This is a guest post by Ali about her recency of practice dilemma.
At the bottom of this post, you will find links to previous Nurse Uncut posts on this issue, plus links to information about refresher courses, scholarships and the new NSWNMA professional indemnity insurance.
I am a Registered Nurse currently on maternity leave caring for my third child. My children are aged four, two and five months. I have returned to work on two separate occasions since first taking maternity leave in September 2008, but due to the close age gaps between my children I still remain 16 shifts short of completing the number of hours required by the Recency of Practice Standard over a five-year period. For me this means I will have to return to work when my baby is 10 months old (April 2013) in order to complete these shifts (without losing my registration).
I only became aware of the Recency Of Practice Standard while on maternity leave with my second baby and six months pregnant with my third child. I had not received any information about the changes and was shocked to learn that I was at risk of losing my registration and also that the standard was retrospective. I was also disappointed to find that the standard had been made in 2010 but no notification had been sent with registration renewal. If I had become aware of the change earlier I would have returned to work from my second stint of maternity leave eight weeks earlier so as not to be in this position now.
When I did return to work when my second child was 22 months old, it was only feasible for me to work two days per week. I worked as long as I was able, until my 38th week of my third pregnancy. This arrangement was a challenge, despite my then-youngest child being a lot older than the 10 months my now-youngest will be next April. The thought of returning to work when the baby is only 10 months old is heartbreaking to me. I plan to breastfeed him until two years of age (as recommended by the World Health Organisation) and feel that returning to work at this time could interfere with my breastfeeding goal, as I’ve recently seen happen to a friend when she returned to work with a baby of the same age.
My baby refuses a bottle at this stage and I am finding the thought of leaving him for a nine to 10-hour day to be very stressful. At this stage in my life I could not be busier, with three young children to care for – I can see expressing enough milk may also be an issue even if he does eventually accept a bottle.
The cost of putting three children into daycare will be high, but more stressful for me is the thought of putting my 10-month-old into care. I realise many people make returning to work positive for their own families and it works for them. However, my husband and I made a personal decision prior to having children that it was extremely important to us for me to have the option of staying at home with our children as long as we felt was necessary. We worked very hard prior to having children and planned very carefully to build up our savings to allow me to remain at home caring for them, without huge financial pressure to return to work. We have lived frugally and regularly gone without so as to achieve this. It is frustrating to be forced back to work to keep my registration.
I have returned to work twice after having kids, first after 15 months of leave and then following 22 months of leave. Both times I found the transition back to work quite easy and was quickly able to pick up on any changes and develop any new skills necessary to perform my job efficiently, safely and professionally. Probably the biggest challenge for me was my level of fatigue and I know that will also be an issue this time around as my two youngest children still wake regularly throughout the night and my eldest sometimes wakes. I feel if I was forced back to work, fatigue would be the biggest risk to my being an unsafe practitioner, not my knowledge or skill level, which I feel is well up-to-date. I have of course been completing my CPD hours, which is also helping me keep up-to-date while on leave.
I am simply requesting to be able to stay at home with my children until my maternity leave ends when my baby will be 23 months old (May 2014). I feel this is not unreasonable as I am still employed by my area health service and the maternity leave is part of the award.
I love being home with my children, but I also love my job and do not want to lose my registration. I have plans to undertake further study when my children are a little older. I am only 30 and we are not having any more children so I am looking forward to many more years in my profession.
Hi Tanya, Kate and Julie,
I am writing to you in the hope that you can help me. I don’t follow politics closely but I have seen both Tanya and Kate on Q&A and feel you are both very trustworthy and feel strongly about women’s rights/issues and are in politics for the right reasons, so I feel if any politicians will be able to help me then you will!
I am a Registered Nurse and mum to three young children. I am currently on maternity leave with my 3rd baby. AHPRA (the Australian Health Practitioner Regulation Agency) has enforced a Recency of Practice Standard in which nurses are required to complete 480 hours of work in their field over five years or they must complete a re-entry course.
I have returned to work between all my children. I will now be forced to return to work when my youngest is 10 months old to complete 16 shifts before my five-year period is up. I understand the standard is a federal policy, which is why I am writing to you. The issues I have with the standard are:
1. It was retrospective. I first went on leave in 2008. The standard was made in 2010. I was not given any extra time to complete my hours. Many nurses who had been away from the job for 5 years but had dutifully been paying their registration every year were told they could no longer practice as a nurse unless they re-trained.
2. AHPRA didn’t tell anyone about the standard. The information started to circulate around the workplace as a rumour that nobody believed could be true! As I was on leave I only found out about the new policy when I was six months pregnant with my third child, with a three year old and 20 month old to care for at home. I would have had to return to work four days a week, which was impossible for me at that time. I returned to work two days a week till 38 weeks of pregnancy, but remain 16 shifts short of achieving my hours.
3. I feel it is discrimination against pregnant women and mothers caring for young children. I am entitled to 23 months of maternity leave to care for my baby under the Award. However I will be forced back to work 13 months earlier to meet the requirements of the standard. I plan to breastfeed until my son is at least 2 years old and I feed on demand. I feel very nervous and emotional about leaving him at that age.
4. In NSW if you are required to complete a re-entry course this involves paying $10,000 for the course. There is currently only one course available, which is one month fulltime and must be completed on campus at the Royal College of Nursing in Sydney (2 hours travel time each way for me and obviously much further if you live in rural areas). Nurses are then required to work unpaid in a clinical setting for one month. [Please see update on this information below.]
5. If I do return and complete my 16 shifts I can then take another four years and nine months off with no questions asked! The longest amount of time I have been away from nursing is 22 months and yet I am being told I cannot continue to practice as an RN if I don’t complete these 16 shifts!
I wrote to AHPRA requesting an extension on the time I had to complete my 16 shifts. I was told this was not possible as the standard does not allow for exceptions.
I am only 30 years old and this is our last baby. I have many many years left in the nursing profession! With a predicted nursing shortage of 109,000 by 2025, I cannot believe the government is placing so many barriers in front of experienced nurses returning to work!
Both times I returned to work following maternity leave I quickly picked up on any small changes that had occurred. I am extremely confident I can do my job safely and effectively! (Returning to work earlier than planned with two kids that wake several times every night and a third who occasionally wakes of a night is a different story! This standard is supposed to ensure safe practice, but with my current level of fatigue I don’t think I would be a safe practitioner!)
I love my profession but my young children come first at this time in my life. I am torn between somehow making it possible to return to work to complete these shifts or leaving nursing. I am sure you can understand though that it is difficult to throw away my career.
I have four months until I will be forced back to work. Thank you for taking the time to read my email. I know you all must be incredibly busy, but please help me!
AHPRA have rejected my request to be allowed to complete my maternity leave. My only choices now are to return to work in four months time when my baby is 10 months old or complete the re-entry course. I have several friends with children my age who are teachers. Interestingly teachers have no problems taking time away from their profession to raise children. This is another double standard.
- The pressure that was brought to bear by the NSWNMA on this issue earlier in 2012 resulted in the NSW Ministry of Health offering re-entry scholarships to nurses. Apparently not all the scholarships were taken up, ie. places are still available.
- Membership of the NSWNMA now automatically gives you professional indemnity insurance, which is necessary if doing supervised practice during refresher courses.
- There is now an online re-entry program available: Institute of Health and Nursing Australia http://www.ihna.edu.au
Previous Nurse Uncut blog posts on this issue: