Registered Nurse - Scope of Practice

Registered nurses utilise nursing knowledge and complex nursing judgment to assess health needs and provide care, and to advise and support people to manage their health. They practise independently and in collaboration with other health professionals, perform general nursing functions and delegate to and direct enrolled nurses, healthcare assistants and others. They provide comprehensive assessments to develop, implement, and evaluate an integrated plan of health care, and provide interventions that require substantial scientific and professional knowledge, skills and clinical decision making. This occurs in a range of settings in partnership with individuals, families, whanau and communities. Registered nurses may practise in a variety of clinical contexts depending on their educational preparation and practice experience. Registered nurses may also use this expertise to manage, teach, evaluate and research nursing practice. Registered nurses are accountable for ensuring all health services they provide are consistent with their education and assessed competence, meet legislative requirements and are supported by appropriate standards. There will be conditions placed in the scope of practice of some registered nurses according to their qualifications or experience limiting them to a specific area of practice.

The Nursing Council competencies for Registered Nurses describe the skills and activities of registered nurses. Click here for competencies for the Registered Nurse scope of practice.

Qualifications

New Zealand Graduates

a) A bachelor degree in nursing (or an equivalent qualification) approved by the Nursing Council of New Zealand, AND

b) A pass in an assessment of Nursing Council Competencies for Registered Nurses by an approved provider, AND

c) A pass in an Examination for Registered Nurses.

Registered Nurses from Overseas

a)     Registration with an overseas regulatory authority, AND

b)     An equivalent international qualification, AND

c)     At the direction of the Nursing Council, a pass in an assessment of the Nursing Council competencies for Registered Nurses by an approved provider, AND/OR

d)     Successful completion of a Nursing Council approved competence assessment programme.

Please click here to view the gazette notice for the registered nurse scope of practice

Expanded practice for registered nurses

Nurses are assuming responsibility for health care activities or roles which have been outside their scope of practice in response to health consumer needs and in the development of new health services. 

The Council’s role is to protect public safety and it is wishes to enable the expansion of nursing practice while also ensuring that appropriate standards and education are put in place to protect the public. 

The Council has developed a guideline for nurses and employers to use when making decisions about expanded practice roles.  Before considering an expansion of practice a number of issues should be considered in a collaborative manner by both the nurse and the employer.  These include identifying legislation and standards to support the expansion, evidence that health outcomes will be improved, organisational policies to support the changes and the education preparation and clinical supervision and assessment required by the nurse.  A flowchart outlining the Decision-making process for expanding scope of nursing practice is included in the Guideline: Expanded practice for registered nurses click here or for a A4 poster of the Decision-making process flowchart click here.