Registered nurse scope of practice
Registered nurses in Aotearoa New Zealand incorporate knowledge, concepts and worldviews of both tangata whenua and tangata tiriti into practice.
Registered nurses uphold and enact ngā mātāpono – principles of Te Tiriti o Waitangi, based on the Kawa Whakaruruhau framework and cultural safety, promoting equity, inclusion, diversity, and rights of Māori as tangata whenua. These concepts also relate to Pacific peoples and all population groups to support quality services that are culturally safe and responsive.
Registered nurses are accountable and responsible for their nursing practice, ensuring that all health care provided is consistent with their education, assessed competence, relevant legislative requirements, and is guided by the Nursing Council of New Zealand’s standards for registered nurses.
Registered nurses use substantial scientific and nursing knowledge to inform comprehensive assessments, determine health needs, develop differential diagnoses, plan care and determine appropriate interventions. Interventions are evaluated to assess care outcomes based on clinical judgement and scientific and professional knowledge.
Registered nurses practise independently and in collaboration with individuals, their whānau, communities, and the interprofessional healthcare team, to deliver equitable person/whānau/ whakapapa-centred nursing care across the life span in all settings.
Registered nurses may also use their expertise in areas and roles such as leadership, management, education, policy and research.
Conditions may be placed on the scope of practice of some registered nurses, dependent on their qualifications and/or experience, limiting them to a specific area of practice. Nurses who have additional experience and have completed the required education will be authorised by the Council to prescribe some medicines within their area of practice and level of competence.
Registered nurses are responsible and accountable for directing and delegating to members of the healthcare team. Registered nurses provide support and guidance to enrolled nurses.
For the avoidance of doubt in other legislation where nurse is defined, this scope of practice includes general nursing and nursing functions.
Nurses often take responsibility for health care activities or roles that could be considered an expanded practice role. Before undertaking an expanded practice role the nurse may complete further education practice with clinical supervision or complete an assessment. Before expanding practice, the nurse and the employer should together consider a number of issues, including:
A flow chart showing the decision-making process for expanding the scope of nursing practice is included in the downloads box on the right of this page. Guidelines for an expanded practice role are also available in the downloads box on this page.