Nursing in Sweden. Appendix 1 BASIC REGISTRATION NURSE TRAINING WITHIN THE EU. Appendix 2 POST - REGISTRATION NURSE TRAINING WITHIN THE EU

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1 Nursing in Introduction Regulation of Nurses Title Field of Activity Training Post basic training EC Law Appendix 1 BASIC REGISTRATION NURSE TRAINING WITHIN THE EU Appendix 2 POST - REGISTRATION NURSE TRAINING WITHIN THE EU Appendix 3 Specialist nurse in anaesthetic care

2 Introduction In in addition to the general care nurse there is also an enrolled nurse that has three years secondary school level training and an auxiliary nurse with one year s secondary level training. The auxiliary nurse is likely to disappear as they are converting to enrolled nurses. Neither of these latter types of nurse are regulated. There is also a branch nurse, the nurse in diagnostic radiology (rontgensjukoterska) that is regulated by transitional legal measures. The rontgensjukoterska role is notavailable to the general care nurse. Regulation of Nurses The Swedish general care nurse is regulated by means of a requirement to be authorised and the title of nurse is also protected. The provisions regulating nursing are set out in the Act on professional activities within the health care system. 1 The law 1998: 531 in chapter 3 paragraph 2 deals with authorisation Paragraph 2 Title One who has, in accordance with what is stated in the table below, 2 graduated from university or has had education and, when its needed, fulfilled practised duty shall, after application, obtain authorisation for the profession The provisions on the protection of title are set out in paragraph five Protection of professional title Paragraph 5 A professional title stated in paragraph 2 (protected professional title) is only allowed to be used by an individual who 1 Act no. 531 of Sjukstköterska = general care nurse

3 according to that paragraph either has authorisation for the profession or practices stated. All nurses in thus are general care nurses and must register with the National Board of Health and Welfare. The nurse in diagnostic radiology does not currently have a protected title, though it is planned to be introduced in The activities of the diagnostic radiology nurse are not available to the general care nurse. Field of Activity The scope of nursing activity is not legally defined but the National Board of Health and Welfare (Socialstyrelsen) has issued general recommendations describing the skills required of the nurse in various fields of nursing. The recommendations of the National Board of Health and Welfare (Socialstyrelsen) are set out in general guidelines. 3 The post basic courses for nurses are not regulated by national law (except for midwives). The practice of the specialist activities are not regulated either in law. 4 Essentially the employment market sorts out the demand for specialised nurses. Nurses may undertake studies in radiology diagnostic nursing. Training 3 See that for anaesthetic nurses in appendix 2 4 The Ministry of Education has plans to regulate this, but they are not yet ready.

4 In the academic year follows a two term system. One academic year of full time studies (40 weeks) gives 40 points. The requirements of most firstdegree programmes vary between 120 and 160 points. The classic types of specialist are set out in the appendix 1. The details found there are from the UMEA University programmes. They are broadly similar, but not identical elsewhere in the other universities. Post basic training The highlighted 5 specialised post basic courses include: - primary health care - paediatrics - opthormology and orthoptics - anistheology - intensive care - operating room - psychiatric - geriatrics - radiology - oncology treatment and nursing Colleges also provide courses in health administration teaching and research training. There is a plan by the Ministry of Education to legally regulate specialist nursing by protecting the title. However this is the responsibility of the Ministry of Education and it is not certain or known when the new regulations may be presented. They are not expected in The Committee of Senior Officials on Public Health in their document on profession of nurses. Ref FVA/pc j:/csp/mono/inf-en/ XV/E/8328/94-EN

5 EC Law As there are no legally defined and protected specialist nurses no especial difficulties arise. The nurse in diagnostic radiology is subject to Directive 89/48/EEC. Appendix 1 BASIC REGISTRATION NURSE TRAINING WITHIN THE EU NURSE QUALIFICATION/SPECIALITY LEVEL DURATION Registered Nurse (Legitimerad sjuksköterska) Basic 3 years Completion of secondary education MANDATORY COMPONENTS (HOURS) CLINICAL ½ time THEORETICAL ½ time Bachelor of Science in Nursing National Board of Health and Welfare STUDENT b APPRENTICE EMPLOYEE Conforms to the sectoral nurse directives

6 Appendix 2 POST - REGISTRATION NURSE TRAINING WITHIN THE EU UMEA data is used as an example throughout this appendix POST-BASIC/POST-REGISTRATION NURSE TRAINING WITHIN THE EU NURSE QUALIFICATION/SPECIALITY Specialist District Nurse LEVEL DURATION 12,5 months Swedish Nurse Registration 24 Months experience as qualified nurse MANDATORY COMPONENTS (HOURS) CLINICAL 360 THEORETICAL TECHNICAL -? TOTAL = 2000 Awaiting legislation Departement of Nursing, Umeå University STUDENT full time Theoretical Hours Pharmachology Public Health Health Care of Adults & the Aged Health Care of Children & Adolescents Public Health Nursing Clinical/Technical Hours District Nursing and Home Care Child Health Care School Nursing 400 (10 points) 400 (10 points) 400 (10 points) 400 (10 points) 200 (10 points) (5 points) 80 (2 points) 80 (2 points) 1 point = 1 week = 40 hours 40 points one academic year degree programmes are between points

7 POST-BASIC/POST-REGISTRATION NURSE TRAINING WITHIN THE EUROPEAN UNION NURSE QUALIFICATION/SPECIALITY Specialist Paediatric Nurse LEVEL DURATION 10 Months Swedish Nurse Registration 6 Months experience as qualified nurse MANDATORY COMPONENTS (HOURS) CLINICAL 600 THEORETICAL TECHNICAL -? TOTAL = 1600 Awaiting legislation Departement of Nursing, Ume University STUDENT full time studies Theoretical Hours Nursing Science Public Health and Social Sciences Medicine:paediatric, disease & treatment procedures 400 (10 points) 240 (6 points) 120 (3 points) Clinical/Technical Hours Child Health and School Nursing 160 (4 points) Medical/Surgical Nursing & Outpatients and Neonatal intensive care, critical care 280 (7 points)

8 POST-BASIC/POST-REGISTRATION NURSE TRAINING WITHIN THE EUROPEAN UNION NURSE QUALIFICATION/SPECIALITY Specialist Geriatric Nurse LEVEL DURATION 24 Months, part time studies Swedish Nurse Registration 12 Months experience as qualified nurse MANDATORY COMPONENTS (HOURS) CLINICAL 0 THEORETICAL 1600 TECHNICAL -? TOTAL = 1600 Awaiting legislation from the national Board of Higher Education Departement of Nursing, Umeå University STUDENT part time studies two years Theoretical Hours Gerontology and Geriatrics 400 (10 points) Geriatric Nursing 800 (20 points) Geriatric Nursing & Research & Development 400 (10 points) Clinical/Technical The clinical studies are totally integrated with the theoretical course work

9 POST-BASIC/POST-REGISTRATION NURSE TRAINING WITHIN THE EUROPEAN UNION NURSE QUALIFICATION/SPECIALITY Specialist Psychiatric Nursing and Supervision LEVEL DURATION two years part time studies Swedish Nurse Registration None MANDATORY COMPONENTS (HOURS) CLINICAL 200 THEORETICAL TECHNICAL -? TOTAL = 1600 Awaiting legislation Departement of Nursing, Ume University STUDENT part time studies two years Theoretical Hours Psychiatric Nursing Psychopathology Cognitive theory and System theory Community Mental Health Nursing 800 (20 points) 200 (5 points) 200 (5 points) 200 (5 points) Clinical/Technical Hours Psychiatric nursing 200 (5 points)

10 POST-BASIC/POST-REGISTRATION NURSE TRAINING WITHIN THE EUROPEAN UNION NURSE QUALIFICATION/SPECIALITY Specialist Oncology Nurse LEVEL DURATION 24 Months part time studies Swedish Nurse Registration 6 Months experience as qualified nurse MANDATORY COMPONENTS (HOURS) CLINICAL 0 THEORETICAL TECHNICAL -? TOTAL = 1600 Awaiting legislation Departement of Nursing, Ume University STUDENT part time studies Theory Hours Oncology Nursing Medical Sciences in Oncology Specific Cancer Treatment Pain and Pain Relief in Cancer Palliative and Terminal Care Clinical/Technical Hours Clinical Oncology Nursing (15 points) 400 (10 points) 200 ( 5 points) 200 (5 points) 200 (5 points) 1600

11 POST-BASIC/POST-REGISTRATION NURSE TRAINING WITHIN THE EUROPEAN UNION NURSE QUALIFICATION/SPECIALITY Specialist Intensive Care Nurse LEVEL DURATION 45 weeks Swedish Nurse Registration 12 Months experience as qualified nurse MANDATORY COMPONENTS (HOURS) CLINICAL 760 THEORETICAL TECHNICAL -? TOTAL = 1800 Awaiting legislation Departement of Nursing, Ume University STUDENT full time studies Theoretical Hours Human Biomedicine Acut, Intensive and Perioperative Nursing Intensive Care Nursing Clinical /Technical Hours Perioperative Nursing General Intensive Care Specialised Intensive Care 400 (10 points) 280 (7 points) 360 (9 points) (5 points) 360 (9 points) 200 (5 points) Summary 760

12 POST-BASIC/POST-REGISTRATION NURSE TRAINING WITHIN THE EUROPEAN UNION NURSE QUALIFICATION/SPECIALITY Nurse Anaesthetist LEVEL DURATION 45 weeks Swedish Nurse Registration 12 Months experience as qualified nurse MANDATORY COMPONENTS (HOURS) CLINICAL 7600 THEORETICAL TECHNICAL -? TOTAL = 1800 Awaiting legislation Department of Nursing, Ume University STUDENT full time studies Theoretical Hours Human Biomedicine Acute, Intensive and Perioperative Nursing Anaesthesiology 400 (10 points) 280 (7 points) 360 (9 points) Summary 1040 Clinical/Technical Hours Nurse Anestethist 760 (19 points) Total 45 points (45 weeks)

13 POST-BASIC/POST-REGISTRATION NURSE TRAINING WITHIN THE EUROPEAN UNION NURSE QUALIFICATION/SPECIALITY Specialist Operation Theatre Nurse LEVEL DURATION 45 weeks Swedish Nurse Registration 0 Months experience as qualified nurse MANDATORY COMPONENTS (HOURS) CLINICAL 760 THEORETICAL 1040 TECHNICAL -? TOTAL = Awaiting legislation Departement of Nursing, Ume University STUDENT full time studies Theoretical Hours Acute, Intensive and Perioperative Nursing Special Surgical Procedures and Perioperative Nursing Human Biomedicine Clinical/Technical Perioperative Nursing 280 (7 points) 360 (9 points) 400 (10 points) (19 points)

14 POST-BASIC/POST-REGISTRATION NURSE TRAINING WITHIN THE EUROPEAN UNION NURSE QUALIFICATION/SPECIALITY Specialist Ophthalmic Nurse is not offered in Umeå LEVEL DURATION Months Swedish Nurse Registration MANDATORY COMPONENTS (HOURS) CLINICAL THEORETICAL TECHNICAL - TOTAL = STUDENT b APPRENTICE EMPLOYEE Theoretical Hours Clinical/Technical Hours

15 POST-BASIC/POST-REGISTRATION NURSE TRAINING WITHIN THE EUROPEAN UNION NURSE QUALIFICATION/SPECIALITY LEVEL DURATION Specialist Diagnostic Radiology Nurse starts in August 1999 after new legislation from the National Board of Higher Education Undergraduate points 120 Weeks Gymnasium two years F.1.1 = Maths B, Natural Sc B, Society and Enviroment Sc B from the Gymnasium MANDATORY COMPONENTS (HOURS) CLINICAL 2080 THEORETICAL TECHNICAL -? TOTAL = 4800 Awaiting legislation Departement of Nursing, Ume University STUDENT full time studies Theoretical and Clinical/Technical Hours are under planning Basic Natural Sciences -electricity -photography X-ray, security precautions -anatomy Radiological Diagnostics & Nursing -diagnostic methods -paediatric radiology -documentation -communication -ethics & integrity of the patient -quality development total

16 Appendix 3 Specialist nurse in anaesthetic care Special field and functions The nurse s special field anaesthetic care includes responsibility of surveillance and/or the practice of local and general anaesthesia, analgesia and sedation of patients of all ages, suffering from usual as well as complicated acute diseases and injuries, who shall go through, or have gone through operations examinations and treatments at pre-, inter- and post surgical unit, anaesthetic unit or other units in specialised open and closed care. Regarded as other units are child delivery units, pain treatment units, emergency units and other clinics at hospitals or sites of accidents and catastrophes. The Law of Healthcare (1982:763) and the Law about Profession in Healthcare (1998:531) regulates the nurse s work. According to these laws a nurse specialised in anaesthetic care must in an ethical manor and in accordance with science and experience in the special field be able to: - participate in operations, treatments and examinations - be responsible for the care of patients - inform patients and their relatives and be able to instruct and teach single, or groups of students and colleagues - follow, use and participate in research and development work and take initiative to and lead development work - lead, plan an develop the work within his or her work-team and co-operate with people of other professions - participate in the care of injured at accidents, catastrophes and war. The nurse must in accordance with the duty obey and be able to practice those laws, advices and other rules which regulates the special field. Tasks

17 Examinations and treatments An anaesthetic nurse must be able to be responsible of surveillance and /or the practice of local and general anaesthesia, analgesia and sedation during operations, examinations and treatments of patients of all ages within specialised and highly specialised open and closed care. The anaesthetic must in accordance with the special needs of the patient and the occasional complexities of the diseases in the special field be able to perform the tasks stated for a registered nurse as well as: - prepare and check the functions of the equipment within this field before and after operation, examination and treatment and see through that faulties are taken care of - use the equipment within the field and their functions in order to make sure that anaesthesia and/or surveillance is undertaken in an adequate and secure manor - surveillance equipment - anaesthetic equipment, such as ventilators, anaesthetic machines and respirators - blood- and infusion pumps - heaters With help from the equipment be able to identify and judge the need for measures and practice general and local anaesthesia, analgesia and sedation and keep the vital functions of the patient during operation, examination and treatment in accordance with the special instructions from a doctor the routines at the unit. Together with operation nurse be responsible for the correct placement of the patient on the operation table. Before anaesthesia, analgesia or sedation inform the patient or the relatives about the measures which are to be taken and about how the patient could experience them.

18 Identify and judge the need of measures and treat the complications which could arise during anaesthesia, analgesia and sedation. Observe the patient during anaesthesia, analgesia and sedation after operation, judge the need for measures and take care of the patient. Administrate medicines, infusions and transfusions in accordance with instructions or routines. Document the anaesthetic treatment. Co-operate with other personnel Assist colleagues at other units during examination and treatment. Care An anaesthetic nurse must be able to be responsible for the care of patients during anaesthesia, analgesia and sedation within specialised and highly specialised open and closed care. The anaesthetic nurse must in accordance with the special needs of the patient and the occasional complexity of the diseases within the special field be able to perform the tasks stated for a registered nurse as well as: Prepare the patients by informing them about and answering them questions before planned anaesthesia, analgesia and sedation. Information, teaching and instructing An anaesthetic nurse must within his or her professional field be able to inform single patients and their relatives and be able to instruct and teach students and colleagues both individually and in groups in giving anaesthesia, analgesia and sedation to patients in specialised or highly specialised open and closed care. The anaesthetic nurse must be able to perform tasks stated for a registered nurse as well as: - inform and teach groups of personnel and students about new results of research within the special field - instruct students and colleagues.

19 Research and development An anaesthetic nurse must within his or her field be able to cope with, use and participate in research and developing work as well as initiate and lead development work regarding giving anaesthesia, analgesia and sedation to patients in specialised and highly specialised open and closed care. The anaesthetic nurse must be able to perform the tasks stated for a registered nurse as well as initiate, perform and lead developing work at the unit or together with other units and create routines for the work. Tasks of planning and leading An anaesthetic nurse must be able to lead, plan and develop the work within the working-team and co-operate with other professionals concerning giving anaesthesia, analgesia and sedation to patients in specialised and highly specialised open and closed care. The anaesthetic nurse must be able to perform the tasks stated for a registered nurse as well as: - in co-operation with the working-team create the aims of the care of the patients and his or her own development of skills and, in doing that, mind the composition of the local population - contribute to effectiveness in costs and make sure that the resources are used in the most effective way. - perform ongoing, systematically and documented quality work Catastrophe stand by An anaesthetic nurse must be able to use his or her anaesthetic knowledge in events of catastrophes and big accidents both in peace and war as well as be able to work in healthcare-groups outside the hospital. The anaesthetic nurse must be able to perform the tasks stated for a registered nurse as well as:

20 - work in a paramedic group at a scene of an accident, gathering place or within an accident area - perform within the special organisation required at big accidents and catastrophes - use the methods of anaesthesia suited for anaesthesia in war