Enrolled Nurse Title Revived
Source: Nursing Review, Vol 10 Issue 9 January 2010
WORKFORCE/FIONA CASSIE
The decision has been warmly welcomed as a Christmas present by
existing enrolled nurses and the New Zealand Nurses Organisation,
viewed as a workable resolution to the issue by many others, but
mourned by some.
Still awaited with interest are details of how current
second-level nurses will be transitioned into the scope and the
education standards.
Council chief executive Carolyn Reed said the council was
pleased to make a decision backed by the majority of submitters.
She said it would enable enrolled nurses to have a greater
role in assessment and work as part of a team with registered
nurses in a variety of settings including acute.
It would also enable nurses to lead unregulated workers in aged
care settings, though still under the direction and delegation of a
registered nurse.
The council received 460 submissions on the ongoing and
contentious issue, including 79 from organisations and 311
individual submissions on NZNO forms.
Just over 60 per cent of non-NZNO organisation submitters
supported the title enrolled nurse for the generic scope but this
swelled to 82 per cent when all submissions were considered.
Chief Nurse Mark Jones said the council had made a "bold and
pragmatic step" to resolve how second-level nurses were used "once
and for all". "I'm clear that we now have a robust future for
the enrolled nurse in the New Zealand health care system".
Among the third of organisations not supportive of the enrolled
nurse title or wider scope were the College of Nurses with
executive director Dr Jenny Carryer severely disappointed by the
decision.
"It will take us back to the very reasons we abandoned this
journey in the early 1990s", said Carryer. And she added that the
adage " those who cannot remember the past are condemned to repeat
it" was apt.
Gary Lees, chair of the nurse executive group NENZ ,was pleased
to see a single, wider scope and said the role of the new EN's
would become more obvious when the education standards and
competencies were released next year.
He said with EN's required to work in teams with RN's in acute
settings, the ability of RN's to "appropriately" direct and
delegate would also be important in how the new EN role evolved in
the workplace.
Jim Green, District Health Boards New Zealand nursing and
midwifery workforce strategy group spokesman, said the decision met
the boards' desire for more flexibility and greater clarity about
the EN role and its relationship as a support role to the RN
workforce.
He said DHB's currently had a variety of models of care and
while some would utilise the new EN scope it was "very early days"
and still unknown whether every board would want to change their
model of care to include the revised role.
Health Minister Tony Ryall said patients would be the big
winners from the revised scope as enrolled nurses could now be more
involved in the care of patients.
A delighted Robyn Hewlett, chair of NZNO's enrolled nurse
section, said the decision was a "good Christmas present" and after
five years fighting to get back the EN title she hoped the issue
was now settled.
She said the new generic scope was only slightly altered from
the one proposed by the section and members were positive that the
move would be food for the health workforce.
NZNO professional nursing advisor Suzanne Rolls said the
organisation welcomed the expanded single scope and title and said
the council decision removed uncertainty for the second-level
nurses, reflected the reality of health service provision and
provided clarity to the public.
Hewlett said how existing EN's and nurses assistants (NAs) would
transition to the new scope was still unknown but the council had
indicated that it would not be too difficult for EN's and she hoped
that Nas would also make the move.
Key Points
+ New generic scope for
all second level nurses to be called enrolled nurse.
+ 18-month education programme with a third of
programme at diploma level. EN's can
practice under "direction and delegation" of an RN across all
health settings but must work in a team with and
RN in acute settings. Nurses in
existing enrolled nurse and nurse assistant scopes to have option
to transition into new scop of practice.
Timeline
1993 Hospital-based enrolled nurse programmes
end
2000 Labour government initiates return of EN
programmes.
2002 First one-year, narrow-scope EN programmes
start.
2004 Title changed to nurse assistant
2008 Advisory group calls for higher, generic
scope EN
2009 Nursing Council backs call and agrees on
EN title.