Nursing Sans Frontieres: A Three Year Case Study of Multi-State Registration of Support Nursing Practice Using Information Technology

Abstract

Objective:
To highlight the registration issues for nurses who
wish to practice nationally, particularly those practicing
within the telehealth sector.
Design:
As part of a national clinical research study,
applications were made to every state and territory
for mutual recognition of nursing registration and
fee waiver for telenursing cross boarder practice for a
period of three years. These processes are described
using a case study approach.
Outcome:
The aim of this case study was to achieve
registration in every state and territory of Australia
without paying multiple fees by using mutual
recognition provisions and the cross-border fee waiver
policy of the nurse regulatory authorities in order to
practice telenursing.
Results:
Mutual recognition and fee waiver for cross-border
practice was granted unconditionally in two states:
Victoria (Vic) and Tasmania (Tas), and one territory:
the Northern Territory (NT). The remainder of
the Australian states and territories would only
grant temporary registration for the period of the
project or not at all, due to policy restrictions or
nurse regulatory authority (NRA) Board decisions.
As a consequence of gaining fee waiver the annual cost
of registration was a maximum of $145 per annum as
opposed to the potential $959 for initial registration
and $625 for annual renewal.
Conclusions:
Having eight individual nurses Acts and NRAs for a
population of 265,000 nurses would clearly indicate a
case for over regulation in this country. The structure
of regulation of nursing in Australia is a barrier to the
changing and evolving role of nurses in the 21st
century and a significant factor when considering
workforce planning.