Enrolled Nurse - Scope of Practice

Enrolled nurses practise under the direction and delegation of a registered nurse or nurse practitioner to deliver nursing care and health education across the life span to health consumers in community, residential or hospital settings.  Enrolled nurses contribute to nursing assessments, care planning, implementation and evaluation of care for health consumers and/or families/whanau.  The registered nurse maintains overall responsibility for the plan of care. Enrolled nurses assist health consumers with the activities of daily living, observe changes in health consumers’ conditions and report these to the registered nurse, administer medicines and undertake other nursing care responsibilities appropriate to their assessed competence.

In acute settings, enrolled nurses must work in a team with a registered nurse who is responsible for directing and delegating nursing interventions.  In some settings, enrolled nurses may coordinate a team of health care assistants under the direction and delegation of a registered nurse.  In some settings, enrolled nurses may work under the direction and delegation of a registered health practitioner*.  In these situations, the enrolled nurse must have registered nurse supervision and must not assume overall responsibility for nursing assessment or care planning.  Enrolled nurses are accountable for their nursing actions and practise competently in accordance with legislation, to their level of knowledge and experience.  They work in partnership with health consumers, families/whanau and multidisciplinary teams.

*A person who is registered under the Act e.g. midwife, medical practitioner, occupational therapist.

The Nursing Council competencies for enrolled nurses describe the skills, knowledge and activities of enrolled nurses. Click here for the Competencies for the enrolled nurse scope of practice

Qualifications

New Zealand Graduates

• Successful completion of an 18-month programme in enrolled nursing at level 5 on the New Zealand Qualification Authority – National Qualifications Framework accredited by the Nursing Council; and
• a pass in an assessment of the Nursing Council competencies for enrolled nurses by an approved provider; and
• a pass in an Examination for Enrolled nurses.

Nurses From Overseas

• Registration with an overseas regulatory authority; and an international qualification that is equivalent to a prescribed qualification.

Overseas applicants may also be required to:

• pass an assessment of the Nursing Council competencies for enrolled nurses by an approved provider; and/or
• successfully complete a programme approved by the Nursing Council for the purpose of assessing competencies for enrolled nurses.

Enrolled nurse scope of practice transition arrangements

The scope of practice for enrolled nurses and nurse assistants changed on 31 May 2010.  To view the gazette notice for the new scope please click here. The new scope of practice enables enrolled nurses to make a broader contribution to health services and give greater support to registered nurses.

Enrolled nurses who do not make the transition by 1 July 2011

Although the Nursing Council set a timeframe of 1 July 2011 for the transition period this does not mean that nurses are precluded from completing the transition into the new scope of practice any time after this period. 

Enrolled nurses (excluding New Zealand educated nurses previously titled nurse assistant) who do not complete the transition will have the following condition included in their scope of practice:

• "may only work with health consumers with stable and predictable health outcomes"

This is the limitation included in the previous enrolled nurse scope of practice that is not included in the new scope of practice. This condition should not make any difference to their present employment but may restrict them from taking on additional responsibilities that are within the new scope of practice. 

For continuing competence purposes the enrolled nurse with this condition will need to be assessed against the competencies for nurses in the enrolled nurse scope of practice but will not be expected to meet the seven new competencies (2.2, 2.3, 2.6, 3.2, 3.3, 4.2 and 4.3).  For a competence assessment form for enrolled nurse in the restricted scope (click here)

This condition can be removed at any time subject to a satisfactory competence assessment against all eighteen competencies, including the new competencies, for enrolled nurses by a Council approved assessor.  For more information (click here). The Council has a list of approved assessors that can be accessed by emailing education@nursingcouncil.org.nz.

For more information on the enrolled nurse transition requirements, phone 0508 enrolled (0508 3676 5533) or email nurseadvisor@nursingcouncil.org.nz. Enrolled nurses who have been out of practice for five years or more will have to complete a competence assessment programme (click here)

Enrolled nurses who were previously New Zealand educated nurse assistants

These enrolled nurses are required to complete an education programme at a School of Nursing.  The Council is aware that it will take these nurses longer to complete requirements.  These nurses will continue to have a condition specifying their area of practice included in their scope of practice until they complete further education.  However, they will not be able to take on increased responsibilities in these settings until they have completed further education.

For continuing competence purposes these enrolled nurses will not be expected to meet the seven new competencies until they have completed further education.