Categories of Nurses in Australia

AIN – Assistant In Nursing
EN – Enrolled Nurse
EEN – Endorsed Enrolled Nurse
RN – Registered Nurse
Midwife – RN Midwifery
NP – Nurse Practitioner

AIN – Assistant In Nursing

An Assistant in Nursing is an employee who essentially works under the direction and supervision of a Registered Nurse, assisting in the performance of nursing duties.

Other similar abbreviations include Assistant in Nursing (A.I.N), Aged Care Worker (ACW), Personal Care Assistant (PCA), Care Support Employee (CSE) and Health Services Assistance (HSA).

Generally speaking (depending on where you work), AIN’s perform duties such as assisting with patient cares and activities of daily living, attending to patient’s personal hygiene needs such as showering & toileting, restocking & looking after equipment & helping patients mobilise / reposition etc.

AIN’s work under the direction of an RN or EN, and potentially have a career pathway to work towards a Certificate IV Aged Care Certification, become an Enrolled Nurse, or continue further studies to become a Registered Nurse.

Most AIN positions require either:

• TAFE qualifications as an Assistant in Nursing Certificate III Acute Care
• Certificate III in Aged Care, or
• Proof of current studies towards EN/RN qualifications

A Certificate III course generally runs over 5 months full-time or 11 months part-time.

EN – Enrolled Nurse

EN’s undertake an 18 month or 2 year course at TAFE or related Health Facilities to achieve a Diploma in Enrolled Nursing.

An Enrolled Nurse is a second level nurse who provides nursing care, working under the direction and supervision of a Registered Nurse. The supervision may be direct or indirect according to the nature of the work delegated to the enrolled nurse.

At all times, the enrolled nurse retains responsibility for his/her actions, and remains accountable in providing delegated nursing care.

Some of the roles Enrolled nurses in Australian hospitals perform, depending on their clinical area of employment, include:

• Maintain patients healthcare by observing, measuring and recording patients’ temperature, pulse, respiration, blood pressure and, when necessary, blood sugar levels, and report changes in patients’ condition to doctors
• Assist with bathing, showering, dressing and bed making to ensure patients’ hygiene and comfort
• Feed patients when required, and support patients during rehabilitation with exercises and programs
• Assist in first aid and emergency situations
• Help educate patients on health and lifestyle issues
• Help maintain a safe environment and help minimalise injuries

ENs contribute to care planning but may not act independently, as the RN or midwife retains overall responsibility. For example, when ENs accept a delegation, they may not re-delegate that activity to another person.

EEN – Endorsed Enrolled Nurse

Changes to accreditation as an Enrolled Nurse are currently being discussed at State/Territory/Commonwealth level in order to achieve consistency across Australia. Basically at present to become an Enrolled Nurse you need to complete an enrolled nurse program which may involve study at a TAFE college or other provider and employment in a hospital.

Endorsed Enrolled Nurses have completed further medication endorsement to their training. EEN’s, who are authorised, may administer Schedule 2, 3, 4 and 8 medications via all routes, except intravenous, epidural, intraventricular and intrathecal. Any medication, which requires checking prior to administration, must be checked with a Registered Nurse or Midwife.

EEN’s are further excluded from administering fluids or medications via CVC lines, PICC lines, Femoral lines, implanted devices or Arterial lines.

They can however, check change and titrate intravenous therapy solutions that have not had any medications/substances added.

RN – Registered Nurse

Registered Nurses have:

• Three years study/training at University and Health Facility to achieve a Bachelor Degree in Health Science (Nursing) or Bachelor Degree in Nursing.
• High level of accountability and more responsibility than EN or AIN Regulated by the Nurses and Midwives Board.
• Roles may include administration, team leader or unit manager duties, medication administration, assessment and management of the client including complex nursing care, specialised nursing care or undertaking research.

An RN is a person with appropriate educational preparation and competence for practice, who is registered and licensed under the appropriate Nursing Act to practise nursing in Australia.

The national competency standards give certain responsibilities exclusively to RNs and midwives, giving them more autonomy in their practice decisions than other nurses. RNs and midwives are then responsible for ensuring the quality of the work through their involvement in teaching, competence assessment, supervision and the evaluation of clients’ outcomes.

Midwife

A midwife is a person with appropriate educational preparation and competence for practice, who is licensed under the appropriate Nursing Act to practise midwifery in Australia. Most midwifes are also licensed Registered Nurses who have additional midwifery qualifications. Their licence records that they are a registered nurse with a midwifery endorsement.

The midwife is recognised as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labour and the postpartum period, to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant.

This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures.

The midwife has an important task in health counselling and education, not only for the woman, but also within the family and the community. This work should involve antenatal education and preparation for parenthood and may extend to women’s health, sexual or reproductive health and child care.

A midwife may practise in any setting including the home, community, hospitals, clinics or health units.

NP – Nurse Practitioner

A nurse practitioner is a registered nurse educated and authorised to function autonomously and collaboratively in an advanced and extended clinical role.

Most Nurse Practitioner courses take 1.5 – 2 years of additional study, and require applicants to:

• hold a nursing or midwifery degree or equivalent degree qualification
• be a registered nurse or midwife
• hold a current practising certificate
• have a minimum of 3 years post-registration experience preferably in a specialty area
• be recognised as an advanced practice nurse/midwife in a specified area of practice, and demonstrated excellence within that role, and
• demonstrate a commitment to, and the capacity to contribute to innovation and leadership within their scope of practice, and provide a completed and signed ‘Clinical Support’ form as evidence that their employer is willing to facilitate the extended clinical practice components of the course within their workplace and/or an affiliated health agency will facilitate the clinical practice in a supernumery capacity

Faculty Boards may, under certain circumstances and subject to specific conditions, admit others who can show evidence of fitness for candidature.

The nurse practitioner role includes assessment and management of clients using nursing knowledge and skills and may include (but is not limited to)

• the direct referral of patients to other health care professionals,
• prescribing medications, and
• ordering diagnostic investigations.

The nurse practitioner role is grounded in the nursing profession’s values, knowledge, theories and practise and provides innovative and flexible health care delivery that complements other health care providers.

The scope of practice of the nurse practitioner is determined by the context in which the nurse practitioner is authorised to practise.

(Job descriptions and information courtesy of health.qld.gov.au, NMB Competencies, GP Qualifications, QNC Scope of practice )