Various authorities perceive the ways and manner which nurses and midwives should discharge their roles and duties apparently because of their different mandates. In academia, these roles and duties are described as objectives of the programme whereas the employer describes the roles and duties as job description. The regulator similarly describes these roles and duties as scope of practice.
The International Council of Nurses (ICN) indicates that scope of practice is not limited to specific tasks, functions or responsibilities but includes direct care giving and evaluation of its impact, advocating for patients and for health, supervising and delegating to others, leading, managing, teaching, undertaking research and developing health policy for health care systems. Furthermore, as the scope of practice is dynamic and responsive to health needs, development of knowledge, and technological advances, periodic review is required to ensure that it continues to be consistent with current health needs and supports improved health outcomes (ICN 1998, revised 2004).
The Nursing and Midwifery Board of Ireland (NMBI) on the other hand views the scope of practice as a range of roles, functions, responsibilities and activities which a registered nurse/midwife is educated, competent and has authority to perform (NMBI, 2000).
The American Nurses Association (ANA) has indicated that scope of practice are the services that a qualified health professional is deemed competent to perform, and permitted to undertake – in keeping with the terms of their professional license (ANA, 2021).
In reference to the aforementioned descriptions, the Nursing and Midwifery Council of Ghana (N&MC) describes scope of practice as the roles and duties that a qualified nurse/midwife is deemed competent to perform which is not limited to specific tasks or functions but include the independent, dependent and interdependent functions or roles of the nurse/midwife as enshrined in the N&MC’s regulations or Legislative Instrument (LI 683, 1971). These could also be deemed as the expanded and extended roles of the nurse/midwife. The scope of practice will be reviewed every 3-5 years.
This scope of practice for Nurses and Midwives in Ghana is hinged primarily on the following nursing theories and one nursing principle: Florence Nightingale, Hildegard Peplau and Ida Orlando’s, Dorothea Orem’s and Virginia Henderson’s theories, Fuerst and Wolf’s nursing principle and the Nursing Process.
The diagrams below illustrate broadly the relationship between the theories stated supra.
STATUTORY MANDATE OF THE NURSING AND MIDWIFERY COUNCIL
The Nursing and Midwifery Council (N&MC) is an agency under the Ministry of Health, Ghana. It is also a statutory body established by Part III of the Health Professions Regulatory Bodies Act 2013 (Act 857).
Statutorily, the object of the Council is to “secure in the public interest the highest standards of training and practice of nursing and midwifery”.
Specifically, as enshrined in the Act 2013 (Act 857), to achieve the object, the Council shall:
The Council recognizes the collaborative roles of various health institutions in service delivery in Ghana such as the Ghana Health Service, Christian Health Association of Ghana, Ahmadiya Muslim Mission Hospitals, Teaching Hospitals, Quaternary Hospital, Military Hospitals, Police Hospitals, Private Hospitals, other Quasi Government Hospitals etc.
The Council further acknowledges that the right staff mix may not be in existence in some hospitals/facilities; thus, institutions have proactively developed policies/protocols for effective and efficient service delivery.
The Council therefore mandates that once all such policies/protocols are written, jointly signed and dated by the appropriate authorities and the Council, they can be used for service delivery. Nurses/midwives should therefore be trained before the policies/protocols are implemented. Similarly, nursing and midwifery training institutions could have policies and protocols to direct faculty practice.
In this era of 4th Industrial Revolution, the Council encourages all nursing and midwifery practitioners to rest their practice on ICT for delightful service delivery. In this regard, all electronic verifiable instructions or sanctions are approved as formal.
The Council emphasizes that all activities that contribute to CPD-points acquisition in the CPD policy document (2020) constitute to the scope of practice for all cadre of nurses and midwives.Signed Felix Nyante (FWACN, FGCNM) Registrar
The Nursing and Midwifery Council of Ghana is indebted to the Minister for Health with his Directors for the policy direction during the development of this Scope of Practice for Nurses and Midwives. The Council is grateful to the Chairperson and Members of the 15th Governing for their strategic direction throughout the development process. To the Registrar, Mr. Felix Nyante, the Council remains grateful for his visionary and transformational leadership roles.
The N&MC is also grateful to its Stakeholders for the sustained cooperation and validation of this document. They are:
Prof. Lydia Aziato - Consultant for the Project and Dean, SoNM – UG, Legon
Hannah Oparebea Acquah - Rector, GCNM
Dr. Barnabas Kwame Yeboah - CPO, N&MS MOH-HQ
Eva Mensah - DNMS, GHS
Perpetual Ofori Ampofo - President, GRNMA
Netta Forson Ackon - President, GRMA
Fredrica Hanson - General Secretary, GRMA
Chief Supt. Dr. Kennedy Japiong - DNMS, Ghana Police Hospital
Col. Rex Kudjoe Adzagba - DNMS, Ghana Armed Forces Medical Services
Judith Asiamah - DNMS, UGMC, Accra
Rita Aryee - DNMS, KBTH, Accra
Sophia Blankson - DNMS, CCTH, Cape Coast
Innocentia Ruby Gborgblorvor - DNMS, HTH, Ho
Marina Assabill - CNO, KATH, Kumasi
Rita Amonoo-Neizer - DDNS, GHS - HQ
Bismark Tufour - DDNS, Ankaful Psychiatric Hospital, Ankaful
Roberta Asiedu - Chief Nurse, CHAG
Selina Dussey - PNO, PPME – MOH
Supt. Paulina Animwaa - Police Hospital
Rev. Philemon Gyapong - National Assistant PRO, GRNMA
Raphael Korkortsi - Secretary, Nurse Specialist Society
The following officers of the Council are also duly acknowledged for their immense contribution towards the development of this document
Philomina A.N. Woolley - Deputy Registrar (Operations)
Agnes Oppong-Baah - Deputy Director (Operations)
Victoria Lamina - Deputy Director (Operations)
Priscilla Arthur Baiden - Deputy Director (Operations)
Ampem Darko Oklodu-Abbey - Deputy Director (Operations)
Hephizibah E. Gyimah - Deputy Director (Operations)
Grace Dankwa - Deputy Director (Operations)
Florence Animwaa Darko - Principal Operations Officer
Gloria Esenam Simpong - Principal Operations Officer
Sophia Wiredu - Principal Operations Officer
Annie F. Oddoye - Senior Operations Officer
Vera Antwi-Amamoo - Senior Operations Officer
Priscilla K. Zigah - Senior Operations Officer
Ophelia Princess Prempeh - Senior Operations Officer
Patsy Ago Adams - Operations Officer
Lydia Dsane-Selby - Operations Officer
Jacqueline Incoom - Operations Officer
Louisa Boateng - Operations Officer
Helena Baaba Botchway - Assistant Operations Officer
Emmanuel Febiri - Assistant Operations Officer
Philemon Aning-Antoh - Assistant Operations Officer
Grace Adjeley Annum - Assistant Administrative Officer
Rexford Siaw - Administrative Officer
Haruna Jalil Yusif - Administrative Officer
Joel T. Josiah - Principal Administrative Assistant
Samuel Nii Odoi Anang - Chief Driver