NURSES AND MIDWIVES: SUBSIDIARY LEGISLATION

INDEX TO SUBSIDIARY LEGISLATION

Nurses and Midwives (Disciplinary) Regulations

Nurses and Midwives (Education) Regulations

Nursing Council for Botswana (Badge) Regulations

Nurses and Midwives (Professional Ethics and Practice) Regulations

Nurses and Midwives (Registration) Regulations

NURSING COUNCIL FOR BOTSWANA (BADGE) REGULATIONS

 

(section 12)

 

(23rd May, 1969)

 

ARRANGEMENT OF REGULATIONS

 

   REGULATION

 

 

 

   1.   Citation

 

   2.   Interpretation

 

   3.   Badge for registered nurses and midwives

 

   4.   Sale of badge by Council

 

   5.   Registered number to be engraved on badge

 

   6.   Manner of wearing badge

 

   7.   Loss of badge to be notified

 

   8.   Restriction on manufacture of badges, etc.

 

   9.   Offences

 

 

S.I. 64, 1969.

 

1.   Citation

   These Regulations may be cited as the Nursing Council for Botswana (Badge) Regulations.

 

2.   Interpretation

   In these rules-

   "badge" means a badge such as is described in regulation 3;

   "register" means the register of nurses or the register of midwives kept in terms of section 8 of the Act.

 

3.   Badge for registered nurses and midwives

   There shall be a badge for registered nurses and registered midwives which shall show the National Flag of Botswana in colour on gilt circled with a black border bearing in gilt the words "Nursing Council for Botswana".

 

4.   Sale of badge by Council

   The badge shall be sold by the Council to registered nurses and registered midwives for a price of 60 thebe.

 

5.   Registered number to be engraved on badge

   Before a badge is delivered to a person to whom it is sold there shall be engraved on the back thereof the number under which such person is entered in the register, and should such person be registered both as a nurse and as a midwife, both the numbers under which she is entered shall be so engraved.

 

6.   Manner of wearing badge

   The badge shall be worn only when the person wearing it is in uniform and shall be worn pinned to the right upper front of the uniform.

 

7.   Loss of badge to be notified

   In the event of a badge being lost, its owner shall notify the Council of the loss.

 

8.   Restriction on manufacture, etc. of badges

   The badge shall not be manufactured, sold or supplied by any person other than a person approved of for that purpose by the Council.

 

9.   Offences

   (1) Any person who contravenes regulation 6 or 7 shall be guilty of an offence and liable on conviction to a fine not exceeding P50.

   (2) Any person who contravenes regulation 8 shall be guilty of an offence and liable on conviction to a fine not exceeding P50 or to imprisonment for a term not exceeding three months, or to both.

NURSES AND MIDWIVES (PROFESSIONAL ETHICS AND PRACTICE) REGULATIONS

 

(section 12)

 

(4th November, 2011)

 

ARRANGEMENT OF REGULATIONS

 

   REGULATION

 

 

 

PART I
Preliminary

 

   1.   Citation

 

   2.   Interpretation

 

 

 

PART II
Professional Ethics

 

   3.   Duties of nurse or midwife

 

   4.   Confidentiality

 

   5.   Attendance to patient

 

   6.   Habit-forming drugs

 

   7.   Severe reaction drugs

 

 

 

PART III
Practice Regulations for Nurse

 

   8.   Scope of practice of nurse

 

   9.   Practice regulations for nurse

 

 

 

PART IV
Practice Regulations for Midwife

 

   10.   Scope of practice of midwife

 

   11.   Practice regulations for midwife

 

   12.   Equipment

 

   13.   Precautions to be taken

 

   14.   Records

 

   15.   Administration of drugs to newborn baby

 

   16.   Duties of midwife during antenatal period

 

   17.   Vaginal and rectal examinations

 

   18.   Attendance on patient during labour

 

   19.   Duties of midwife during puerperium

 

   20.   Breastfeeding

 

   21.   Medical aid

 

 

 

PART V
General Practice Regulations for Nurse or Midwife

 

   22.   Administration of anaesthetics

 

   23.   Hypodermic and intramuscular injections

 

   24.   Intradermal injections

 

   25.   Intravenous injections, etc.

 

   26.   Blood transfusions, etc.

 

   27.   Drugs to be used in event of anaphylactoid or other severe reactions

 

 

 

PART VI
Practice Regulations for Nurse Specialist and Enrolled Nurse

 

   28.   Practice regulations for nurse specialist

 

   29.   Practice regulations for enrolled nurse

 

 

 

      Schedule

S.I. 90, 2011.

PART I
Preliminary (regs 1-2)

 

1.   Citation

   These Regulations may be cited as the Nurses and Midwives (Professional Ethics and Practice) Regulations.

 

2.   Interpretation

   In these Regulations, unless the context otherwise requires"”

   "anaphylactogenic drug" means a drug which causes immediate systemic or generalised hypersensitivity;

   "habit-forming drug" means a drug whose extensive use is likely to cause an addiction to the drug;

   "health care facility" means any government institution, non-governmental organisation or private institution engaged, directly or indirectly, in providing health care or health services to members of the public; and

   "puerperium" means the period of about six weeks after childbirth during which the patient's reproductive organs return to their original non- pregnant condition.

PART II
Professional Ethics (regs 3-7)

 

3.   Duties of nurse or midwife

   A nurse or midwife shall"”

 

   (a)   provide services with respect for human dignity, unrestricted by considerations for social or economic status, personal attributes or the nature of a patient's health problems;

 

   (b)   ensure the protection of personal information of a patient under the nurse's or midwife's care;

 

   (c)   safeguard the interests of the patient where the patient's health and safety is compromised;

 

   (d)   be responsible and accountable for his professional actions;

 

   (e)   exercise responsibility to maintain his competence in the practice of nursing or midwifery;

 

   (f)   communicate the evaluation outcome to a patient, the patient's spouse, next of kin or guardian where necessary, and to other health care team members;

 

   (g)   utilise evaluation findings as a basis for reassessing a patient, revising strategies and possibly changing midwifery interventions throughout all levels of the childbearing process;

 

   (h)   promote patient advocacy at all times;

 

   (i)   promote his professional responsibility and accountability;

 

   (j)   engage in research to"”

 

      (i)   generate knowledge and information

 

      (ii)   enhance his professional development, and

 

      (iii)   improve nursing care;

 

   (k)   acknowledge any limitation in his knowledge and competence;

 

      and

 

   (l)   adhere to the Code of Professional and Ethical Conduct for Nurses and Midwives as set out in the Schedule.

 

4.   Confidentiality

   A nurse or midwife shall at all times hold in confidence"”

 

   (a)   personal information entrusted to the nurse or midwife in the course of his duties;

 

   (b)   information regarding the treatment and diagnosis of a patient;

 

   (c)   a patient's medical case notes; and

 

   (d)   information acquired during the course of the nurse's or midwife's duties.

 

5.   Attendance to patient

   (1) A nurse or midwife shall not attend to a patient where the attention required by the patient falls outside the scope of practice of the nurse or midwife.

   (2) A nurse or midwife shall, before deciding that the attention required by a patient falls outside the scope of practice of the nurse or midwife, ensure that all the necessary nursing or midwifery procedures have been carried out.

   (3) Subregulation (1) shall not apply in an emergency or where a medical practitioner is not available.

   (4) The nurse or midwife shall report the facts of the case, in writing, to his immediate supervisor as soon as is practicable after attending to a patient in the circumstances referred to in subregulation (3).

 

6.   Habit-forming drugs

   A nurse or midwife shall, when handling habit forming drugs"”

 

   (a)   keep a register of all such drugs supplied to the nurse or midwife and record the names and addresses of the suppliers;

 

   (b)   record"”

 

      (i)    the date on which he received the drugs,

 

      (ii)   on a separate page, the strength of the drugs supplied,

 

      (iii)   the total amount of drugs received, and

 

      (iv)   the name of every patient to whom a drug is to be administered, the name of the drug to be administered to the patient, the method of administration, the dosage and the date and time it is to be administered, designation and signature of the nurse or midwife;

 

   (c)   keep the drugs in a secured locker or such other method of safekeeping as may be determined by the Council;

 

   (d)   make a register of the drugs available for inspection at any time, by the pharmacy technician, pharmacist or management of the health care facility at which the nurse or midwife works;

 

   (e)   immediately report the loss or theft of any drug, giving a written statement of the circumstances of the loss or theft to"”

 

      (i)   the pharmacy technician, pharmacist, or management at the health care facility in question at which the nurse or midwife works,

 

      (ii)   the Council, or

 

      (iii)   the nearest police station;

 

   (f)   ensure that the dosage and expiry date of the drug to be administered has been checked by another nurse or midwife, medical practitioner, pharmacy technician or pharmacist; and

 

   (g)   ensure that he and the nurse, midwife, medical practitioner, pharmacy technician or pharmacist who checked the dosage and expiry date of the drug, signs the drug register accordingly.

 

7.   Severe reaction drugs

   (1) When administering an anaphylactogenic drug, serum or other drug which may cause a severe reaction in a patient, the nurse or midwife administering the drug shall"”

 

   (a)   ensure at all times, that the standard emergency tray as laid down in a drug catalogue or other pharmaceutical protocol is available;

 

   (b)   enquire from the patient about the patient's sensitivity to the drug;

 

   (c)   where the patient is sensitive to the drug to be administered, inform a medical practitioner in charge so that an alternative drug can be prescribed; and

 

   (d)   request that the patient to whom the anaphylactogenic drug, serum, or other drug which may cause a severe reaction has been administered, not to leave the room where the drug was administered until that patient's condition stabilises.

   (2) Where a patient refuses to comply with a nurse's or midwife's request in terms of subregulation (1) (d), the nurse or midwife shall record, in writing, the fact that the patient acted against the nurse's or midwife's advice and obtain, where possible"”

 

   (a)   the patient's signature;

 

   (b)   in the case of a patient who cannot read or write, the patient's thumbprint or fingerprint, on the record; or

 

   (c)   the signature or thumbprint of at least two witnesses, where it is not possible to obtain the patient's thumbprint or fingerprint.

PART III
Practice Regulations for Nurse (regs 8-9)

 

8.   Scope of practice of nurse

   The scope of practice of a registered nurse shall entail"”

 

   (a)   activities or procedures, which may be performed by scientifically based physical, chemical, psychological, social, educational and technological means applicable to health care practice; and

 

   (b)   the regulations contained in Part V of these Regulations.

 

9.   Practice regulations for nurse

   A nurse shall"”

 

   (a)   conduct and document nursing assessments of the health status of a patient, family or community in collaboration with the patient by collecting subjective data in respect of the patient from interviews, from the patient's next of kin, records, physical examinations and investigations accurately and timeously;

 

   (b)   validate any data collected by interacting with team members when necessary;

 

   (c)   define a patient's deviation from normal and develop a strategy of care;

 

   (d)   utilise theoretical frameworks and models to backup nursing care;

 

   (e)   implement a strategy of care by"”

 

      (i)   prescribing appropriate nursing interventions,

 

      (ii)   giving assistance and direct care to a patient, and

 

      (iii)   referring the patient to the appropriate health care providers;

 

   (f)   accompany a patient for referral or transfer to another health care facility; and

 

   (g)   in the case of an emergency, where a patient cannot for any reason be transferred to another health care facility, remain with the patient and provide the best care for the patient until the emergency is attended.

PART IV
Practice Regulations for Midwife (regs 10-21)

 

10.   Scope of practice of midwife

   The scope of practice for a registered midwife shall"”

 

   (a)   entail scientifically based activities or procedures which apply to the practice of midwifery and which also relate to a mother and child in the course of pregnancy, labour and puerperium; and

 

   (b)   be as provided for in Part V of the Regulations.

 

11.   Practice regulations for midwife

   A midwife shall"”

 

   (a)   conduct and document midwifery and nursing assessment of the health status of a family, childbearing woman, expectant mother and fetus, patient in labour and delivery, delivered female patient and a newborn baby, by"”

 

      (i)   collecting subjective data in respect of the patient from interviewing the patient's spouse, next of kin or guardian, and

 

      (ii)   recording physical examinations and investigations accurately and timeously;

 

   (b)   identify the needs of a patient at each stage of the childbearing processes and provide appropriate services and care which include"”

 

      (i)    providing sound family planning information and services,

 

      (ii)   diagnosing pregnancy and monitoring the pregnancy's progress to ensure maternal health and fetal wellbeing and development,

 

      (iii)   developing a plan of care for a patient on the basis of diagnosis and needs identified,

 

      (iv)   providing childbirth preparation including advice on hygiene, nutrition and other health promotion matters,

 

      (v)   diagnosing labour, caring for and assisting the mother during all the four stages of labour and monitoring the condition of the fetus in the uterus by appropriate means,

 

      (vi)   conducting deliveries and where required performing an episiotomy,

 

      (vii)   recognising the warning signs of abnormality in a pregnant patient or a newborn baby, which necessitate referral to a doctor or obstetrician,

 

      (viii)   examining and caring for a newborn baby and taking the initiative where necessary, to carry out immediate resuscitation,

 

      (ix)   caring for and monitoring the progress of the female patient during the postnatal period in order to give the female patient all the necessary advice on infant care, self-care and family planning,

 

      (x)   utilising theoretical frameworks to backup nursing care, and

 

      (xi)   maintaining a clear record of all activities rendered to the female patient;

 

   (c)   evaluate a female patient's response to midwifery interventions, in collaboration with other members of the health care team; and

 

   (d)   operate according to national policies and guidelines in the event of acquiring new knowledge and or skills such as those offered by the safe method of Prevention of Mother to Child Transmission of HIV and AIDS (in these Regulations referred to as PMTCT) or infant feeding programmes.

 

12.   Equipment

   When attending to a patient, a midwife shall have available all the equipment necessary for the proper conduct of his work, including"”

 

   (a)   an intravenous infusion set;

 

   (b)   at least two 1000 milliliters of five per cent dextrose in a normal saline solution; and

 

   (c)   the equipment and material necessary to"”

 

      (i)    perform an episiotomy,

 

      (ii)   suture an episiotomy, or

 

      (iii)   suture a first or second degree tear of the perineum.

 

13.   Precautions to be taken

   (1) A midwife shall"”

 

   (a)   when attending to a patient, scrupulously observe the rules of asepsis; and

 

   (b)   before attending to any other patient, observe thorough infection control measures, where the midwife had been attending to, or in contact with a person"”

 

      (i)   suffering from,

 

      (ii)   suspected to be suffering from,

 

      (iii)   who died from, or

 

      (iv)   suspected to have died from,

   any septic, infectious or contagious condition.

   (3) A midwife who is suffering from any infectious or contagious condition shall not attend to a patient unless otherwise directed by a medical practitioner, or until the midwife is completely free of the condition.

 

14.   Records

   A midwife shall keep a record of each patient that he attended to in the chart used for maternity cases in government, mission, mining and private hospitals.

 

15.   Administration of drugs to newborn baby

   (1) A midwife"”

 

   (a)   shall apply an approved antibiotic eye ointment as a prophylactic into the eyes of a newborn baby;

 

   (b)   shall not administer any other solution or ointment to a newborn baby without a written order from a medical practitioner; and

 

   (c)   may, if he considers it necessary, administer to the mother of a newborn baby after delivery of the placenta"”

 

      (i)   injections of pethedine totalling not more than 200 mgms; or

 

      (ii)   intramuscular injection of not more than 0.50 mgs of ergometrine.

   (2) Where the drugs in subregulation (1) (a) and (b) are administered, the administration of the drugs may be repeated once, only after four hours.

   (3) In the case of pregnancy induced hypertension, a midwife shall administer a magnesium sulphate injection and anti-hypertensive drugs according to the safe motherhood protocol.

   (4) A midwife shall, depending on the HIV status of a mother, administer to a female patient, after confinement, and her newborn baby, anti retro viral drugs as per the PMTCT protocol.

   (5) Where"”

 

   (a)   a medical practitioner is not available;

 

   (b)   while a midwife is awaiting the arrival of a medical practitioner; or

 

   (c)   a patient or the patient's next of kin refuses the assistance of a medical practitioner and a midwife considers that the condition of the patient warrants it,

the midwife may, in the case of postpartum haemorrhage, administer not more than 0.50 milligrams ergometrine by intramuscular injection before or after the delivery of the placenta and the administration may be repeated once only, or administer one milligram of vitamin K by intramuscular injection in the lateral aspect of the thigh of the newborn baby.

   (6) Where a patient refuses medicine, a midwife shall"”

 

   (a)   endorse the record of the case accordingly;

 

   (b)   obtain the name and signature of the patient and in the case of a patient who cannot read or write, obtain a thumbprint or fingerprint of the patient;

 

   (c)   obtain the signature or thumbprint of at least two witnesses, where it is not possible to obtain the patient's signature, thumbprint or fingerprint; and

 

   (d)   where it is not possible to obtain the patient's signature, thumbprint or fingerprint or the signature of at least two witnesses, immediately report, in writing, the facts of the case to the midwife's immediate supervisor.

 

16.   Duties of midwife during antenatal period

   (1) Where a midwife is attending to a patient in confinement, and the attendance includes the giving of antenatal and postnatal care, the midwife shall"”

 

   (a)   advise the patient to be medically examined at least once during pregnancy;

 

   (b)   advise the patient to undergo a blood test;

 

   (c)   ascertain whether any previous pregnancy ended in an abortion, a premature labour, or a stillbirth and if so, advise the patient to seek medical advice; or

 

   (d)   ascertain whether any abnormality occurred during any previous pregnancy, labour or puerperium, and if so, advise the patient to seek medical advice.

   (2) Where the patient, for any reason, does not accept the advice referred to in subregulation (1), the midwife shall"”

 

   (a)   endorse the record of the case accordingly;

 

   (b)   obtain the signature of the patient and in the case of a patient who cannot read or write, the obtain a thumbprint or fingerprint of the patient;

 

   (c)   obtain the signature or thumbprint of at least two witnesses, where it is not possible to obtain the patient's signature, thumbprint or fingerprint; and

 

   (d)   where it is not possible to obtain the patient's signature, thumbprint or fingerprint or the signature of two witnesses, report immediately, in writing, the facts of the case to the midwife's immediate supervisor.

   (3) A midwife shall, where possible, examine a patient who is pregnant"”

 

   (a)   at least once a month until the 28th week of pregnancy;

 

   (b)   at least once a fortnight until the 36th week of pregnancy; and

 

   (c)   at least once a week after the 36th week of pregnancy until confinement.

 

17.   Vaginal and rectal examinations

   A midwife shall not carry out a vaginal or rectal examination in the case of an antepartum haemorrhage and in all other cases, the midwife shall not make more examinations than are necessary.

 

18.   Attendance on patient during labour

   (1) A midwife"”

 

   (a)   who is attending to a patient in labour shall not leave the female patient unattended;

 

   (b)   shall, after the beginning of the second stage of labour, stay with the female patient until after the birth of the newborn baby, and for as long as the condition of the female patient or the newborn baby may demand thereafter;

 

   (c)   shall monitor the female patient for at least one hour after the expulsion of the placenta and membranes;

 

   (d)   shall monitor fetal and maternal wellbeing as per PMTCT safe motherhood protocol;

 

   (e)   shall perform all activities according to PMTCT safe motherhood guidelines and protocol during labour; and

 

   (f)   shall conduct a physical examination on the newborn baby.

 

19.   Duties of midwife during puerperium

   (1) A midwife shall"”

 

   (a)   during puerperium, attend to a patient and her newborn baby for at least 24 hours and if it is impossible for the midwife to attend to the patient, the midwife shall endorse the record of the case accordingly, giving reasons why it is impossible;

 

   (b)   ensure that a patient and her newborn baby are discharged after a full physical examination by a medical practitioner;

 

   (c)   administer all necessary vaccinations to a newborn baby at birth;

 

   (d)   advise a patient to be examined by a medical practitioner or at a postnatal clinic at least once during the three months following the confinement, and preferably six weeks after delivery;

 

   (e)   follow PMTCT safe motherhood and tuberculosis protocols and guidelines; and

 

   (f)   carry out domiciliary, two to 10 days post-partum.

 

20.   Breastfeeding

   A midwife shall take all reasonable steps to promote breastfeeding of the newborn baby by the patient unless there is medical advice to the contrary.

 

21.   Medical aid

   (1) In all cases where an illness, abnormality, or complication occurs in a patient or her baby during the period when the midwife is in attendance, the midwife shall immediately, in consultation with the patient, refer her to a medical practitioner stating, wherever possible, the reason for the referral.

   (2) Where a medical practitioner is not available, the midwife shall, immediately, endorse the record of the case and notify his immediate supervisor.

   (3) Where a patient's spouse, next of kin or guardian refuses to consent to the referral to a medical practitioner, the midwife shall endorse the record and"”

 

   (a)   obtain the signature of the patient's spouse, next of kin or guardian;

 

   (b)   obtain the signature or thumbprint of at least two witnesses, where it is not possible to obtain the signature of the patient's spouse, next of kin or guardian;

 

   (c)   and where it is not possible to obtain the signature of the patient's spouse, next of kin or guardian or, the signature of two witnesses, report immediately, in writing, the facts of the case to midwife's immediate supervisor.

   (4) Where it is impossible to consult the patient, the patient's spouse, next of kin or guardian, the midwife shall act on his own judgment and enter the facts of the case in the record and report the facts fully to the midwife's immediate supervisor.

   (5) The provisions of this regulation shall apply in particular to the following illnesses, abnormalities or complications which occur"”

 

   (a)   during pregnancy, such as "”

 

      (i)   excessive vomiting,

 

      (ii)   an abortion, inevitable or threatened,

 

      (iii)   loss of blood,

 

      (iv)   rise in blood pressure or albumen in urine,

 

      (v)   puffiness of hands, face or feet,

 

      (vi)   excessive gain in weight,

 

      (vii)   fits or convulsions,

 

      (viii)   purulent discharge from the genitalia, (ix) a sore on the genitalia,

 

      (x)   deformity, stunted growth or other condition suggesting disproportion between the head of the fetus and pelvis of the pregnant patient, or

 

      (xi)   abnormal presentation after the 32nd week of pregnancy;

 

   (b)   during labour"”

 

      (i)    fits or convulsions,

 

      (ii)    purulent discharge from the genitalia,

 

      (iii)   a sore on the genitalia,

 

      (iv)   excessive bleeding,

 

      (v)   premature labour before the 37th week of pregnancy,

 

      (vi)   a presentation other than an uncomplicated head,

 

      (vii)   where no presentation can be ascertained, (viii) undue prolongation of any stage of labour,

 

      (ix)   excessive uterine action,

 

      (x)   fetal distress,

 

      (xi)   placenta not completely expelled 30 minutes after birth of the newborn baby,

 

      (xii)   rupture of perineal body, or other injuries to the soft parts,

 

      (xiii)   if the head does not engage early in a primigravida, or

 

      (xiv)   multiple pregnancy;

 

   (c)   during the puerperium"”

 

      (i)   fits or convulsions,

 

      (ii)   abnormal distension and tenderness,

 

      (iii)   offensive lochia,

 

      (iv)   rigor with raised temperature,

 

      (v)   rise of temperature to 37.7 °C for a period of 24 hours, or its recurrence within that period, or a rise of temperature to 37.4°C on two successive days,

 

      (vi)   continuously rapid or steadily rising pulse rate,

 

      (vii)   unusual swelling of the breasts with local tenderness or pain,

 

      (viii)   excessive or prolonged bleeding,

 

      (ix)    pain over the vessels of the lower limbs, especially pain in the calves of the legs,

 

      (x)   excessive sleeplessness or mental depression, or

 

      (xi)   retention of urine; and

 

   (d)   to the newborn baby"”

 

      (i)    injuries received during birth,

 

      (ii)    malformation or deformity, whether endangering life or not,

 

      (iii)   undue feebleness, whether the newborn baby is premature or not,

 

      (iv)   inflammation of or any discharge from the eyes, however slight,

 

      (v)   serious skin eruptions, especially those marked by the formation of watery blisters,

 

      (vi)   inflammation around or haemorrhage from the umbilicus,

 

      (vii)   jaundice,

 

      (viii)   convulsions,

 

      (ix)   neonatal haemorrhage,

 

      (x)   excessive or projectile vomiting,

 

      (xi)   failure to pass urine or meconium within the first 24 hours after birth, or

 

      (xii)   failure to gain weight after the first 10 days following birth.

PART V
General Practice Regulations for Nurse or Midwife (regs 22-27)

 

22.   Administration of anaesthetics

   (1) A nurse or midwife shall not administer a local anaesthetic unless a medical practitioner is of the opinion that it is in the interest of a patient to allow the nurse or midwife to administer the local anaesthetic and the nurse or midwife shall administer the local anaesthetic only"”

 

   (a)   on a written or verbal order from a medical practitioner;

 

   (b)   in the presence of such medical practitioner; and

 

   (c)   under the medical practitioner's direction.

   (2) Notwithstanding the provisions of subregulation (1), a nurse or mid-wife shall only administer a local anaesthetic, in the absence of a medical practitioner"”

 

   (a)   where the nurse or midwife is faced with a patient who has a life threatening condition; or

 

   (b)   where necessary, when the nurse or midwife is attending to a patient delivering a newborn baby.

   (3) Except as provided for in subregulation (1) and (2), or in these Regulations, a midwife shall not administer a local anaesthetic.

   (4) A midwife shall"”

 

   (a)   order and administer a local anaesthesic when performing a suturing episiotomy; and

 

   (b)   take appropriate precautions in administering the local anaesthetic.

 

23.   Hypodermic and intramuscular injections

   (1) A nurse or midwife may administer a hypodermic or intramuscular injection"”

 

   (a)   on the written or verbal order from a medical practitioner or a dentist and, during an emergency, in the presence of a responsible witness:

 

      Provided that the written confirmation of the oral order is obtained from the medical practitioner or the dentist within 48 hours and where the written confirmation of the oral order cannot be obtained within 48 hours, the midwife shall report immediately, in writing, the facts of the case to his immediate supervisor, or the Council; and

 

   (b)   in an emergency"”

 

      (i)   where the nurse or midwife is of the opinion that the life of a patient is endangered, the nurse or midwife shall make appropriate arrangements for the patient to be referred to a medical practitioner at the earliest opportunity if in the nurse's or mid-wife's opinion, the patient's life will not be jeopardised by travelling,

 

      (ii)   where the nurse or midwife is of the opinion that it would be dangerous to move the patient, the nurse or midwife shall as soon as possible, inform the nearest medical practitioner explaining the circumstances of the case, giving the details as aforesaid, and asking for further instructions.

   (2) Where a nurse or midwife administers a hypodermic or intramuscular injection in accordance with subregulation (1), the nurse or midwife shall submit a written report to his immediate supervisor, stating the circumstances under which he gave the injection and the preparation that was used.

   (3) Subject to subregulation (1), a nurse or midwife may, in the absence of a medical practitioner, administer an injection of a drug provided for in a Schedule to be prescribed by the Minister"”

 

   (a)   where the nurse's or midwife's position implies that he is in charge of a government clinic or private clinic; and

 

   (b)   where the nurse's or midwife's duties are supervised at regular intervals.

 

24.    Intradermal injections

   (1) A nurse or midwife may"”

 

   (a)   on the written order from a medical practitioner, administer an in- tradermal injection only; or

 

   (b)   in the absence of a medical practitioner, administer an injection of a drug provided for in a Schedule to be prescribed by the Minister"”

 

      (i)   if the midwife's position implies that he is in charge of an antenatal, a postnatal, or a maternity unit in a government clinic or private clinic;

 

      (ii)   if the nurse's position implies that he is in charge of a government clinic or private clinic, and

 

      (iii)   if the nurse's or midwife's duties are supervised at regular intervals.

 

25.   Intravenous injections, etc

   (1) A nurse or midwife"”

 

   (a)   may, subject to subsection (2)"”

 

      (i)    administer an intravenous injection,

 

      (ii)    administer an intravenous infusion, or

 

      (iii)    draw blood from the vein of a patient only on the written order from a medical practitioner; and

 

   (b)   shall not employ the cut down method when administering an intravenous injection or an intravenous infusion, or when drawing blood from the vein of a patient.

   (2) A nurse may, in an emergency, take blood from a patient's vein to"”

 

   (a)   conduct investigations that he considers necessary during the emergency; or

 

   (b)   supply blood for purposes of grouping or cross-matching.

   (3) A midwife may, in the absence of a medical practitioner or a phlebotomist, take blood from a patient's vein to"”

 

   (a)   conduct investigations that he considers necessary during the emergency; or

 

   (b)   supplying blood for grouping or cross-matching.

   (4) A nurse or midwife may, in an emergency, where the nurse or mid-wife is of the opinion that the life of a patient is endangered, administer an intravenous injection on the verbal or written order from a medical practitioner.

   (5) Where subregulation (4) applies, a nurse or midwife shall"”

 

   (a)   make appropriate arrangements for the patient to be referred to a medical practitioner at the earliest opportunity if, in the nurse's or midwife's opinion, the patient's life will not be jeopardised by travelling;

 

   (b)   submit a written report to his immediate superior, stating"”

 

      (i)    the circumstances under which the injection was given,

 

      (ii)   the time and dosage of the injection, and

 

      (iii)   the preparation that was used; and

 

   (c)   if he considers it dangerous to move the patient, immediately inform the nearest medical practitioner explaining the circumstances of the case, giving the details as aforesaid, and asking for further instructions.

 

26.   Blood transfusions, etc.

   A nurse or midwife"”

 

   (a)   shall not, except as provided in paragraphs (b) and (c), start a blood transfusion unless it is on a written order from and in the presence of a medical practitioner;

 

   (b)   shall not insert a needle into a patient's vein in order to perform a blood transfusion, except on a written order from and in the presence of a medical practitioner;

 

   (c)   may change an intravenous infusion to a blood transfusion only on a verbal or written order from a medical practitioner, and on the condition that the procedure is checked by another nurse, midwife or medical practitioner:

 

         Provided that the written confirmation of the verbal order shall be obtained from the medical practitioner within 24 hours and if the written confirmation cannot be obtained within 24 hours the nurse or midwife shall report immediately the facts, in writing, to his immediate supervisor, if any;

 

   (d)   may change a blood transfusion to an intravenous infusion only after the container has been checked by a medical practitioner, another nurse or midwife; and

 

   (e)   may connect up a second or subsequent container only on a written or verbal order given by a medical practitioner and on the condition that the procedure is checked by another nurse, midwife or medical practitioner:

   Provided that a written confirmation of the verbal order shall be obtained from the medical practitioner within 24 hours, and should the written confirmation not be obtained within 24 hours, the nurse or midwife shall immediately report the facts, in writing, to his immediate superior, if any.

 

27.   Drugs to be used in event of anaphylactoid or other severe reactions

   A nurse or midwife shall ensure that he has available at all times"”

 

   (a)   a fresh solution of adrenalin;

 

   (b)   an injectable hydrocortisone; or

 

   (c)   an injectable anti-histamine,

   for use in the event of anaphylatoid or other severe reactions.

PART VI
Practice Regulations for Nurse Specialist and Enrolled Nurse (regs 28-29)

 

28.   Practice regulations for nurse specialist

   A nurse specialist shall, in addition to general nursing practice"”

 

   (a)   develop and interpret policies and guidelines pertinent to the provision of health care and facilitate the development of procedure manuals;

 

   (b)   demonstrate expertise in specific areas of his specialisation and facilitate professional development of himself and other nurse specialists to improve nursing care;

 

   (c)   develop programmes of care in collaboration with other health care practitioners and specialists;

 

   (d)   coordinate available resources to facilitate the effective implementation of nursing interventions;

 

   (e)   engage in research to generate knowledge and information necessary for the improvement of nursing care;

 

   (f)   develop and utilise theoretical frameworks and models to backup nursing care; and

 

   (g)   acknowledge any limitations in his knowledge and competence, decline any duties or responsibilities unless he is able to perform them in a safe and skilled manner.

 

29.   Practice regulations for enrolled nurse

   An enrolled nurse shall"”

 

   (a)   ensure that his nursing practice and conduct meet the standards of the Code of Professional and Ethical Conduct requirements as set out in the Schedule;

 

   (b)   demonstrate accountability and responsibility within a health care team when assisting or working under the direction of a nurse or midwife;

 

   (c)   accept responsibility and accountability for delegated care within his level of competence;

 

   (d)   identify policies and procedural guidelines impacting on enrolled nursing practice;

 

   (e)   provide nursing care according to organisational policies and guidelines;

 

   (f)   act in accordance with enrolled nurse educational preparation;

 

   (g)   recognise a nurse or midwife as a point of reference to assist in decision making;

 

   (h)   accurately collect information on the health and functional status of a patient;

 

   (i)   use health care technology appropriately;

 

   (j)   use a range of data gathering techniques including observation, interview, physical examination and measurement in the nursing care of a patient;

 

   (k)   document information regarding the health and functional status of a patient accurately and clearly according to organisational guidelines;

 

   (l)   observe and report changes in the health and functional status of a patient to a nurse or midwife or appropriate members of a health care team;

 

   (m)   contribute to the development and review of health care plans for a patient in conjunction with a nurse or midwife;

 

   (n)   collect, document and report relevant data to evaluate the progress of a patient towards expected outcomes as guided by a nurse or mid-wife;

 

   (o)   implement planned nursing care as outlined in health care plans;

 

   (p)   provide nursing care to address immediate health care needs and progress towards expected outcomes;

 

   (q)   promote patient independence whilst assisting with activities of daily living;

 

   (r)   clarify written orders for nursing care with a nurse or midwife;

 

   (s)   prioritise the delivery of nursing care of a patient appropriately under the supervision of a nurse;

 

   (t)   manage his own workload in accordance with the nursing care plan;

 

   (u)   work with other members of the health care team to carry out planned nursing care of a patient;

 

   (v)   identify potential risks or hazards to a patient associated with a health care environment;

 

   (w)   adhere to standards and procedures related to restraint, infection control and administration of therapeutic substances;

 

   (x)   apply relevant principles to ensure the safe administration of therapeutic substances;

 

   (y)   provide accurate and appropriate education to a patient related to the maintenance and promotion of their health in consultation with a nurse; and

 

   (z)   report immediately to a nurse or midwife any incident of unsafe practice and where appropriate explore ways to prevent reoccurrence of an unsafe practice.

SCHEDULE

 

(reg 3)

CODE OF PROFESSIONAL AND ETHICAL CONDUCT FOR NURSES AND MIDWIVES

 

1.   Introduction

 

The Code of Professional and Ethical Conduct (herein referred to as the "code of conduct") for nurses and midwives is a set of expected national standards of professional conduct for nurses and midwives in Botswana. The code of conduct outlines principles and expectations that are binding to all nurses and midwives in Botswana. It provides guidance for decision making in dealing with ethical issues and with matters of professional conduct. According to the code of conduct, all nurses and midwives registered with the Nursing and Midwifery Council of Botswana shall at all times act in such a manner to maintain public trust and confidence, uphold the professional image of the nursing profession in Botswana, serve the public interest.

 

2.   Purpose

 

The purpose of the code of conduct is to"”

 

   2.1   Reinforce the standards of professional ethics and conduct required of nurses and midwives as they render care and exercise their professional accountability and responsibility.

 

   2.2   Guide the professionals to adapt and acquaint themselves with the changes occurring in nursing and midwifery education, practice, research, leadership and management for the enhancement of quality health care delivery.

 

   2.3   Assist nurses and midwives to make good professional judgment within the complex health care system based on social values and needs of the client of health care.

 

   2.4   Promote self evaluation and reflection regarding nursing and midwifery education and practice.

 

   2.5   Provide a basis for peer review initiatives.

 

   2.6   Guide the development of a disciplinary code of conduct which focuses on offences that are relevant to the nurses' or midwives' practice.

 

3.   Definitions

 

The following are the terms which are commonly used with this code of conduct.

 

   "code of conduct" means a list of written statements describing the ideal moral behaviour;

 

   "code of ethics" means a list of written statements describing morals, values, beliefs, norms or principle that direct actions as being right or wrong;

 

   "ethics" means a system of morals, values, beliefs, norms, and principles that direct action as being right or wrong.

 

   "impropriety" means behaviour that is dishonest, morally wrong or inappropriate in the circumstances;

 

   "malpractice" means careless, illegal, or unethical behaviour by somebody in a professional or official position that endangers the life of clients, staff, co-workers, self or environment;

 

   "misconduct" means unacceptable and improper behaviour especially of a professional;

 

   "negligence" means lack of proper care and attention, or failure to exercise proper care in regard to manner of discharging duty; and

 

   "value" means something that is dearly cherished, treasured, respected, held in high regard or deeply cared for.

 

4.   Rules of professional and ethical conduct for nurses and midwives.

 

A nurse and a midwife shall at all times observe the following rules"”

 

   4.1 Professional secrecy and confidential information.

 

   4.1.1.   Nurses and midwives shall hold in confidence all personal information entrusted to them in the course of their duties. The information must be used only for the purposes for which it was given.

 

   4.1.2.   Information regarding a patient's diagnosis, treatment and diagnosis shall not be disclosed to anyone without prior permission from the patient or the medical officer in charge of the patient. As it is impractical to obtain consent every time the nurse or mid-wife needs to share information with others, the nurse or midwife shall ensure that patients and clients understand that some information may be made available to other members of the team involved in the delivery of care.

 

   4.1.3. No information of any kind regarding a patient shall be disclosed to the press, any member of the public, or any other person without prior permission from the patient, the medical practitioner or the hospital authorities.

 

   4.1.4   No person, other than the person directly responsible for the patient shall have access to the patient's medical notes, unless prior permission is granted by the medical practitioner in charge of the patient.

 

   4.1.5   No information regarding a patient's diagnosis shall be conveyed to relatives or friends either by telephone or by word of mouth by any nurse or midwife unless that nurse or midwife has had prior permission or has been authorised to disclose such information. If required to disclose information outside the team that will have personal consequences for patients, the nurse or midwife must obtain the patient's consent. If the patient withholds consent, or if consent cannot be obtained for whatever reason, disclosure may only be made only where"”

 

      (a)   it can be justified in the public interest (usually where disclosure is essential to protect the patient or someone else from the risk of significant harm); and

 

      (b)   it is required by law or by order of a court.

 

   4.1.6   It is a breach of confidence to discuss any personal information given to a nurse or midwife by a patient, unless it has some bearing on the patient's condition, and this information can only be given to the medical practitioner or the senior nurse or midwife.

 

   4.1.7   No member of the nursing or midwifery staff shall discuss with or relay to any member of the public any information pertaining to any patient, or any other member of the staff, so as to bring into disrepute the good name of a health care facility.

 

   4.1.8   Every nurse and midwife, when discharging his duties of providing services has a duty to"”

 

      (a)   guard against breaches of confidentiality by protecting information from improper disclosure at all times;

 

      (b)   seek patients' and clients' wishes regarding the sharing of information with their family and others;

 

      (c)   recognise that the decision to provide or withhold information should be taken with the greatest caution and responsibility; and

 

      (d)   cooperate, communicate effectively and respect each other 's expertise and contributions.

 

5.   Respect for humankind and the patient as an individual

 

A nurse or midwife should strive at all times when providing services to"”

 

   (a)   value human life and honour the patient's wishes regarding their quality of life;

 

   (b)   recognise and appreciate the uniqueness of each client regardless of his cultural and socio-economic status;

 

   (c)   treat a patient with respect and dignity;

 

   (d)   promote an environment in which the human rights, values, cultural and spiritual beliefs of an individual are respected;

 

   (e)   respect the privacy of a patient in such a way that during the procedure, privacy is provided and maintained throughout;

 

   (f)   ensure that no action or omission on his part or within his sphere of responsibility is harmful to the interests, condition, safety and wellbeing of a patient;

 

   (g)   recognise and respect the roles of patients as partners in their care and the contribution they can make to it and in so doing the nurse and mid-wife shall have regard to the limits of professional practice, existing legislation, resources and goals of therapeutic relationship; and

 

   (h)   respect a patients' autonomy to undergo any health care intervention which is protected under the law.

 

6.   Obtain consent

 

   6.1   When obtaining consent to receive treatment from a patient, a nurse or midwife must ensure that the consent is given voluntarily and by a legally competent person.

 

   6.2   A nurse or midwife shall presume that every patient is legally competent to consent to receiving treatment unless otherwise assessed by a suitably qualified medical practitioner.

 

   6.3   A patient or a client who is legally competent can understand and retain treatment information and can use it to make an informed choice.

 

   6.4   A patient who is legally competent may give consent in writing or orally and the patient may also refuse to give consent.

 

   6.5   A nurse or midwife shall ensure that all discussions and associated decisions relating to obtaining consent from a patient are documented in the patient's health care records.

 

   6.6   Where a patient is no longer legally competent to consent to receiving treatment and has lost the capacity to consent to or refuse treatment and care, a nurse or midwife shall find out whether the patient previously indicated preferences in an advance statement.

 

   6.7   A nurse or midwife shall respect any refusal to care or treatment given when the patient was legally competent to give such refusal; provided that the decision is clearly applicable to the present circumstances and that there is no reason to believe that the patient changed his mind.

 

   6.8   When an advanced statement is not available, a patient's wishes, if known, shall be taken into account and if these wishes are not known, the criteria for treatment must be that it is in their best interests of the patient.

 

   6.9   The principles of obtaining consent shall apply equally to a patient who has a mental illness and whilst a nurse or midwife should be involved in the patient's assessment, it will also be necessary to involve a qualified person such as a psychiatrist with expertise in people with mental illnesses.

 

   6.10   A nurse or midwife shall endeavour to involve in the assessment of a mentally ill patient, family members or people close to the mentally ill patient.

 

   6.11   All patients and clients have a right to receive treatment information about their condition.

 

   6.12   Treatment information about a patient should be accurate, truthful and presented in such a way as to make it easily understood.

 

   6.13   A nurse or midwife may need to seek legal or professional advice or guidance from his immediate supervisor, a medical practitioner of hospital authorities in relation to the giving or withholding of consent.

 

   6.14   A nurse or midwife must be sensitive to a patient's needs and respect the wishes of those who refuse or are unable to receive information about their condition.

 

   6.15   A nurse or midwife must respect patients' autonomy, especially their right to decide whether or not to undergo any health care intervention, even where a refusal may result in harm, unless a court of law orders to the contrary.

 

   6.16   In emergencies, where treatment is necessary to preserve life, a nurse or midwife may provide care without the consent of a patient if the patient is unable to give it; provided that the nurse or midwife can demonstrate that they are acting in their best interest of the patient.

 

   6.17   A person has no right to give consent on behalf of a competent adult.

 

   6.18   In relation to obtaining consent for a child, the involvement of those with parental responsibility in the consent procedure is usually necessary, but will depend on the age and understanding of the child.

 

   6.19   A nurse or midwife who will be responsible for performing any procedure on a patient shall also have the responsibility of obtaining the patient's or the client's consent.

 

7.   Maintaining professional competence

 

Nurse or midwife must strive at all times to achieve and maintain high professional standards in providing quality care and in doing so the nurse or midwife shall"”

 

   (a)   demonstrate a high level of competence in his practice;

 

   (b)   acknowledge the limits of professional competence and only practice those activities in which he is competent;

 

   (c)   always consider the safety of a patient in his professional practice;

 

   (d)   acquire new knowledge and skills continuously and use them effectively;

 

   (e)   provide care based on knowledge, skills and abilities expected from a nurse or midwife of his status, even when faced with an emergency situation; and

 

   (f)   strive to deliver care based on current evidence, best practice and where applicable, validated research.

 

8.   Responsibility and accountability

 

   8.1.    A nurse or midwife is responsible for maintaining professional standards for quality care and be accountable for his actions and shall observe the following"”

 

      (a)   responsibility of providing quality service in conscientious, diligent and efficient manner;

 

      (b)   obligation and expectation to handle nursing and midwifery matters without undue delay, risk or unnecessary expense to the employer, client or patient;

 

      (c)   accountability for his actions or omissions through formal lines of authority and responsibility;

 

      (d)   respect and comply with rules and regulations in a manner that promotes public confidence, the integrity of nursing and midwifery services and profession;

 

      (e)   desist from conduct capable of drawing an impression of being involved in corruption;

 

      (f)   in case of delegation, delegate the nursing work with close supervision;

 

      (g)   as a manager, have a duty towards a patient, client, colleague, community and his organisation in which he works;

 

      (h)   when facing professional dilemma, first consideration in all circumstances shall be the interest and safety of patients and clients; and

 

      (i)   maintain personal hygiene, good nutrition and dress in acceptable manner in accordance with acceptable nursing and midwifery practice.

 

   8.2.   A matron shall ensure that a nurse or midwife is registered and if the nurse or midwife is not registered, the matron shall report the matter to the Council.

 

9.   Honesty and fairness

 

Every nurse or midwife has a duty to"”

 

   (a)   behave in a way that upholds good reputation of the nursing and mid-wifery profession;

 

   (b)   avoid using his registration status in the promotion of a commercial product or service;

 

   (c)   not to solicit, force or accept bribes from a patient or patient's family and relatives for any reasons;

 

   (d)   refuse any gift, favour or hospitality that might be interpreted, now or in the future as an attempt to obtain preferential consideration;

 

   (e)   use official time in an honest way to fulfill professional responsibility;

 

   (f)   be fair in distributing resources; and

 

   (g)   tell the truth at all times and be loyal and avoid deception in whatever form.

 

10.   Collaboration and team work

 

Every nurse or midwife, when discharging his duties of providing health care services has a duty to"”

 

   (a)   work as a team which includes a client or patient, patient's family and other health care professionals in the health care delivery system;

 

   (b)   share his knowledge and skills and respect others views for the benefit of clients or patients;

 

   (c)   give due weight and consideration to official views and respect colleagues, including their right to privacy especially when handling personal information;

 

   (d)   give credit to colleagues with outstanding performance and not seek personal credit at their expenses;

 

   (e)   act appropriately to protect a patient from risks if he believes that his colleague is not fit to practice for reasons of misconduct, ill-health or incompetence;

 

   (f)   behave, at all times, in such a manner that maintains the good reputation of the profession; and

 

   (g)   not involve himsel for herself in drug or alcohol abuse.

 

11.   Identify and minimise the risk to patients and clients

 

A nurse and midwife shall"”

 

   (a)   work with other members of the team to promote a health care environment that is conducive for safe, therapeutic and ethical practice;

 

   (b)   act quickly to protect patients and clients from risk if the nurse or mid-wife has a good reason to believe that he, or a colleague from his own or another profession, may not be fit to practice for reasons of conduct, health or competence;

 

   (c)   be aware of legislation that offers protection for people who raise concerns about health and safety issues;

 

   (d)   not remedy circumstances in the environment of care that could jeopardise standards of practice and shall report the circumstances, in writing, to a senior person with sufficient authority to manage the circumstance and, in the case of midwifery, to the supervisor of midwives; and

 

   (e)   have a professional duty to provide care in an emergency, in or outside the work setting and the care provided shall be judged against what is reasonably expected from a nurse or midwife with such knowledge, skills and abilities when placed in those particular circumstances.

 

12.   Dress code for nurses and midwives

 

In addition to the dress code prescribed for the Public Service, a nurse or midwife shall wear a complete uniform or attire as specified in this code of conduct and includes the following"”

 

   12.1   Uniform"”

 

      (a)   shall be clean, neat and in a good state of repair; reflecting high professional standards at all times;

 

      (b)   dress or skirt length shall not be shorter than the middle of the knee or longer than 10cm below the knee;

 

      (c)   appropriate undergarments shall be worn and shall not be visible by style or colour;

 

      (d)   all jewellery is highly discouraged and if jewellery is worn, it shall be restricted to a watch (non-wrist watch), one pair of earrings less than 13mm in diameter, or a wedding band;

 

      (e)   earrings must be neat and professional, allowing for no contact with a patient;

 

      (f)   clean and closed navy blue or black uniform shoes must be worn or brown shoes for male nurses and the shoes must be protective;

 

      (g)   shoe heel not exceeding 6cm is acceptable for female nurses and flat shoes for male nurses; and

 

      (h)   subdued coloured pantyhose are acceptable for female nurses.

 

   12.2   Personal hygiene"”

 

      (a)   body and hair must be clean and odour free;

 

      (b)   hair length longer than shoulder length must be worn off the face, secured, and shall not extend below the collar;

 

      (c)   faddish hair colour, for example, bright reds, greens, blues, etc is unacceptable and not permitted;

 

      (d)   beards and moustaches are acceptable if neatly trimmed;

 

      (e)   make-up should be conservative and well applied;

 

      (f)   fingernails should be clean and no longer than one quarter inch beyond the tip of the finger;

 

      (g)   subdued colours of nail polish may be worn and should be free of chips;

 

      (h)   artificial nails, tips, or nail glue-on decorations are not permitted; and

 

      (i)   visible tattoos are not permitted.

NURSES AND MIDWIVES (DISCIPLINARY) REGULATIONS

 

(section 12)

 

(4th November, 2011)

 

ARRANGEMENT OF REGULATIONS

 

   REGULATION

 

 

 

   1.   Citation

 

   2.   Interpretation

 

   3.   Disciplinary offences

 

   4.   Disciplinary Committee

 

   5.   Lodging of complaint

 

   6.   Investigation of complaint

 

   7.   Investigating team

 

   8.   Powers of investigating team

 

   9.   Interim orders by Council

 

   10.   Charge

 

   11.   Directive to accompany charge

 

   12.   Effect of admission of charge

 

   13.   Disciplinary hearing

 

   14.   Summoning of witnesses

 

   15.   Disobedience of summons

 

   16.   Procedure at disciplinary hearing

 

   17.   Evidence at disciplinary hearing

 

   18.   Disciplinary action after conviction or acquittal of criminal charges

 

   19.   Proof of commission of criminal offence

 

   20.   Finding

 

   21.   Copy of record may be applied for

 

   22.   Punishment

 

   23.   Report to Council

 

   24.   Appeal

S.I. 91, 2011

 

1.   Citation

   These Regulations may be cited as the Nurses and Midwives (Disciplinary) Regulations.

 

2.   Interpretation

   In these Regulations, unless the context otherwise requires"”

   "Committee" means the Disciplinary Committee appointed under regulation 4;

   "health care facility" means any government institution, non-governmental organisation or private institution engaged, directly or indirectly, in providing health care or health services to members of the public; and

   "health care service" means health care provided to a client in an inpatient or outpatient environment.

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