Registered Nurse Scope of Practice
Registered nurses use nursing knowledge and complex nursing judgment to assess health needs and provide care, and to advise and support people to manage their health. They practise independently and in collaboration with other health professionals, perform general nursing functions, and delegate to and direct enrolled nurses, health care assistants and others. They provide comprehensive assessments to develop, implement, and evaluate an integrated plan of health care, and provide interventions that require substantial scientific and professional knowledge, skills and clinical decision making. This occurs in a range of settings in partnership with individuals, families, whānau and communities.
Registered nurses may practise in a variety of clinical contexts depending on their educational preparation and practice experience. Registered nurses may also use this expertise to manage, teach, evaluate and research nursing practice. Registered nurses are accountable for ensuring all health services they provide are consistent with their education and assessed competence, meet legislative requirements and are supported by appropriate standards.
There will be conditions placed in the scope of practice of some registered nurses according to their qualifications or experience limiting them to a specific area of practice. Some nurses who have completed the required additional experience, education and training will be authorised by the Council to prescribe some medicines within their competence and area of practice.
The Nursing Council's Competencies for Registered Nurses describe the skills and activities of registered nurses.
For information, see the documents in the downloads box on this page.
Expanded practice for registered nurses
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:
- identifying the legislation and standards that support the expansion
- gathering evidence that health outcomes will be improved
- developing organisational policies to support the changes
- identifying what educational preparation, clinical supervision and assessment the nurse will require.
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.