In June 2008 Australia's nurses and midwives celebrated the appointment of Rosemary Bryant as the country's first chief nursing and midwifery officer (CNMO). After 25 years of lobbying by nursing and midwifery groups, the administration of Australia's prime minister, Kevin Rudd, elected in 2007, established the post as part of the $2.5 billion National Health and Hospitals Reform Plan.
Australia is a vast country with a relatively small population. Like the United States, it has a federal government and a government for each of its six states and two territories. Health care professionals are currently regulated by the laws of their state or territory, all of which have different practice and education standards for nurses and midwives.
In a federal effort to improve the overall quality of nursing care and institute standardization in the late 1980s and early 1990s, all basic nursing programs were shifted from hospital schools to universities, which were mandated to offer a three-year program for a bachelor's degree in nursing. By the end of the 1990s nursing students could obtain degrees through the doctoral level at universities in all Australian states and territories.
Midwifery in the early 2000s began gaining recognition as a discipline distinct from nursing. The field developed its own codes of ethics and conduct and standards for practice and accreditation. In several states students now can earn a bachelor's degree in midwifery without first being educated as nurses.
In recent years, however, the national legislature has been moving to unify the eight jurisdictions' disparate practice requirements and discrete registration rolls into a single national registration and accreditation system. In another move toward cohesion, the country's six major nursing and midwifery groups banded together as the Australian Peak Nursing and Midwifery Forum (APNMF) to lobby on national issues. State and territory chief nursing and midwifery officers also meet regularly to work toward a consistent national approach to health care. Although these measures have helped to bring the jurisdictions and professional associations together, it is only with the appointment of Bryant as CNMO that the country will have a government-endorsed voice speaking collectively for nursing and midwifery in federal and international policy discussions. Finally Australia, which has one of the world's strongest nursing and midwifery communities, comprising more than 50% of the country's health care workforce, will have official representation at the World Health Organization's chief nursing and midwifery officers' meetings and at the World Health Assembly.
As CNMO, Bryant, formerly executive director of Australia's Royal College of Nursing and currently second vice-president of the International Council of Nurses and a member of AJN's International Advisory Board, will play an important role in implementing and evaluating policy, reshaping health services and systems, and overseeing programs addressing specific health problems. She will also advise the government on other matters related to nursing and midwifery, including an initiative to train 10,000 new nurses, the development of review standards for primary care and midwifery, and promoting and strengthening nursing as a career of choice.
Jill White, PhD, RN, RM
Dean, faculty of nursing and midwifery, University of Sydney, Australia