and registration of overseas trained health professionals as provided for
in legislation.
(ii)
assist overseas trained applicants through the provision of information, professional interpreters
and translation services, as required, to register.
Overseas Qualified Nurses - Recognition of Qualifications
The Nurses Registration Board receives applications for and makes decisions concerning eligibility for
registration, authorisation to practise midwifery and enrolment in accord with the provisions of the
Nurses Act 1991. Assessment of interstate and overseas nurses for accreditation to practise as a
registered nurse, certified midwife, or enrolled nurse is undertaken by comparing the education attained
by the nurse against the education required in New South Wales.
Applicants are required to submit specified documents regarding education, registration and professional
experience. Interviews are not usually included in the application process. In some instances an
interview with a Nursing Officer may be required, or the applicant may request an interview. In all other
instances the application may be made by mail or documents may be lodged at the Board’s office.
47
An applicant may be required to undertake an assessment program to demonstrate safe practice and the
national nursing competencies prior to gaining accreditation as a registered nurse, certified midwife,
enrolled nurse or enrolled nurse (mothercraft). Assessment programs approved by the Nurses
Registration Board are conducted by the New South Wales College of Nursing. Access to these
programs, which are funded by the New South Wales Health Department. is subject to holding an
appropriate visa as specified by the Department, and meeting the entry requirements determined by the
College. Applicants who are resident in country areas of New South Wales and who have difficulty in
accessing the assessment program at the College of Nursing may apply to the Board for approval to
undertake a hospital assessment.
The following information which has been extracted from the records indicates:
the number of referrals issued for assessments of competence,
the number of applicants who have completed an assessment program and approved by the
Board as being eligible for registration/enrolment/authorisation to practise midwifery
(ATPM).
The category of assessment is indicated, whether for registration, enrolment or authorisation to practise
midwifery, and the mode, ie through the approved program conducted by the New South Wales College
of Nursing, or by an approved hospital.
Letters issued during the period 1 July 2002 to 30 June 2003 authorising assessment for
registration, authorisation to practise midwifery and enrolment
Category of Assessment
Registration
Enrolment
Midwifery
Location
The New South Wales College of Nursing
Number of letters
issued
365
Hospital
0
The New South Wales College of Nursing
81
Hospital
0
The New South Wales College of Nursing
16
Hospital
0
Applicants, eligible for registration, enrolment or authorisation to practise midwifery following
completion of an assessment of competence during the period 1 July 2002 to 30 June 2003
Category
Location
Registration
The New South Wales College of Nursing
64
Hospital
0
The New South Wales College of Nursing
27
Enrolled
Total
48
Authorisation to practise
midwifery
Hospital
0
The New South Wales College of Nursing
6
Hospital
0
Interpreter and Translation Services
During the reporting year:•
HPRB staff provide assistance to clients in the following languages:
Arabic, Cantonese, English, Filipino (Tagalog), French, German, Greek, Hokien, Hindi, Punjabi,
Rumanian, Russian, Singhalese, Spanish and Turkish.
•
Interpreters are available to assist applicants when required. The Telephone Translation Interpreting
Service provides this service in a range of languages (Afghan, Bosnian, Chinese, Croatian, Estonian,
French, Greek, Iranian, Iraqi, Japanese, Korean, Macedonian, Nepalese, Peruvian, Polish, Russian,
Serbian, Singhalese, Spanish). As interviews are no longer mandatory this service is used
infrequently.
15. HEALTH PROFESSIONALS REGISTRATION BOARDS
ADMINISTRATION – MANAGEMENT AND STRUCTURE
The Health Administration Corporation manages the accounts and employs the staff required to
administer the Health Professionals Registration Boards established by the following Acts:Chiropractors Act 2001
Dental Technicians Registration Act 1975
Nurses Act 1991
Optical Dispensers Act 1963
Optometrists Act 1930
Osteopaths Act 2001
Podiatrists Act 1989
Physiotherapists Registration Act 2001
Psychologists Act 2001
The Boards as statutory bodies deal with professional issues under their respective Acts. The
functions of the Boards include the determination of health professional standards, qualifications and
experience required for registration and the maintenance of professional and ethical standards
through the administration of disciplinary provisions.
The Boards are self funding and performed within their commitment of service. Registration notices
were issued expeditiously and routine renewals were processed within 5 days of receipt.
49
In accordance with legislation the Boards’ accounts were paid by the Health Administration
Corporation from fees received and transmitted to the Corporation.
Within the Boards' accumulated funds recognition has been given for future expenditure for
refurbishment or relocation, the election of Board members (where required) litigation and
disciplinary costs.
The total administrative expenditure for all the above Boards in 2002/2003 was $6,631.435
compared with $5,790,962 in 2001/2002.
For the reporting year the staff of the Health Professionals Registration Boards filled the equivalent
of 52 full time positions (including one executive officer position at level 2). For the preceding 2
years the staff establishment was the equivalent of 52 and 49 full-time positions respectively.
Staff as employees of the Corporation derive the benefits of the personnel policies of the Department
of Health including occupational practices and are subject to the Department's Code of Conduct.
The performance of the Corporation in respect of the Boards' staff relating to: (i)
(ii)
(iii)
personnel policies
industrial relations policies/procedures
occupational health and safety including details of work related injuries
is reported in the Department of Health's Annual Report.
The Boards are managed by Mr J Tzannes ( Director) and Mr R Dwyer ( Deputy Director) for the
Corporation.
OVERSEAS TRAVEL
In November 2002, Ms K. Dyer, Deputy President, and Ms A. Kettle, Nursing Officer, travelled to
Hong Kong to participate in the 4th Meeting of Nurse Regulatory Authorities from the Western
Pacific and South East Asian Regions.
In January 2002, Ms A. Kettle, Nursing Officer, travelled to United Kingdom and Scandinavia as
part of a special overseas recruitment team formed by the NSW Health Department. The officer’s
role was to provide advice and facilitate applications for registration. The officer travelled under
arrangements approved by the Director General, NSW Health Department, and costs were paid by
the Health Department.
NEW SOUTH WALES HEALTH SYSTEM - ADMINISTRATIVE STAFF
NSW DEPARTMENT OF HEALTH
CODE OF CONDUCT
Introduction
The people of New South Wales have the right to expect that staff employed by the Department of
Health demonstrate fairness, integrity and sound professional and ethical practice at all times
50
in every respect of their employment. Just as importantly, you have the right to a workplace free of any
form of bullying, harassment or unfair discrimination. Ensuring these rights requires a professional
standard of behaviour that demonstrates respect for the rights of the individual and the community as
well as promoting and maintaining public confidence and trust in the work of government agencies.
The purpose of this Code of Conduct is to provide an ethical framework for your decisions and actions.
It is not possible for this Code to address all ethical questions or behaviour that you may encounter. You
need to be aware of and comply with relevant legislation and departmental circulars, policies and
guidelines as they relate to your work. Managers will assist you in maintaining an awareness of
departmental standards of conduct and in resolving ethical dilemmas. However, this does not remove
your responsibility to be accountable for your own actions and decisions.
This Code of Conduct covers all staff members working in the NSW Department of Health including
managers, contractors, consultants and students. Members of the Chief Executive Service and Senior
Executive Service are covered by a separate Code of Conduct and are also required to meet all
requirements of this Code.
Statement of Values
Values define our organisation. They underpin how you and your colleagues deal with each other, with
other organisations and the public. They also form the basis for our Vision, planning and priorities. The
Department’s Values are
Fairness - striving for an equitable health system and being fair in all our dealings
Respect - recognising the worth of individuals through trust, courtesy, sensitivity and open
communication
Integrity - achieving ends through ethical means, with honesty and accountability.
Learning and creativity - seeking new knowledge and understanding, and thinking with innovation
Effectiveness - pursuing quality outcomes.
Personal and Professional Behaviour
To demonstrate your commitment to the highest ethical standards you are required to:
•
•
•
•
•
•
•
perform your duties impartially, with professionalism, objectivity and integrity
work effectively, efficiently and economically
behave fairly and honestly, including reporting others who may be behaving dishonestly
avoid conflicts of interest and act in the best interests of the people of NSW
accept instructions from managers and supervisors
obey any lawful direction from managers/senior executives. If you have a dispute about
carrying out a direction you may appeal through existing grievance proceduresfollow
departmental policies, guidelines and procedures
avoid any form of exploitation or power imbalances in personal relationships in the
51
workplace.
Fairness and Equity
You should undertake your work and make decisions consistently, promptly and fairly. This involves
dealing with matters in accordance with approved procedures, in an impartial, non-discriminatory
manner and in line with the principles of administrative good conduct outlined by the NSW
Ombudsman.
You should apply the principles of procedural fairness/natural justice and reasonableness when
exercising statutory or discretionary powers. Staff members or clients adversely affected by a decision
must be informed of their rights to object, appeal or obtain a review.
Conflicts of Interest
You must avoid any financial or other interest that could compromise or be perceived to influence the
impartial performance of your duties. Conflicts of interest that lead to biased decision making may
constitute corrupt conduct.
Conflicts of interest might occur where you (and at times your family)
•
•
•
•
•
•
•
•
have financial interests in a matter the Department is involved with
are Board members, directors or employees of outside organisations, such as NonGovernment Organisations in which the Department has a financial interest
hold personal beliefs or attitudes that influence your impartiality
have personal relationships with people the Department is dealing with or investigating which
go beyond the level of a professional working relationship
are involved in secondary employment, business, commercial, or other activities outside the
workplace which impact on the Department, its clients or staff
are involved in party political activities which could be perceived as you using your official
role to gain influence or where you find yourself in conflict in serving the current government.
(If you are an election candidate special arrangements apply)
have access to information that could be used for personal gain
participate in outside activities including volunteer work which could adversely affect your
ability to do your work.
It is your responsibility to disclose any potential or actual conflict of interest to your manager or other
senior officer. Managers will assist you in resolving the conflict through solutions such as divestment of
the interest, your withdrawing from the conflict situation and declaring or documenting the interest.
Bribes, Gifts, Benefits, Travel and Hospitality
You must not accept any gifts, hospitality, travel or benefits that might in any way tend to influence, or
appear to influence, your ability to act impartially. You should also ensure that partners and family
members are not recipients of benefits that could be seen to indirectly influence you or secure favourable
treatment.
In deciding whether to accept any gift or benefit you should consider the relationship of the Department
to the donor, the primary business of the donor and any possible adverse consequences for the
Department. Approval of your manager is required prior to accepting any gift or benefit. You may
accept unsolicited gifts of a token and insignificant nature or moderate acts of hospitality. Accepting
52
them is a matter of judgement and you must be satisfied that neither you nor the Department is in any
way compromised.
You must not solicit or accept any bribe, or other improper inducement. Any approaches of this nature
are to be reported to senior management.
Outside Employment
If you are a full time employee you must have approval from a delegated officer to engage in any
secondary employment or business activity, including participation in a family company. If you work
part-time you must advise of any real or potential conflict of interest between your employment in the
Department and any other employment. Managers are responsible for monitoring and following up on
any impact of secondary employment on the quality and effectiveness of an individual’s work.
Use of Departmental Resources
All departmental resources including funds, staffing, computers, photocopiers, equipment, stationery,
travel and motor vehicles must be used effectively and economically on work related matters. You must
seek approval to use departmental resources for non-official purposes (eg to aid in a charitable event). If
authorised, you are responsible for safeguarding, repairing and replacing, if lost, the Department’s
property.
Use of Computer, Email and Internet facilities
To use the Department’s computer, internet and email facilities you must agree to the conditions of
access. These require that the facilities be used for work activities in a responsible, ethical and legal
manner. Unacceptable use includes violation of the rights of others; commercial use; breach of copyright
or intellectual property; illegal activity or gambling; use for harassment, threat or discriminatory acts;
storing or conveying inappropriate or objectionable material such as nudity, sexual activity, drug misuse,
crime, cruelty or violence.
You must safeguard your password access. The Department monitors the network, programs and usage
to ensure the integrity of the system and maintains records of activities.
53
Corruption, Maladministration and Serious and Substantial Waste
You must not engage in corrupt conduct, maladministration or serious and substantial waste. Corrupt
conduct is defined in the ICAC Act 1988; the key notion being the misuse of public office. Corruption
can take many forms including bribery and blackmail; unauthorised use of confidential information;
fraud and theft. Maladministration is action or inaction of a serious nature that is contrary to law;
unreasonable, unjust, oppressive or improperly discriminatory; or based on improper motives. Serious
and substantial waste refers to any uneconomical, inefficient or ineffective use of funds or resources
which results in significant wastage.
You have a duty to report any possible corrupt conduct, maladministration and serious and substantial
waste of public resources to your senior manager. You may wish to report suspected incidents to an
external organisation with corruption being reported to the ICAC, maladministration to the Ombudsman
and waste to the Auditor-General. The Protected Disclosures Act, 1994 provides certain protection
against reprisals for any staff member who voluntarily reports possible corruption, maladministration or
serious/substantial waste. Managers must ensure staff members have information about reporting these
matters.
Public Comment
Although you have the right as a private citizen to express your personal views through public comment
on political and social issues you must not make or appear to make statements on behalf of the
Department. Public comment includes public speaking engagements, comments in the media, views
expressed in letters to newspapers, online services (such as Internet bulletin boards) or in publications.
You may make an official comment when you are authorised to do so or when giving evidence in court.
The Department’s media guidelines must be followed in any dealings with the media. When undertaking
speaking engagements you must comply with the Department’s policy and guidelines on participation in
external seminars.
You must not access, use, disclose or release any internal departmental documents or privileged
information unless you need to do so in the course of your work or are authorised to do so. You must
protect the privacy of client information as required by the Department’s Privacy Code of Practice.
Security of Official Information
Confidential information must not be disclosed other than in the course of your work, when required by
the law or when authorised. You must ensure that confidential information in any form (e.g. documents,
computer files) cannot be accessed by unauthorised persons. It should be securely stored overnight or
when unattended. Confidential information must not be discussed except in the course of your work and
must not be misused by you to gain personal advantage.
Information about NSW Health staff or clients is subject to the Department’s Privacy Code of Practice,
privacy legislation and guidelines. In some instances information regarding your employment will be
provided to external bodies (eg: NSW Superannuation Board and the Australian Taxation Office) and
the Department will confirm details held by financial institutions if you have applied for a loan/credit.
Intellectual Property/Copyright
54
Intellectual property includes rights relating to scientific discoveries, industrial designs, trademarks,
service marks, commercial names and designations, inventions and from activity in the industrial,
scientific, literary or artistic fields. The Department is the owner of intellectual property created by you
in the course of your work unless a specific agreement with the Director-General has been made to the
contrary.
Employment Screening
The Department is committed to safeguarding the welfare of its staff and protecting the interests of those
who rely on our services. Criminal record checks are undertaken on all recommended applicants for
permanent, temporary or seconded employment. Where a pending charge or conviction is identified the
relevance and implications of this is carefully assessed taking into account such factors as the nature and
number of offences, the severity of punishment, age and mitigating circumstances.
Staff members are required to notify the Department’s Corporate Personnel Services in writing if they
are charged with or convicted of a serious criminal offence.
Discrimination, Harassment and Bullying
You must not harass or discriminate against colleagues or clients for any reason including gender,
physical appearance, pregnancy, age, race, sexual preference, ethnicity or national origin, religious or
political conviction, marital status, physical or intellectual disability. The principles of Equal
Employment Opportunity apply in the workplace.
Bullying is the repeated less favourable treatment of a person by another in the workplace and can
include verbal abuse, sarcasm, criticising people in front of others or in private and creating work
overload. The Department does not tolerate bullying.
If you witness discrimination, harassment or bullying you should do something to stop it if possible and
report it to your manager. Direct intervention by senior management may be used to resolve the issue.
Grievance procedures are available if you believe you have been subject to discrimination, harassment
or bullying.
The use of obscenities or offensive language is unacceptable in the workplace.
Occupational Health and Safety
Managers must ensure that their work area provides for the health, welfare, physical and psychological
safety of their staff and clients. Specifically managers are responsible for providing safe systems of
work; a safe work environment; supervision and information; safe equipment and facilities; identifying
and controlling risks; responding to staff members’ reports of issues.
You also share a responsibility for occupational health and safety by following safety and security
directives, using security and safety equipment provided, keeping your work area tidy and safe and
raising potential safety issues promptly.
Drugs and Alcohol
55
The misuse of alcohol and other drugs can affect staff members’ work performance and jeopardise the
safety and welfare of colleagues. You must not perform your work, remain in the workplace or
undertake work-related activities if you are impaired by alcohol or other drugs.
Post Employment
Staff members should not misuse their position to gain opportunities for future employment nor allow
themselves to be influenced in their work by plans for or offers of outside employment. Staff members
leaving the Department are required to return all documentation and equipment and should respect the
confidentiality of information obtained during their employment and not use it for gain until it has
become publicly available. Be careful in dealings with former staff members to make sure that you do
not give, nor appear to give, favourable treatment or access to privileged information.
Legislative Framework
This Code of Conduct does not stand alone nor take the place of any Act or Regulation. Important laws
that apply include:
Anti-Discrimination Act 1977
Crimes Act 1900
Commission for Children and Young People Act 1998
Freedom of Information Act 1989
Health Care Complaints Act 1993
Health Services Act 1997
Independent Commission Against Corruption Act 1988
Occupational Health and Safety Act 1983
Ombudsman Act 1974
Privacy and Personal Information Protection Act 1998
Protected Disclosures Act 1994
Public Sector Management Act 1988
Relevant Departmental Circulars (a selection - as amended from time to time)
93/70
95/21
97/72
97/73
98/101
99/41
99/18
99/43
99/99
00/41
00/69
Department of Health Fraud Strategy
Public Staff Members Contesting State Elections
Grievance Policy and Resolution Procedures
Freedom from Harassment Policy and Procedures
Protected Disclosures
NSW Department of Health Restructuring Procedures
NSW Health Information Privacy Code of Practice
NSW Department of Health Alcohol and Other Drugs Policy
Electronic Messaging Policy
Reporting Possible Corrupt Conduct to the ICAC
NSW Department of Health Policy on Employment Screening
56
Breaches of the Code of Conduct
You are required to comply with this Code of Conduct. If you breach this Code you will be subject to a
range of administrative actions which include disciplinary action as set out in the Public Sector
Management Act, 1988. Breaches of certain sections may also be punishable under other legislation.
Training and Development
The Department’s Corporate Personnel Services includes training on the Code of Conduct in its
induction program. It also offers a range of training in areas including occupational health and safety,
ethics, equity, harassment and grievance handling of direct relevance to the Code. Managers have a
responsibility to provide their staff with training on this Code.
Further Information and Feedback
If you need further information on the Code of Conduct consult your manager or contact Corporate
Personnel Services. Feedback on the Code is also welcomed and should be sent to the Director,
Executive and Corporate Support.
NURSES
NSW GOVERNMENT ACTION PLAN FOR WOMEN
The principle of equality of access and rights of participation are the cornerstones of the NSW
Government's philosophy in relation to women.
Central to the core business of all government agencies is the promotion of the position of women in all
aspects of society.
The focus is on women with the least access to social and economic resources. The key objectives are to
eradicate violence against women, to improve the health and quality of life of women and to provide the
responsive environment for women to participate fully in the economic, social and educational life of
our society.
The Government is committed to ensuring that membership of Boards reflects the broader community
and that in filling current vacancies consideration is given, inter-alia, to the nomination of female
representatives. It is the Government's intention to progressively increase the number of women on
Boards to 50% of Board representation. It is recognised that not all nominations to Boards are made by
the Minister. Nominating bodies are advised of the Government's policy in relation to female
representation when vacancies occur or when nominations for a new Board are requested.
As at 30 June 2003, there were 2 vacancies. Of the remaining 11 members of the Board 7 are female.
Whilst the Board is not responsible for the promotion of access to the profession for women it is in a
position to indicate the number of women who have satisfied registration/enrolment requirements and
who currently hold an authority to practise.
For the reporting year (2002/2003) the number of female registered nurses was 71,867 (90.7% of total
registrants) as compared with 70,474 (90.8% for 2001-2002).
The number of female Enrolled Nurses was 14,838 (91.5% of total enrolled nurses), as compared with
14,744 (91.8% 2001-2002).
These figures vary during the reporting period in line with the changing status of registrants during
renewal periods.
57
WASTE REDUCTION AND PURCHASING POLICY
Throughout the major part of the reporting period, the Waste Reduction and Purchasing Policy
(WRAPP) reporting guidelines of 2001 – 2003 applied. The Health Professionals Registration
Boards (HPRB), through its WRAPP Plan (Plan), implemented measures to reduce waste, increase
the purchase of materials with recycled content and generally recycle its paper products and office
equipment and consumables.
The period commenced with policies and contractual provisions in place, whereby all white A4/A3
paper purchases were for 60% recycled content product and all envelopes continued to possess a
minimum of 70% recycled content.
Purchases of A4 recycled white paper increased by 15% and total paper waste sent to recycling
increased from 6.5 tonnes in 2001/2002 to 8.6 tonnes in the current period.
Health Professionals Registration Boards:
• recycled 88% of its total paper waste
• made no purchases of A3 paper in the period, limiting usage to available stock
• restricted its purchase (and corresponding use) of writing pads, to the equivalent of two (2)
pads per staff member across the entire period
• recycled 100% of paper/cardboard packaging
Operational policies in place ensured that all toner cartridges were returned to suppliers. Purchases
of recycled content cartridges commenced on a trial basis, forming 8% of acquisitions.
Various agency practices ensured an improvement in waste avoidance and recycling systems across
the agency:
• message and note taking on scrap recycled paper
• increased use of internal email, archiving messages and minutes of importance to the
agency
• paper recycling containers at all desks for later transfer to recycling bins, avoiding usage of
waste paper baskets and decreasing waste to landfill
• double sided printing
• promotion of web site usage to clients, as an alternative to hard copy information packages
Following the purchase of new computers (CPU’s) and monitors, a number of surplus used units in
the agency resulted. Affirmative waste avoidance and recycling action entailed:
• recycling unused older units to community organizations, utilising contractors listed with
Resource NSW. This action complied with the NSW Government’s ReConnect.nsw
Computer Program guidelines and HPRB liaised closely with the ICT Skills Unit of the
Office of Information Technology, DITM, throughout the process
• upgrading existing CPU’s displaced by the acquisitions and recycling to staff members.
Upgrades included CD burners, in an attempt to reduce paper usage and waste
Excel and Word tables complimented waste audits, in providing effective data collection systems for
the reporting of agency progress in the implementation of WRAPP. The rotation of WRAPP Officer
duties and attendance of a WRAPP seminar, combined successfully with
58
Resource NSW literature to increase staff awareness of WRAPP.
Several Boards commenced using recycled content letterhead and following a trial in the next
period, it is anticipated that the remaining Boards will follow. Suppliers of stationery advise the
agency of products containing recycled content and this practice will assist HPRB in increasing its
range and quantity of purchases of such items.
The end of the period witnessed the introduction of the NSW Waste Avoidance & Resource Recovery
Strategy 2003. In accordance with the Premier’s Memorandum No.2003-5, the HPRB moves to the
next period with a commitment to achieving sustainable waste minimisation and resource recovery
targets by:
• critically considering waste management issues associated with the agency’s operational
responsibilities and
• monitoring facilities, product and usage patterns, to enable strategic updates to the
agency’s Plan.
FREEDOM OF INFORMATION
There were no applications under the Freedom of Information Act for information held by the
Board.
LEGISLATIVE CHANGE
There were no amendments to the Nurses Act 1991.
CONSULTANCIES
No consultants were engaged by the Board.
59
Organisational Chart
Health Professionals Registration Boards
60
16.
FINANCE & BUDGET
1.
FORMAT
In order to comply with statutory and audit requirements the Board's fees received and transmitted to
the Health Administrative Corporation are shown as entries in the Statement of Income and
Expenditure. The income and expenditure for administrative purposes appear in the accounts of the
Department of Health for the Health Administration Corporation. Details of the administrative
operations are also contained in the notes to the audited accounts set out in the annual report.
2.
PERFORMANCE
The accounts in respect of the Board's administrative operations for the year show expenditure of
$4,301,580. This is less than the budgeted operating expenditure of $4,463,746 (after adjusting for
the Education and Research allocation) as contained in last year's annual report.
3.
BUDGET
The Budget in respect of the administration operation for the period 1 July 2003 to 30 June 2004 is
as follows:$
INCOME
Fees
3,508,861
Interest
369,779
Total
3,878,640
EXPENDITURE
Salaries & Associated Staff Costs
Building Expenses
Subsistence & Transport
Members Fees
Fees for Service
Post & Communications
Printing & Stationery
Plant & Equipment
Education & Research
Miscellaneous
Depreciation
2,969,199
256,136
133,578
227,818
827,912
240,700
232,794
3,437
315,000
141,561
22,000
Total
5,370,135
Operations Surplus
4.
(1,491,495)
EXPENSES
The 2003/2004 year's budget includes salary oncost charges which reflect deferred liability
provisions for Superannuation as well as anticipated expenditure in relation to the Australian Nursing
Council Inc, and disciplinary hearings. Provisions also includes cash of holding an election of Board
members. The deficit will be comfortably met from accumulated funds.
5.
PAYMENTS PERFORMANCE
The payments in respect of the Boards' administration expenditure is included in the accounts of the
Health Administration Corporation. A selected sample for each quarter of the year provided the
following information: 61
Accounts paid on time
Quarter
September
December
March
June
Target %
Actual %
100.00
100.00
100.00
100.00
74.74
83.38
65.55
84.75
Less Than 30
days overdue
(%)
19.21
15.39
22.55
12.75
Between 30 to More than 90
60 days
days
overdue
overdue
(%)
(%)
6.05
1.23
10.53
1.37
2.08
0.42
No interest was paid on late payments.
Similarly, in regard to the payments made out of the Education and Research Account administered
by the Board, the expenditure performance is as follows: Aged analysis at the end of each quarter
Quarter
September
December
March
June
Current
(within due
date)
$
93,536
73,006
79,654
Less than 30
days overdue
$
-
Between 30
and 60 days
overdue
$
-
Between 60
and 90 days
overdue
$
-
More than
90 days
overdue
$
-
Accounts paid on time within each quarter
Total Accounts Paid on time
Quarter
September
December
March
June
Target %
Actual %
$
100.00
100.00
100.00
100.00
100.00
100.00
93,536
73,006
79,654
Total Amount
Paid
$
93,536
73,006
79,654
No interest was paid on late payments.
6.
INVESTMENT PERFORMANCE
The Board through a Special Interest Arrangement with the Commonwealth Bank of Australia earned
an average of 4.25%p.a. on its daily bank balances. In addition an average rate of interest of
4.73%p.a. was earned on investments held in Negotiable Certificates of Deposit.
7.
INSURANCE AND RISK MANAGEMENT
Insurance activities were undertaken by the Department of Health Insurance cover, as follows:
<
<
<
<
Industrial Special Risks Policy to cover all buildings, plant and contents;
Comprehensive Motor Vehicle Insurance Policy;
Public/Liability Insurance Policy;
Personal Accident Policy.
Risk Management were as follows:62
<
<
<
<
<
8.
Regular preventive maintenance programs on all plant and equipment;
Security alarm system for premises occupied by the Board;
Security entry system for access to the Board's building during office hours;
Disaster Recovery Plan for the computer system;
Off site back-up of computer data.
ANNUAL REPORT COSTS
This year the Board has planned to publish 300 copies of the Annual Report at an approximate cost
of $3.40 per copy (includes GST).
63
64
NURSES REGISTRATION BOARD
YEAR ENDED 30 JUNE 2003
STATEMENT BY MEMBERS OF THE BOARD
Pursuant to the Public Finance and Audit Act, 1983, and in accordance with the resolution of the
members of the Nurses Registration Board, we declare on behalf of the Board that in our opinion:1
The accompanying financial statements exhibit a true and fair view of the financial position
of the fees received on behalf of the Health Administration Corporation as at 30 June 2003
and transactions for the year then ended.
2.
The statements have been prepared in accordance with the provisions of Australian
Accounting Standards, Urgent Issues Group Consensus views, other authoritative
pronouncements for the Australian Accounting Standards Board, the Public Finance and
Audit Act, 1983, the Public Finance and Audit (General) Regulation, 1995, and the
Treasurer's Directions.
Further, we are not aware of any circumstances which would render any particulars included in
the financial statements to be misleading or inaccurate.
65
NURSES REGISTRATION BOARD
STATEMENT OF FINANCIAL POSITION
AS AT 30 JUNE 2003
2003
$
2002
$
11
1,313,871
1,061,502
11
952,644
668,032
5 & 11
12,427
333,854
Total Current Assets
2,278,942
2,063,388
Total Assets
2,278,942
2,063,388
Notes
Current Assets
Cash
Accrued expense to be paid by Health
Administration Corporation
Receivables
Current Liabilities
Payables
6
21,768
12,356
Accrued expenses
11
952,644
668,032
Total Current Liabilities
974,412
680,388
Total Liabilities
974,412
680,388
1,304,530
1,383,000
1,304,530
1,383,000
1,304,530
1,383,000
Net Assets
Accumulated Funds
7
Total Equity
The statement of financial position should be read in conjunction with the accompanying
66
NURSES REGISTRATION BOARD
STATEMENT OF FINANCIAL PERFORMANCE
FOR THE YEAR ENDED 30 JUNE 2003
2003
$
2002
$
3
315,000
315,000
4
54,561
48,610
9
4,301,580
4,009,767
4,671,141
4,373,377
Notes
Income
Contributions by Health Administration
Corporation for Education and Research
Interest
Value of services provided and costs
met by Health Administration
Corporation
Expenditure
Education & Research Expenses
10
448,031
237,221
Expenses from ordinary activities
excluding E&R activities
9
4,301,580
4,009,767
4,749,611
4,246,988
(78,470)
126,389
Surplus/ (Deficit) for the year from
ordinary activities
Total revenues, expenses and valuation
adjustments other than with owners as
owners
Total changes in equity other than those
resulting from transactions with owners
as owners
-
7
(78,470)
-
126,389
The statement of financial performance should be read in conjunction with the accompanying notes.
67
NURSES REGISTRATION BOARD
STATEMENT OF CASH FLOWS
FOR THE YEAR ENDED 30 JUNE 2003
Notes
Cash flows from operating activities
Allocation from fees
2003
$
630,000
Interest Received
54,092
Receipt of GST receivable
15,275
Operating Expenses
2002
$
50,138
-
(446,998)
(253,484)
252,369
(203,346)
Cash at the beginning of the financial
year
1,061,502
1,264,848
Cash at the end of the financial year
1,313,871
1,061,502
Net cash flows provided by/(used in)
operating activities
8
The statement of cash flows should be read in conjunction with the accompanying notes.
68
NURSES REGISTRATION BOARD
NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 30 JUNE 2003
1.
ACCOUNTING POLICIES
1.1 The Nurses Registration Board performs the duties and functions contained in the Nurses
Registration Act 1991 and its financial affairs are administered by the Health Administration
Corporation.
1.2 The Board's financial report is a general purpose financial report which has been prepared in
accordance with applicable Australian Accounting Standards, Urgent Issues Group Consensus
views, other authoritative pronouncements of the Australian Accounting Standards Board, the
Public Finance and Audit Act 1983, and the Treasurer's Directions. An accrual basis of
accounting has been adopted. The Statement of Financial Position has been prepared on an
historical cost basis and does not take into account changing money values.
1.3 The Board only holds the assets of the Education and Research Account in its name and is
responsible only for the liabilities arising from the operation of the Education and Research
Account. All other assets and liabilities relating to the Board are recorded in the financial
statements of the Department of Health (Health Administration Corporation).
1.4 All income and expenditure of the Board’s operations, including those transactions accounted for
through the Health Administration Corporation (HAC) (See Note 9), are prepared on an accrual
basis.
The expenses paid by HAC on behalf of the Board, are not included in the Statement of
Cashflows as they are not a cashflow of the Board.
2.
TRANSMISSION OF FEES
The Nurses Registration Board is required by statute to collect fees from its registrants and transmit
the monies to the Health Administration Corporation. The Corporation may pay out from such
monies the amounts required to meet the costs incurred in the administration or execution of the Act
establishing the Board. An amount of $3,539,439 ($3,464,150 in 2002) was transmitted. The figures
relate to actual receipts distinct from accrual figures.
3.
FEES FOR EDUCATION AND RESEARCH PURPOSES
The Nurses Registration Board is responsible for the administration of the Education and Research
Account.
The Minister for Health may determine that a set amount out of the fees received from nurses be
transferred to the Education and Research Account. In 2002/2003 an amount of $315,000 was
transferred ($315,000 in 2001/2002).
69
NURSES REGISTRATION BOARD
NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 30 JUNE 2003
4.
INTEREST
Special Interest Earning Arrangement
2003
$
54,561
Commonwealth Bank of Australia
2002
$
48,610
The interest received from the Commonwealth Bank of Australia, was paid under a Special
Interest Arrangement with the Bank which applied to all daily balances of bank accounts
administered on behalf of all Health Professional Boards by the Health Administration
Corporation. In addition to daily balances receiving interest at a rate revised each week, the
Bank also waived normal bank fees payable such as transaction fees, dishonoured cheques
fees and charges applicable to overseas drafts. The average interest rate earned for the year
was 4.25% p.a. (4.01% p.a. in 2001/2002).
5.
RECEIVABLES
2003
$
-
Allocation of fees
6.
Interest receivable
4,049
Publications
8,378
GST suspense
-
2002
$
315,000
3,579
15,275
12,427
333,854
2003
$
21,768
2002
$
12,356
21,768
12,356
PAYABLES
Scholarships
70
NURSES REGISTRATION BOARD
NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 30 JUNE 2003
7.
TOTAL ACCUMULATED FUNDS RECONCILIATION
2003
$
Total accumulated funds at the beginning of the year
Total changes in equity other than those resulting from
transactions with owners as owners
Surplus/(Deficit) for the year from ordinary activities
Total accumulated funds at the end of the year
8.
1,383,000
-
2002
$
1,256,611
-
(78,470)
126,389
1,304,530
1,383,000
NOTES TO THE STATEMENT OF CASH FLOWS
8.1 For the purpose of the statement of cash flows, cash relates to cash in the Bank.
8.2 Reconciliation of net cash flows from operating activities to surplus for the year.
2003
$
Surplus/(Deficit) for the year from ordinary activities
(78,470)
126,389
(Increase)/Decrease in receivables
321,427
(313,472)
9,412
(16,263)
252,369
(203,346)
(Decrease)/Increase in accruals
Net cash provided by/(used in) operating activities
9.
2002
$
EXPENDITURE ACCOUNTED FOR THROUGH THE HEALTH ADMINISTRATION
CORPORATION
Expenditure in respect of the Board's operations form part of the accounts of the Department of
Health for the Health Administration Corporation. The Health Administration Corporation has
determined which costs are allocated to the Board and the basis of allocation. The costs may not
include all costs associated with running the Board.
Details of transactions accounted for through the Health Administration Corporation are as follows:
71
NURSES REGISTRATION BOARD
NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 30 JUNE 2003
9.
EXPENDITURE ACCOUNTED FOR THROUGH THE HEALTH ADMINISTRATION
CORPORATION (cont.)
2003
$
2002
$
Expenditure
Salaries & Associated Staff Costs
Building Expenses
Subsistence & Transport
Members Fees
Fees for Service
Post & Communications
Printing & Stationery
Plant & Equipment
Miscellaneous
Audit Fees (allocation)
2,457,639
198,970
130,193
222,045
669,587
234,600
226,895
24,079
129,572
8,000
2,336,174
174,766
117,823
309,006
329,070
298,177
282,772
49,262
104,717
8,000
Total
4,301,580
4,009,767
As at 30 June 2003 the Health Administration Corporation recorded cash and investments of $6,763,286
($7,429,353 in 2002), held in relation to this Board.
10.
EDUCATION AND RESEARCH
The following categories of expenditure were incurred:
2003
$
Grants
2002
$
13,636
28,202
Scholarships
212,943
203,843
Publications
221,452
-
Miscellaneous
-
929
Conferences
-
4,247
448,031
72
237,221
NURSES REGISTRATION BOARD
NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 30 JUNE 2003
11.
FINANCIAL INSTRUMENTS
Financial instruments give rise to positions that are a financial asset of either the company or its
counterpart and a financial liability (or equity instrument) of the other party. They include negotiable
certificates of deposit, cash at bank, receivables and creditors. All classes of financial instruments,
including revenue, expenses or other cash flows arising from financial instruments, are recognised at
cost on an accrual basis.
In accordance with Australian Accounting Standard AAS33, information is disclosed regarding
interest rate risk and credit risk of financial instruments. All amounts are carried in the accounts at
net fair value which is considered to be the same as the carrying amount in the balance sheet.
Interest rate risk affects cash at bank and investments where the value of these instruments is subject
to fluctuation due to changes in market interest rates.
The Board's exposure to interest rate risk and the effective interest rates of financial
instruments at year end are:
2003
$
Cash all at floating interest rates
2002
$
1,313,871
1,061,502
Receivables all at non-interest bearing
12,427
333,854
Creditors all at non-interest bearing
21,768
12,356
Accrued expenses to be paid by HAC
all at non interest bearing
952,644
668,032
Accrued expenses all at non interest bearing
952,644
668,032
It is not considered that the receivables are subject to a credit risk.
12.
CONSULTANCY CHARGES
The Health Administration Corporation arranged for consultancy services on behalf of the boards it
administered during the year. The Nurses Registration Board's share of these consultancy costs was
$nil (nil in 2002).
13.
SUBSEQUENT EVENTS
None to report.
End of Audited Financial Statements
73
INDEX
Access
Accounts - Statement of
Activities of the Board
Administration/Staffing
Aims
Annual Renewal Registration/Enrolment
Annual Report - Cost of Production
Assessment - Applicants/ other countries
Attendance at Meetings (Nurses Registration Board)
Auditor General's Certificate
Authority to Practise Midwifery
Badges (Metal)
"Board Works" Newsletter
Budget - June 2003
Page/s
3
66
24
23
1
44
63
26
5
64
26
46
43
61
Charter
Clientele
Codes of Conduct
Code of Professional Conduct
Code of Conduct for Members of the Nurses Registration Board
and Committees of the Board
Code of Conduct for Administrative Staff
Committees Health Committee
Professional Standards Committee
Conduct Committee
Research and Development Committee
Consultancies
Consultation Forums - Education of Enrolled Nurses
Consumer Response
Costs of Administration of Board
Course Accreditation
Disciplinary Matters
Deputy President, Nurses Registration Board
1
2
41
5
51
22
9
7
22
59
25
44
46
25
7
5
Education Nurse Inspections
Education and Research Account
Enrolled Nurse - Recognised Institutions
Enrolment
33
30
36
26
Fees Payable
Freedom of Information
Functions of the Board
45
59
1
Health Professional Registration Boards Ethnic Affairs Priority Statement
Management
Organisational Chart
Staff Code of Conduct
47
49
60
51
74
Human Resources
23
Internet Web-Site
43
Legislative Change
59
Management of Health Professionals Registration Boards
Meetings of Nurses Registration Board (attendance at Board meetings)
Membership of Nurses Registration Board
Midwifery - Recognised Institutions
Mutual Recognition
49
5
3
34
27
New South Wales Government Action Plan for Women
Nurse Education Inspections
Nurses Tribunal
57
33
11
Objectives of the Board
Organisation Chart (Health Professionals Registration Boards)
Overseas Qualified Applicants/Statistics
Overseas Travel
1
60
29
50
Portfolios for Registered Nurses and Enrolled Nurses
Powers of the Board
President of the Board
Professional Standards Committees
Projects: Special Initiatives
Psychiatric Assessment
Publications
26
2
4
9
42
9
43
Recognised Education Institutions
Leading to Authorisation to Practise as a Nurse Practitioner
Leading to Authorisation to Practise Midwifery
Leading to Enrolment on List A of the Roll
Leading to Registration on List A of the Register
Register of Nurses/Statistics
Research and Development Committee
Review of Operations
Roll of Nurses/Statistics
34
34
36
33
28
22
24
28
Scholarships
Categories
Committee (Research and Development)
Recipients
Seminars for Nurses
Strategic Plan
Statement of Income and Expenditure
31
31
22
32
25
42
66
Time for Provision of Services
Applications
Annual Renewal
Waste Reduction And Purchasing Policy (WRAPP)
44
44
44
58
75