According to Roy Morgan Research, nurses continued their supremacy of Australia’s most highly regarded professions with “94% of Australians in 2017 (up 2% from 2016) rating nurses ‘very high’ or ‘high’ for their ‘ethics and honesty’”. Since inception of the annual Image of Professions survey by Roy Morgan in 1994, nurses have remained at the top as the most trusted of all professions.
The fact that this is so should be no surprise. A Code of Professional Conduct for Nurses in Australia was first published in 1990, which provided guidance on minimum standards of conduct expected of members of the nursing profession. It should also be no surprise that the then Australian Nursing Federation (ANF) was a lead organisation in the Code’s development, and has continued involvement over the years since in subsequent revisions. Again, in 2008, the ANF contributed to the first Code of Professional Conduct for Midwives in Australia.
Given the good standing of nurses and midwives in the community, it’s reasonable to conclude these Codes have played their part in upholding standards of professional conduct above what could be expected of the ‘ordinary person in the street’ (Nursing and Midwifery Board of Australia, 2010 ).
Since 2010, the practice of nurses and midwives has been governed by the Health Practitioner Regulation National Law Act 2009 (the National Law)(Office of the Queensland Parliamentary Counsel, 2008). Registration standards, codes and guidelines for nurses and midwives fall within that National Law, and this has included the Codes of Professional Conduct. Whether they provide direct care to individuals or communities, or use their nursing or midwifery knowledge in management, research, education or policy roles, all nurses and midwives on the register are bound by these codes for their professional behaviour.
Under the National Law, the Nursing and Midwifery Board of Australia (NMBA) is obliged to review all standards, codes, and guidelines for the nursing and midwifery professions on a regular basis. This ensures these documents remain evidence-based and relevant to contemporary professional and societal expectations and needs. Earlier this year the NMBA commenced a process of revising the Code of Professional Conduct for Nurses in Australia and the Code of Professional Conduct for Midwives in Australia. Extensive research included a review of relevant international and national literature and other codes of conduct; an analysis of notifications (complaints) made about the conduct and behaviour of nurses and midwives; workshops with key groups, key stakeholder working groups (one each for the nursing and midwifery professions); focus groups; and, a period of public consultation. During this process the decision was taken to streamline documentation by incorporating the Nurses’ guide to professional boundaries and Midwife’s guide to professional boundaries within the Codes of conduct documents.
In its submission to the public consultation, the ANMF requested the NMBA consider combining the Codes of Conduct and the Codes of Ethics for the professions into one document, just as the Professional Boundaries document had been incorporated within the Codes of Conduct document. We argued there is an extensive number of regulatory documents that nurses and midwives need to read and consider in order to safely undertake their day to day practice. It thereby makes sense to streamline their professional reference material by combining the Codes into one document, as is the case in the United Kingdom (Nursing and Midwifery Council, United Kingdom). However, there wasn’t sufficient support from all stakeholders for a merging of the Codes of conduct and Codes of Ethics, for this notion to be pursued at this time.
Although there was overwhelming support from nursing for one Code of conduct for nurses and midwives, the NMBA has elected to stay with two Codes. On 1 March 2018 a new Code of conduct for nurses and a new Code of conduct for midwives will come into effect. These documents are essentially the same except for the different terminology of ‘person-centred practice’ and ‘woman-centred practice’ respectively. The codes are substantially different from the predecessors in language and layout. Of particular importance is a focus on Aboriginal and Torres Strait Islander peoples’ health and cultural safety. Members’ attention is specifically drawn to a definition of ‘Cultural safety’ in the Glossary, which has been provided by our colleagues at the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM). Other notable inclusions are mandatory reporting, bullying and harassment, end-of-life care, and, professional boundaries.
The new Codes documents for nurses and midwives feature four domains, namely:
- practise legally;
- practise safely, effectively and collaboratively;
- act with professional integrity;
- promote health and wellbeing.
Under these domains are principle and value statements to guide professional behaviour and conduct expectations for all nurses and midwives, irrespective of context of practice. This includes those in direct clinical care, and those working in non-clinical roles such as management, education, research, regulation, or policy.
While the primary intent of the Codes of conduct is to guide professional behaviour and conduct of nurses and midwives, they also serve as the standards the public can expect from nurses and midwives in Australia.
Julianne Bryce, Elizabeth Foley and Julie Reeves
Federal Professional Officers
1 Roy Morgan Research. http://www.roymorgan.com/findings/7244-roy-morgan-image-of-professions-may-2017-201706051543
2 Nursing and Midwifery Board of Australia. 2010. Code of Professional Conduct for Nurses in Australia. (adopted from Australian Nursing & Midwifery Council, 2008), available at www.nursingmidwfieryboard.gov.au
3 Office of the Queensland Parliamentary Counsel. Health Practitioner Regulation National Law Act 2009. Available at: https://www.legislation.qld.gov.au/view/html/inforce/current/act-2009-045
4 Nursing and Midwifery Council, United Kingdom. The Code: Professional standards of practice and behaviour for nurses and midwives. Available at: https://www.nmc.org.uk/standards/code/