Making a notification – our professional obligation

As a registered nurse or midwife, you are required to assess the risk of harm to the public and decide whether to make a mandatory notification about a colleague.

By law, you must make a mandatory notification if you are concerned about a colleagues’: 

• impairment 
• intoxication on the job 
• significant failure at meeting professional standards
• sexual misconduct. 

There are specific guidelines to assist you in deciding whether to make a notification or you can contact the regulator directly for assistance. 

When you self-identify you need help with your health, you will not be subject to a mandatory notification. Aphra: mandatory notifications

Understand how notifications work

A complaint or a notification – what’s the difference

A complaint about your performance, health or conduct may be managed initially by your employer. If a concern is raised about you with the regulator it is called a notification. This is usually when there is a concern that you may be putting public safety at risk.  

Who can make a notification 

A notification can be made against you by a person you have cared for, their family, your employer, another health practitioner, or a member of the community if they have reason to be concerned about your health, your conduct or your performance as a nurse or a midwife.  

Reasons a notification can be made

Complaints can be about your:

• performance 
• conduct
• health

Examples of poor performance include persistent medication errors, unsatisfactory clinical care or poor or missing documentation.

Concerning conduct includes inappropriate relationships with a person you cared for, fraud, theft or dishonesty, or criminal conduct outside of practise 

If the concern is about your health, this usually relates to an unmanaged health condition which the person believes has an impact on your ability to provide safe clinical care. 

Who manages concerns about nurses and midwives 

Ahpra investigates complaints in most states. In NSW complaints are managed by the NSW Health Professional Councils Authority and the NSW Health Care Complaints Commission. 

In Queensland complaints about individual practitioners are received through the Office of the Queensland Health Ombudsman. 

 The regulator must follow up a notification about you. It’s important to know that approximately 70% of notifications do not lead to any action against the person who that concern is about.  

Professional conduct, standards and safe practice

Both the Code of conduct for nurses and the Code of conduct for midwives set out legal requirements, professional behaviour and the conduct expected of you in all practice settings. You need understand the expectation in relation to many issues that might arise.

Professional boundaries – acting with professional integrity 

• Can a nurse or midwife have a sexual relationship with a patient? 
• If a patient in the care of a nurse or midwife contacts them on a dating site, can they go out with them? 
• Can a nurse or midwife date someone they have cared for if they meet at a party after they have been discharged? 
• Can a nurse or midwife care for someone on the ward if they have an existing personal relationship with them? 

The answer to each of these is no. Nurses and/or midwives must recognise that when they are in a treating relationship with a patient or a client there will be an inherent power imbalance, particularly as we can deal with some of the most vulnerable in the community at a difficult time in their life.  

Conflicts of interest – act with professional integrity

• Can a nurse or midwife recommend a service to someone in which they or a relative has a financial interest? 
• Can a nurse or midwife decline to provide someone care or a referral to care when they personally object to that type of care (i.e., abortion services)? 

Answer: no. We are trusted health professionals and are often seen as independent practitioners providing advice, referrals and even treatment. It would unprofessional to refer a patient/client to an entity where you or a relative maintained a financial interest or received a financial benefit.  

Financial arrangements and gifts – act with professional integrity 

• If someone gives a nurse or midwife a gift will they be in trouble? 
• Can a nurse or midwife be the beneficiary of someone’s will or be their power of attorney? 

We must be honest and transparent and to ensure that there is no perception of or actual personal gain when in a treating relationship. Only accept token gifts and always declare them to your workplace. Patients, residents or their families should not be encouraged or influenced to leave money, property or other gifts to nurses/midwives that care for them. 

Promote health and well-being – yours and that of your colleagues 

• What if a nurse or midwife is asked to do a 12-hour shift and is so fatigued that they probably won’t be able to make good decisions?
• What if a nurse or midwife’s decision-making starts to be impacted because they are very stressed?
• What I have concerns about my mental health – should I tell someone that I work with? 
• Should I report my health condition to the regulator? 

We have a responsibility to address our own health and wellbeing. We must take action to reduce the impacts of fatigue and stress to ensure that we remain safe health practitioners. 

The regulator does not want to know if you have a well-managed health condition that does not impact on your ability to practise. This may be a condition that impacts your mental health but is actively being managed by a treating team including a psychiatrist.  

 Ahpra code of conduct