A Reflection on Evolution of Nursing Regulation

Nurses’ Day 2021

A Reflection on Evolution of Nursing Regulation

Nursing regulation is one of the powerful pillars of the nursing profession worldwide and can be valued as the engine to transform the nursing and midwifery professions.  History of nursing regulation shows evidence that  our  predecessors had to face many controversies and struggles before the idea to establish an Act to regulate nursing and midwifery practice could be accepted, despite the fact that it would mark nursing as a profession. Florence Nightingale the founder of modern nursing did not join in the advocacy with other great nursing leaders of her time, to promote this innovative idea. She could not guarantee that the law could ensure that nursing qualities like compassionate care could be preserved.   However, the first Nursing Act was eventually passed in December, 1919, under the leadership of Royal College of Nurses in Great Britain.

In Seychelles the registration of nurses started in 1926, and the first Nurses and Midwives Act, was passed in 1929, and this law was repealed in 1950, in favor of two new legislations which were The Nurses ordinance 1950 and The Midwives ordinance, 1950. These were be replaced in 1985, by the existing Act, which is the Nurses and Midwives Act, 1985. The Nursing and Midwifery Council ( SNMC) is the functioning arm of the Nurses and Midwives Act, 1985 and Nurses and Midwives Regulation, 1989.  The mandate of the regulatory body is to protect the public by ensuring that they receive safe nursing and midwifery care by the professionals registered under the Nurses and Midwives Act. It also protects the Title ‘Nurse’ and ‘Midwife’ which are legally binding.  The regulatory body has a responsibility to maintain a register of Nurses and Midwives, as such control the practice of nurses and midwives, establish standards, promote and maintain discipline in the professions. The required educational level and competence to practice the profession are also regulated by the Act.   All Nurses and Midwives have to abide to the professional code of practice and ethics   in Seychelles, when offering nursing and midwifery care. However, similar to other pillars in nursing, evolution in nursing regulation over the decades has been fueled by the different changes in the trend of health care, such as disease pattern and the psychosocial milieu.

Nursing regulation, continuously scans the environment of practice and education, so as to remain relevant, with the dynamics in health landscape. During the past decades nursing Council has achieved, a position for a full time nurse-midwife registrar to function in secretariat of the Council which would ensure continuity in the introduction of new development in regulatory elements. In 2009, a proposal for practice license renewal was put to the nurses of Seychelles in the biennial Nurses Association meeting and this gained the unanimous support of nurses and midwives.  The introduction of practice license renewal, brought significant changes in the credibility of the nursing and midwifery professions in Seychelles, which can be compared favorably with countries regionally and internationally.

The license renewal brought two new standards in the regulation of nursing and midwifery practice. These are the practice standards and the continuous professional development standard (CPD). It is mandatory to attain the standards every three years to ensure nurses and midwives can practice safely, as they have to upgrade their knowledge and skills, thus promoting patient confidence in the professions. In line with this standard a National CPD framework was also developed for the first time and is being implemented. Further to that the Nurses and Midwives of Seychelles through the regulatory body has been able to secure sponsorship from the commonwealth of learning (COL) for on-line CPD on the World Continuing Education Alliance Platform (WCEA). 

This came at an appropriate period in the history of nursing when internationally World Health Organization (WHO) and International Council of Nurses (ICN) declared the year 2020, as the year of the Nurse and Midwife. More so, it was the year that Seychelles started to experience the effect the Covid-19 pandemic. What a coincidence for Seychelles nurses and midwives to be able to access on-line CPD at this point in time when lock down and restraints imposed to curtail mobilization and gatherings. The on line CPD, can be accessed from any location with no additional cost. At the end of the Year 2020 over 500 nurses had accessed the on-line CPD and the COL agreed to extend the sponsorship for another year. Congratulation to the practicing nurses and midwives in Seychelles.

 The Seychelles nurses and midwives Council found it necessary to adjust its strategies and encourage nurses and midwives to be more technologically oriented during this pandemic.  The Council has therefore significantly minimized face to face encounters and increased the utilization of on line interaction with nurses and midwives. They have found  it necessary to update their personal email address whereby giving feedback and maintaining contact is now more accessible.  The Covid-19, pandemic somehow helped us to think more broadly in the achievement of our goals to maintain quality nursing and midwifery care.

The Seychelles Nurses and Midwives Council was de-linked from Ministry of Health in 2012, and secured financial assistance from a government budget in 2013.  This increased the financial autonomy of this regulatory body. Attendance to virtual regional workshops and meetings are amongst the new normal which the SNMC members have experienced similar to other agencies, Ministries and departments, so there is a need to ensure that available technology is standardized.   

The emergence of the African Health Regulatory Collaboration for Nurses and Midwives, which emerged in 2011, lasted for a four year period. This moment involved the four representatives of the nursing pillars from the East, Central and southern African Region for regular meetings and professional exchanges. The representative of the four pillars were given the opportunity to submit grant proposal for financial support once they have identified the appropriate regulatory element they wanted to develop. The Seychelles team comprising of the four nursing pillars submitted three proposals which were successfully considered for grants. This seed money from the grant was very helpful to initiate the revision of the Nurses and Midwives Act, 1985, the National CPD framework, and the HIV/AIDS program at advanced Diploma level together with its scope of practice.

Nursing regulation continues to function in line with its mandate, by keeping abreast with current situation, adapting and adjusting its approaches to ensure public protection through safe practice. Nursing regulation calls for close collaboration with all nursing pillars to reflect on the future of nursing .

Prepared and Submitted by:

 Winifred Agricole (Mrs)

Registrar, Seychelles Nurses and Midwives Council

12th May 2021