NURSES REGISTRATION BOARD

New South Wales NURSES REGISTRATION BOARD Annual Report 30 JUNE 1998

CONTENTS Charter 1 Aims and Objectives: Functions 1 Clientele of the Board 2 Access 3 MANAGEMENT AND STRUCTURE Membership 3 Meetings of the Board 6 Attendance at Meetings 7 Disciplinary Matters Conduct Committee 7 Complaint Statistics 8 Psychiatric Assessment 9 Professional Standards Committees 9 Nurses Tribunal 10 Committee Structure Research and Development Committee 12 Professional Liaison Committees 13 Professional Practice Committees 13 Health Committee 14 Human Resources Administrative Staffing 14 REVIEW OF OPERATIONS Activities Course Accreditation 16

Recognised Institutions:- Assessment of Applicants from Other Countries 16 Registration, Enrolment, Authority to Practise Midwifery 16 Statistics: Registration/Enrolment/Midwives 16 Mutual Recognition 17 Statistics 17 Overseas Qualified Applicants for Registration and Enrolment 18 Statistical Breakdown by Country 19 Nurses Registration Board Education and Research Account 20 Scholarships 20 Nurse Education Inspections 22 Leading to Registration on List A 23 Leading to an Authorisation to Practise Midwifery 23 Leading to Enrolment on List A 25 Code of Professional Conduct Registered/Enrolled Nurses 28 Nurses Registration Board Projects: Special Initiatives "Board Works" Newsletter 29 Internet Web-Site 29 Project to Review and Examine Expectations of Beginning Registered Nurses in the Workforce 30 Nursing Practice Research Grant 31 Publications 31 Consumer Response 32 Time for Provision of Services Applications 32 Annual Renewal of Registration/Enrolment 33

General Fees Payable - List of fees and comparison between years 1997/98 33 Metal Badges 34 Health Professionals Registration Boards Ethnic Affairs Priority Statement 35 Administration - Management and Structure 38 Year 2000 (Millennium Bug) 39 Administrative Staff - Code of Conduct 39 NSW Government Action Plan for Women 40 Organisational Chart 41 Finance Finance and Budget 42 Auditor-General's Certificate 44 Statement of Accounts 45 Index 55

1. CHARTER The Nurses Registration Board of NSW was established by an Act of the NSW Parliament in 1926. Presently the NSW Nurses Registration Board operates under the Provisions of the Nurses Act 1991 (as amended) to exercise the powers, authorities, duties and functions prescribed by the Act. 2. AIMS AND OBJECTIVES 2.1 Functions! To maintain the Register of legally qualified registered nurses.! To maintain the Roll of legally qualified enrolled nurses.! To grant registration and enrolment to nurses with the appropriate qualifications.! To grant authority to practise midwifery to nurses with the appropriate qualifications.! To hold examinations and to determine the character, subjects and conduct of those examinations.! To appoint examiners and supervisors in respect of examinations.! To appoint places and times at which examinations shall be held.! To determine applications for registration as a nurse, for authorisation to practise midwifery and for enrolment as enrolled nurses.! To issue certificates of registration to registered nurses, certificates of authorisation to practise midwifery to registered nurses authorised to practise midwifery and certificates of enrolment to enrolled nurses.! To issue authorities to practise as a registered nurse or enrolled nurse.! To grant recognition to hospitals, nursing homes and educational and other institutions offering courses for the training of nurses, midwives and enrolled nurses.! To grant recognition to the curricula for such courses.! To grant recognition to the diplomas, certificates and other qualifications awarded to those persons who successfully complete those courses.! To investigate the conduct of a registered nurse, enrolled nurse or certified midwife where a complaint is received or where the Board decides that it is desirable to do so. 1

! To promote and maintain professional standards of nursing practice in New South Wales.! To promote the education of nurses and educational programs relating to nursing.! To advise the Minister on matters relating to the registration and enrolment of nurses, standards of nursing practice and any other matter arising under or related to the Act or the Regulations.! To publish and distribute information concerning the Act and the regulations to nurses and other interested persons.! To impose requirements or conditions for or relating to registration as a nurse, authorisation to practise midwifery or enrolment as an enrolled nurse or enrolled nurse (mothercraft).! To grant to persons in prescribed circumstances or cases exemptions from a requirement or condition for or relating to registration as a nurse, authorisation to practise midwifery or enrolment as an enrolled nurse.! To make recommendations to the Minister for Health for appropriate amendments to the Act and Regulations. The Board is empowered! To terminate as it considers appropriate any appointment of examiners and to vary the place and times of examinations.! To withdraw, or vary the conditions of, any recognition or exemption granted.! In accordance with the Act, to cancel or suspend any registration as a nurse, authorisation to practise midwifery or enrolment as an enrolled nurse or, where appropriate, to restore any such registration, authorisation or enrolment. 3. CLIENTELE OF THE NSW NURSES REGISTRATION BOARD! All Registered and Enrolled Nurses in NSW! Any member of the public who has cause to enquire regarding the regulation of nursing or complain of the professional actions of Registered and Enrolled Nurses.! Employers of Registered and Enrolled Nurses.! Hospitals and other Health Care Facilities. 2

4. ACCESS The NSW Nurses Registration Board is located at the following address:- Level 2 Hours of Business Postal Address: 28-36 Foveaux Street 8.30 am - 4.30 pm PO Box K599 SURRY HILLS Monday to Friday HAYMARKET 1238 SYDNEY 2010 Telephone: (02) 9219 0222 5. MANAGEMENT AND STRUCTURE 5.1 Membership Facsimile: (02) 9212 7126 Membership of the Board is prescribed under Section 9 of the Nurses Act 1991 and consists of 13 members who are appointed by the Governor, of whom From 1 July 1997 to 12 March 1998 Three (3) are registered nurses elected in the prescribed manner by registered nurses who are eligible to vote at elections held for the purpose: Rosemary Angela Snodgrass, RN, CM, ADNA, MINA, MCN (NSW), J & J Wharton Fellow, University of Pennsylvania, USA, 1997, appointed under section 9(2)(a) Paul John Schofield, RN, CM, A & E Cert., B.Health.Sc. (Nursing) JP, appointed under section 9(2)(a) John Kelly, RN, BA (Hons) (Qld), LLB (UNSW), Grad. Dip. Leg. Prac. (UTS), FRCNA, FCN (NSW), AFAIM, MAPS, appointed under section 9(2)(a) One (1) is an enrolled nurse or enrolled nurse (mothercraft) elected in the prescribed manner by the enrolled nurses and enrolled nurses (mothercraft) who are eligible to vote at elections held for the purpose: Stephen Brand, EN (List A), AMRCNA appointed under section 9(2)(b) One (1) is a registered nurse nominated by the New South Wales Nurses' Association: Julie Venamore, RN, BA, Coronary Care Cert., appointed under section 9(2)(c) [appointed October 1995] 3

One (1) is a registered nurse nominated by the New South Wales College of Nursing: Joan Englert, AM, RN, CM, MSc Soc, BHA, DNA, COTM, FCN(NSW), FCNA, MINA, FAIM, appointed under section 9(2)(d) One (1) is a registered nurse who is an officer of the Department of Health, an Area Health Service, the Ambulance Service of NSW or the Corporation, nominated by the Minister: Judith Louise Meppem, RN, CM, BHA (NSW), COTM, FRCNA, FCN (NSW), FINA (NSW and ACT), AFAIM, appointed under section 9(2)(e) One (1) is a registered nurse who is an educator of nurses jointly nominated by the Minister for School Education and Youth Affairs and the Minister for Further Education, Training and Employment: Ruth Lynette Russell, RN, CM, DNE (NSW), BA (Hons), PhD (Newcastle), FCNA, FCN (NSW), MACE, appointed under section 9(2)(f) One (1) is a barrister or solicitor nominated by the Minister: Yvonne Grant, BA, Bachelor of Law, Master of Law (London), Diploma of Air & Space Law (London), appointed under section 9(2)(g) Two (2) are persons nominated by the Minister as a representative of consumers: Donald Maxwell, Solicitor appointed under section 9(2)(h) Vacant One (1) is a registered nurse authorised by the Board to practise midwifery who is elected in accordance with the regulations by registered nurses who are eligible to vote at elections held for the purposes of this paragraph: Pauline Elizabeth Green, RN, CM, Maternal and Infant Care Cert, DNE, BA, M.Ed (Adult Ed), FACM, MCN appointed under section 9(2)(b1) (appointed on 12 March 1997 to 15 January 1997) One (1) is to be a registered nurse who is nominated by the Minister who practises nursing in the area of mental health: Charles Linsell, RN, BA, Dip.Ed, Grad.Dip. Of Business Studies (Industrial Relations) appointed under section 9(2)(f1) (appointed by Minister on 21 May 1997) 4

From 25 March 1998 to 30 June 1998 Three (3) are registered nurses elected in the prescribed manner by registered nurses who are eligible to vote at elections held for the purpose: Rosemary Angela Snodgrass, RN, CM, ADNA, MINA, MCN (NSW), J & J Wharton Fellow, University of Pennsylvania, USA, 1997, appointed under section 9(2)(a) Paul John Schofield, RN, CM, A & E Cert., B.Health.Sc. (Nursing) JP, appointed under section 9(2)(a) John Kelly, RN, BA (Hons) (Qld), LLB (UNSW), Grad. Dip. Leg. Prac. (UTS), FRCNA, FCN (NSW), AFAIM, MAPS, appointed under section 9(2)(a) One (1) is an enrolled nurse or enrolled nurse (mothercraft) elected in the prescribed manner by the enrolled nurses and enrolled nurses (mothercraft) who are eligible to vote at elections held for the purpose: Stephen Brand, EN (List A), AMRCNA appointed under section 9(2)(b) One (1) is a registered nurse nominated by the New South Wales Nurses' Association: Julie Venamore, RN, BA, Coronary Care Cert., appointed under section 9(2)(c) One (1) is a registered nurse nominated by the New South Wales College of Nursing: Joan Englert, AM, RN, CM, MSC Soc, BHA, DNA, COTM, FCN(NSW), FCNA, MINA, FAIM, appointed under section 9(2)(d) One (1) is a registered nurse who is an officer of the Department of Health, an Area Health Service, the Ambulance Service of NSW or the Corporation, nominated by the Minister: Judith Louise Meppem, RN, CM, BHA (NSW), COTM, FRCNA, FCN (NSW), FINA (NSW and ACT), AFAIM, appointed under section 9(2)(e) One (1) is a registered nurse who is an educator of nurses jointly nominated by the Minister for School Education and Youth Affairs and the Minister for Further Education, Training and Employment: Ruth Lynette Russell, RN, CM, DNE (NSW), BA (Hons), PhD (Newcastle), FCNA, FCN (NSW), MACE, appointed under section 9(2)(f) 5

One (1) is a barrister or solicitor nominated by the Minister: Yvonne Grant, BA, Bachelor of Law, Master of Law (London), Diploma of Air & Space Law (London), appointed under section 9(2)(g) Two (2) are persons nominated by the Minister as a representative of consumers: Chris Guest, B.Ec (I), Monash University 1975, MA (Econ, Hons. I), University of Melbourne 1980, M.App.Fin. Macquarie University 1987. (Appointed from 20 May 1998.) Vacant One (1) is a registered nurse authorised by the Board to practise midwifery who is elected in accordance with the regulations by registered nurses who are eligible to vote at elections held for the purposes of this paragraph: Pauline Elizabeth Green, RN, CM, Maternal and Infant Care Cert, DNE, BA, M.Ed (Adult Ed), FACM, MCN appointed under section 9(2)(b1) One (1) is to be a registered nurse who is nominated by the Minister who practises nursing in the area of mental health: Charles Linsell, RN, BA, Dip.Ed, Grad.Dip. Of Business Studies (Industrial Relations) appointed under section 9(2)(f1) Of the members of the Board, one who is a registered nurse is appointed as President and one (who may or may not be a registered nurse) is appointed as Deputy President, by the Governor. President Joan Englert, AM, RN, CM, MSc Soc, BHA, DNA, COTM, FCN(NSW), FCNA, MINA, FAIM Deputy President Rosemary Angela Snodgrass, RN, CM, ADNA, MINA, MCN (NSW) 5.2 Meetings of the Board The Board met on 11 occasions during the reporting period, usually on the first Thursday of each month between 1 July 1997 to 30 June 1998. 6

5.3 Attendance at Meetings Board Members Number of meetings attended J Englert 9 R Snodgrass 8 S Brand 10 Y Grant 9 P Green 10 C Guest (appointed May 1998) 1 J Kelly 8 C Linsell 9 P Schofield 10 D Maxwell 5 J Meppem 4 L Russell 8 J Venamore 7 5.4 DISCIPLINARY MATTERS (a) Conduct Committee The Conduct Committee has been established by the Board to review all issues dealing with disciplinary matters or professional misconduct/ unsatisfactory conduct complaints sent to the Board. All matters referred from individuals, the courts, the Health Care Complaints Commission, other nurse registering authorities, hospitals, Health Department Regional and Area Offices, Pharmaceutical Services Section (Health Department) concerning the professional conduct of registered/enrolled nurses are considered by the Conduct Committee. Those persons making application for registration or enrolment as a nurse who make declaration that they had a felony, misdemeanour/criminal convictions prior to application were reviewed by the Conduct Committee. The Conduct Committee met on 11 occasions during the reporting period. Members R Snodgrass D Maxwell (Resigned 17.3.97) J Kelly P Green Observers M Walton, Commissioner Health Care Complaints Commission 7

(a)(i) Statistics From 1 July 1997 to 30 June 1998 the following types of complaints were made to the Nurses Registration Board concerning the conduct of registered/enrolled nurses and considered by the Conduct Committee. Complaint/Offence Total Breach of Confidentiality 3 Patient care and work standards/competence 34 Complaints re Character 6 Providing False Information 1 Firearms offence 1 False claims re. Qualifications 7 Drug related offence 18 Drug Authority Withdrawn 7 Assault Patients 9 Sexual Assault (Patients) 3 Sexual Relationship with client/others 2 Advice from other Boards about Registration 81 Impairment (Psychological) 4 Impairment (Drug Alcohol) 3 Making false Instrument 1 Notifications from criminal checks 16 Nurses Scheduled under Mental Health Act 3 Driving offences 4 Total 203 Court Convictions: Offensive Conduct 1 PCA 5 Shoplifting 1 Assault 3 Total 10 Disclosures/Information relating to applicants for registration/enrolment Stealing 3 Shoplifting 7 Assault charges 5 Traffic offences / Speeding 193 PCA 28 Drug Related Offence 8 Physical/Mental Impairment 14 Offensive Conduct 1 False Declarations 1 Larceny 2 8

University related matters 3 Other 4 (a)(ii) Psychiatric Assessment The Screening Committee directed that a number of nurses attend for psychiatric examination under s.45(5) and (6) of the Act. (b) Professional Standards Committees These Committees are independent of the Nurses Registration Board. When the Board decides to refer a complaint or is informed by the Director-General of Health of his decision to refer a complaint to a Committee, the Board appoints three persons to sit as the Committee for the purpose of conducting an inquiry into the complaint. The Chairperson and members of these Committees are appointed to sit on a particular Inquiry by the President of the Board, delegated to perform this function by the Nurses Registration Board. The members are drawn from a panel of Board approved nurses and a panel of lay persons approved by the Minister for Health. The Committee is composed of two registered nurses with appropriate qualifications, depending on the case to be heard, and one lay person who does not have nursing qualifications. Professional Standards Committees may only conduct Inquiries which do not provide grounds for the suspension or cancellation of the nurse s accreditation to practise. However these Committees are empowered to place conditions on a nurse s registration if a complaint is proved. Status of matters before Professional Standards Committees Five (5) matters went to Inquiry:. One matter dealt with a nurse issuing an anonymous inappropriate letter threatening a patient. Following the inquiry the nurse was cautioned and required to undertake an approved education course.. One matter dealt with a nurse failing to appropriately consult as required and administering medication without authorisation. Following inquiry nurse was found guilty of unsatisfactory professional conduct and cautioned. 9

. One matter dealt with a midwifery competence matter. The nurse failed to perform appropriate examination, adequately monitor or administer required oxygen to the foetus. The patient was left alone for unacceptable periods of time and inadequate monitoring occurred. The inquiry has been completed and a decision is awaited.. One matter dealt with an assault on an elderly disoriented patient and not providing adequate care when patient left the institution alone late at night. Following inquiry nurse required to undertake counselling, an education course and to report on practise and progress on a regular basis. Following the monitoring of the conditions by the Board the nurse requested lifting of the Orders. The Professional Standards Committee met again in October 1997 and lifted the conditions, at which time the matter was closed.. One matter dealt with the failure by the nurse to notify appropriate personnel of patient s condition. The nurse failed to record or document patient s condition and did not recognise the seriousness of the situation. Following inquiry the nurse was reprimanded and required to successfully complete an appropriate education course which included documentation of observations in patient records. Following the monitoring of the conditions by the Board the nurse requested lifting of the Orders. The Professional Standards Committee met again in September 1997 and lifted the conditions, at which time the matter was closed (c) The Nurses Tribunal The Nurses Tribunal was established by the Nurses Act 1991. The Nurses Tribunal is a statutory authority independent of the Nurses Registration Board. Complaints which may provide grounds for the suspension or cancellation of a nurse s accreditation must be referred to the Nurses Tribunal. The Governor appoints the Chairperson and Deputy Chairperson who have the appropriate legal qualifications as specified by the Act. For the purpose of conducting an Inquiry or Hearing an appeal, the Tribunal consists of: (a) (b) a Chairperson two accredited nurses drawn from a panel of nurses, having such qualifications as may be prescribed, and who are appointed by the Board 10

(c) one lay person is appointed by the Board, drawn from a panel of persons nominated by the Minister. Lay persons do not have nursing qualifications. Chairperson: Deputy Chairperson: Irving Wallach Cedrick Vass Status of matters before the Nurses Tribunal Thirteen (13) matters were before the Nurses Tribunal for Inquiry.. Three matters related to drug impairment.. Following inquiry two nurses were removed from the Register... Following inquiry one nurse was removed from the Roll and may apply to the Tribunal in two (2) years for restoration to the Roll.. One matter related to inappropriate sexual behaviour towards a female patient and inappropriately reviewing the patient s hospital/medical reports. Following inquiry the nurse was removed from the Register.. Five matters related to serious physical assault on patients... Following inquiry the nurse had conditions imposed on registration. These included undertaking an educational course, restrictions being placed on employment and the employer reporting on the nurse s practice... Following the inquiry the nurse was reprimanded and was required to undertake an education course and restrictions were placed on practice... Following inquiry restrictions placed on practice. Nurse also required to report on practice... Following inquiry the nurse was removed from the Register. Eligible to apply to the Tribunal for restoration to the Register after two years... One matter currently before the Tribunal. 11

. One matter related to providing inaccurate curriculum vitae to gain employment, together with false birth certificate. Also gave false information to the Screening Committee of the Nurses Registration Board. Following inquiry the nurse was removed from the Register.. One matter related to providing false and misleading information to an interview panel at a District Hospital. Following inquiry was suspended for two months. Following reinstatement to the Register the nurse must work under the supervision of a senior nurse until the Board is satisfied the nurse does not suffer from a mental illness.. One matter related to failure to arrange or provide first aid, failure to report patient s actions and to request assistance. Failed to take appropriate action after finding a false report of an incident. Following inquiry the nurse was suspended from the Roll for twelve months and must attend approved education courses within that twelve months.. One matter relates to midwifery practice and issues relating to competence. Inquiry completed and awaiting decision. 5.5 COMMITTEE STRUCTURE A number of Committees have been established by the Board to facilitate the decision making process and to ensure that advice is received from representatives of professional groups, consumers, government departments and other interested parties on matters which are addressed by the Board in accordance with the Nurses Act 1991. In recognition of the diverse nature of the Board's responsibilities committees have been established to report on professional issues and scholarship matters. (a) Research and Development Committee The Research and Development Committee is responsible for the scholarship program currently offered by the Nurses Registration Board for eligible registered and enrolled nurses in NSW. The functions of this committee include review of applications, the conduct of interviews, making recommendations to the Board regarding the granting of scholarships. Membership Members of the Board External Members P Schofield J Lumby J Kingston L Russell S McKinley S Carpenter S Brand M McMillan 12

The Committee invites external members to attend as required. The Committee met on 10 occasions during the reporting period. (b) Professional Liaison Committees Functions of these committees include:- The consideration of matters relating to professional issues as referred by the Nurses Registration Board in accordance with the Nurses Act 1991. To advise and make recommendations to the Nurses Registration Board on matters referred to it by the Board. To liaise with representatives of the profession on such matters as required. The Professional Liaison Committee includes representatives from the following organisations - New South Wales Nurses' Association Institute of Nursing Executives of NSW and ACT The New South Wales College of Nursing Australian Nurse Teachers Society (NSW) Ethnic Affairs Commission of New South Wales Private Hospitals Association of New South Wales Inc Nursing Homes and Extended Care Association of NSW Ltd NSW Council of Nurse Academics NSW Health Department Meetings of Professional Liaison Committees Professional Liaison Committees met on the following days during the reporting period - 26 August 1996 5 December 1996 (c) Professional Practice Committees The functions of the Professional Practice Committees include: The consideration of matters relating to professional practice as referred by the Nurses Registration Board in accordance with the Nurses Act 1991. To provide information to the Board with regard to those matters referred to it by the Board and to make recommendations as appropriate. 13

The Committees include representatives from the following organisations: NSW Midwives Association Inc Australian College of Mental Health Nurses Professional Association of Nurses in Developmental Disability Areas Australian Council of Community Nursing Services (NSW Branch) Confederation of Australian Critical Care Nurses (NSW Branch) Nursing Unit Managers Society NSW Migrant Employment Qualifications Board The Professional Liaison Committee was not required to meet during the year. Meetings of Professional Practice Committees The Professional Practice Committee was not required to meet during the year. The Committee invites external members to attend as required. (d) Health Committee 6. HUMAN RESOURCES Administrative Staffing Amendments to the Nurses Act 1991 relating to impairment matters commenced on 6 December 1996. These amendments provide for the referral of matters to an Impaired Nurses Panel which the Board considers indicates that an accreditated nurse suffers from an impairment. If the Board refers a matter to an Impaired Nurses Panel, three (3) persons must be appointed as the Panel to deal with the matter. The panel must consist of at least one (1) registered nurse and at least one medical practitioner. The Health Committee of the Board has met on six (6) occasions and eighteen (18) matters were referred to a Panel for inquiry. An Impaired Nurses Panel is to inquire into any matter referred to it by the Board. Registrar: Ronald Keith Dwyer Executive Director: Jan Dent, RN, CM, DNE, Cardio Thoracic Cert., BA (Ed) Associate Executive Director: Michael Cleary, RN, DNE, BA, MHP, FCN (NSW) 14

Nursing Officers: Deputy Registrar: Janet Brooks, RN, CM, Cardio Thoracic Cert., Neurology Cert., DNE, BA Anna Kettle, RN, CM, B.Econ., Dip.Ed., MA(Ed), M.Management Maureen Giddins Blues, RN, CM, Paed.Cert., BA Ron Lazucki, BA, Dip.Ed. (Sydney) JP Signing Officer: Stenographer: Michael Jaques, A.Dip.Health Admin. Frances McDonald JP. Registrations, Enrolments, Restorations and Telephone Enquiries: Barbara Gamble Virginia Kristiansen JP Samantha Roylance Eseta Hoffman JP Karen Mitchell (part-time) Mutual Recognition, Verifications and Examinations Elaine Harrop JP Enquiry Counter Staff: Diamante Rofe Suzan Dardass JP Jean Letts-Littlefield (Part-time) Plus 12 full-time and 6 part-time support staff serving the Health Professional Registration Boards in the areas of: Finance Cashiering Word processing/stenography Computer Operations Office Administration Mailing 7. REVIEW OF OPERATIONS 7.1 Activities Seminars and Workshops held by the Registration Board from 1 July 1997 to 30 June 1998 in the form of Professional Development Programs. 15

(a) Course Accreditation Thirteen (13) programs leading to registration are currently approved in New South Wales by the Nurses Registration Board. This includes a pilot four (4) year external study course for enrolled nurses, approved for a single intake in 1994. Another program, original approved for on-campus study, has been adapted for external study for enrolled nurses and has been approved for this purpose. There are eight (8) approved programs leading to an authorisation to practise midwifery. Enrolled nurse education programs continue to be conducted by the New South Wales Technical and Further Education Commission in conjunction with participating hospitals, as approved by the Nurses Registration Board. (b) Assessment of Applicants from Other Countries A number of applicants, who have been educated as nurses outside Australia are required to undertake a period of assessment in an approved clinical setting and to demonstrate safe practice and the competencies for registration/enrolment/authority to practise midwifery. Usually, applicants with an appropriate visa status, permitting employment are required to complete an approved overseas qualified nurses course conducted by the NSW College of Nursing. Applicants for an authorisation to practise midwifery or enrolment, required to undertake an assessment, currently complete an assessment at an approved institution. 7.2 Registration, Enrolment and Authority to Practise Midwifery The Board has maintained the Register and the Roll of Nurses in NSW as required under the provisions of Section 16 and Section 26 respectively of the Nurses Act 1991. Total number of Registered Nurses as at 30 June 1998 74,895 Total number of Enrolled Nurses as at 30 June 1998 16,343 Total number of Midwives as at 30 June 1998 19,898! Midwives are already registered on List A or List B and are therefore already counted in figures for List A or B. (ie, already included in the figure of the total number of registered nurses). 16

The Register and the Roll are subdivided into:- Register of Nurses List A: 74,695 List B: 198 Roll of Nurses List A: 15,880 List B: 523 *List A & B + 15,880 + 523-60 * An enrolled nurse may be listed on both List A and List B, hence the number so listed is subtracted from the total of List A and List B, to obtain the total number of enrolled nurses. 7.3 Mutual Recognition (a) Under the principle of mutual recognition, nurses registered/enrolled in one Australian State/Territory are entitled to be registered/enrolled in another State/Territory of Australia, providing certain conditions, as outlined in the mutual recognition legislation are met. In accordance with the Mutual Recognition Act 1992, the Nurses Registration Board, between 1 July 1997 and 30 June 1998, has Registered 806 registered nurses Enrolled 145 enrolled nurses (b)(i) Statistics Statistics concerning States/Territories from which nurses are applying to NSW under mutual recognition legislation - 17

From 1 July 1997 to 30 June 1998 State/Territory Registered Nurse Enrolled Nurse Authority to Practise Midwifery * Aust Overseas Aust Overseas Aust Overseas Queensland 168 70 34 2 26 4 Northern Territory 13 9 6-5 - ACT 60 5 9 1 6 1 Victoria 211 48 72 1 26 4 Tasmania 32 3 2-1 - South Australia 72 9 12-7 2 Western Australia 46 60 6-6 6 Totals 602 204 141 4 77 17 Total Registered Nurses 806 Total Enrolled Nurses 145 (b)(ii) Requests for Information from Interstate Registering Authorities 1 July 1997-30 June 1998 ACT QLD N.T S.A VIC TAS WA NZ TOTAL JULY 21 0 31 1 23 3 31 0 110 SEPT 19 0 16 7 19 3 19 0 83 OCT 12 0 20 5 21 3 28 0 89 NOV 28 0 23 9 21 2 22 0 105 DEC 19 0 14 3 13 0 21 0 70 JAN 30 1 27 7 59 5 39 0 168 FEB 27 0 24 9 30 0 63 0 153 MAR 11 0 19 14 57 2 35 0 138 APR 18 0 18 5 22 5 39 0 107 MAY 14 1 20 3 28 2 23 1 92 JUNE 19 3 40 2 16 0 35 3 118 TOTAL 231 7 277 71 326 25 381 4 1322 OVERSEAS NURSES MAKING PERSONAL APPLICATION FOR REGISTRATION/ENROLMENT 1 July 1997 to 30 June 1998 During the period 1 July 1997 to 30 June 1998 there were 523 interviews (356 were initial interviews, 166 subsequent interviews) undertaken by the Nursing Officers of the Board for persons seeking registration/enrolment on the basis of overseas qualifications. 18

The following data indicates the number of interviews undertaken in regard to country of education as a nurse. Country Number of Country Number of Interviews interviews Afghanistan 4 Korea 17 Algeria 1 Lebanon 10 Argentina 1 Macedonia 10 Austria 1 Malaysia 2 Bosnia/Herzegovina 30 Myanmar 2 Botswana 2 Nepal 8 Bulgaria 1 Netherlands 5 Canada 11 Nigeria 3 Chile 1 Papua New Guinea 3 China 57 Pakistan 18 Croatia 4 Philippines 107 Czechoslovakia 1 Peru 7 East Timor 2 Poland 13 Egypt 1 Romania 2 El Salvador 1 Russia 4 Eritrea 1 Singapore 6 Estonia 1 Sri Lanka 6 Fiji 15 South Africa 3 Finland 1 Sweden 2 France 2 Switzerland 1 Germany 18 Taiwan 11 Ghana 3 Thailand 4 Greece 2 Tonga 2 Hong Kong 1 Turkey 1 Hungary 3 United Arab Emirates 2 India 15 United States of America 9 Iran 27 Former USSR 2 Iraq 7 Ukraine 10 Italy 2 Uruguay 1 Japan 15 Vietnam 1 Jordan 3 Western Samoa 1 Yugoslavia 16 19

Registered nurse applications from countries requiring assessment but not requiring interview:- Canada 19 Eire (Republic of Ireland) 367 New Zealand 69 Republic of South Africa 23 United Kingdom (includes England, 491 Scotland, Wales and Northern Ireland) United States of America 18 Hong Kong 31 Total 1018 Enrolled nurse applications from countries requiring assessment but not requiring interview:- New Zealand 8 United Kingdom 12 Total 20 7.4 Nurses Registration Board Education and Research Account This account was established pursuant to Section 76 of the Nurses Act 1991. In accordance with the terms of that Section, the account may be used by the Board for education, including post graduate education, and research in nursing or any public purpose connected with the profession of nursing. During the year 1 July 1997 to 30 June 1998 an amount of $273,916.75 was expended for Scholarships, Research, etc. The total amounts spent on individual items is reflected in the account at the back of this report. (a) Research and Development Scholarships The Nurses Registration Board continues to provide scholarships for registered and enrolled nurses. In this financial year the sum of $350,000 was allocated for this purpose. Recipients of scholarships to support research, study projects or attendance at a conference are required to submit a written report to the Board. These reports are available, on application to the Registrar. The following categories of scholarships were offered for the period Categories 1. to complete the final year of study leading to an academic award 2. for a recognised education programme, or the final year of a programme, which does not lead to an academic award 20

3. for a study project in a specific nursing field 4. attendance at an international, national or local conference, or seminar, etc. 5. to undertake research in the discipline of nursing 6. to support the completion of a thesis for doctoral studies relevant to nursing. Scholarships offered by the Board promote and maintain standards of practice by providing valuable support for the extension of nursing knowledge through education of individual nurses, promotion of nursing research and attendance of nurses at national and international conferences. The Board awarded: Category 1 Scholarships 36 Category 2 Scholarships 12 Category 3 Scholarships 1 Category 4 Scholarships 31 Category 5 Scholarships 16 Category 6 Scholarships 2 1997-98 Scholarship Recipients were - Category 1 ANASTASIA, E.J. LAU, T.M.Y. BARBER, C.E LAWSON, K.A. BROWN, L. LEAVEY, J. CAMPBELL, L. MAGUIRE, M.E. CHRISTOPHER, S.A. MCMILLAN, P.A. COLLEY, C.M. METZ, A.M. COLLINS, D. PEAT, A.G. DE GUZMAN, Z. PIPPEN, S.M. DIXON, N.P.J. RAYNER, T.L. DOBBYNS, V.R. ROGERS, S.T. DWYER, A.L. SAPSFORD, K.L. FOSTER, J.R. SPARKS, J.M. FOXALL, C. STOREY, K.E. GAYKO, A.T. SZEP, H. GOOCH, D.J. TAM, R.Y.Y. GRIMMOND, P.L. WATTLE, V.J. HATCHER, S.J. WINSKILL, R.A. JACOBS, D.L. WRIGHT, K.E. Category 2 COOPER, L.A. FLETCHER, A.L. GAULD, R. KELSEY, C.K. KISONKA, D. MASON, K.M. MULLANE, S.M. NATION, M.T. OLIVER, J.S. PREUSS, L.M. WIKSHROM, D.M. WILLIS, D.M. 21

SOUTH-VUKASOVIC, R. Category 3 Category 4 BEALE, B.L. LEMKE, M.L. BLACKA, J.M. MALCOLM, A.E. BONNEY, V.M. MARCHANT, J.D. CAROLAN, C. MURPHY, B.F. COX, K.M. NADEW, K. DALY, S.M. NERY, M.L. DREW, D.M. O'DONNELL, H.M. DUNNE, S.G. PRYOR, J.A. ELBER, J.O. ROBINSON, B.E. EVANS, V.J. ROSE, M.E. HAND, R.I. ROSINA, R. HOLLIS, M.E. SCHIEFELBEIN, J. KOOLIK, B.J. STOTT, C.A. LANCASTER, L. TROTTER, A.M. LANDER, J.C. WILLIAMSON, N. LANG, F.V. Category 5 ALEXANDER, P.J. FISHER, M.J. ALLAN, J.R. JORDAN, R. ARTHUR, C. KAMAKER, D. BECKMANN, C.J. LOVIE, R. BELLCHAMBERS, H.L CONWAY, J.F. DONALDSON, H.J. MCCANN, T.V. O'BRAUGH, J.E SHARKEY, R. ELWIN, C.A. Category 6 BONEY, J.M. HAWLEY, R. 7.5 Nurse Education Inspections A total of 74 nurse education inspections were conducted during the period 1 July 1997 to 30 June 1998. The inspections included health institutions approved to conduct Enrolled Nurse or Midwifery courses as well as health and other agencies which provide clinical experience for students in such courses. Competencies as required by the Nurses Registration Board are able to be developed by students undertaking approved programs at the following institutions. As in previous years, inspection reports have identified that medication charts and drug registers do not always meet the requirements of the Health Department of NSW and such instances continue to be brought to the attention of the Chief Executive Officers of Area Health Services and/or the Private Health Care Branch of the NSW Health Department, as appropriate. 22

7.6 RECOGNISED INSTITUTIONS (a) N.S.W. TERTIARY EDUCATION INSTITUTIONS RECOGNISED BY THE NURSES REGISTRATION BOARD OF NEW SOUTH WALES TO CONDUCT APPROVED NURSING PROGRAMS WHICH MEET THE LEGISLATIVE REQUIREMENTS LEADING TO REGISTRATION AS A NURSE IN NEW SOUTH WALES Australian Catholic University, New South Wales Division (PO Box 968, North Sydney NSW 2059) Avondale College, Wahroonga (PO Box 19, Cooranbong NSW 2265) Charles Sturt University, Mitchell (Private Bag 29, Bathurst NSW 2795) Charles Sturt University, Riverina (PO Box 588, Wagga Wagga NSW 2678) Southern Cross University (PO Box 157, Lismore NSW 2480) University of New England (Armidale NSW 2351) University of Newcastle (Newcastle NSW 2309) University of Sydney (Sydney NSW 2006) University of Sydney, Cumberland Campus (PO Box 170, Lidcombe NSW 2141) University of Technology, Sydney (PO Box 123, Broadway NSW 2007) University of Western Sydney, Hawkesbury (Locked Bag 1, Richmond NSW 2753) University of Western Sydney, Macarthur (PO Box 555, Campbelltown NSW 2560) University of Western Sydney, Nepean (PO Box 10, Kingswood NSW 2747) University of Wollongong (PO Box 1144, Wollongong NSW 2500) (b) INSTITUTIONS RECOGNISED BY THE NURSES REGISTRATION BOARD FOR THE PURPOSE OF CONDUCTING OR PARTICIPATING IN APPROVED MIDWIFERY PROGRAMS WHICH MEET THE LEGISLATIVE REQUIREMENTS LEADING TO AN AUTHORITY TO PRACTISE MIDWIFERY IN NEW SOUTH WALES HEALTH INSTITUTIONS Auburn District Hospital, Auburn 2144 Bankstown/Lidcombe Hospital, Bankstown 2200 Bathurst Base Hospital, Bathurst 2795 Belmont District Hospital, Belmont 2280 Blacktown Hospital, Blacktown 2148 Blue Mountains District Anzac Memorial Hospital, Katoomba 2780 Calvary Hospital Wagga Wagga Inc 2650 Campbelltown District Hospital, Campbelltown 2560 Canterbury Hospital, Campsie 2194 Central Coast Area Health Service, Gosford 2250 Christo Road Private Hospital, Waratah 2298 Coffs Harbour Base Hospital, Coffs Harbour 2450 Dubbo Base Hospital, Dubbo 2830 Fairfield Hospital, Fairfield 2165 Glen Innes District Hospital, Glen Innes 2370 Gosford Hospital, Gosford 2250 Grafton Base Hospital, Grafton 2460 Griffith Base Hospital, Griffith 2680 Hornsby and Kuring-gai Hospital, Hornsby 2077 Illawarra Regional Hospital, Wollongong 2500 23

Inverell and District Hospital, Inverell 2360 Jamison Private Hospital, Penrith 2750 John Hunter Hospital, Newcastle 2310 Kareena Private Hospital, Caringbah 2229 Lismore Base Hospital, Lismore 2480 Liverpool Hospital, Liverpool 2170 Macksville and District Hospital, Macksville 2447 Maitland Hospital, Maitland 2320 Manly District Hospital, Manly 2095 Manning Base Hospital, Taree 2430 Mona Vale Hospital, Mona Vale 2103 Moree Plains Health Service, Moree 2400 Nepean Hospital, Penrith 2750 New England Regional Hospital, Armidale 2350 NIB Private Hospital, New Lambton 2305 Orange Base Hospital, Orange 2800 Port Macquarie Base Hospital, Port Macquarie 2444 Royal Hospital for Women, Randwick 2031 Royal North Shore Hospital, St Leonards 2065 Royal Prince Alfred Hospital, Camperdown 2050 Ryde Hospital, Eastwood 2122 Shellharbour Hospital, Shellharbour 2529 Shoalhaven District Memorial Hospital, Nowra 2541 St George Hospital, Kogarah 2217 St George Private Hospital, Kogarah 2217 Sutherland Hospital, Caringbah 2229 Sydney Adventist Hospital, Wahroonga 2076 Tamworth Base Hospital, Tamworth 2340 Wagga Wagga Base Hospital, Wagga Wagga 2650 Westmead Hospital, Westmead 2145 Wingecarribee Health Service, Bowral 2576 Wodonga District Hospital (Victoria) Wyong Hospital, Wyong 2259 TERTIARY EDUCATION INSTITUTIONS Avondale College Charles Sturt University, Riverina (External Course) University of Newcastle University of Sydney University of Sydney, Cumberland Campus University of Technology, Sydney University of Western Sydney, Hawkesbury University of Western Sydney, Macarthur University of Wollongong 24

(c) LIST OF INSTITUTIONS APPROVED BY THE NURSES REGISTRATION BOARD FOR THE PURPOSE OF CONDUCTING ENROLLED NURSE COURSES IN ASSOCIATION WITH TECHNICAL AND FURTHER EDUCATION INSTITUTIONS Anglicare Chesalon, Beecroft 2119 Autumn Lodge Nursing Home, Macksville 2447 Bankstown/Lidcombe Hospital, Bankstown 2200 Bathurst Base Hospital, Bathurst 2795 Belmont District Hospital, Belmont 2280 Bega District Hospital, Bega 2550 Bloomfield Hospital, Orange 2800 Bourke District Hospital, Bourke 2840 Broken Hill Base Hospital, Broken Hill 2880 Bushland Place Nursing Home, Taree 2430 C.A. Brown Anglican Village, Booragul 2284 Camden Health Service, Camden 2570 Campbelltown Health Service, Campbelltown 2560 Carey Bay Nursing Home, Carey Bay 2283 Central Coast Area Health Service, Gosford 2250 Participating Institutions: Kincumber Health Centre, Roma Gosford Hospital Long Jetty Community Care Facility Woy Woy Hospital Wyong Hospital Central Sydney Health Service Enrolled Nurse School, Camperdown 2050 Participating Institutions: Balmain Hospital, Balmain Canterbury Hospital, Campsie Our Lady of Loreto Nursing Home, Strathfield Rachel Forster Hospital, Redfern Repatriation Hospital, Concord Royal Prince Alfred Hospital, Camperdown Rozelle Hospital, Rozelle Cessnock District Hospital, Cessnock 2325 Cobar District Hospital, Cobar 2835 Condobolin Health Service, Condobolin 2877 Cooma District Hospital, Cooma 2630 Cowra District Hospital, Cowra 2794 Crookwell District Hospital, Crookwell 2583 Elizabeth Lodge Nursing Home, Willoughby 2068 Eurobodalla Shire Nursing Home, Dalmeny 2546 Fairfield Health Service, Fairfield 2165 Forbes District Hospital, Forbes 2871 Forrest Centre, Wagga Wagga 2650 Gladesville Macquarie Hospital, North Ryde 2113 Goulburn Base Hospital, Goulburn 2580 Grafton Base Hospital, Grafton 2460 Greater Murray Health Service, Wagga Wagga 2650 Participating Institutions: Albury Base Hospital Calvary Hospital Wagga Wagga Corowa Hospital 25

Cootamundra Hospital Deniliquin Hospital Griffith Base Hospital Gundagai District Hospital Hay Hospital Hillston District Hospital Holbrook District Hospital Junee District Hospital Leeton District Hospital Narrandera District Hospital Temora and District Hospital Tumut Hospital Wagga Wagga Base Hospital Green Hills Churches of Christ Nursing Home, East Maitland 2323 Greenwich Hospital, Greenwich, 2065 Harbourside Haven Retirement Village, Shoal Bay 2315 H.N. McLean Memorial Nursing Home, Inverell 2360 Hornsby and Kuring-gai Hospital, Hornsby 2077 Hunter Region Developmental Disability Service, Stockton Centre, Stockton 2295 Illawarra Area Health Service School of Nursing, Port Kembla 2505 Participating Institutions: Bulli District Hospital Coledale Hospital Coniston Nursing Home Community Health Services, Shoalhaven Sector Culburra Nursing Home David Berry Hospital, Berry Illawarra Private Hospital, Figtree Illawarra Regional Hospital, Wollongong campus Illawarra Regional Hospital, Port Kembla campus John & Helen Robinson Nursing Home, Gerringong Mount Warrigal Nursing Home, Warilla Osborne Nursing Home, Nowra Sarah Claydon Nursing Home, Milton Shellharbour Hospital Shoalhaven District Memorial Hospital, Nowra Towradgi Park Nursing Home Woonona Nursing Home Inverell and District Health Service, Inverell 2360 John Hunter Hospital, Lambton 2310 Kenmore Hospital, Goulburn 2580 Kurri Kurri District Hospital, Kurri Kurri 2327 Lady Davidson Hospital, Turramurra 2074 Lady Gowrie Nursing Home, Gordon 2072 Liverpool Health Service, Liverpool 2170 Macquarie Health Service, Dubbo 2830 Participating institutions: Coonamble District Hospital Dubbo Base Hospital Gilgandra District Hospital Lourdes Hospital, Dubbo Mudgee-Gulgong District Health Service Narromine Hospital and Community Health Service Nyngan District Hospital Warren District Hospital 26

Wellington District Hospital Maitland Hospital, Maitland 2320 Manly District Hospital, Manly 2095 Maroba Nursing Home, Waratah 2298 Maximilian Kolbe House, Sandgate 2304 Mercy Care Centre, Young 2594 Mid North Coast Health Service, Taree 2443 Participating institutions: Fyson Nursing Home, Kempsey Gloucester Soldiers Memorial Hospital Kempsey District Hospital Lourdes Nursing Home, Port Macquarie Manning Base Hospital, Taree Wauchope District Memorial Hospital Wingham District Hospital Mona Vale Hospital, Mona Vale 2103 Moree Health Service, Moree 2400 Morisset Hospital, Morisset 2264 Moruya District Hospital, Moruya 2537 Narrabri Health Service, Narrabri 2390 Narrandera Nursing Home, Narranderra 2700 Neringah Hospital, Wahroonga 2076 New England Regional Hospital, Armidale 2350 New England Health Service, Tamworth 2340 Participating Institutions: Barraba Health Service Gunnedah Health Service Gunnedah Nursing Home Manilla Health Service Quirindi Health Service Tamworth Base Hospital Orange Base Hospital, Orange 2800 Parkes District Hospital, Parkes 2870 Queanbeyan District Hospital and Health Service, Queanbeyan 2620 Queen Victoria Memorial Hospital, Picton 2571 Royal Newcastle Hospital, Newcastle 2300 Royal North Shore Hospital, St Leonards 2065 Royal Rehabilitation Centre Sydney, Ryde 2112 Ryde Hospital, Eastwood 2122 Singleton District Hospital, Singleton 2330 South-Eastern Sydney Area Health Service, Kogarah 2217 Participating institutions: Camelot Nursing Home, Maroubra Junction Chesalon Nursing Home, Malabar Frenchman s Lodge Nursing Home, Randwick Garrawarra Centre for Aged Care, Waterfall Prince Henry Hospital, Little Bay Prince of Wales Hospital, Randwick Royal Hospital for Women, Randwick Royal South Sydney Community Health Services and Programs Sir Joseph Banks Nursing Home, Botany Sydney Hospital St George Hospital, Kogarah Sutherland Hospital, Caringbah Sydney Children s Hospital, Randwick 27

St John of God Hospital, Goulburn 2580 St Joseph's Home, Sandgate 2304 St Vincent's Hospital, Darlinghurst 2010 Toronto Nursing Home, Toronto 2283 Turramurra House Nursing Home, Turramurra 2074 Wahroonga Nursing Home, Wahroonga 2076 Walgett District Hospital, Walgett 2832 Wentworth Area Health Service, Penrith 2750 Participating Institutions: Blue Mountains District Anzac Memorial Hospital, Katoomba Catholic Health Care Bodington, Wentworth Falls Governor Phillip Nursing Home, Penrith Hawkesbury Hospital, Windsor Nepean Health, Penrith Nepean Health, Division of Community Health Services Queen Victoria Memorial Aged Care Facility, Wentworth Falls Western Sydney Area Health Service, Westmead 2145 Participating institutions: Auburn District Hospital, Auburn Blacktown-Mt Druitt Health Service: Blacktown Hospital campus Blacktown-Mt Druitt Health Service: Mount Druitt Hospital campus Cumberland Hospital, Westmead Lottie Stewart Hospital, Dundas St Joseph's Hospital, Auburn Westmead Hospital and Community Health Service, Westmead Western Sydney Developmental Disability Service, Westmead 2145 Wingecarribee Health Service, Bowral 2576 Woodlands Nursing Home, Cherrybrook 2126 Young District Hospital, Young 2594 COLLEGES OF THE TECHNICAL AND FURTHER EDUCATION COMMISSION PARTICIPATING IN THE ENROLLED NURSE PROGRAM Hunter Institute of Technology, Newcastle Campus Illawarra Institute of Technology, Shellharbour College of TAFE New England Institute of TAFE, Gunnedah College of TAFE Northern Sydney Institute of TAFE, Meadowbank College of TAFE Northern Sydney Institute of TAFE, North Sydney College of TAFE Riverina Institute of TAFE, Cootamundra Campus South Western Sydney Institute of TAFE, Wetherill Park College of TAFE Southern Sydney Institute of TAFE, St George College of TAFE Sydney Institute of Technology, Ultimo Western Institute of TAFE, Dubbo Campus Western Sydney Institute of TAFE, Werrington College of TAFE 8. CODE OF PROFESSIONAL CONDUCT Registered/Enrolled Nurses The Nurses Registration Board has adopted national codes of professional conduct and ethics which were developed by the Australian Nursing Council Inc following wide consultation. 28

Purpose of the Code of Professional Conduct is to # inform the profession of the minimum standards for professional conduct; # inform the public of the minimum standards for professional conduct; and, # provide appropriate bodies with a basis for decisions regarding standards of professional conduct. Each nurse will (1) Provide safe and competent nursing care. (2) Uphold the agreed standards of the profession. (3) Practise in accordance with laws relevant to the nurse s area of practice. (4) Respect the dignity, culture, values and beliefs of patients/clients and significant others in the provision of nursing care. (5) Promote and support the health, well-being and informed decision-making of patients/clients in the provision of nursing care. (6) Promote and preserve the trust that is inherent in the privileged relationship between nurses and their patients/clients with respect to both their person and their property. (7) Treat as confidential personal information obtained in a professional capacity. (8) Refrain from engaging in exploitation, misinformation and misrepresentation in regard to health care products and nursing services. Persons registered or enrolled with the Nurses Registration Board of New South Wales shall at all times act in such a manner to justify public trust and confidence, uphold the good standing of the profession, serve the public interest and those for whom they care. 9. NURSES REGISTRATION BOARD PROJECTS: SPECIAL INITIATIVES (a) "Board Works" Newsletter In considering its functions, including those relating to the promotion and maintenance of professional standards of nursing practice and the publication and distribution of information concerning the Nurses Act and Regulations, the Board decided to issue a newsletter to all accredited nurses. The first issue was distributed in November 1997 and it is proposed to continue to issue this journal at least annually. (b) Internet Web-Site While a newsletter can achieve wide circulation at the date of issue, it is recognised that internet communications permit users to access information on a date and at a time of their choosing, from any location with an internet connection. Recognising the potential of this means of communication, a web-site has been established at http://nursesreg.health.nsw.gov.au. 29