Nurses are regulated by An Bord Altranais or the Nursing Board. It maintains the registers of nurses.
The Board consists of representatives of various types of nursing: nurses engaged in administration, nurses engaged in clinical nursing, persons appointed by the minister including representatives of various related bodies, medical practitioners, health boards. The nursing representatives are elected. The register may be registered into divisions as the minister directs.
The board may approve education and examination requirements. It may hold examinations and approve hospitals and other institutions for training purposes. The board must ensure compliance with minimum EU standards.
Enquiries into alleged professional misconduct or unfitness to engage in practice by reason of physical or mental disability are dealt with by a fitness to practise enquiry. An initial enquiry is made upon a complaint being made.
If there is a prima facia case for holding an enquiry, it is held. The enquiry has similar powers to a High Court Judge in relation to calling witnesses and compelling attendance and answering. It is an offence not to co-operate.
The Council generally makes its decision on the basis of the Committees\’ finds and give directions. There are a range of sanctions up to suspension and strike off. Conditions may be attached to the continuation of registration.
The person concerned may appeal to the High Court. Where the person does not appeal the board may apply to the High Court for confirmation of the decision, in the case of major sanctions. The High Court confirms the decision unless there is a good reason to the contrary.
Nurses and Midwives Act 2011
The Act is designed to update provisions relating to the regulation of nurses and midwives by the regulatory body and to enhance the protection of the public in its dealing with these professions. The Act is consistent with the commitment in the Health Strategy, ‘‘Quality and Fairness — A Health System for You’’ to strengthen and expand provisions for the statutory registration of health professionals, including nurses and midwives.
The existing Nurses Act 1985 provided for the establishment of An Bord Altranais and the regulation of the professions of nursing and midwifery. Since that time there have been many developments and changes in nursing and midwifery and in the regulatory framework governing other health professionals. The expectations of the public have greatly increased since the 1985 Act was passed. There is a need to ensure stronger governance and accountability.
The purpose of the Act was to enhance the protection of the public in its dealings with nurses and midwives and to ensure the integrity of the practice of nursing and midwifery. It was designed to provide for a modern, efficient, transparent and accountable system for the regulation of the nursing and midwifery professions, which will satisfy the public and these professions that all nurses and midwives are appropriately qualified and competent to practice in a safe manner on an ongoing basis.
Principal Elements of the Act
The main elements of the Act are as follows:
- Provision for the repeal of the Nurses Act 1985 and for a new legislative framework in respect of nurses and midwives.
- Provision for the enhanced protection of the public in its dealings with nurses and midwives.
- Provision for a regulatory body to be known as Bord Altranais agus Cnáimhseachais na hÉireann, or the Nursing and Midwifery Board of Ireland and an explicit statement that it performs its functions in the public interest.
- The recognition of midwifery as a separate and distinct profession. Provides for clinical supervision of midwives who must have adequate indemnity insurance.
- The provision of a non-nursing/midwifery majority on the Board and on the Fitness to Practise Committee.
- The provision of a stronger governance and accountability structure for the Board.
- An improved investigation mechanism for complaints about nurses and midwives including the setting up of an assessment committee prior to Fitness to Practise investigations and the appointment of investigators to facilitate such preliminary investigations.
- Prohibition on unregistered nurses and midwives engaging in the practice of nursing or midwifery.
- Registration of nurses and midwives and also registration of candidates and the registration of Advanced Nurse/Midwife Practitioner posts.
- Approval of programmes of education and further education necessary for the purposes of registration.
- Specification of standards of practice for registered nurses and midwives and guidance on all matters related to professional conduct and ethics.
- A new statutory framework for the maintenance of professional competence of registered nurses and midwives.
- An obligation on employers to facilitate the maintenance of professional competence of nurses and midwives in particular by providing learning opportunities in the workplace.
- Fitness to Practise inquiries will generally be held in public.
The Fitness to Practise Committee may decide, on application by the nurse or midwife or a witness, including the complainant, to hold some or all of an inquiry in private, depending on the circumstances.
Dissolution of the National Council for the Professional Development of Nursing and Midwifery and the transfer of its staff, assets and liabilities into the Board.
The 2011 Act provides for the continuance in being of the Board but with a new name — Bord Altranais agus Cnáimhseachais na hÉireann or, in the English language, the Nursing and Midwifery Board of Ireland. It also includes saving provisions for matters which have been commenced by the Board under the 1985 Act but not completed at the time of its repeal. This section also provides for the Board to regulate its own procedures, subject to the provisions of the Act.
The objective of the Board, which is the protection of the public in its dealings with nurses and midwives and the integrity of the practice of nursing and midwifery through the promotion of high standards of professional education, training and practice and professional conduct among nurses and midwives.
Functions of Board
The Board will perform its functions in the public interest. Its functions=
- include the registration of nurses, midwives,candidates and Advanced Midwife Practitioner /Advanced NursevPractitioner posts,
- the regulation of nursing and midwifery education and training and matters relating to the recognition of qualifications of nurses and midwives, including the recognition of qualifications awarded in other countries.
The Board’s functions also include:
- the setting of standards of practice and ethical guidance for nurses and midwives and the maintenance of their professional competence, the specification of criteria for the creation by employers of specialist posts,
- the handling of complaints and inquiries relating to the conduct of nurses and midwives and advising the public on all matters of general interest relating to the functions of the Board and relating to nurses and midwives and their practice.
The Board also has functions in relation to advising the Minister and in appointing and setting standards for clinical supervising authorities for midwives.
The Board is to have regard to the functions performed by other bodies which are similar to the functions of the Board and the policies and objectives of the Government to the extent that they relate to the functions of the Board and to ensure the most effective and efficient use of resources.
The Minister may confer additional functions on the Board by order and that any such order made must be laid before each House of the Oireachtas.
There is power for the Minister to give general policy directions in writing to the Board in relation to its functions, excluding matters relating to professional conduct and ethics andfitness to practise.
Rules by Board
The Board has power to make rules on a range of matters , including the operation of committees, registration, the receiving of evidence by the Preliminary Proceedings Committee and the Fitness to Practise Committee, the setting of standards and criteria in relation to nursing and midwifery education and training, clinical supervising authorities for midwives, requirements for indemnity insurance for midwives and any professional competence scheme.
Rules will be subject to publication in draft form, to a public consultation and to Ministerial approval. The Minister for Finance must give consent to any rules relating to a professional competence scheme. Rules must be laid before each House of the Oireachtas.
The Board may prepare and publish guidelines on the manner in which the Board proposes to perform its functions.
Unregistered nurses and midwives may not practise nursing or midwifery or advertise that they practise that profession. It also protects the title of advanced nurse practitioner, advanced midwife practitioner, nurse practitioner and midwife practitioner.
A person is prohibited from attending a woman in childbirth for payment, unless the person is a midwife with adequate indemnity insurance, a registered medical practitioner or a person undergoing training to be a medical practitioner or training as a midwife or undergoing training in obstetrics. It states that it is not an offence if the person attends in an emergency situation.
It provides that it is an offence to contravene this section. Penalties for summary convictions are a maximum fine of €5,000 and/or 6 months imprisonment. Penalties on convictions on indictment are, for a first offence, a maximum fine of €65,000 and/or 5 years imprisonment and for a subsequent offence, a maximum fine of €160,000 and/or 10 years imprisonment.
Registered midwives can perform a DAHR (donor assisted human reproduction) procedure. Currently only registered medical practitioners and registered nurses can perform these procedures.