Today’s correspondent asks
If a Registered Nurse is retired, but registered as a non-practising, they can use the title for personal reasons but are they allowed to still practice as an RN?
Scenario:
RN is retired and registered as non-practising. RN works for a Event Medical Service. Can that individual still identify themselves as an RN through e.g. epaulettes/tabbards and therefore also treat patients up to the allowed scope of a registered, practising RN?
By definition a non-practising nurse cannot practice as a nurse. The Nursing and Midwifery Board publishes a fact sheet on non-practising registration – see https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/FAQ/Non-practising-registration-for-nurses-and-midwives.aspx#. It says:
Non-practising registration would apply to a person who wishes to retain a protected nursing and/or midwifery title but:
- has retired from nursing or midwifery practice
- is experiencing an illness, or
- is intending to take a long period of absence from practice.
As a matter of professional etiquette, the NMBA expects the non-practising registrant to make it clear that they hold non-practising registration.
If you are practising in the profession you must be on the national register with a registration type other than ‘non-practising’.
Practice is:
… any role, whether remunerated or not, in which the individual uses their skills and knowledge as a health practitioner in their profession. For the purposes of the Board’s standards, practice is not restricted to the provision of direct clinical care. It also includes using professional knowledge in a direct non-clinical relationship with clients, working in management, administration, education, research, advisory, regulatory or policy development roles, and any other roles that impact on safe, effective delivery of services in the profession.
A non-practising nurse ‘cannot identify themselves as an RN through e.g. epaulettes/tabbards and therefore also treat patients up to the allowed scope of a registered, practising RN’ because if they did they would be a practising, not a non-practising RN and that would be inconsistent with their registration status.
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Australian Emergency Law 
There is another dimension to this question which is about non-practicing RN/paramedic/medical practitioners who then instead are recognised as first aiders/first responders/EMTs/etc. and are using their professional knowledge base but not maintaining their registration.
I have always held the view that these things were incompatible, that is you either needed general practicing registration or no registration, and recognition as a first aider, as opposed to someone having non-practicing registration AND being a first aider. It becomes difficult to seperate the generalist nature of the care being provided and the professional skills of one of those practitioners.
Indonhwoever wonder if the basis for understanding this from a regulatory perspective is within the meaning of non-practicing registration? For instance, if we accept that the person is NOT practicing then doing first aiders and not identifying themselves as a nurse/paramedic/doctor is technically in keeping with the expectations upon them…? And as far as the expectations of the regulator, I’m not sure if they would consider the person to be skirting the edges of what is practice or not, but it seems a bit messy/unclear.
Any thoughts?
A non-practising health practitioner is welcome to practice in the health field eg as an event first aider provided they do not use the title related to their registration. That is, in the scenario described there would be no issue if the person did not ‘identify themselves as an RN through e.g. epaulettes/tabbards’. As for scope of practice that is defined by what you know, not what you are called.
When I was an RN in NSW, I was deregistered for something I did out on the public street, not in uniform, not in the workplace, on my days off.
Certainly nothing ‘clinical’, however, the matter was deemed “In the practise of Nursing” ( a Section in the Act ), and they ‘threw the book at me’.
Any Health Professional is scrutinised 24/7 … both in the workplace and in the wider community.
You are labelled, just as anyone who has ever been under your care at any time, will always be labelled YOUR ‘patient’ ( Nurses don’t have patients … they are the hired help, on an hourly wage. It is the Consultant doctor who has the patient assigned to them ).
A Health Professional can never have a friendship with a patient ( even when in the community on the HP’s non work time ).
The ‘grey’ area is never spoken about . No clarification of the UNWRITTEN rule ( it is obvious, about in the workplace … but what about meeting an ex patient in a social context ? )
Gordon, I don’t think the point your making is really relevant to the question of a person with non-practising registration both practising and holding themselves out as if they were registered to practice.
Whether Nurses have patients or are ‘hired help, on an hourly wage’ would depend on the circumstances. Where and how nurses work is varied. A theatre nurse who has never met the patient may fit the description you’ve given, but a nurse working regularly with patients in a residential care facility has quite different relationships.
But yes, conduct that takes place away from work can affect one’s standing as a health professional for example health practitioners are disciplined and sometime struck off for criminal behaviour that occurred no-where near their practice as it affects the assessment of whether they are a fit and proper person to hold registration. And yes, there is lots of literature around the power imbalance between practitioners (of all sorts) and those under their care and therefore why social – and in particular sexual – relationships are considered improper. These are matters that are spoken about and are significant issues in an understanding of health care ethics. Your own case may even help inform that discussion. As I’ve noted before, your description of your own matter does not accord with what the Tribunal says your case was about – https://www.austlii.edu.au/cgi-bin/viewdoc/au/cases/nsw/NSWCATOD/2023/35.html. The judgment describes conduct which, according to the tribunal most of which you admitted, (see [15]) as much more than a social interaction with an ex-patient outside the workplace.
Except, the HCCC work on the ‘balance of probabilities’, and take the facts out of context.
More than half of what is printed is false. The media at the time were even worse, making the situation seem like a criminal offence, when it was not.
I was advised by the Union lawyer, not to attempt to defend myself. The NMWA abandoned me.
What none of the authorities accept, is that a person labelled as a patient, has basic rights …. including to choose their own friends. The prejudice of those with any mental health history is still as much alive today, as it was a century ago.
As you should know, the Law isn’t always fair and just.