Ratio of RANs to Population

Position Statement:

1. Ratio of RANs to Population:

CRANA believes that in staffing of remote locations the following points should be considered. The number of RANs should:

• Reflect the workload
• Meet the needs of the community
• Reflect the hours of service required
• Provide for all scopes of health care provision, especially Primary Health Care
• Help to sustain both clients and staff
• Reviewed by organisations at regular intervals based on the needs of the community, health centre activity and with a view to staff welfare
• Reflect CRANA’s position on sole practice

It is also CRANA’s position that indigenous health worker recruitment, training and support should be actively encouraged and that the same considerations be applied in order to assist and promote community empowerment and ownership.


2. Equipment:

• There should be a minimum standard of functional appropriate equipment to meet the needs of the community.
• Organisations be committed to providing appropriate education on the use and maintenance of equipment provided.
• Organisations be committed to the provision of regular scheduled maintenance, ideally with loan equipment available.
• Where possible equipment needs to be “user and environmentally friendly.
• That organisations factor into equipment budgets the need to replace or refurbish equipment in line with manufacturers guidelines.

3. Duty of Care:

CRANA believes that organisations have a responsibility to provide:

• Safe living and workplace environments
• Policies and procedures to deal sensitively and appropriately with incidents of workplace stress in consultation with appropriately qualified professionals
• Every available resource to ease the burden of preventable stressors
• Management with relevant background knowledge of remote health issues
• Appropriate and relevant orientation and ongoing education


4. Cultural Awareness:

• All RANs providing services to Aboriginal and Torres Strait Islander communities should receive a minimum of 2-3 days cultural awareness training during their orientation before taking up work/position.


5. Cultural Safety:

• All members should strive to become culturally safe in their practice. This should be seen as a whole of career process.
• Education about cultural safety should be included in undergraduate, postgraduate education of RANs and in orientation and in-service programs.
• All members should work in partnership with a cultural member.


6. Nurse Practitioners:

CRANA is committed to the development of a credentialling process that recognises the unique generalist and specialist competencies of remote area nurses.

With remote area accreditation, nurses could be recognised by a national registration body whose endorsement to practice was recognised by enabling legislation and modified regulation in all states and territories.

Remote area nurses could continue to practise under existing law, regulation and policy, including the use of the protected title “Nurse Practitioner” where this is provided for.

Undertaking the rigorous credentially process would allow nurses to demonstrate they have received, and can now offer to their peers, a high level of formal and informal education, training, orientation and support.

The attractiveness of accreditation as a remote area nurse specialist would include:
a) No border trauma: Automatic authority to practice throughout Australia, in accordance with the endorsements of the national registration authority.
b) Employability: Immediate recognition of the remote area nurses’ skills and level of preparation by employers of nurses with and without the rural/remote context.
c) Protection: Remote area nurses would not be reliant on employees to “cover them” for their practice in fields traditionally the domain of other health professionals. The realities of health care needs in extended practice would be acknowledged by confirmation of the RAN’s preparation for this work.

The benefits of RAN accreditation to the community would include:
a) Recruitment: Attracting more nurses to remote work because they know they could more easily move to other specialty areas later with recognised skills attractive to other specialties and professions.
b) Competition: By maintaining accreditation, nurses can readily demonstrate their competence to employees making shifting employees easier, particularly shifting to other states or territories. This would act to improve core standards across Australia - an advantage of professional standard-setting that results in better consumer care.
c) Standards: Accredited RANs would be in a stronger position to demand safe workplace standards, eg no single nurse posts, resulting in better community care.