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Margaret Cooke

Year of Award: 2013 Award State: New South Wales Health And Medicine > Nursing
To undertake a cross-jurisdictional study of regulatory requirements and programs for managing health and performance notifications about nurses and midwives to improve safety and standards - UK, Ireland, USA, Canada, New Zealand
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I am a nurse and a midwife and currently hold the position of Executive Officer of the Nursing and Midwifery Council of NSW. The objectives of the Council are to maintain professional standards and protect public safety and trust in the professions. The Council is responsible for managing conduct, performance and health impairment reports made about nurses and midwives.

The purpose of my Churchill Fellowship project was to examine the way other countries regulate nurses and midwives to minimize risk, and improve professional standards. Particular areas of interest were strategies used for early intervention and prevention.

During the Fellowship I visited five countries: UK, Ireland, US, Canada and NZ. I collected an enormous amount of information and data, learnt a great deal and made some new friends. I will use the information gained to advocate for changes in the law in Australia; facilitate improved governance by the Council; introduce and trial new techniques in the management of complaints in NSW; and facilitate collaboration with the goal of sharing intelligence to enable the early identification and mitigation of risks to public safety.

There are differences in terminology between the various jurisdictions and care must be taken when interpreting information and documents from other jurisdictions. For example, impairment in the UK relates to impaired fitness to practise generally, whereas, impairment in NSW relates specifically to physical or mental health impairment. There are many such differences in meaning in the jurisdictions and misunderstanding may have occurred. If clarification is required, I recommend that readers seek information from the regulator’s website in the first instance and if more information is needed contact the regulator directly.

Regulators function under very different legislation, which both directs and limits regulatory processes in different ways in all the jurisdictions. Sometimes these limitations of legislation lead to innovative “work arounds” and on other occasions legislative change is required. The environment in which the regulators function also differs greatly and this can significantly impact on the roles and functions of regulators, the actions taken by regulators and the relationships they form with other organisations. In short, it is complex. Nevertheless, all the regulators in the project had similarity of purpose, which was the protection of the public through the development and assurance of professional standards. 

It is unlikely that I have picked up all the nuances in the different jurisdictions in the short time I visited. I have been working and implementing the Health Practitioner Regulation National Law (NSW) for 3 years and I am still learning new things about the Law and its interpretation. 

I would like to thank the Churchill Trust for making the project possible, the Health Professional Regulation Agency and the Nursing and Midwifery Council for allowing me the privilege of doing the project and all my colleagues with whom I work (especially Kim Bryant) for continuing their excellent work while I was away.

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