October 7, 2026

Professional Perspectives

Professional Perspectives: Fetal heart monitoring and RN scope

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I am an RN employed at a remote NSW MPS site with no maternity facilities. Yesterday, a pregnant woman attended our facility concerned about reduced fetal movements, but there were no midwives, nor dual-qualified staff on-shift to assess her. I was asked by the Remote Medical Consultation Service (RMCS) to auscultate the fetal heart rate with a handheld doppler. Is it within my scope of practice to do this?

No. Women presenting with decreased fetal movements require comprehensive assessment and management as per local policy and pathways. This assessment must be undertaken by a midwife, who is appropriately trained and skilled in providing antenatal care including abdominal palpation and performing clinical observations on both the mother and unborn baby. If there are no appropriately skilled staff on-shift to perform this assessment, the woman must be referred to the nearest maternity facility, as per local policy.

Under the National Law, nursing and midwifery are recognised as two separate professions, with each having unique education, knowledge, skills and standards for practice and individual responsibilities. Auscultation of fetal heart sounds falls outside the scope of practice of an RN, meaning that you are breaching the NMBA’s registration standards, standards for practice, codes and guidelines.

Professional Perspectives: Finding support during MidStart

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I have been an RN for five years and have just commenced the MidStart Program. I am feeling incredibly overwhelmed studying again! Who can I turn to for help?

Being a student midwife can be overwhelming. Assignments, clinical placements and high workloads can be stressful, so it is essential that you have support to maintain your wellbeing to ultimately succeed in the MidStart program.

To assist in the development and consolidation of your midwifery knowledge, skills and practice, we encourage you to have regular conversations with senior midwives, who can offer advice, feedback and encouragement to help you navigate your midwifery studies. If you have any concerns, your mentor, Clinical Midwifery Educator and University Program Convenor should be your first contacts. Your facility may have access to an Employee Assistance Program to help you manage your wellbeing.

Alternatively, Nurse & Midwife Support provides a free, 24/7, confidential national support service for nurses and midwives, including those enrolled in postgraduate midwifery programs. You can contact them on 1800 667 877. You can also contact the NSWNMA on (02) 8595 1234.

Professional Perspectives: Redeployment and scope of practice

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I am a New Graduate “direct entry” midwife. Recently, due to staffing shortages at my facility, I have been redeployed to a general nursing ward to work in the capability of an AIN. In that role, I am caring for male patients under RN supervision. I feel unsafe. What should I do?

A “direct entry” or “single registered” midwife holds midwifery qualifications, without prior nursing registration. These midwives are trained specifically in knowledge, skills and practice relating to women’s health, reproductive and sexual health, and child and family health care only. Due to this specific scope of practice, these midwives cannot be responsible for the direct care of general patients, including males.

Rather, as per the Decision-Making Framework for Nursing and Midwifery, “direct entry” midwives can be delegated tasks to assist in the care of general patients, for example observations, medication administration, answering call bells, or any other skill within their scope of practice. They must then report all findings back to their nursing colleague, who will have ultimate responsibility for the patient. This is an example of team nursing/midwifery, where each practitioner provides their expertise collaboratively.

In this situation, it is important that you bring such scope of practice concerns to the attention of the Team Leader, NUM and/or the after-hours manager as soon as possible. This protects not only your registration, but also patient wellbeing.

Professional Perspectives: What the new RACGP Standards mean

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I’m an RN in a general practice and I heard the new RACGP Standards are out. What’s changed and new that I need to know?

The RACGP has recently published the 6th edition of the Standards for General Practices, which set out the requirements general practices must meet for accreditation. There are several new or strengthened requirements nurses should be aware of.

All active patient records must now document known allergies, or that the patient has no known allergies, in a codable field. Practices must also document each attempt to contact and recall patients with clinically significant results and have a process for following up results or investigations that have not been provided to the GP. Infection prevention requirements have also been strengthened, including safe reprocessing of reusable medical devices and traceable sterilisation load numbers to individual patients when sterile instruments are used.

There is a new focus on environmental sustainability, digital health and AI. Practices must identify climate-related risks, take steps to improve climate resilience, document strategies to reduce environmental impact, and nominate a team member responsible for sustainability. New digital health requirements address safe and secure use of technologies such as telehealth, patient portals, remote monitoring, and secure messaging, while practices using AI must address informed consent, privacy, staff training, and governance. There is also a stronger focus on staff safety and wellbeing, including managing occupational exposures, supporting staff following emergencies or incidents, and monitoring workloads. There’s also opportunity for nurses to get involved with quality improvement activities.

For more information, see https://www.racgp.org.au/running-a-practice/practice-standards/standards-6th-edition/standards-6th-edition-hub and for support with some of these new requirements, reach out to your PHN.

 

Professional Perspectives: The pathway from midwife to Endorsed Midwife

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What is an Endorsed Midwife and how do I become one?

Endorsed Midwives are experts in maternity care, providing vital and safe care for birthing women. Endorsed Midwives have been assessed and subsequently endorsed by the Nursing and Midwifery Board of Australia (NMBA) to autonomously prescribe Schedule 2,3,4, and 8 medications, appropriate for midwifery practice, and in accordance with the Health Practitioner Regulation National Law, in force in each state and territory (National Law). Additionally, Endorsed Midwives can request pathology and ultrasound imaging.

To adhere to the Registration Standard: Endorsement for Scheduled Medicines for Midwives, Endorsed Midwives must:

  • Complete an approved postgraduate program
  • Hold current general registration as a midwife in Australia with no conditions or undertakings relating to unsatisfactory professional performance or unprofessional conduct
  • Have undertaken the equivalent of three years’ full-time clinical practice (5,000 hours) in the past six years.

Professional Perspective: Continuing Professional Development and dual registration

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I am a nurse, thinking about completing my midwifery degree. What would be my CPD requirements once I am dual registered?

All nurses and midwives must complete at least 20 hours of CPD (Continuing Professional Development) every year from 1 June to 31 May, relevant to their context of practice for each registration they hold. For those registered as both a nurse and midwife, 20 hours of CPD is required for each registration. It should be noted there can be crossover of CPD, if relevant to both professions. For example, a medication module could count towards both nursing and midwifery CPD hours and can be recorded under each registration.

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