The role of an Assistant in Nursing (AIN) in an acute facility is greatly limited in terms of assisting direct patient care.
Careful consideration must be given to employing AINs in acute units of a facility, as patients requiring acute care commonly have complex concurrent needs and conditions that are unstable.
The demands of providing nursing care in the acute environment are often unpredictable and the system can be complex to navigate.
Consequently, a high level of supervision and support for AINs is required.
Regulation
The Nursing and Midwifery Board of Australia (NMBA) defines a health worker as someone who is not registered to practice under the National Law.
Students in nursing/midwifery are registered with the Australian Health Practitioner Regulation Agency (AHPRA) through their education provider, which allows the NMBA to act on health impairment matters that may affect public safety.
AINs and students must comply with the national code of conduct for unregulated health care workers. Their practice can be the subject of complaints made to the Queensland Health Ombudsman.
Advice
The QNMU is aware of facilities where health services have employed student nurses as AINs.
Registered nurses and midwives should be very familiar with the NMBA’s criteria that must be considered prior to delegating an activity to an AIN. These criteria can be found at Statement 4 of the NMBA’s Decision Making Framework for nursing and midwifery.
The QNMU advises the following in relation to student nurse employment:
- Student nurses employed as AINs in acute facilities must only undertake work consistent with the job description of an AIN.
- In accordance with the NMBA national framework for the development of decision-making tools for nursing and midwifery practice, the RN or RM must decide within a risk management framework that the nursing activity can be performed by an AIN or student.
- It is the responsibility of the RN or RM to determine, before delegating any care activity, if the AIN or student is competent (ie: has the necessary education, experience and skill to perform the activity from the nursing/midwifery care plan safely).
- The individual RN or RM responsible for implementing the care plan cannot delegate that responsibility to anyone else, including the employer or a representative of the employer.
- It is clear then that the Director of Nursing or the employer cannot delegate nursing activities on behalf of the individual RN or RM.
- The majority of nursing/midwifery work will be undertaken under the direct supervision of a RN or RM.
- If a facility employs a student as an AIN, that individual employee (student) must work as an AIN utilising skills and knowledge at the level of an AIN.
Undergraduate Student
in Nursing
Queensland’s Department of Health Nursing and Midwifery Classification Structure currently has a classification for students in nursing/midwifery within EB10 (Schedule 1 – Wage Rates). A student employed in this classification level is subject to a specific position description — Undergraduate Student in Nursing (USIN).
The decision to delegate an activity to a USIN must be “congruent with the educational goals of the program in which the student is enrolled, and with the professional role (enrolled nurse, registered nurse, midwife) that the student will undertake once they graduate” (Nursing and Midwifery Board of Australia, 2020, pg.14).
The roles of AIN and USIN are separate and distinct.
The nursing work undertaken for each distinct position will be described by the position description and determined by the RN or RM, consistent with the NMBA codes and guidelines.
References
For more information, contact Member Connect on 3099 3210 or 1800 177 273 (toll free outside Brisbane).