Report of the
Nursing Council
of New Zealand
for the year ended 31 March 2007
Report of the
Nursing Council
of New Zealand
for the year ended 31 March 2007
Presented to the Minister of Health
pursuant to Section 134
of the Health Practitioners Competence Assurance Act 2003
1
2
Contents
Foreword
5
Chairperson’s report
6
Chief Executive’s report
9
Governance
11
Communication
16
Nursing education
18
Professional standards
22
Nursing registration
25
Health and disability
28
Complaints
29
Financial statements
33
3
4
Foreword
Nursing Council of New Zealand members as at 31 March 2007
Back (left to right) Margaret Millard, Kathrine Townshend, Roxanne McKerras, Christine Payne.
Front (left to right) Margaret Southwick (Deputy Chairperson), Beverley Rayna (Chairperson),
Noeline Warmington. Inset: Frances Hughes
The Nursing Council of New Zealand has much pleasure in presenting its annual
report for the year ended 31 March 2007.
The term of office for all Council members expired in September 2006, and a
new Council was appointed. Four members did not seek reappointment. Former
Chairperson, Annette Huntington, Brenda Hall, Mere Hammond and Marie Kiely
have made a tremendous contribution to the Council over the past few years
and their commitment to the profession and its regulation is acknowledged and
appreciated.
The Council identified strategic objectives in four areas:
• leadership in nursing regulation nationally and internationally
• an increasingly complex and diverse environment
• commitment to the Treaty of Waitangi
• confidence in the competency framework.
Activities to achieve these are outlined in this report.
It is now nearly four years since enactment of the Health Practitioners
Competence Assurance Act (2003), and the Council continued to review and
consolidate the plans and procedures put in place to implement the requirements
of the Act. The Council will now focus more strategically on the issues affecting
public safety and the role of the regulatory authority in addressing these. The
Council looks forward to the challenge.
5
Chairperson’s report
The Council continued to provide proactive leadership for the
profession both nationally and internationally and maintained its active
participation in the global regulatory network. In May 2006 the
Chairperson and Chief Executive attended meetings of the
International Council of Nurses in Geneva, and in August the Council
hosted the biennial meeting of Western Pacific and South East Asian
nursing and midwifery regulators (WPSEAR) in Wellington. The
Council’s annual forum, held in Auckland, Wellington and Christchurch,
was once again highly successful.
This year the Council reviewed its governing policies to ensure
alignment with current best practice. Continual monitoring of the
national and international nursing environments enabled the Council
to evaluate the effectiveness of its policies and processes to ensure
a nursing workforce that is responsive to the changing needs of the
New Zealand population.
The Council is committed to maintaining the annual practising
certificate (APC) fee at a level affordable for nurses. While the Council
anticipated the need to increase the fee to meet the costs of
implementing the Health Practitioners Competence Assurance Act
2003 (HPCA Act), it delayed that increase until a more accurate
identification of costs was possible.
With the establishment of the Health Practitioners Disciplinary
Tribunal (Tribunal), disciplinary costs have increased markedly and
in the interests of transparency a disciplinary levy was struck for the
first time. A rigorous pricing process was undertaken and full cost
recovery policy adopted for implementation over five years. The new
prices came into effect on 1 October 2006, unfortunately too late to
prevent a negative equity situation. The Council is cognisant of its
fiscal responsibility to use all revenue wisely and appropriately to
ensure both statutory obligations and strategic objectives are met.
Cash flow is healthy, and the Council is confident that positive equity
will be achieved within the next financial year.
6
In maintaining its commitment to the Treaty of Waitangi the Council
retained an appointed Kaumatua and a number of Maori advisors,
nurses nominated by Maori, who assisted the Council in its regulatory
functions thus strengthening the Council’s responsiveness to issues
of concern to Maori. The Council is strongly committed to its ongoing
process of working in partnership and continues to consult on how
best to achieve this.
As a responsible authority appointed under the HPCA Act the Council
regulates nursing practice to protect public safety. It is responsible
for maintaining practice standards and the competence assurance
framework, including continuing competence and competence
reviews, and it has maintained an ongoing programme of informing
nurses and their employers of its regulatory requirements. It continues
to establish and strengthen a robust framework for the development
of professional standards and guidelines. The Council anticipates
that the public will have confidence in the safety and competence of
the nursing workforce. The definition of nursing practice was reviewed
and amended to acknowledge that practice extends beyond direct
clinical contact with patients/clients. A system for initial assessment
of notifications and complaints was developed.
Legal matters this year include two court decisions of particular note:
an appeal by the Professional Conduct Committee in relation to the
Tribunal’s decision on penalty for Lesley Martin; and an appeal by a
group of nurse assistants against their title.
The Council welcomed the decision to cancel Ms Martin’s registration.
Ms Martin was convicted in the High Court in August 2003 of one charge
of attempted murder after deliberately administering an overdose of
morphine to her terminally ill mother and had been sentenced to 15
months imprisonment.
The Tribunal was of the view that serious questions are raised about
a health professional’s fitness to practise if she/he is convicted of
attempted murder and resolved to impose conditions on Ms Martin’s
ability to practise as a nurse.
7
The Professional Conduct Committee appealed to the High Court that
the Tribunal had erred in failing to order that Ms Martin’s registration
be cancelled and this was upheld. In his judgement Justice Gendall
stated that cancellation of registration was “the only proper orders
…to protect the public…and to ensure the professional standards are
adhered to…”. Feedback received by the Council indicates that
nurses are concerned about maintaining the trust and confidence of
the public and other health practitioners with whom they work, and
this decision recognises that concern.
The appeal by the nurse assistants against their title was struck out
because the decision was not appealable under section 106 of the HPCA
Act, however the debate continued as the New Zealand Nurses
Organisation sought the intervention of the Regulation Review Committee.
The decision of that committee was not available by the end of year.
Another issue that confronted the Council this year was the possibility
that nurses from Zimbabwe had gained registration in New Zealand with
fraudulent documents (see page 27). The process of investigation and
resolution of this issue was costly and time consuming for the Council
and the nurses concerned, but was necessary in order to ensure public
confidence in nursing practice. It also served to remind the Council of
the need for vigilance and scrutiny of documentation so that we continue
to meet the requirements of the HPCA Act in ensuring public safety.
Overall, the past year has been one of consolidation and building on the
successful transition to the new legislation and I thank all Council members
and staff for their continued commitment and hard work to achieve this.
Beverley Rayna
Chairperson
8
Chief Executive’s report
The 2006/07 year has been one of settling down and continuing to
adapt to the new regulatory environment. It has involved the
development of new systems to increase both our efficiency and
improve the quality of our service to nurses and our ability to protect
the public.
The second half of the year was consumed with a major enquiry into
the status of the verifications of good standing received from
Zimbabwe. The Council was concerned to learn in August 2006 that
the Nurses Council of Zimbabwe could not guarantee that all
verifications and certificates of good standing were genuine. Working
closely with the New Zealand Immigration Service, we undertook a
thorough investigation and identified 137 nurses or applicants from
Zimbabwe with potentially fraudulent verifications. The investigation
included a visit to the Nurses Council of Zimbabwe, an interesting
experience.
Although the experience was obviously distressing for those involved,
not to mention time consuming for the Council, it demonstrated not
only the seriousness with which the Council views its responsibility
to protect public safety, but also the robustness of the systems that
the Council has in place to safeguard against fraudulently obtained
registrations.
Employment of second level nurses
The Council hosted a meeting of key stakeholders in June 2006 to
discuss the role and preparation of nurse assistants, as it had become
obvious that there was confusion in the sector about both potential
employment settings for nurse assistants and the appropriate
utilisation of existing enrolled nurses.
The roles of nurses registered in both the nurse assistant and enrolled
nurse scopes of practice were clarified in letters to the sector that
emphasised the need for all nurses to work within their regulated
scopes of practice.
9
New definition of practising
The Council adopted a new definition of practising to ensure that it better
fulfilled its purpose of protecting the health and safety of the public by ensuring
that nurses are competent and fit to practise:
Nursing practice is using nursing knowledge in
a direct relationship with clients or working in
nursing management, nursing administration,
nursing education, nursing research, nursing
professional advice or nursing policy
development roles, which impact on public safety.
The new definition more accurately reflects the range of roles in which nurses
practise in the health sector.
Overall, it was a busy yet rewarding year for the Council, and now that we
have settled into our new regime, we are confident in continuing to do our
work to effectively regulate nursing practice to protect public safety. I especially
want to acknowledge the great contribution of the staff in carrying out the
Council’s duties and functions under the Health Practitioners Competence
Assurance Act 2003.
Marion Clark
Chief Executive
10
Governance
At the beginning of the year, the Council comprised Annette Huntington
(Chairperson), Beverley Rayna (Deputy Chairperson), Meretene Hammond,
Brenda Hall, Marie Kiely, Margaret Millard, Margaret Southwick and Noeline
Warmington.
Beverley Rayna, Margaret Millard, Margaret Southwick and Noeline
Warmington were all reappointed for terms of three years with effect from 25
September 2006. Roxanne McKerras, Christine Payne and Kathrine
Townshend were appointed for terms of three years with effect from 25
September 2006, and Frances Hughes was appointed for a term of three
years with effect from 1 November 2006, completing the makeup of the new
Nursing Council of New Zealand.
Beverley Rayna was elected Chairperson and Margaret Southwick was
elected Deputy Chairperson at the first meeting of the new Council.
Beverley Rayna
Chairperson
Beverley Rayna is Nurse Manager of St Allisa Court Rest Home in
Christchurch. She is a registered nurse and has had 30 years experience in
nursing education both as a teacher and a manager. Her clinical practice
experience has been mainly in medical and surgical nursing. She was first
appointed to the Council as a registered nurse under section 4(1)(d)(i) of the
Nurses Act in October 2000.
Margaret Southwick
Deputy Chairperson
Dr Margaret Southwick (Tuvalu/Pakeha) is Dean of Faculty, Health, Education
and Social Science at Whitireia Community Polytechnic. She is a registered
nurse and was first appointed to the Council as an academic staff member
under section 4(1)(c) of the Nurses Act in April 2002.
Frances Hughes
Dr Frances Hughes has 25 years of experience in the New Zealand health
service as a health clinician, manager, government health policy advisor and
educator and is a member of many national and international nursing groups.
She has held many nursing positions in New Zealand and overseas. She
was appointed to the Council as a health practitioner member with effect
from 1 November 2006.
11
Roxanne McKerras
Roxanne graduated as a registered general and obstetric nurse in 1983.
She has a Diploma in Health Services Management and a Master in Nursing.
Her clinical experience has been comprehensive, with the last ten years in
emergency nursing. She is currently seconded into a new role as Night Team
Coordinator at Christchurch Public Hospital. She was first appointed to the
Council as a health practitioner member with effect from 25 September 2006.
Margaret Millard
Margaret Millard, of Palmerston North, has worked for many years in the
voluntary sector, including significant involvement in the rural women’s
network. She has extensive governance experience, including being a
Councillor and Chairperson of the Open Polytechnic of New Zealand. She
was first appointed to the Council as a lay member under section 4(1)(d) of
the Nurses Act in November 2002.
Christine Payne
Christine has extensive nursing experience as a clinician in ICU/CCU
medicine and elder care plus management, education and professional
leadership as a Director of Nursing in the UK. Christine has been in New
Zealand since 1998 and is currently Executive Director of Nursing and
Midwifery at Bay of Plenty District Health Board. She has also been
Chairperson of Nurse Executives of New Zealand and is currently Chairperson
of Magnet NZ. She was first appointed to the Council as a health practitioner
member with effect from 25 September 2006.
Kathrine Townshend
Kathrine Townshend has worked in a law office and as a counsellor working
with survivors of sexual abuse and domestic violence. She also spent six
years on committees involved in the ethical review of research involving human
participants prior to being appointed to the Council. She was first appointed
to the Council as a lay member with effect from 25 September 2006.
Noeline Warmington
Noeline Warmington (Ngapuhi/Ngati Kahu/Te Rarawa) is employed by the
Department of Corrections in forensic nursing. She has a particular interest
in health promotion and nursing development. She was first appointed to the
Council as a registered nurse under section 4(1)(a) of the Nurses Act in April
2002.
12
Council meetings
The Council met 12 times.
Committees of the Nursing Council of New Zealand
Four committees assisted the Council to fulfil its obligations under the HPCA
Act.
Education Committee
The Education Committee considers education issues and advises the
Council on matters relating to education policy. The committee is responsible
for the Council’s process for accrediting and monitoring nursing programmes.
The Education Committee met nine times to assess and review programme
accreditations and audits, assess educational equivalence for nurse
practitioner applicants, assess applications for change in condition in scopes
of practice and consider recognition of prior learning and requests for
extended programme timeframes.
Annette Huntington (Convenor until September 2006)
Noeline Warmington (until September 2006)
Margaret Southwick (Convenor from November 2006)
Christine Payne (from November 2006)
Roxanne McKerras (from November 2006)
Finance Committee
The Finance Committee scrutinises the financial accounts, reviews and
maintains financial systems and reviews the Council’s finance and
management policies.
The Finance Committee met seven times. It considered the budget, monthly
financial reports and annual accounts as well as approving all cheque
payments and investments.
Marie Kiely (Convenor until October 2006)
Margaret Millard (Convenor from November 2006)
Annette Huntington (until October 2006)
Beverley Rayna (from November 2006)
Kathrine Townshend (from November 2006)
13
Health Committee
The Health Committee considers cases of health and disability or suspected
disability that had been notified to the Council, with delegated powers from
the Council to make decisions under sections 45-51 of the HPCA Act. The
Health Committee met 11 times and held hearings involving 46 nurses
Beverley Rayna (Convenor until September 2006)
Marie Kiely (until October 2006)
Noeline Warmington (from April 2006)
Margaret Millard (from November 2006)
Frances Hughes (from November 2006)
Registration Committee
The Registration Committee has delegated authority for individual registration
decisions, including registration of both overseas applicants and New Zealand
graduates, and consideration of practising certificate applications. The
Registration Committee met 11 times.
Annette Huntington (Convenor until October 2006)
Margaret Millard (until October 2006)
Margaret Southwick (from April 2006)
Beverley Rayna (Convenor from November 2006)
Christine Payne (from November 2006)
Secretariat
Chief Executive Marion Clark and 28 other staff support the Council. The
following list sets out staff members as at 31 March 2007.
Corporate
Marion Clark
Jen Toogood
Tony Hanna
Anita Broughton
Nicole Hay
Frances Bennington
Lynne McKenzie
Darryl Ward
Chief Executive/Registrar
Executive Assistant
Office Manager (temporary)
Accountant (temporary)
Personal Assistant
Receptionist/File Administrator
Accounts Administrator
Communications Advisor
Education
Carolyn Reed
Moira Aberdeen
Education Advisor
Personal Assistant
14
Professional standards
Pam Doole
Sue MacDonald
Jackie Turvey
Professional Standards Manager
Nurse Advisor Professional Standards
Professional Standards Coordinator
Registration
Barry Ayling
Suzy Arnold
Pauline Cook
Margaret Adamson
Denise Nelson
Heather Rutherford
Krys Wos
Damian Gilmour
Michael Gribble
Tara Leonard
Xiaohui (Chris) Cui
Registration Manager
Personal Assistant
Nurse Advisor Registration
Nurse Advisor Registration
Team Leader Overseas Registration
Overseas Registration Administrator
Overseas Registration Administrator
Team Leader New Zealand Registration
New Zealand Registrations Administrator
New Zealand Registrations Administrator
New Zealand Registrations Administrator
Legal
Clare Prendergast
Sarah Kennedy
Stephanie Doran
Senior Investigator/Legal Advisor
Investigator/Legal Advisor
Legal Personal Assistant
Health and complaints
Janice Byford-Jones
Lisa Bone
Nurse Advisor Health and Complaints
Personal Assistant
15
Communication
Forum 2006
The Council’s annual forum was held in Auckland, Wellington and Christchurch
and was attended by 496 nurses.
Western Pacific and South East Asian nursing and
midwifery regulators
The Council hosted the biennial meeting of Western Pacific and South East
Asian nursing and midwifery regulators (WPSEAR). It was attended by 63
delegates from 18 countries, and feedback on the organisation and content
of the meeting was very positive. A full report of the meeting was distributed
to all WPSEAR members.
International relations
The Chairpersons and Chief Executives of the Council and the Australian
Nursing and Midwifery Council made reciprocal visits.
The Chairperson and Chief Executive participated in the ICN Triad meeting
and regulatory forum in Geneva, Switzerland, in May 2006.
The Registration Manager attended the ICN Nurse Practitioner/Advanced
Practice Nursing Network Conference in Johannesburg, South Africa, in June
2006.
The Chief Executive represented the Council at the ICN Credentialing Forum
in Copenhagen, Denmark, in November 2006.
Submissions
The Council made a number of submissions on relevant government policy,
health issues, development of the nursing profession and other public policy
issues that affect the health and safety of the public including:
•
Ministry of Health about the Therapeutic Products and Medicines
Bill; the regulation of anaesthetic technicians and the regulation of
acupuncturists under the HPCA Act; the review of the policy relating
to the operation of the Medicines (Standing Orders) Regulations
16
(2002); and regulation of acupuncturists and anaesthetic
technicians
•
District Health Boards New Zealand about the Nursing Workforce
Strategy
•
the Government Administration Committee about the Therapeutic
Products and Medicines Bill.
Publications
A revised edition of the Code of conduct for Nurses was published in June
2006 and, an edition of News Update newsletter was published in July 2006.
17
Nursing Education
The Council prescribes the qualifications for every scope of practice and
sets the education standards, accredits and monitors the providers of the
prescribed qualifications to ensure that the implementation continues to meet
the standards prescribed. The Council also provides advice and guidance
to education providers about legislative requirements and current Council
policies. The Council sets and administers the state final examinations and
receives and processes applications for registration.
Summary of key activities
This year the Nursing Council of New Zealand:
•
approved four competence assessment programmes and
monitored two competence assessment programmes
•
monitored five undergraduate programmes
•
accredited two post-registration programmes
•
monitored four post registration programmes
•
approved 14 nurse entry to practice programmes
•
prepared and administered state examinations for 1,318 nurses.
Approving nursing programmes
Competence assessment programmes
The Council approved competence assessment programmes at Rosebank
Residential Homes, Guardian Health Care, Northland Polytechnic and the
Royal New Zealand Plunket Society respectively. Programmes at
Christchurch Institute of Technology and Guardian Health Care were
monitored.
Nurse entry to practice programmes
The Council approved fourteen nurse entry to practice programmes and the
approval process was commenced for a further seven programmes during
the reporting period.
18
The following district health boards were approved to offer nurse entry to
practice programmes:
•
Canterbury District Health Board
•
Counties Manukau District Health Board
•
Northland District Health Board
•
Bay of Plenty District Health Board
•
Otago District Health Board
•
Nelson Marlborough District Health Board
•
Lakes District Health Board
•
Southland District Health Board
•
Taranaki District Health Board
•
Waikato District Health Board
•
Capital and Coast District Health Board
•
Wairarapa District Health Board
•
Hutt Valley District Health Board
•
South Canterbury District Health Board.
Monitoring nursing programmes
The Council monitored Bachelor of Nursing programmes at Western Institute
of Technology’s (in partnership with Institutes of Technology and Polytechnics
Quality), Northtec, Christchurch Polytechnic Institute of Technology, UCOL
(three sites) and UNITEC.
The Council accredited two new post-registration programmes, a Master of
Nursing (Clinical) at Victoria University of Wellington and a Master of Nursing
at Wintec. The Council also monitored post graduate programmes at the
Whitireia Community Polytechnic (three programmes) and Victoria University
of Wellington.
19
Administering state examinations
Under section 12(2)(c) of the HPCA Act, the Council requires a pass in an
examination, set by itself, as qualification for registration for the registered
nurse and nurse assistant scopes of practice.
The Council administers these three times a year.
Table 1 – Registered nurse candidates sitting state examination
Exam period
Sat
Passed
Percentage passed
July 2006
322
293
90.99%
November 2006
916
891
97.27%
March 2007
61
48
78.69%
The following table shows the numbers of candidates who sat the registered
nurse examination and compares these figures with the previous four years.
Table 2 – Registered nurse candidates sitting state examination
Comparison with previous years
Year ended 31 March
Sat
Passed
Percentage passed
2007
1,299
1,232
94.84%
2006
1,384
1,336
96.53 %
2005
1,229
1,201
97.72 %
2004
1,225
1,206
98.45 %
2003
1,105
1,059
95.84 %
20
Nurse assistants
Nineteen candidates sat the examination for registration as nurse assistants
and 18 were successful.
The following table shows the numbers of candidates who sat the nurse
assistant examination and compares this figure with the previous three years.
Table 3 – Nurse assistant candidates sitting state examination
Comparison with previous years
Year ended 31 March
Sat
Passed
Percentage passed
2007
19
18
94.74 %
2006
19
19
100 %
2005
81
78
96.30%
2004
74
70
94.59%
21
Professional standards
Summary of key activities
This year the Nursing Council of New Zealand:
•
approved seven new recertification programmes (professional
development and recognition programmes) and extension of one
existing programme under section 41 of the HPCA Act
•
completed recertification audits of 1,288 nurses, of whom 1,129
met requirements
•
received competence notifications for 50 registered nurses
•
reviewed the competence of 20 registered nurses.
Professional development and recognition
programmes
The Council approved professional development and recognition programmes
under section 41 of the HPCA Act at:
•
Wakefield Hospital
•
Auckland District Health Board
•
Otago District Health Board and Mercy Hospital
•
Canterbury and West Coast District Health Boards
•
Capital & Coast District Health Board
•
Taranaki District Health Board
•
Bowen Hospital.
The Council also approved the extension of Southern Cross Hospital’s
professional development and recognition programme to include Oxford Hospital.
22
Recertification
The Council randomly selects 5% of individual nurses for audit of their
evidence that they are meeting the continuing competence requirements.
This year the Council audited 1,288 nurses, of whom 1,129 (87.7%) met
requirements. Nurses who did not meet the requirements were issued with
interim practising certificates with conditions under section 43 of the HPCA
Act until the requirements were met.
Competence notifications
The Council received 42 new competence notifications under section 34 of
the HPCA Act. Eight further competence notifications were initiated by the
Council under section 36(4)(a) of the HPCA Act. All 50 competence
notifications concerned registered nurses.
Table 4 - Notifications by area of practice
Area of practice
Total
Percentage
Primary health care
2
4%
Child health
3
6%
Palliative care
1
2%
Continuing care
24
48%
District nursing
2
4%
Mental health
5
10%
Medical
7
14%
Perioperative care
1
2%
Surgical
2
4%
Obstetrics
1
2%
Rural hospital
1
2%
Emergency
1
2%
Total
50
100%
23
Competence reviews
The Council conducted competence reviews of twenty nurses between 1
April 2006 and 31 March 2007. Interim suspension was ordered for two
nurses and interim conditions were ordered for three other nurses on the
grounds that their practice posed a risk of serious harm to the public under
section 39 of the HPCA Act. Other orders under section 38 of the HPCA Act
following review include individualised competence programmes,
competence assessments, professional supervision and conditions placed
in nurses’ scopes of practice.
Table 5 - Outcomes of competence reviews
Outcome
Total
Interim suspension or conditions
5
Required to undertake competence programme
8
Required to undertake professional supervision
5
Required to undertake a competence assessment
9
Conditions placed in scope of practice
3
No further action
4
Outcomes still under consideration
4
1
1
The total exceeds number of reviews, as some nurses had several requirements
included in their orders.
24
Nursing registration
Summary of key activities
This year the Nursing Council of New Zealand:
•
registered 1,215 New Zealand applicants and 1,327 overseas
applicants
•
registered nine nurse practitioners
•
authorised three nurse practitioners to prescribe
•
issued 45,774 practising certificates
•
issued 1,744 verifications to nurses applying to work overseas.
New registrations
The Council registered 1,215 New Zealand applicants, comprising 1,199
registered nurses and 16 nurse assistants.
The Council registered 1,327 overseas applicants during the year, comprising
1,285 registered nurse and 42 nurse assistants.
Nurse practitioners
Thirteen nurses applied for registration as nurse practitioners during the year.
The Council completed the assessments of 12 applications, some of which
had been received during the previous year. Of these, nine applicants were
registered as nurse practitioners during the year and three were declined.
As at 31 March 2007 there were 30 nurse practitioners registered, of whom
14 were authorised to prescribe. The Council was currently assessing nine
applications for the nurse practitioner scope of practice as at the end of the
year.
25
Table 6:
All registrations and enrolments
Comparison with previous years
Date
ENs & NAs 1
RNs
31 Mar N Z
O/seas
Total
NZ
O/seas
Total
Total
2007
1,199
1,285
2,484
16
42
58
2,542
2006
1,313
1,560
2,873
41
36
77
2,950
2005
1,224
1,574
2,798
78
37
115
2,913
2004
1,310
1,720
3,030
70
45
115
3,145 2
2003
1,169
1,515
2,684
0
56
56
2,740 3
1
2
3
Nurses are no longer enrolled, following implementation of the HPCA Act
on 18 September 2004.
Two overseas nurses were registered and enrolled.
Five overseas nurses/midwives were registered and enrolled.
Practising certificates
The Council issued 45,774 practising certificates, of which 2,696 were for
periods of less than one year. As at 31 March 2007, there were 43,916
nurses with current practising certificates (including interim practising
certificates). 4
4
Nurses who do not meet Council’s requirements for ensuring continuing
competence are issued interim practising certificates under section 31 of the
HPCA Act. These are replaced by full practising certificates as the nurses meet
the required conditions.
Verifications
The Council issued 1,744 verifications of registration for New Zealand nurses
applying to register with overseas authorities.
Authorisations
The Council approved 50 applications to supply the emergency contraceptive
pill; approved nine applications to provide diagnostic imaging and authorised
three nurse practitioners to prescribe under the Medicines (Designated
Prescriber: Nurse Practitioners) Regulations 2005.
26
Changes of conditions
The Council received 27 applications from nurses who wished to change
their conditions in their scopes of practice. The Council changed or removed
the conditions of three nurses and advised 20 applicants of requirements
necessary to remove the condition. Four applications were withdrawn.
Registration of nurses from Zimbabwe
In August 2006, the Council was advised by the Nurses Council of Zimbabwe
that there had been fraudulent verifications of nurses from Zimbabwe seeking
registration in New Zealand between June 2004 and December 2006.
Following an investigation 137 nurses from Zimbabwe were identified as
having potentially fraudulent verifications. These nurses were subsequently
advised that the verifications they had submitted were possibly fraudulent
and were all invited to either make submissions to or meet with the Registration
Committee.
The process to determine which of these 137 nurses would have their
registrations upheld, be suspended or be removed from the register was still
taking place as at the end of the year.
The Council is confident that the process was fair and it is pleased to be able
to reassure the public that all measures have been taken to ensure the safety
of the New Zealand public.
This experience has reinforced the need for ongoing vigilance and scrutiny
of documentation to ensure that the Council continues to meet the
requirements of the HPCA Act to ensure the safety of the public.
27
Health and disability
Summary of key activities
This year the Nursing Council of New Zealand received 42 new notifications
under section 45 of the HPCA Act.
Hearings
The Health Committee of the Council met with 46 nurses to consider new
and existing notifications. 1 The Committee
•
permitted 14 nurses to practise with conditions under section 50(4) of
the HPCA Act
•
suspended 7 nurses from practice under section 50(3) of the HPCA Act
•
revoked the conditions of practice of 4 nurses under section 51(2) of the
HPCA Act
•
took no further action on the notification in 14 nurses’ cases
•
permitted 2 nurses suspended under section 50(3) under section 50(4)
of the HPCA Act to practise
•
varied the conditions of 12 nurses under section 51(3) of the HPCA Act
•
required 2 nurses to meet conditions on their return to practice.
1
Note that some nurses met with the Committee more than once during the year.
The Health Committee was monitoring 43 nurses with health conditions or
disabilities at the end of the year.
28
Complaints
Summary of key activities
This year the Nursing Council of New Zealand:
•
held one disciplinary hearing under the Nurses Act
•
received 200 notifications/complaints about nurses
•
referred 39 nurses to Professional Conduct Committees
•
completed investigations into complaints made against 21 nurses
•
prosecuted charges against 11 nurses before the Health
Practitioners Disciplinary Tribunal.
Assessing complaints and notifications
All complaints and notifications received by the Council are initially assessed
to determine the best way of dealing with them. Under section 64 of the
HPCA Act, any complaint affecting a consumer is forwarded to the Health
and Disability Commissioner (unless it was received from the Health and
Disability Commissioner). The Council assesses the complaint, obtains
further information if required and then decides the action to take.
Table 7 - Sources of complaints received
Source
Total
Nursing Council of New Zealand 1
53
Employers
74
Health and Disability Commissioner
16
Consumers
9
ACC
1
Court registrars
10
Other health professionals
11
Self notifications
26
Total
200
1
41 of these were for nurses practising without practising certificates.
29
Table 8 - Outcomes of complaints
Outcome
Total
No further action
49
Referred to Professional Conduct Committees
39
Referred for review of competence
41
Referred to the Health Committee
42
Referred to the Health and Disability Commissioner
22
Pending
7
Total
200
Professional Conduct Committee investigations
Appointment of Professional Conduct Committees
The Council appointed 31 Professional Conduct Committees under section
71 of the HPCA Act to consider complaints received.
Table 9 - Areas of practice of nurses referred to Professional
Conduct Committees under the HPCA Act
Area of practice
Total
Mental health
2
Acute care
8
Continuing care
17
Primary health care
3
Not practising
1
Total
31
Professional Conduct Committee investigations completed
The Professional Conduct Committees completed 21 investigations of
conduct during the year. This number includes some investigations that
commenced in the 2005-2006 year and a number of the 31 complaints
referred during this year.
30
Table 10 - Outcomes of investigations
Outcome
Total
Charges laid with the Tribunal
5
Charges laid and scope of practice reviewed
2
No further action
6
Letter of counsel
3
Referred for health monitoring
3
Referred for competence review
1
Referred for competence review and letter of counsel
1
Total
21
Court convictions
The Council appointed a Professional Conduct Committee to consider court
convictions. Sixteen court convictions that had been referred to this
Committee under section 68(2)(b) of the HPCA Act were considered in this
year. This number includes some court convictions that were referred in the
2005-2006 year and a number of the referrals received in this year.
Table 11 – Outcomes of court convictions
Outcome
Total
Charges laid with the Tribunal 1
9
No further action
3
Referred for health monitoring
3
Letter of counsel
1
Total
16
1
Two of the nurses who were referred to the Tribunal had also practised without
practising certificates and are included in the number below.
31
Practising without practising certificates
The Council also appointed a Professional Conduct Committee to investigate
allegations of nurses practising without practising certificates. These allegations
were referred to this PCC under section 68(3) of the HPCA Act. The Committee
considered five nurses in this year, of which two were referred as charges under
section 80(3)(b) of the HPCA Act, and no further action was taken on the remaining
three. This number includes some referrals made during the 2005-2006 year
and a number of the referrals received in this year.
Nursing Council of New Zealand hearing
There was one hearing held by the Council sitting in its disciplinary function
under the transitional provisions of the HPCA Act.
A registered nurse was charged with attempting to use alternative/spiritual healing
on clients without their consent and imposing his religious/spiritual beliefs on
relatives and/or staff. While the charges were proven, the Council did not consider
that they either singularly or cumulatively constituted professional misconduct.
Appeals to the High Court
A registered nurse who had been found guilty by the Council in 2005 of two
charges of professional misconduct appealed to the High Court against both the
Council’s finding in respect of the first charge and penalty in respect of both
charges, pursuant to section 49 of the Nurses Act. In a High Court decision
dated 2 October 2006, Wild J dismissed the nurse’s appeal.
A registered nurse who had been found guilty by the Council in 2005 of
professional misconduct appealed to the High Court against the decision of the
Council that the outcome of disciplinary proceedings against her be published.
The appeal against publication of her name was dismissed.
Health Practitioners Disciplinary Tribunal
Professional Conduct Committees prosecuted charges against eleven nurses
during the year.
Tribunal hearings
The Tribunal held 15 disciplinary hearings into complaints against 16 nurses.
These decisions are available on its website: www.hpdt.org.nz
32
Financial
statements
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52