New website for Nurses & Midwives to navigate: Changes for 2010

The year has began and for me it is going to be a very busy year with all the expected legislative changes affecting Nursing and Midwifery for Australia with National Registration being one of them.

The Australian Health Practitioner Regulation Agency Website:

This will be the website for updated information relating to National Registration for July 2010.

Here are some key points from Louise Morauta Project Director:for the full report see Australian Health Ministers’ Advisory Council
National Registration and Accreditation Implementation Project
PROJECT UPDATE DECEMBER 2009
The national law has now been passed in Queensland and adopted in New South Wales and Victoria. The adopting legislation has also been introduced but not yet passed in Tasmania, ACT, and NT. What is happening to WA? we have to wait until Parliament re commences for the New Year. The expectation is that the legislation will be passed in all jurisdictions in time for commencement day on 1 July 2010.

The boards commenced work with their first meeting on 20 September 2009.
Work commenced in November on the data migration project which transfers information from the existing boards to the new national boards.
The Agency announced Martin Fletcher as its inaugural CEO on 18 September 2009.
Martin commences on 21 December 2009.


Nursing and Midwifery Board of Australia

From 1 July 2010 Nurses and Midwives across Australia will have to meet the same requirements to be registered and their registration will be recognised in all States and Territories. Wow I have been waiting for this for about 20 years... that's a long time for change to occur......these things move very slowly and this just proves it.

The Board was established under the Health Practitioner Regulation (administrative arrangements) Act, 2009. From 1 July 2010 the Board will operate with its full range of functions under the Health Practitioner Regulation National Law (the national law) where adopted in a jurisdiction.

Members of the inaugural Nursing and Midwifery Board of Australia were appointed by the Australian Health Workforce Ministerial Council for a period of three years on 31 August 2009 and here they are if you don't already know.

Ms Gillie Anderson - Appointed as a community member
Ms Angela Brannelly - Appointed as a practitioner member (registered nurse and midwife) from the Northern Territory
Professor Elizabeth (Mary) Chiarella - Appointed as a practitioner member (registered nurse) from New South Wales
Ms Anne Copeland - Appointed as Chair and a practitioner member (registered nurse and midwife) from Queensland
Dr Lynette Cusack - Appointed as a practitioner member (registered nurse) from South Australia
Professor Denise Fassett - Appointed as a practitioner member (registered nurse) from Tasmania
Mrs Lynne Geri - Appointed as a practitioner member (enrolled nurse) from Victoria
Ms Louise Horgan - Appointed as a practitioner member (registered nurse) from Western Australia
Ms Mary Kirk - Appointed as a practitioner member (registered nurse and midwife) from the ACT
Dr Christine Murphy - Appointed as a community member
Ms Heather Sjoberg - Appointed as a community member
Ms Margaret Winn - Appointed as a community member

There are some familiar names here for me and I even know a few....don't know what that says about me....for that's enough information.... keep watching for more...

Cyber Talk and Midwives

Tonight I presented a lecture about Cyber talk: The presentation was a brief introduction to the Internet, focusing mainly on blogging. The aim of the presentation was to raise the awareness of midwives about the internet, who blogs and why, also to highlight the legal and professional responsibility of cyber mediums such as Facebook, MySpace, Skype, YouTube, Twitter and blogging. Currently there are approximately 22million blogs online. Blogs are becoming one of the fastest growing mediums for discussions relating to marketing, legal issues, health, political activism and social change.1


So, what is a blog? It’s a journal, reflection, diary, newsreel or a newsletter. However you describe it, it is something you write that is personal and informal for the world to read. Blogs are designed for the public forum – they can be updated daily, weekly, monthly or whenever the writer chooses. Blogs are very easy to set up – any of the major search engines will direct you to a site of your choice and you simply follow the instructions. 2

Major legal issues surrounding publishing on the Internet relate to: defamation, copyright, trademarks, moral rights and confidentiality. I am sure there are more but for now I will concentrate on these relating to midwifery.

All Midwives be they; community, independant, hospital based are bound by legislation such as the Nurses and Midwives Act. Within this framework we are regulated by the ANMC Code of Conduct (2008),

Code of Ethics(2008) &

The Competency Standards for the Registered Midwife (2006). If midwives fail to meet the required standards of these Codes, then they can face disciplinary action as stated within the legislation. Therefore midwives need to know and understand what the Codes mean and how they work. It is important to remember when you are blogging to be professional at all times, being mindful not to bring our profession into disrepute. Once something is published on the web it is very hard to delete, it is passed around the cyber world like lightening creating lots of threads and being saved in different places.

There are many health professionals blogging, sharing stories, practices, education and reflecting care given. This increases the risk of breaking patient/client confidentiality due to the blogger or authors sharing too much information, such as subspecialties, names, places and content.

The Journal of General Internal Medicine published an article titled “STUDY HIGHLIGHTS RISK OF BREAKING CONFIDENTIALITY IN BLOGS” this was a study that examined 271 medical blogs and found that 56% of the blogs contained enough information to reveal the author’s identity. 3 The study found that blogging was a great way to reach both patients and health professionals so long as people were responsible about it. However “blogging does pose serious concerns about confidentiality and bringing the profession into disrepute. 3”

Defamation occurs when one person communicates material that damages the reputation of another. This can be verbal, written or pictures and the publication must reach someone else other than the person being defamed. However there are several defences to defamation such as: is it a ‘fair comment’ on a matter of public interest or was it simply an opinion, was it an honest opinion of the author 3.

ANMC Professional conduct refers to the manner in which a person behaves while acting in a professional capacity. It is generally accepted that when performing their duties and conducting their affairs professionals will uphold exemplary standards of conduct, commonly taken to mean standards not generally expected of lay people or the ‘ordinary person in the street’.

The moral from this evening's presentation is to know your ANMC Codes inside out, they provide you with a tremendous framework. As for my presentation, I must remember to have my cheat sheet with me, because once I start talking lots of new ideas come through and I forget the ones I was going to focus on. This is such a massive topic that I really just tipped the iceberg.

Happy Blogging - 'have blog will travel'



References:
1. Sylvia Mercado-Kierkegaard, Blogs, lies and the doocing: The next hotbed of litigation? Science Direct.
2.http://www.artslaw.com.au/legalinformation/LegalIssuesForBloggers.asp
3. BMJ 2008;337:a1043; Study highlights risk of breaking patient confidentiality in blogs.

All Australian legislation makes reference to Indemnity Insurance for (independent) midwives:

South Australia currently has the Nurses and Midwives Bill 2008 going through parliament (As laid on the table and read a first time, 23 September 2008) – what is good about this legislation is that the definition of

midwifery means any treatment, care or advice provided by a person to — (a) a woman in relation to her pregnancy; woman or child in relation to the birth of the child, (whether such treatment, care or advice is provided)

‘midwifery’ ( is much more defined in the SA Bill than the Nurses & Midwives Act 2006 WA ('midwifery' means the practice of assisting a woman in childbirth) our definition of 'midwifery' is very broad– however definitions aside, both legislations puts restrictions on midwives when it comes to indemnity insurance.

This is the South Australia Nurses & Midwives Bill 2008 section 41 page 27 states:
“41—Services providers to be indemnified against loss

1) A services provider must not, unless exempted by the Board, provide nursing or midwifery care through the instrumentality of a nurse or midwife unless insured or
15 indemnified in a manner and to an extent approved by the Board against civil
liabilities that might be incurred by the nurse or midwife or services provider in
connection with the provision of such care.
Maximum penalty: $10 000.
(2) The Board may, subject to such conditions as it thinks fit, exempt a services provider,
20 or a class of services provider, from the requirements of this section and may, whenever it thinks fit, revoke an exemption or revoke or vary the conditions under which an exemption operates.”

(This is very similar to the West Australian Nurses & Midwives Act 2006: Section 32 Professional indemnity insurance page 24 states.....2 “(a) that – (i) the nurse or midwife must hold professional indemnity insurance: (ii) the professional care provided by the nurse or midwife must be covered by professional indemnity insurance. (iii) the nurse or midwife must be specified or referred to in professional indemnity insurance......(b) that the professional indemnity insurance must meet the minimum terms and conditions approved by the Board.” 4. The Board may, on its own motion or on the application of a person the subject of a condition imposed under this section, on reasonable grounds, revoke or vary the condition.”

What does this all mean: the bottom line is the word “MAY” it is very open and powerful. This is the word that is detrimental for independent midwives. It means that The Board can insist that before you can register as a midwife you have to have indemnity insurance.

I know the Australian College of Midwives is actively trying to find and insurer before National Registration comes in, we have to work together to resolve this issue. This is a worldwide problem, not just synonamous to Australia.

Reference: http://www.parliament.sa.gov.au/BillsMotions/
http://www.slp.wa.gov.au/legislation/statutes.nsf/main_mrtitle_647_homepage.html

Finally a direction: Legal & Ethical issues in Midwifery

This is my newest grandchild due 12 July 2008 - 20 week scan.

I have been bloging for about 10 weeks now. During this time I have experimented with different topics and I have not had any clear direction, except that I wanted to share knowledge with women and midwives regarding pregnancy and childbirth. I have read many other blogs from both midwives and women, some of them have a theme and others do not. I also enjoy having a commentary regarding the subject material. At this point I would like to acknowledge the support of fellow blogers Carolyn McIntosh and Sarah Stewart who have been good mentors. I do find it frustrating sometimes when I do not have the technical / computer skills required to do the things I want to do with my blog. This then entails reading pages of material trying to put a link on the blog. Despite these challenges I do enjoy bloging and find that it is quite contagious even though it can be time consuming. However, I have decided that as an educator it is important to focus on a particular area within my scope of practice. My passion is “law” and “ethics”, to get the message across to midwives the importance of professional practice issues; these being; Legislation that governs our practice, ANMC Competency Standards, ANMC Code of Ethics, Code of Conduct and Nurses & Midwives Board requirements, negligence, confidentiality, consent, documentation, Scope of Practice and any other topic that may come under this heading. This means that this blog will now specifically look at legal and ethical issues (women's rights vs fetal rights) relating to pregnancy and childbirth, of which there are many. If you as a reader of this blog have any questions or issues that you would like to discuss and or cover please just leave me a comment and I will follow it up. Each month I will cover a legal or ethical topic relating the subject to legislation and midwifery practice. If you have any burning issues please ask the question or share the experience so that we may all learn from it.