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Regulation and practice

Audit notice

Download the ANMF federal office audit policy, which provides advice to all ANMF members on the process to follow if they receive an audit notification from NMBA.


ANMF recommends members always print or save their professional indemnity insurance certificates and keep them safe. The ANMF provides all members with a ‘Professional Portfolio’ which should be kept up to date in the event you are audited. Additional pages for the portfolio can be downloaded at

Contact the ANMF membership department via if you need previous copies of your professional indemnity insurance certificate.


Nurses on the nurses’ register must do at least 20 hours of continuing nursing professional development per year. Midwives on the midwives’ register must do at least 20 hours of continuing midwifery professional development per year.

Registered nurses and midwives who hold scheduled medicines endorsements or endorsements as nurse or midwife practitioners under the National Law must complete at least 10 hours per year in education related to their endorsement.

One hour of active learning will equal one hour of CPD. It is the nurse or midwife’s responsibility to calculate how many hours of active learning have taken place. If CPD activities are relevant to both nursing and midwifery professions, those activities may be counted in each portfolio of professional development.

The CPD must be relevant to the nurse or midwife’s context of practice. You must keep documentation of your CPD.

For more information about CPD requirements, visit the Nursing and Midwifery Board of Australia and see the 'Continuing professional development registration standard'.


On 23 December 2015, our nurse/midwife: patient ratios became law in Victoria. This not only makes ratios more secure but also makes enforcement of ratios less complex.

Where can I find the legislated ratios?

Ratios are now contained in the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015 and the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Regulations 2015.

Nurse to patient ratios are contained in Division 2 of the Act, and midwife to patient ratios are in Division 3. For example, Section 15 of Part 2 sets out the ratios to apply to level  1 hospitals, and states:

The operator of a level 1 hospital must staff a general medical or surgical ward as follows—

(a)     on the morning shift or the afternoon shift—

(i) one nurse for every four patients; and

(ii) one nurse in charge;

(b)     on the night shift, one nurse for every eight patients.

The ‘level’ of each hospital is specified in Schedule 1 of the Act, and reflects the 2011/12 enterprise agreement requirements.

What if we are always ‘above ratios’?

The Act contains ‘transitional’ provisions.  Section 47 refers to ‘pre-existing higher staffing arrangements’. If your staffing levels were above ratios and this was the subject of a formal written agreement with, for example, the ANMF, or was funded by the Health Department (as the 50% rule EFT was) then this applies as though it was the ratio, and is enforceable.

What if we are always ‘below ratios’?

Section 48 of the Act allows for “pre-existing lower staffing arrangements’ – where a health service was entitled to staff below the enterprise agreement minimum before the Act, then they can continue to do so for a maximum of 12 months from 23 December 2015. After that date the health service must apply the relevant ratio.

What do I do if the ratios are breached?

The Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Regulations 2015 set out the process for resolving local ratio breaches. It is critical that this process be followed exactly and promptly. Regulation 11 explains the process.

  1. A nurse or midwife employee of the health service, or the ANMF on their behalf, must notify in writing, the operator of the hospital (through the nurse or midwife’s immediate supervisor) of an alleged breach of the ratio.
  2. Without prejudice to the outcome of the dispute, the health service must, as soon as practicable after being notified as above, suspend the course of conduct alleged to constitute a breach of the ratio for the duration of the resolution procedures. 
  3. The health service must arrange a meeting within 48 hours between the nurse/midwife/ ANMF and the immediate supervisor, or a representative of the health service, to discuss the dispute.
  4.  If the dispute is not resolved at the meeting, the health service, or the nurse/midwife/ANMF or representative must arrange another meeting within 48 hours (remembering that the breach must be suspended during this time).

All parties must genuinely attempt to resolve the dispute in a timely manner through the procedure, act cooperatively and genuinely consider resolution options.

What if it still isn’t resolved, or my employer won’t suspend the breach?

A nurse of midwife, with ANMF support, can apply to the Magistrates' Court under section 42(1) of the Act where the health service fails to comply with the resolution procedures.

What can the Magistrates’ Court do?

The court can:

  • grant an interim injunction restraining the health service from engaging in or continuing the breach
  • make a declaration that the health service did not comply with the ratio
  • grant an injunction restraining the health service from contravening or continuing to contravene the ratio.

If the Magistrates' Court makes a declaration of non-compliance with a ratio, the court may make an order imposing a penalty of up to 60 penalty units.  Penalty units are used to define fines for many offences and are set each year. At present, one penalty unit equates to $151.67.

If the court declares that a ratio has been breached, the health service must also declare this in its annual report.



A profession’s scope of practice incorporates the full spectrum of roles, functions, responsibilities, activities and decision making capacity that individuals within that profession are educated, competent and authorised to perform.

In Australia, nursing practice is defined through practice standards, codes and guidelines which were adopted by the Australian Health Practitioners Regulation Agency (AHPRA) and the Nursing and Midwifery Board of Australia (NMBA) at the introduction of national registration under the 'Health Practitioner Regulation National Law (Victoria) 2009'.

Nursing practice is further defined through the competencies and practice standards for enrolled nurses,  registered nurses, and nurse practitioners, as well as the nurses' code of conduct and code of ethics. Midwifery practice is defined through the midwifery competency standards, code of ethics and code of conduct.

The national competency and practice standards are the framework under which all nurses and midwives are licensed and authorised to practice.

There are decision making frameworks, available at the Nursing and Midwifery Board of Australia website, to guide nurses and midwives in determining what falls within their scope of practice.

Personal care workers and assistants in nursing do not have a defined scope of practice as they are not regulated health practitioners, so nurses and midwives should use the decision making frameworks to guide them in deciding whether to do a task themselves or whether it can be delegated.

Want more information about decision making frameworks?


Delegation and supervision of nursing tasks and activities is a fundamental component of a professional registered nurse's or registered midwife's role and responsibilities.

The Department of Health Victoria has prepared a guideline document to assist Victorian nurses and midwives to make decisions relating to delegation and supervision in a safe, effective and efficient manner. View the guidelines.


Making a complaint 

If you wish to make a complaint about a registered health practitioner, visit the Australian Health Practitioner Regulation Agency (AHPRA) website for more information about notifications and to download the notification form.


If you are a member of ANMF, contact us immediately for personalised advice and support using the member assistance form below.

In some instances the ANMF professional officers will assist you, or you may be referred to the solicitors at Gordon Legal for legal assistance. Ask to speak to your industrial organiser who will refer you to a professional officer for advice.


Advice to members regarding medicinal cannabis

If you know that a patient is taking marijuana for medicinal purposes  while in your care (whether prescribed or not), firstly determine if the treating medical officer or consultant has obtained a permit from the Secretary of the Department of Health permitting administration and supply of marijuana to that particular patient.

Assisting, directly or indirectly, in the supply, possession or administration of marijuana to a patient could expose you to criminal charges by police, unless there is a valid permit in place.  Without such a permit a court could find the patient and the nurse equally guilty of the crime of possession and or supply of a drug of dependence. You may also be subject to disciplinary proceedings from your employer or be referred to AHPRA.

Download our 'Statement of advice to members' regarding medicinal and medically prescribed use of marijuana - nursing issues for more information.

Criminal Complicity, Victorian Legal Aid publication, 2014.


Midwives code of conduct 

This Code of Professional Conduct for Midwives sets the minimum standards for practice a professional person is expected to uphold both within and outside of professional domains in order to ensure the ‘good standing’ of the midwifery profession.


Code of conduct for nurses 

This Code of Professional Conduct for Nurses sets the minimum standards for practice a professional person is expected to uphold both within and outside of professional domains in order to ensure the ‘good standing’ of the nursing profession.


If you are accused of doing something wrong at work, or your work performance is questioned, your employer can invoke the disciplinary procedure in your enterprise agreement.

Your employer must advise you of their concerns in writing. They must conduct a fair investigation, having proper regard to 'procedural fairness'. Procedural fairness requires that you be provided with any material which forms the basis of their concerns, and/or any allegation against you. You must also be given reasonable time to respond. You must be informed of the reason for any interview and your employer must take all reasonable steps to give you an opportunity to answer any concerns or allegations.

In considering whether you should be disciplined, the employer must consider whether there was a valid reason arising from the investigation; whether you knew or ought to have known that the conduct was below acceptable standards; and any explanation you give relating to the conduct. They must also inform you of any disciplinary action in writing.

You are entitled to having an ANMF representative with you at any meetings.

Want more information about disciplinary proceedings?