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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 proceduresfollow 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