NURSES AND MIDWIVES: SUBSIDIARY LEGISLATION

INDEX TO SUBSIDIARY LEGISLATION

Nurses and Midwives (Disciplinary) Regulations

Nurses and Midwives (Education) Regulations

Nursing Council for Botswana (Badge) Regulations

Nurses and Midwives (Professional Ethics and Practice) Regulations

Nurses and Midwives (Registration) Regulations

NURSING COUNCIL FOR BOTSWANA (BADGE) REGULATIONS

(section 12)

(23rd May, 1969)

ARRANGEMENT OF REGULATIONS

REGULATION

1. Citation

2. Interpretation

3. Badge for registered nurses and midwives

4. Sale of badge by Council

5. Registered number to be engraved on badge

6. Manner of wearing badge

7. Loss of badge to be notified

8. Restriction on manufacture of badges, etc.

9. Offences

S.I. 64, 1969.

1. Citation

These Regulations may be cited as the Nursing Council for Botswana (Badge) Regulations.

2. Interpretation

In these rules—

“badge” means a badge such as is described in regulation 3;

“register” means the register of nurses or the register of midwives kept in terms of section 8 of the Act.

3. Badge for registered nurses and midwives

There shall be a badge for registered nurses and registered midwives which shall show the National Flag of Botswana in colour on gilt circled with a black border bearing in gilt the words “Nursing Council for Botswana”.

4. Sale of badge by Council

The badge shall be sold by the Council to registered nurses and registered midwives for a price of 60 thebe.

5. Registered number to be engraved on badge

Before a badge is delivered to a person to whom it is sold there shall be engraved on the back thereof the number under which such person is entered in the register, and should such person be registered both as a nurse and as a midwife, both the numbers under which she is entered shall be so engraved.

6. Manner of wearing badge

The badge shall be worn only when the person wearing it is in uniform and shall be worn pinned to the right upper front of the uniform.

7. Loss of badge to be notified

In the event of a badge being lost, its owner shall notify the Council of the loss.

8. Restriction on manufacture, etc. of badges

The badge shall not be manufactured, sold or supplied by any person other than a person approved of for that purpose by the Council.

9. Offences

(1) Any person who contravenes regulation 6 or 7 shall be guilty of an offence and liable on conviction to a fine not exceeding P50.

(2) Any person who contravenes regulation 8 shall be guilty of an offence and liable on conviction to a fine not exceeding P50 or to imprisonment for a term not exceeding three months, or to both.

NURSES AND MIDWIVES (PROFESSIONAL ETHICS AND PRACTICE) REGULATIONS

(section 12)

(4th November, 2011)

ARRANGEMENT OF REGULATIONS

REGULATION

PART I
Preliminary

1. Citation

2. Interpretation

PART II
Professional Ethics

3. Duties of nurse or midwife

4. Confidentiality

5. Attendance to patient

6. Habit-forming drugs

7. Severe reaction drugs

PART III
Practice Regulations for Nurse

8. Scope of practice of nurse

9. Practice regulations for nurse

PART IV
Practice Regulations for Midwife

10. Scope of practice of midwife

11. Practice regulations for midwife

12. Equipment

13. Precautions to be taken

14. Records

15. Administration of drugs to newborn baby

16. Duties of midwife during antenatal period

17. Vaginal and rectal examinations

18. Attendance on patient during labour

19. Duties of midwife during puerperium

20. Breastfeeding

21. Medical aid

PART V
General Practice Regulations for Nurse or Midwife

22. Administration of anaesthetics

23. Hypodermic and intramuscular injections

24. Intradermal injections

25. Intravenous injections, etc.

26. Blood transfusions, etc.

27. Drugs to be used in event of anaphylactoid or other severe reactions

PART VI
Practice Regulations for Nurse Specialist and Enrolled Nurse

28. Practice regulations for nurse specialist

29. Practice regulations for enrolled nurse

Schedule

S.I. 90, 2011.

PART I
Preliminary (regs 1-2)

1. Citation

These Regulations may be cited as the Nurses and Midwives (Professional Ethics and Practice) Regulations.

2. Interpretation

In these Regulations, unless the context otherwise requires—

“anaphylactogenic drug” means a drug which causes immediate systemic or generalised hypersensitivity;

“habit-forming drug” means a drug whose extensive use is likely to cause an addiction to the drug;

“health care facility” means any government institution, non-governmental organisation or private institution engaged, directly or indirectly, in providing health care or health services to members of the public; and

“puerperium” means the period of about six weeks after childbirth during which the patient’s reproductive organs return to their original non- pregnant condition.

PART II
Professional Ethics (regs 3-7)

3. Duties of nurse or midwife

A nurse or midwife shall—

(a) provide services with respect for human dignity, unrestricted by considerations for social or economic status, personal attributes or the nature of a patient’s health problems;

(b) ensure the protection of personal information of a patient under the nurse’s or midwife’s care;

(d) be responsible and accountable for his professional actions;

(e) exercise responsibility to maintain his competence in the practice of nursing or midwifery;

(f) communicate the evaluation outcome to a patient, the patient’s spouse, next of kin or guardian where necessary, and to other health care team members;

(g) utilise evaluation findings as a basis for reassessing a patient, revising strategies and possibly changing midwifery interventions throughout all levels of the childbearing process;

(h) promote patient advocacy at all times;

(i) promote his professional responsibility and accountability;

(j) engage in research to—

(i) generate knowledge and information

(ii) enhance his professional development, and

(iii) improve nursing care;

(k) acknowledge any limitation in his knowledge and competence;

and

(l) adhere to the Code of Professional and Ethical Conduct for Nurses and Midwives as set out in the Schedule.

4. Confidentiality

A nurse or midwife shall at all times hold in confidence—

(a) personal information entrusted to the nurse or midwife in the course of his duties;

(b) information regarding the treatment and diagnosis of a patient;

(d) information acquired during the course of the nurse’s or midwife’s duties.

5. Attendance to patient

(1) A nurse or midwife shall not attend to a patient where the attention required by the patient falls outside the scope of practice of the nurse or midwife.

(2) A nurse or midwife shall, before deciding that the attention required by a patient falls outside the scope of practice of the nurse or midwife, ensure that all the necessary nursing or midwifery procedures have been carried out.

(3) Subregulation (1) shall not apply in an emergency or where a medical practitioner is not available.

(4) The nurse or midwife shall report the facts of the case, in writing, to his immediate supervisor as soon as is practicable after attending to a patient in the circumstances referred to in subregulation (3).

6. Habit-forming drugs

A nurse or midwife shall, when handling habit forming drugs—

(a) keep a register of all such drugs supplied to the nurse or midwife and record the names and addresses of the suppliers;

(b) record—

(i) the date on which he received the drugs,

(ii) on a separate page, the strength of the drugs supplied,

(iii) the total amount of drugs received, and

(iv) the name of every patient to whom a drug is to be administered, the name of the drug to be administered to the patient, the method of administration, the dosage and the date and time it is to be administered, designation and signature of the nurse or midwife;

(d) make a register of the drugs available for inspection at any time, by the pharmacy technician, pharmacist or management of the health care facility at which the nurse or midwife works;

(e) immediately report the loss or theft of any drug, giving a written statement of the circumstances of the loss or theft to—

(i) the pharmacy technician, pharmacist, or management at the health care facility in question at which the nurse or midwife works,

(ii) the Council, or

(iii) the nearest police station;

(f) ensure that the dosage and expiry date of the drug to be administered has been checked by another nurse or midwife, medical practitioner, pharmacy technician or pharmacist; and

(g) ensure that he and the nurse, midwife, medical practitioner, pharmacy technician or pharmacist who checked the dosage and expiry date of the drug, signs the drug register accordingly.

7. Severe reaction drugs

(1) When administering an anaphylactogenic drug, serum or other drug which may cause a severe reaction in a patient, the nurse or midwife administering the drug shall—

(a) ensure at all times, that the standard emergency tray as laid down in a drug catalogue or other pharmaceutical protocol is available;

(b) enquire from the patient about the patient’s sensitivity to the drug;

(c) where the patient is sensitive to the drug to be administered, inform a medical practitioner in charge so that an alternative drug can be prescribed; and

(d) request that the patient to whom the anaphylactogenic drug, serum, or other drug which may cause a severe reaction has been administered, not to leave the room where the drug was administered until that patient’s condition stabilises.

(2) Where a patient refuses to comply with a nurse’s or midwife’s request in terms of subregulation (1)(d), the nurse or midwife shall record, in writing, the fact that the patient acted against the nurse’s or midwife’s advice and obtain, where possible—

(a) the patient’s signature;

(b) in the case of a patient who cannot read or write, the patient’s thumbprint or fingerprint, on the record; or

(c) the signature or thumbprint of at least two witnesses, where it is not possible to obtain the patient’s thumbprint or fingerprint.

PART III
Practice Regulations for Nurse (regs 8-9)

8. Scope of practice of nurse

The scope of practice of a registered nurse shall entail—

(a) activities or procedures, which may be performed by scientifically based physical, chemical, psychological, social, educational and technological means applicable to health care practice; and

(b) the regulations contained in Part V of these Regulations.

9. Practice regulations for nurse

A nurse shall—

(a) conduct and document nursing assessments of the health status of a patient, family or community in collaboration with the patient by collecting subjective data in respect of the patient from interviews, from the patient’s next of kin, records, physical examinations and investigations accurately and timeously;

(b) validate any data collected by interacting with team members when necessary;

(d) utilise theoretical frameworks and models to backup nursing care;

(e) implement a strategy of care by—

(i) prescribing appropriate nursing interventions,

(ii) giving assistance and direct care to a patient, and

(iii) referring the patient to the appropriate health care providers;

(f) accompany a patient for referral or transfer to another health care facility; and

(g) in the case of an emergency, where a patient cannot for any reason be transferred to another health care facility, remain with the patient and provide the best care for the patient until the emergency is attended.

PART IV
Practice Regulations for Midwife (regs 10-21)

10. Scope of practice of midwife

The scope of practice for a registered midwife shall—

(a) entail scientifically based activities or procedures which apply to the practice of midwifery and which also relate to a mother and child in the course of pregnancy, labour and puerperium; and

(b) be as provided for in Part V of the Regulations.

11. Practice regulations for midwife

A midwife shall—

(a) conduct and document midwifery and nursing assessment of the health status of a family, childbearing woman, expectant mother and fetus, patient in labour and delivery, delivered female patient and a newborn baby, by—

(i) collecting subjective data in respect of the patient from interviewing the patient’s spouse, next of kin or guardian, and

(ii) recording physical examinations and investigations accurately and timeously;

(b) identify the needs of a patient at each stage of the childbearing processes and provide appropriate services and care which include—

(i) providing sound family planning information and services,

(ii) diagnosing pregnancy and monitoring the pregnancy’s progress to ensure maternal health and fetal well-being and development,

(iii) developing a plan of care for a patient on the basis of diagnosis and needs identified,

(iv) providing childbirth preparation including advice on hygiene, nutrition and other health promotion matters,

(v) diagnosing labour, caring for and assisting the mother during all the four stages of labour and monitoring the condition of the fetus in the uterus by appropriate means,

(vi) conducting deliveries and where required performing an episiotomy,

(vii) recognising the warning signs of abnormality in a pregnant patient or a newborn baby, which necessitate referral to a doctor or obstetrician,

(viii) examining and caring for a newborn baby and taking the initiative where necessary, to carry out immediate resuscitation,

(ix) caring for and monitoring the progress of the female patient during the postnatal period in order to give the female patient all the necessary advice on infant care, self-care and family planning,

(x) utilising theoretical frameworks to backup nursing care, and

(xi) maintaining a clear record of all activities rendered to the female patient;

(c) evaluate a female patient’s response to midwifery interventions, in collaboration with other members of the health care team; and

(d) operate according to national policies and guidelines in the event of acquiring new knowledge and or skills such as those offered by the safe method of Prevention of Mother to Child Transmission of HIV and AIDS (in these Regulations referred to as PMTCT) or infant feeding programmes.

12. Equipment

When attending to a patient, a midwife shall have available all the equipment necessary for the proper conduct of his work, including—

(a) an intravenous infusion set;

(b) at least two 1000 milliliters of five per cent dextrose in a normal saline solution; and

(i) perform an episiotomy,

(ii) suture an episiotomy, or

(iii) suture a first or second degree tear of the perineum.

13. Precautions to be taken

(1) A midwife shall—

(a) when attending to a patient, scrupulously observe the rules of asepsis; and

(b) before attending to any other patient, observe thorough infection control measures, where the midwife had been attending to, or in contact with a person—

(i) suffering from,

(ii) suspected to be suffering from,

(iii) who died from, or

(iv) suspected to have died from,

any septic, infectious or contagious condition.

(3) A midwife who is suffering from any infectious or contagious condition shall not attend to a patient unless otherwise directed by a medical practitioner, or until the midwife is completely free of the condition.

14. Records

A midwife shall keep a record of each patient that he attended to in the chart used for maternity cases in government, mission, mining and private hospitals.

15. Administration of drugs to newborn baby

(1) A midwife—

(a) shall apply an approved antibiotic eye ointment as a prophylactic into the eyes of a newborn baby;

(b) shall not administer any other solution or ointment to a newborn baby without a written order from a medical practitioner; and

(i) injections of pethedine totalling not more than 200 mgms; or

(ii) intramuscular injection of not more than 0.50 mgs of ergometrine.

(2) Where the drugs in subregulation (1)(a) and (b) are administered, the administration of the drugs may be repeated once, only after four hours.

(3) In the case of pregnancy induced hypertension, a midwife shall administer a magnesium sulphate injection and anti-hypertensive drugs according to the safe motherhood protocol.

(4) A midwife shall, depending on the HIV status of a mother, administer to a female patient, after confinement, and her newborn baby, anti retro viral drugs as per the PMTCT protocol.

(5) Where—

(a) a medical practitioner is not available;

(b) while a midwife is awaiting the arrival of a medical practitioner; or

(c) a patient or the patient’s next of kin refuses the assistance of a medical practitioner and a midwife considers that the condition of the patient warrants it,

the midwife may, in the case of postpartum haemorrhage, administer not more than 0.50 milligrams ergometrine by intramuscular injection before or after the delivery of the placenta and the administration may be repeated once only, or administer one milligram of vitamin K by intramuscular injection in the lateral aspect of the thigh of the newborn baby.

(6) Where a patient refuses medicine, a midwife shall—

(a) endorse the record of the case accordingly;

(b) obtain the name and signature of the patient and in the case of a patient who cannot read or write, obtain a thumbprint or fingerprint of the patient;

(c) obtain the signature or thumbprint of at least two witnesses, where it is not possible to obtain the patient’s signature, thumbprint or fingerprint; and

(d) where it is not possible to obtain the patient’s signature, thumbprint or fingerprint or the signature of at least two witnesses, immediately report, in writing, the facts of the case to the midwife’s immediate supervisor.

16. Duties of midwife during antenatal period

(1) Where a midwife is attending to a patient in confinement, and the attendance includes the giving of antenatal and postnatal care, the midwife shall—

(a) advise the patient to be medically examined at least once during pregnancy;

(b) advise the patient to undergo a blood test;

(c) ascertain whether any previous pregnancy ended in an abortion, a premature labour, or a stillbirth and if so, advise the patient to seek medical advice; or

(d) ascertain whether any abnormality occurred during any previous pregnancy, labour or puerperium, and if so, advise the patient to seek medical advice.

(2) Where the patient, for any reason, does not accept the advice referred to in subregulation (1), the midwife shall—

(a) endorse the record of the case accordingly;

(b) obtain the signature of the patient and in the case of a patient who cannot read or write, obtain a thumbprint or fingerprint of the patient;

(c) obtain the signature or thumbprint of at least two witnesses, where it is not possible to obtain the patient’s signature, thumbprint or fingerprint; and

(d) where it is not possible to obtain the patient’s signature, thumbprint or fingerprint or the signature of two witnesses, report immediately, in writing, the facts of the case to the midwife’s immediate supervisor.

(3) A midwife shall, where possible, examine a patient who is pregnant—

(a) at least once a month until the 28th week of pregnancy;

(b) at least once a fortnight until the 36th week of pregnancy; and

17. Vaginal and rectal examinations

A midwife shall not carry out a vaginal or rectal examination in the case of an antepartum haemorrhage and in all other cases, the midwife shall not make more examinations than are necessary.

18. Attendance on patient during labour

(1) A midwife—

(a) who is attending to a patient in labour shall not leave the female patient unattended;

(b) shall, after the beginning of the second stage of labour, stay with the female patient until after the birth of the newborn baby, and for as long as the condition of the female patient or the newborn baby may demand thereafter;

(d) shall monitor fetal and maternal well-being as per PMTCT safe motherhood protocol;

(e) shall perform all activities according to PMTCT safe motherhood guidelines and protocol during labour; and

(f) shall conduct a physical examination on the newborn baby.

19. Duties of midwife during puerperium

(1) A midwife shall—

(a) during puerperium, attend to a patient and her newborn baby for at least 24 hours and if it is impossible for the midwife to attend to the patient, the midwife shall endorse the record of the case accordingly, giving reasons why it is impossible;

(b) ensure that a patient and her newborn baby are discharged after a full physical examination by a medical practitioner;

(d) advise a patient to be examined by a medical practitioner or at a postnatal clinic at least once during the three months following the confinement, and preferably six weeks after delivery;

(e) follow PMTCT safe motherhood and tuberculosis protocols and guidelines; and

(f) carry out domiciliary, two to 10 days post-partum.

20. Breastfeeding

A midwife shall take all reasonable steps to promote breastfeeding of the newborn baby by the patient unless there is medical advice to the contrary.

21. Medical aid

(1) In all cases where an illness, abnormality, or complication occurs in a patient or her baby during the period when the midwife is in attendance, the midwife shall immediately, in consultation with the patient, refer her to a medical practitioner stating, wherever possible, the reason for the referral.

(2) Where a medical practitioner is not available, the midwife shall, immediately, endorse the record of the case and notify his immediate supervisor.

(3) Where a patient’s spouse, next of kin or guardian refuses to consent to the referral to a medical practitioner, the midwife shall endorse the record and—

(a) obtain the signature of the patient’s spouse, next of kin or guardian;

(b) obtain the signature or thumbprint of at least two witnesses, where it is not possible to obtain the signature of the patient’s spouse, next of kin or guardian;

(c) and where it is not possible to obtain the signature of the patient’s spouse, next of kin or guardian or, the signature of two witnesses, report immediately, in writing, the facts of the case to midwife’s immediate supervisor.

(4) Where it is impossible to consult the patient, the patient’s spouse, next of kin or guardian, the midwife shall act on his own judgment and enter the facts of the case in the record and report the facts fully to the midwife’s immediate supervisor.

(5) The provisions of this regulation shall apply in particular to the following illnesses, abnormalities or complications which occur—

(a) during pregnancy, such as—

(i) excessive vomiting,

(ii) an abortion, inevitable or threatened,

(iii) loss of blood,

(iv) rise in blood pressure or albumen in urine,

(v) puffiness of hands, face or feet,

(vi) excessive gain in weight,

(vii) fits or convulsions,

(viii) purulent discharge from the genitalia, (ix) a sore on the genitalia,

(x) deformity, stunted growth or other condition suggesting disproportion between the head of the fetus and pelvis of the pregnant patient, or

(xi) abnormal presentation after the 32nd week of pregnancy;

(b) during labour—

(i) fits or convulsions,

(ii) purulent discharge from the genitalia,

(iii) a sore on the genitalia,

(iv) excessive bleeding,

(v) premature labour before the 37th week of pregnancy,

(vi) a presentation other than an uncomplicated head,

(vii) where no presentation can be ascertained, (viii) undue prolongation of any stage of labour,

(ix) excessive uterine action,

(x) fetal distress,

(xi) placenta not completely expelled 30 minutes after birth of the newborn baby,

(xii) rupture of perineal body, or other injuries to the soft parts,

(xiii) if the head does not engage early in a primigravida, or

(xiv) multiple pregnancy;

(i) fits or convulsions,

(ii) abnormal distension and tenderness,

(iii) offensive lochia,

(iv) rigor with raised temperature,

(v) rise of temperature to 37.7 ℃C for a period of 24 hours, or its recurrence within that period, or a rise of temperature to 37.4℃C on two successive days,

(vi) continuously rapid or steadily rising pulse rate,

(vii) unusual swelling of the breasts with local tenderness or pain,

(viii) excessive or prolonged bleeding,

(ix) pain over the vessels of the lower limbs, especially pain in the calves of the legs,

(x) excessive sleeplessness or mental depression, or

(xi) retention of urine; and

(d) to the newborn baby—

(i) injuries received during birth,

(ii) malformation or deformity, whether endangering life or not,

(iii) undue feebleness, whether the newborn baby is premature or not,

(iv) inflammation of or any discharge from the eyes, however slight,

(v) serious skin eruptions, especially those marked by the formation of watery blisters,

(vi) inflammation around or haemorrhage from the umbilicus,

(vii) jaundice,

(viii) convulsions,

(ix) neonatal haemorrhage,

(x) excessive or projectile vomiting,

(xi) failure to pass urine or meconium within the first 24 hours after birth, or

(xii) failure to gain weight after the first 10 days following birth.

PART V
General Practice Regulations for Nurse or Midwife (regs 22-27)

22. Administration of anaesthetics

(1) A nurse or midwife shall not administer a local anaesthetic unless a medical practitioner is of the opinion that it is in the interest of a patient to allow the nurse or midwife to administer the local anaesthetic and the nurse or midwife shall administer the local anaesthetic only—

(a) on a written or verbal order from a medical practitioner;

(b) in the presence of such medical practitioner; and

(2) Notwithstanding the provisions of subregulation (1), a nurse or mid-wife shall only administer a local anaesthetic, in the absence of a medical practitioner—

(a) where the nurse or midwife is faced with a patient who has a life threatening condition; or

(b) where necessary, when the nurse or midwife is attending to a patient delivering a newborn baby.

(3) Except as provided for in subregulation (1) and (2), or in these Regulations, a midwife shall not administer a local anaesthetic.

(4) A midwife shall—

(a) order and administer a local anaesthesic when performing a suturing episiotomy; and

(b) take appropriate precautions in administering the local anaesthetic.

23. Hypodermic and intramuscular injections

(1) A nurse or midwife may administer a hypodermic or intramuscular injection—

(a) on the written or verbal order from a medical practitioner or a dentist and, during an emergency, in the presence of a responsible witness:

Provided that the written confirmation of the oral order is obtained from the medical practitioner or the dentist within 48 hours and where the written confirmation of the oral order cannot be obtained within 48 hours, the midwife shall report immediately, in writing, the facts of the case to his immediate supervisor, or the Council; and

(b) in an emergency—

(i) where the nurse or midwife is of the opinion that the life of a patient is endangered, the nurse or midwife shall make appropriate arrangements for the patient to be referred to a medical practitioner at the earliest opportunity if in the nurse’s or mid-wife’s opinion, the patient’s life will not be jeopardised by travelling,

(ii) where the nurse or midwife is of the opinion that it would be dangerous to move the patient, the nurse or midwife shall as soon as possible, inform the nearest medical practitioner explaining the circumstances of the case, giving the details as aforesaid, and asking for further instructions.

(2) Where a nurse or midwife administers a hypodermic or intramuscular injection in accordance with subregulation (1), the nurse or midwife shall submit a written report to his immediate supervisor, stating the circumstances under which he gave the injection and the preparation that was used.

(3) Subject to subregulation (1), a nurse or midwife may, in the absence of a medical practitioner, administer an injection of a drug provided for in a Schedule to be prescribed by the Minister—

(a) where the nurse’s or midwife’s position implies that he is in charge of a government clinic or private clinic; and

(b) where the nurse’s or midwife’s duties are supervised at regular intervals.

24. Intradermal injections

(1) A nurse or midwife may—

(a) on the written order from a medical practitioner, administer an in- tradermal injection only; or

(b) in the absence of a medical practitioner, administer an injection of a drug provided for in a Schedule to be prescribed by the Minister—

(i) if the midwife’s position implies that he is in charge of an antenatal, a postnatal, or a maternity unit in a government clinic or private clinic;

(ii) if the nurse’s position implies that he is in charge of a government clinic or private clinic, and

(iii) if the nurse’s or midwife’s duties are supervised at regular intervals.

25. Intravenous injections, etc

(1) A nurse or midwife—

(a) may, subject to subsection (2)—

(i) administer an intravenous injection,

(ii) administer an intravenous infusion, or

(iii) draw blood from the vein of a patient only on the written order from a medical practitioner; and

(b) shall not employ the cut down method when administering an intravenous injection or an intravenous infusion, or when drawing blood from the vein of a patient.

(2) A nurse may, in an emergency, take blood from a patient’s vein to—

(a) conduct investigations that he considers necessary during the emergency; or

(b) supply blood for purposes of grouping or cross-matching.

(3) A midwife may, in the absence of a medical practitioner or a phlebotomist, take blood from a patient’s vein to—

(a) conduct investigations that he considers necessary during the emergency; or

(b) supplying blood for grouping or cross-matching.

(4) A nurse or midwife may, in an emergency, where the nurse or mid-wife is of the opinion that the life of a patient is endangered, administer an intravenous injection on the verbal or written order from a medical practitioner.

(5) Where subregulation (4) applies, a nurse or midwife shall—

(a) make appropriate arrangements for the patient to be referred to a medical practitioner at the earliest opportunity if, in the nurse’s or midwife’s opinion, the patient’s life will not be jeopardised by travelling;

(b) submit a written report to his immediate superior, stating—

(i) the circumstances under which the injection was given,

(ii) the time and dosage of the injection, and

(iii) the preparation that was used; and

(c) if he considers it dangerous to move the patient, immediately inform the nearest medical practitioner explaining the circumstances of the case, giving the details as aforesaid, and asking for further instructions.

26. Blood transfusions, etc.

A nurse or midwife—

(a) shall not, except as provided in paragraphs (b) and (c), start a blood transfusion unless it is on a written order from and in the presence of a medical practitioner;

(b) shall not insert a needle into a patient’s vein in order to perform a blood transfusion, except on a written order from and in the presence of a medical practitioner;

(c) may change an intravenous infusion to a blood transfusion only on a verbal or written order from a medical practitioner, and on the condition that the procedure is checked by another nurse, midwife or medical practitioner:

Provided that the written confirmation of the verbal order shall be obtained from the medical practitioner within 24 hours and if the written confirmation cannot be obtained within 24 hours the nurse or midwife shall report immediately the facts, in writing, to his immediate supervisor, if any;

(d) may change a blood transfusion to an intravenous infusion only after the container has been checked by a medical practitioner, another nurse or midwife; and

(e) may connect up a second or subsequent container only on a written or verbal order given by a medical practitioner and on the condition that the procedure is checked by another nurse, midwife or medical practitioner:

Provided that a written confirmation of the verbal order shall be obtained from the medical practitioner within 24 hours, and should the written confirmation not be obtained within 24 hours, the nurse or midwife shall immediately report the facts, in writing, to his immediate superior, if any.

27. Drugs to be used in event of anaphylactoid or other severe reactions

A nurse or midwife shall ensure that he has available at all times—

(a) a fresh solution of adrenalin;

(b) an injectable hydrocortisone; or

for use in the event of anaphylatoid or other severe reactions.

PART VI
Practice Regulations for Nurse Specialist and Enrolled Nurse (regs 28-29)

28. Practice regulations for nurse specialist

A nurse specialist shall, in addition to general nursing practice—

(a) develop and interpret policies and guidelines pertinent to the provision of health care and facilitate the development of procedure manuals;

(b) demonstrate expertise in specific areas of his specialisation and facilitate professional development of himself and other nurse specialists to improve nursing care;

(d) co-ordinate available resources to facilitate the effective implementation of nursing interventions;

(e) engage in research to generate knowledge and information necessary for the improvement of nursing care;

(f) develop and utilise theoretical frameworks and models to backup nursing care; and

(g) acknowledge any limitations in his knowledge and competence, decline any duties or responsibilities unless he is able to perform them in a safe and skilled manner.

29. Practice regulations for enrolled nurse

An enrolled nurse shall—

(a) ensure that his nursing practice and conduct meet the standards of the Code of Professional and Ethical Conduct requirements as set out in the Schedule;

(b) demonstrate accountability and responsibility within a health care team when assisting or working under the direction of a nurse or midwife;

(d) identify policies and procedural guidelines impacting on enrolled nursing practice;

(e) provide nursing care according to organisational policies and guidelines;

(f) act in accordance with enrolled nurse educational preparation;

(g) recognise a nurse or midwife as a point of reference to assist in decision making;

(h) accurately collect information on the health and functional status of a patient;

(i) use health care technology appropriately;

(j) use a range of data gathering techniques including observation, interview, physical examination and measurement in the nursing care of a patient;

(k) document information regarding the health and functional status of a patient accurately and clearly according to organisational guidelines;

(l) observe and report changes in the health and functional status of a patient to a nurse or midwife or appropriate members of a health care team;

(m) contribute to the development and review of health care plans for a patient in conjunction with a nurse or midwife;

(n) collect, document and report relevant data to evaluate the progress of a patient towards expected outcomes as guided by a nurse or mid-wife;

(o) implement planned nursing care as outlined in health care plans;

(p) provide nursing care to address immediate health care needs and progress towards expected outcomes;

(q) promote patient independence whilst assisting with activities of daily living;

(r) clarify written orders for nursing care with a nurse or midwife;

(s) prioritise the delivery of nursing care of a patient appropriately under the supervision of a nurse;

(t) manage his own workload in accordance with the nursing care plan;

(u) work with other members of the health care team to carry out planned nursing care of a patient;

(v) identify potential risks or hazards to a patient associated with a health care environment;

(w) adhere to standards and procedures related to restraint, infection control and administration of therapeutic substances;

(x) apply relevant principles to ensure the safe administration of therapeutic substances;

(y) provide accurate and appropriate education to a patient related to the maintenance and promotion of their health in consultation with a nurse; and

(z) report immediately to a nurse or midwife any incident of unsafe practice and where appropriate explore ways to prevent reoccurrence of an unsafe practice.

SCHEDULE

(reg. 3)

CODE OF PROFESSIONAL AND ETHICAL CONDUCT FOR NURSES AND MIDWIVES

1. Introduction

The Code of Professional and Ethical Conduct (herein referred to as the “code of conduct”) for nurses and midwives is a set of expected national standards of professional conduct for nurses and midwives in Botswana. The code of conduct outlines principles and expectations that are binding to all nurses and midwives in Botswana. It provides guidance for decision making in dealing with ethical issues and with matters of professional conduct. According to the code of conduct, all nurses and midwives registered with the Nursing and Midwifery Council of Botswana shall at all times act in such a manner to maintain public trust and confidence, uphold the professional image of the nursing profession in Botswana, serve the public interest.

2. Purpose

The purpose of the code of conduct is to—

2.1 Reinforce the standards of professional ethics and conduct required of nurses and midwives as they render care and exercise their professional accountability and responsibility.

2.2 Guide the professionals to adapt and acquaint themselves with the changes occurring in nursing and midwifery education, practice, research, leadership and management for the enhancement of quality health care delivery.

2.3 Assist nurses and midwives to make good professional judgment within the complex health care system based on social values and needs of the client of health care.

2.4 Promote self evaluation and reflection regarding nursing and midwifery education and practice.

2.5 Provide a basis for peer review initiatives.

2.6 Guide the development of a disciplinary code of conduct which focuses on offences that are relevant to the nurses’ or midwives’ practice.

3. Definitions

The following are the terms which are commonly used with this code of conduct.

“code of conduct” means a list of written statements describing the ideal moral behaviour;

“code of ethics” means a list of written statements describing morals, values, beliefs, norms or principle that direct actions as being right or wrong;

“ethics” means a system of morals, values, beliefs, norms, and principles that direct action as being right or wrong.

“impropriety” means behaviour that is dishonest, morally wrong or inappropriate in the circumstances;

“malpractice” means careless, illegal, or unethical behaviour by somebody in a professional or official position that endangers the life of clients, staff, co-workers, self or environment;

“misconduct” means unacceptable and improper behaviour especially of a professional;

“negligence” means lack of proper care and attention, or failure to exercise proper care in regard to manner of discharging duty; and

“value” means something that is dearly cherished, treasured, respected, held in high regard or deeply cared for.

4. Rules of professional and ethical conduct for nurses and midwives.

A nurse and a midwife shall at all times observe the following rules—

4.1 Professional secrecy and confidential information.

4.1.1. Nurses and midwives shall hold in confidence all personal information entrusted to them in the course of their duties. The information must be used only for the purposes for which it was given.

4.1.2. Information regarding a patient’s diagnosis, treatment and diagnosis shall not be disclosed to anyone without prior permission from the patient or the medical officer in charge of the patient. As it is impractical to obtain consent every time the nurse or mid-wife needs to share information with others, the nurse or midwife shall ensure that patients and clients understand that some information may be made available to other members of the team involved in the delivery of care.

4.1.3. No information of any kind regarding a patient shall be disclosed to the press, any member of the public, or any other person without prior permission from the patient, the medical practitioner or the hospital authorities.

4.1.4 No person, other than the person directly responsible for the patient shall have access to the patient’s medical notes, unless prior permission is granted by the medical practitioner in charge of the patient.

4.1.5 No information regarding a patient’s diagnosis shall be conveyed to relatives or friends either by telephone or by word of mouth by any nurse or midwife unless that nurse or midwife has had prior permission or has been authorised to disclose such information. If required to disclose information outside the team that will have personal consequences for patients, the nurse or midwife must obtain the patient’s consent. If the patient withholds consent, or if consent cannot be obtained for whatever reason, disclosure may only be made only where—

(a) it can be justified in the public interest (usually where disclosure is essential to protect the patient or someone else from the risk of significant harm); and

(b) it is required by law or by order of a court.

4.1.6 It is a breach of confidence to discuss any personal information given to a nurse or midwife by a patient, unless it has some bearing on the patient’s condition, and this information can only be given to the medical practitioner or the senior nurse or midwife.

4.1.7 No member of the nursing or midwifery staff shall discuss with or relay to any member of the public any information pertaining to any patient, or any other member of the staff, so as to bring into disrepute the good name of a health care facility.

4.1.8 Every nurse and midwife, when discharging his duties of providing services has a duty to—

(a) guard against breaches of confidentiality by protecting information from improper disclosure at all times;

(b) seek patients’ and clients’ wishes regarding the sharing of information with their family and others;

(c) recognise that the decision to provide or withhold information should be taken with the greatest caution and responsibility; and

(d) co-operate, communicate effectively and respect each other ‘s expertise and contributions.

5. Respect for humankind and the patient as an individual

A nurse or midwife should strive at all times when providing services to—

(a) value human life and honour the patient’s wishes regarding their quality of life;

(b) recognise and appreciate the uniqueness of each client regardless of his cultural and socio-economic status;

(d) promote an environment in which the human rights, values, cultural and spiritual beliefs of an individual are respected;

(e) respect the privacy of a patient in such a way that during the procedure, privacy is provided and maintained throughout;

(f) ensure that no action or omission on his part or within his sphere of responsibility is harmful to the interests, condition, safety and well-being of a patient;

(g) recognise and respect the roles of patients as partners in their care and the contribution they can make to it and in so doing the nurse and mid-wife shall have regard to the limits of professional practice, existing legislation, resources and goals of therapeutic relationship; and

(h) respect a patients’ autonomy to undergo any health care intervention which is protected under the law.

6. Obtain consent

6.1 When obtaining consent to receive treatment from a patient, a nurse or midwife must ensure that the consent is given voluntarily and by a legally competent person.

6.2 A nurse or midwife shall presume that every patient is legally competent to consent to receiving treatment unless otherwise assessed by a suitably qualified medical practitioner.

6.3 A patient or a client who is legally competent can understand and retain treatment information and can use it to make an informed choice.

6.4 A patient who is legally competent may give consent in writing or orally and the patient may also refuse to give consent.

6.5 A nurse or midwife shall ensure that all discussions and associated decisions relating to obtaining consent from a patient are documented in the patient’s health care records.

6.6 Where a patient is no longer legally competent to consent to receiving treatment and has lost the capacity to consent to or refuse treatment and care, a nurse or midwife shall find out whether the patient previously indicated preferences in an advance statement.

6.7 A nurse or midwife shall respect any refusal to care or treatment given when the patient was legally competent to give such refusal; provided that the decision is clearly applicable to the present circumstances and that there is no reason to believe that the patient changed his mind.

6.8 When an advanced statement is not available, a patient’s wishes, if known, shall be taken into account and if these wishes are not known, the criteria for treatment must be that it is in their best interests of the patient.

6.9 The principles of obtaining consent shall apply equally to a patient who has a mental illness and whilst a nurse or midwife should be involved in the patient’s assessment, it will also be necessary to involve a qualified person such as a psychiatrist with expertise in people with mental illnesses.

6.10 A nurse or midwife shall endeavour to involve in the assessment of a mentally ill patient, family members or people close to the mentally ill patient.

6.11 All patients and clients have a right to receive treatment information about their condition.

6.12 Treatment information about a patient should be accurate, truthful and presented in such a way as to make it easily understood.

6.13 A nurse or midwife may need to seek legal or professional advice or guidance from his immediate supervisor, a medical practitioner of hospital authorities in relation to the giving or withholding of consent.

6.14 A nurse or midwife must be sensitive to a patient’s needs and respect the wishes of those who refuse or are unable to receive information about their condition.

6.15 A nurse or midwife must respect patients’ autonomy, especially their right to decide whether or not to undergo any health care intervention, even where a refusal may result in harm, unless a court of law orders to the contrary.

6.16 In emergencies, where treatment is necessary to preserve life, a nurse or midwife may provide care without the consent of a patient if the patient is unable to give it; provided that the nurse or midwife can demonstrate that they are acting in their best interest of the patient.

6.17 A person has no right to give consent on behalf of a competent adult.

6.18 In relation to obtaining consent for a child, the involvement of those with parental responsibility in the consent procedure is usually necessary, but will depend on the age and understanding of the child.

6.19 A nurse or midwife who will be responsible for performing any procedure on a patient shall also have the responsibility of obtaining the patient’s or the client’s consent.

7. Maintaining professional competence

Nurse or midwife must strive at all times to achieve and maintain high professional standards in providing quality care and in doing so the nurse or midwife shall—

(a) demonstrate a high level of competence in his practice;

(b) acknowledge the limits of professional competence and only practice those activities in which he is competent;

(d) acquire new knowledge and skills continuously and use them effectively;

(e) provide care based on knowledge, skills and abilities expected from a nurse or midwife of his status, even when faced with an emergency situation; and

(f) strive to deliver care based on current evidence, best practice and where applicable, validated research.

8. Responsibility and accountability

8.1. A nurse or midwife is responsible for maintaining professional standards for quality care and be accountable for his actions and shall observe the following—

(a) responsibility of providing quality service in conscientious, diligent and efficient manner;

(b) obligation and expectation to handle nursing and midwifery matters without undue delay, risk or unnecessary expense to the employer, client or patient;

(d) respect and comply with rules and regulations in a manner that promotes public confidence, the integrity of nursing and midwifery services and profession;

(e) desist from conduct capable of drawing an impression of being involved in corruption;

(f) in case of delegation, delegate the nursing work with close supervision;

(g) as a manager, have a duty towards a patient, client, colleague, community and his organisation in which he works;

(h) when facing professional dilemma, first consideration in all circumstances shall be the interest and safety of patients and clients; and

(i) maintain personal hygiene, good nutrition and dress in acceptable manner in accordance with acceptable nursing and midwifery practice.

8.2. A matron shall ensure that a nurse or midwife is registered and if the nurse or midwife is not registered, the matron shall report the matter to the Council.

9. Honesty and fairness

Every nurse or midwife has a duty to—

(a) behave in a way that upholds good reputation of the nursing and mid-wifery profession;

(b) avoid using his registration status in the promotion of a commercial product or service;

(d) refuse any gift, favour or hospitality that might be interpreted, now or in the future as an attempt to obtain preferential consideration;

(e) use official time in an honest way to fulfill professional responsibility;

(f) be fair in distributing resources; and

(g) tell the truth at all times and be loyal and avoid deception in whatever form.

10. Collaboration and team work

Every nurse or midwife, when discharging his duties of providing health care services has a duty to—

(a) work as a team which includes a client or patient, patient’s family and other health care professionals in the health care delivery system;

(b) share his knowledge and skills and respect others views for the benefit of clients or patients;

(c) give due weight and consideration to official views and respect colleagues, including their right to privacy especially when handling personal information;

(d) give credit to colleagues with outstanding performance and not seek personal credit at their expenses;

(e) act appropriately to protect a patient from risks if he believes that his colleague is not fit to practice for reasons of misconduct, ill-health or incompetence;

(f) behave, at all times, in such a manner that maintains the good reputation of the profession; and

(g) not involve himself for herself in drug or alcohol abuse.

11. Identify and minimise the risk to patients and clients

A nurse and midwife shall—

(a) work with other members of the team to promote a health care environment that is conducive for safe, therapeutic and ethical practice;

(b) act quickly to protect patients and clients from risk if the nurse or mid-wife has a good reason to believe that he, or a colleague from his own or another profession, may not be fit to practice for reasons of conduct, health or competence;

(d) not remedy circumstances in the environment of care that could jeopardise standards of practice and shall report the circumstances, in writing, to a senior person with sufficient authority to manage the circumstance and, in the case of midwifery, to the supervisor of midwives; and

(e) have a professional duty to provide care in an emergency, in or outside the work setting and the care provided shall be judged against what is reasonably expected from a nurse or midwife with such knowledge, skills and abilities when placed in those particular circumstances.

12. Dress code for nurses and midwives

In addition to the dress code prescribed for the Public Service, a nurse or midwife shall wear a complete uniform or attire as specified in this code of conduct and includes the following—

12.1 Uniform—

(a) shall be clean, neat and in a good state of repair; reflecting high professional standards at all times;

(b) dress or skirt length shall not be shorter than the middle of the knee or longer than 10cm below the knee;

(d) all jewellery is highly discouraged and if jewellery is worn, it shall be restricted to a watch (non-wrist watch), one pair of earrings less than 13mm in diameter, or a wedding band;

(e) earrings must be neat and professional, allowing for no contact with a patient;

(f) clean and closed navy blue or black uniform shoes must be worn or brown shoes for male nurses and the shoes must be protective;

(g) shoe heel not exceeding 6cm is acceptable for female nurses and flat shoes for male nurses; and

(h) subdued coloured pantyhose are acceptable for female nurses.

12.2 Personal hygiene—

(a) body and hair must be clean and odour free;

(b) hair length longer than shoulder length must be worn off the face, secured, and shall not extend below the collar;

(d) beards and moustaches are acceptable if neatly trimmed;

(e) make-up should be conservative and well applied;

(f) fingernails should be clean and no longer than one quarter inch beyond the tip of the finger;

(g) subdued colours of nail polish may be worn and should be free of chips;

(h) artificial nails, tips, or nail glue-on decorations are not permitted; and

(i) visible tattoos are not permitted.

NURSES AND MIDWIVES (DISCIPLINARY) REGULATIONS

(section 12)

(4th November, 2011)

ARRANGEMENT OF REGULATIONS

REGULATION

1. Citation

2. Interpretation

3. Disciplinary offences

4. Disciplinary Committee

5. Lodging of complaint

6. Investigation of complaint

7. Investigating team

8. Powers of investigating team

9. Interim orders by Council

10. Charge

11. Directive to accompany charge

12. Effect of admission of charge

13. Disciplinary hearing

14. Summoning of witnesses

15. Disobedience of summons

16. Procedure at disciplinary hearing

17. Evidence at disciplinary hearing

18. Disciplinary action after conviction or acquittal of criminal charges

19. Proof of commission of criminal offence

20. Finding

21. Copy of record may be applied for

22. Punishment

23. Report to Council

24. Appeal

S.I. 91, 2011

1. Citation

These Regulations may be cited as the Nurses and Midwives (Disciplinary) Regulations.

2. Interpretation

In these Regulations, unless the context otherwise requires—

“Committee” means the Disciplinary Committee appointed under regulation 4;

“health care service” means health care provided to a client in an inpatient or outpatient environment.

3. Disciplinary offences

A nurse, enrolled nurse or midwife commits a disciplinary offence if the nurse, enrolled nurse or midwife—

(a) advertises himself or any other nurse, enrolled nurse or midwife for professional gain, without following advertising guidelines as may be laid down by the Council;

(b) allows himself to be used by another person for advertising purposes without following advertising guidelines as may be laid down by the Council;

(d) during the course of his practice as a nurse, enrolled nurse or midwife—

(i) acts carelessly,

(ii) acts incompetently,

(iii) acts improperly,

(iv) assaults or batters a patient, client or colleague,

(v) provides services that are not appropriate for the patient’s well-being, or

(vi) breaches these Regulations;

(e) has been convicted of an offence the nature of which renders the person unfit to practice as a nurse, enrolled nurse or midwife;

(f) practises beyond his scope of registration;

(g) divulges any confidential matter which it is his duty to keep secret;

(h) engages in dishonest activities which may compromise the quality of care of a patient;

(i) misappropriates—

(i) drugs,

(ii) a prescription for drugs, or

(iii) hospital equipment;

(j) breaches any contract of service into which he may have entered, to the detriment of a patient;

(k) adversely reports about the professional integrity of another nurse, enrolled nurse or midwife, other than to the appropriate authority;

(l) fails to—

(i) apply due care and attention in the course of his professional duties,

(ii) comply with established nursing or midwifery procedures, or

(iii) report to the management responsible for the health care facility at which the nurse, enrolled nurse or midwife works, an accident or injury to a patient under the care of the nurse, enrolled nurse or midwife;

(m) conducts himself in a manner unbecoming of a nurse, enrolled nurse or midwife by—

(i) being insubordinate, or

(ii) failing to comply with established procedures;

(n) having been suspended from the practice of nursing or midwifery by the Council, continues to practise as a nurse, enrolled nurse or mid-wife;

(o) mal-administers drugs;

(p) consumes intoxicating liquor or takes habit forming drugs while on duty;

(q) renders himself, whilst on duty, unfit for duty through the consumption of intoxicating liquor or habit forming drugs;

(r) is affected by his use of or dependence on intoxicating liquor or habit forming drugs to such an extent that his ability to practice as a nurse, enrolled nurse or midwife is or is likely to be affected;

(s) falsifies—

(i) a patient’s medical records, or

(ii) malpractice records;

(t) gives false information—

(i) during a medical examination, or

(ii) to authorities or colleagues regarding his duties as a nurse, enrolled nurse or midwife;

(u) is found in possession of property, belonging to a health care facility, without reasonable excuse; or

(v) breaches the Code of Professional and Ethical Conduct for Nurses and Midwives set out in the Schedule to the Nurses and Midwives (Professional Ethics and Practice) Regulations.

4. Disciplinary Committee

(1) There is hereby appointed, in accordance with section 6 of the Act, a committee to be known as the Disciplinary Committee, (hereinafter referred to as “the Committee”).

(2) The object of the Committee shall be to deal with breaches of discipline or professional ethics by nurses, enrolled nurses and midwives.

(3) The Council shall appoint five persons to the Committee from among its members.

(4) The Committee shall at its first meeting elect a Chairperson, who shall preside at all disciplinary hearings and a Vice Chairperson to preside at all disciplinary hearings in the absence of the Chairperson.

(5) A member of the investigating team shall not be appointed to the Committee.

(6) The quorum at any meeting of the Committee shall be five members.

(7) In the event of an equality of votes, the Chairperson shall have a casting vote in addition to a deliberative vote.

(8) Subject to the provisions of these Regulations, the Committee shall regulate its own proceedings.

(9) The Committee shall, upon receiving the report referred to in regulation 7(4), charge the nurse, enrolled nurse or midwife with a breach of discipline or professional ethics in accordance with regulation 10.

5. Lodging of complaint

(1) A person may lodge, in the form of a written statement, a complaint, charge or allegation in relation to a disciplinary matter in relation to a nurse, enrolled nurse or midwife.

(2) The written statement under subregulation (1) shall be lodged with the Council.

6. Investigation of complaint

The Council shall, after calling for further information from the complainant, submit the matter to the investigating team to carry out such investigation as may be considered necessary.

7. Investigating team

(1) There is hereby appointed, in accordance with section 6 of the Act, a committee to be known as the investigating team.

(2) The function of the investigating team shall be to investigate lodged complaints, charges or allegations.

(3) The Council shall appoint members to the investigating team from among its members.

(4) The investigation team shall—

(a) prepare a report on an investigation and make recommendations as to the manner in which the complaint should be dealt with; and

(b) within seven day, after preparing the report, submit a copy of the report to the Committee.

8. Powers of investigating team

(1) An investigating team may for the purposes of an investigation—

(a) enter and inspect the premises where the alleged complaint occurred;

(b) require a person to produce to the investigating team any document or other thing concerning the investigation that is in the possession or under the control of the person;

(c) inspect any document or other thing produced to the investigating team and retain it for such reasonable period as the investigating team thinks fit, and make copies of a document or any of its contents; and

(d) require a person, including a nurse, enrolled nurse or midwife—

(i) to give the investigating team such information as the investigating team requires, and

(ii) to answer any question put to that person, in relation to the subject matter of the investigation.

(2) A requirement made under subregulation (1)(b)—

(a) shall be made by notice in writing to the person required to produce the document or other thing;

(b) shall specify the time at or within which the document or other thing is to be produced;

(c) may, require that the document or other thing required be produced at a place and by means specified in the requirement; and

(d) shall, where the document required is not in a readable format, be treated as a requirement to produce—

(i) the document itself,

(ii) the contents of the document in a readable format and authenticated by management of the health facility where the complaint occurred.

(3) A requirement made under subregulation (1)(d)—

(a) may be made by notice in writing served on the person required to give information or answer a question, as the case may be;

(b) shall specify the time at or within which the information is to be given or the question is to be answered, as the case may be; and

(i) be given in writing,

(ii) be given at or sent or delivered to a place specified in the requirement, or

(iii) in the case of written information or answers, be sent or delivered by means specified in the requirement.

(4) The investigating team shall inform a person who is required under these Regulations to produce a document or thing, if under subregulation (1)(b) an investigating team requires a person to produce any document or other thing, concerning the investigation, which is in the possession or under the control of the person.

(5) The investigating team shall inform a person who is required under these Regulations to give information or answer a question, if under subregulation (1)(d) an investigating team requires a person to give information or answer a question concerning the investigation.

9. Interim orders by Council

(1) Where the Council is of the opinion that an activity of a nurse, enrolled nurse or midwife involves or may involve a risk of imminent injury or harm to the physical or mental health of any person, the Council may, without further inquiry—

(a) issue to the nurse, enrolled nurse or midwife who is carrying on that activity, an order prohibiting the carrying on of the activity for a period of not more than 30 days;

(b) issue to the nurse, enrolled nurse or midwife an order to comply, within 30 days, with such conditions as the Council thinks fit in relation to the practice of nursing or midwifery, as the case may be, by that person; or

(c) issue to the nurse, enrolled nurse or midwife, an order suspending the nurse, enrolled nurse or midwife’s registration to practice, either generally or in relation to any specified circumstances, for a period of not more than 30 days.

(2) An order made under subregulation (1) shall—

(a) state that the Council is of the opinion that the activity of the nurse, enrolled nurse or midwife involves or may involve a risk of imminent injury or harm to the physical or mental health of any person;

(b) specify the activity that in the Council’s opinion involves or may involve the risk and the matters that give or may give rise to the risk; and

(c) advise that, within 14 days of the making of the order, the Council shall revoke the order or make an allegation about the matter to the Committee.

(3) The Council may, by subsequent order given to the person to whom the order made under subregulation (1) relates, revoke or vary the original order at any time before making an allegation about the matter to the Committee.

10. Charge

(1) On receipt of a report from the investigating team, where a nurse, enrolled nurse or midwife is the person who is the subject of the proceedings of a breach of discipline or professional ethics, the Committee shall charge the nurse, enrolled nurse or midwife, in writing, with that breach.

(2) The Committee shall cause a written charge to be served personally upon the nurse, enrolled nurse or midwife concerned.

(3) For purposes of subregulation (2), service of a written charge on the nurse, enrolled nurse or midwife shall be proved by an affidavit of the person who effected service and by the production of a signed receipt of the service.

11. Directive to accompany charge

The charge shall—

(a) be accompanied by a written directive calling upon the person charged to transmit or deliver, within a reasonable period specified in the directive to a specified person, a written admission or denial of the charge, and if he so desires, a written explanation of the breach with which he is charged;

(b) be accompanied by any report of any findings by the investigating team; and

12. Effect of admission of charge

Where a nurse, enrolled nurse or midwife charged with a breach of discipline or professional ethics, admits the charge, the nurse, enrolled nurse or midwife shall sign a form, to be prescribed by the Minister, admitting the charge of the breach of discipline or professional ethics with which he has been charged.

13. Disciplinary hearing

(1) Where the nurse, enrolled nurse or midwife admits or denies the charge, the Committee shall conduct a disciplinary hearing to try the nurse, enrolled nurse or midwife on the charge.

(2) The Committee shall meet at such times and places as the Chairperson may determine to conduct a disciplinary hearing.

(3) All the proceedings of the Committee shall be held in camera.

(4) The Chairperson shall give the nurse, enrolled nurse or midwife who is the subject matter of the proceedings to be conducted by the Committee 14 days notice in writing to appear before the Committee, stating the disciplinary charge laid against the nurse, enrolled nurse or midwife and the time and place of the proceedings.

(5) The Committee may request the attendance of a legal practitioner to advice on questions of law and procedure, but shall have no vote in the decisions of the Committee.

(6) A nurse, enrolled nurse or midwife who is the subject of proceedings before the Committee shall have the right to be heard either personally or by a legal representative, and may call witnesses and cross-examine witnesses called by the Committee.

(7) The Chairperson shall inform the nurse, enrolled nurse or the mid-wife who is the subject of the proceedings before the Committee, in writing, of the decision of the Committee and the reasons for reaching that decision, within 14 days of the end of the proceedings.

(8) Every question before the Committee shall be determined by a majority of votes of the members of the Committee.

(9) Where there is an equality of votes on the question of findings, the Chairperson shall have a casting vote.

(10) The Chairman shall record or cause to be recorded the proceedings of the disciplinary hearing and all evidence adduced at the disciplinary hearing.

14. Summoning of witnesses

The Committee may—

(a) summon, to attend the disciplinary hearing, any person whose evidence appears to be material to the determination of the charge;

(b) administer an oath or solemn affirmation to any person so summoned or to any person who appears at the disciplinary hearing to give evidence; or

(c) order the production, at the disciplinary hearing, by any person of any book or document in his possession or under his control, which book or document is relevant to the subject of the disciplinary hearing.

15. Disobedience of summons

(1) Any person summoned as a witness under regulation 14 who—

(a) fails to attend at the time and place appointed; or

(b) refuses to give evidence or to answer a lawful question or to do any lawful thing required by the Committee, commits an offence and is liable to a fine not exceeding P1 000.

(2) Where in any proceedings under these Regulations, any witness who, having been duly sworn or affirmed, makes any false statement knowing the same to be false, such witness commits an offence and is liable to a fine not exceeding P1 000.

16. Procedure at disciplinary hearing

(1) When the nurse, enrolled nurse or midwife who is the subject of the proceedings appears at the disciplinary hearing, the procedure shall be as follows—

(a) the Chairperson shall read the charge served in accordance with regulation 10 and present its case;

(b) the nurse, enrolled nurse or midwife who is the subject of the proceedings shall then present his case and where the case is stated in writing, the statement shall be read by the nurse, enrolled nurse or midwife;

(c) the Chairperson may address the Committee on the case generally on conclusion of the case, whether the nurse, enrolled nurse or mid-wife has produced evidence or not;

(d) the nurse, enrolled nurse or midwife who is the subject of the proceedings may then address the Committee on the case generally;

(e) the nurse, enrolled nurse or midwife who is the subject of the proceedings shall be permitted to produce further evidence after the address by the Chairperson, and the reply shall be confined to matters arising out of the evidence;

(f) where the nurse, enrolled nurse or midwife who is the subject of the proceedings has in his address raised any matter of law, the reply shall be confined to the matter of law raised; and

(g) the Committee may impose a punishment on the nurse, enrolled nurse or midwife who is the subject of proceedings before the Committee, in accordance with regulation 22.

(2) Where the nurse, enrolled nurse or midwife who is the subject of the proceedings does not appear at a disciplinary hearing after a directive was served in accordance with regulation 11—

(a) the Committee shall read the charge served in accordance with regulation 10 and may—

(i) issue a written warning, to the nurse, enrolled nurse or mid-wife who is the subject of the proceedings, informing him or her that a fine will be imposed if the nurse, enrolled nurse or midwife disregards a subsequent directive, or

(ii) issue a written warning accompanied with a fine of P1 000 for not appearing; or

(b) the Committee may postpone the disciplinary hearing and give instructions for the nurse, enrolled nurse or midwife to be served with another directive.

17. Evidence at disciplinary hearing

(1) Verbal evidence shall be taken on oath or solemn affirmation, which shall be administered by the Chairperson.

(2) The Chairperson, members of Committee through the Chairperson, and the nurse, enrolled nurse or midwife who is the subject of the proceedings may examine or cross-examine witnesses.

(3) The Chairperson and the members of the Committee may, through the Chairperson, put questions to witnesses.

(4) The Committee may at any stage of the proceedings, call or recall any person to give evidence.

(5) The record or part of the record of proceedings in any court of law, including inquest proceedings, may be handed in as evidence by producing a certified copy by the clerk or registrar of the court of record, provided that the Committee may direct that any or all the witnesses whose evidence appears in such record or part of a record, be summoned to give evidence.

(6) Affidavits shall be admissible as evidence and the Committee may direct that a deponent be summoned to give evidence.

18. Disciplinary action after conviction or acquittal of criminal charges

Where a nurse, enrolled nurse or midwife has been convicted or acquitted of a criminal charge by a court, the conviction or acquittal shall not operate as a bar to disciplinary proceedings being instituted against such nurse, enrolled nurse or midwife arising out of the same facts if such facts also disclose a different offence under these Regulations.

19. Proof of commission of criminal offence

(1) Where the breach of discipline or professional ethics with which the nurse, enrolled nurse or midwife is charged amounts to or involves an offence of which he has been convicted by a court, a certified copy of the record of the trial and conviction shall, upon the identification of the nurse, enrolled nurse or midwife as the person referred to in the record, be sufficient proof of the commission of the offence by the nurse, enrolled nurse or midwife, unless the conviction has been set aside by a superior court.

(2) It shall be competent for the nurse, enrolled nurse or midwife charged, to adduce evidence that he was wrongly convicted.

20. Finding

(1) Upon the conclusion of the disciplinary hearing, the Committee shall deliberate upon the finding.

(2) The nurse, enrolled nurse or midwife, who is the subject of the proceedings before the Committee, shall be informed of the finding and where he is found to be in breach of discipline or breach of professional ethics, the Committee shall state whether the nurse, enrolled nurse or mid-wife has been found guilty of breach of discipline or breach of professional ethics.

(3) Where a nurse, enrolled nurse or midwife, who is the subject of the proceedings before the Committee, is charged on various counts, separately or in the alternative, the Committee shall make a finding on each of the counts.

(4) Where the nurse, enrolled nurse or midwife is found guilty of breach of discipline or breach of professional ethics, the Committee may adduce evidence of any previous convictions under the Act.

(5) The nurse, enrolled nurse or midwife may challenge the certified copy of the record of the trial and conviction under regulation 19(1), and the record of the proceedings where the nurse, enrolled nurse or midwife was found guilty.

(6) The Committee shall deliberate on the punishment to be imposed and shall inform the nurse, enrolled nurse or midwife, in writing, of the punishment imposed.

(7) The nurse, enrolled nurse or midwife may, through the Committee, submit written representations to the Council in mitigation.

(8) The decision of the Council shall be announced to the nurse, enrolled nurse or midwife by the Committee.

21. Copy of record may be applied for

If found guilty, the nurse, enrolled nurse or midwife may within seven days of being informed of the finding, apply to the Committee for a copy of the record of the proceedings at the disciplinary hearing including any evidence admitted and the statement of finding and the punishment imposed.

22. Punishment

(1) The Committee may impose any of the following punishments—

(a) a reprimand;

(b) a fine not exceeding P1 000;

(c) a recommendation to the Council for the suspension of the nurse, enrolled nurse or midwife from practice for a period not exceeding three months; or

(d) a recommendation to the Council to remove the nurse, enrolled nurse or midwife from the register.

(2) The Committee shall, within 14 days of completing its proceedings, forward a copy of the record of proceedings to the nurse, enrolled nurse or midwife found guilty of a disciplinary offence.

23. Report to Council

The Committee shall report to the Council by submitting a copy of the record of the proceedings.

24. Appeal

(1) A nurse, enrolled nurse or midwife who has been found guilty of a disciplinary offence may, within 14 days of receipt of the record of proceedings of the Committee, appeal against the findings or punishment of the Committee, to the Council, by giving the Chairperson, written notice of appeal, and stating the grounds of the appeal.

(2) The Chairperson of the Committee shall, within seven days of receipt of notice of appeal, forward to the Council the record of the proceedings of the Committee together with the notice of appeal.

(3) The Council may, during a period of 21 days when considering the appeal, require the Committee to produce any evidence that the Council may consider necessary.

(4) The Council may dismiss the appeal made in terms of subregulation (1) or allow it in whole or in part, and shall notify the appellant in writing of the outcome of the appeal.

(5) Where the appeal is dismissed, the Council shall notify the appellant in writing and shall state the reasons for such dismissal.

(6) A nurse, enrolled nurse or midwife aggrieved by the decision of the Council may appeal to the Minister in writing, within 14 days of receiving notification in terms of subregulations (4) and (5).

(7) The Minister shall, within seven days of receipt of an appeal made in terms of subregulation (6), inform the appellant of the outcome of appeal, and the reasons of the appeal.

(8) A nurse, enrolled nurse or midwife aggrieved by the decision of the Minister may, within 14 days of receipt of the decision by the Minister, appeal to the High Court.

NURSES AND MIDWIVES (REGISTRATION) REGULATIONS

(section 12)

(4th November, 2011)

ARRANGEMENT OF REGULATIONS

REGULATION

1. Citation

2. Interpretation

3. Application for registration

4. Registers

5. Certificate of registration

6. Validity of certificate

7. Renewal of certificate

8. Issue of duplicate certificate

9. Refusal to register

10. Suspension of registration

11. Revocation of certificate

12. Re-registration

13. Removal from register

14. Restoration of name to register

15. Appeal against refusal to register

16. Return of certificate of registration to Council

17. Register to be prima facie evidence

18. Offences in connection with register

19. Fees payable under the Act

Schedule 1

Schedule 2

S.I. 92, 2011,
S.I. 130, 2014.

1. Citation

These Regulations may be cited as the Nurses and Midwives (Registration) Regulations.

2. Interpretation

In these Regulations, unless the context otherwise requires—

“Chairman” means the chairman of the Council;

“certificate” means a certificate of registration issued under regulation 5;

“Council” means the Nursing and Midwifery Council of Botswana established under section 3 of the Act;

“register” means a register kept and maintained in accordance with section 8 of the Act; and

“Registrar” means the Registrar of the Council.

3. Application for registration

(1) A person trained in Botswana shall apply to the Council in Form 1 set out in Schedule 1, within 90 days following completion of training, to be registered under these Regulations as a—

(a) General Nurse;

(b) Midwife;

(d) Enrolled Nurse;

(e) Student Nurse; or

(f) Student Midwife.

(2) A person trained outside Botswana, who wishes to be registered under these Regulations shall apply to the Council to be registered, in Form 2 set out in Schedule 1.

(3) A person who wishes to be registered as a student nurse or Student Midwife shall apply to the Council, to be registered as such in Form 3, set out in Schedule 1.

(4) An application under subregulations (1), (2), or (3) shall be accompanied by—

(a) a certificate of any qualification on which the applicant relies for registration, or a certified copy thereof, and, where the certificate is not in English, a certified translation thereof; and

(b) evidence of identity and other evidence or information as may be required by the Council.

(5) A citizen of Botswana who fails to register under these Regulations within 90 days following training in terms of subregulation (1) shall pay a late registration fee specified in Schedule 2.

(6) Where the Council is satisfied that an applicant meets the requirements of this regulation it shall register the applicant in the relevant register in accordance with regulation 4.

4. Registers

(1) The registers kept in accordance with section 8 of the Act shall be kept in the Registrar’s office, in hard and soft copy, and shall be open to inspection during office hours by any member of the public.

(2) The Council shall—

(a) enter in the relevant register, in relation to a nurse or midwife—

(i) his name,

(ii) his permanent address,

(iii) his qualifications, and

(iv) other particulars as the Council may, from time to time, determine;

(b) direct the Registrar to make, in the relevant register, any necessary alterations to the particulars referred to under paragraph (a) where such alterations are supported by a legal document;

(i) who has died,

(ii) who has ceased to practice as a nurse or midwife, or

(iii) whose period of enrolment has expired; or

(d) when required to do so under the Act or in pursuance of an order of a court—

(i) register a nurse or midwife,

(ii) suspend, from practice, a registered nurse or midwife, or

(iii) remove, from the register, the name of a registered nurse or midwife.

5. Certificate of registration

(1) The Council shall, where it registers a nurse or midwife trained in Botswana, issue him or her with a certificate of registration in Form 4 set out in Schedule 1.

(2) The Council shall, where it registers a nurse or midwife trained outside Botswana, issue him or her with a provisional certificate of registration in Form 5 set out in Schedule 1.

6. Validity of certificate

(1) A certificate of registration shall be valid for a period of 12 months from the date of issue.

(2) A provisional certificate of registration issued to a person trained outside Botswana shall be valid for a period of two years, after which period, the Council may register a person trained outside Botswana and issue him or her with a certificate of registration in Form 6 set out in Schedule 1.

7. Renewal of certificate

(1) A registered nurse or midwife may, upon expiry of their certificate and by 31st of January, apply to the Council for renewal, and shall—

(a) produce a valid original certificate of registration; and

(b) pay a fee specified in Schedule 2.

(2) A registered nurse or midwife who fails to renew their certificate by 31st of January each year shall pay a late registration renewal fee specified in Schedule 2.

8. Issue of duplicate certificate

The Council may issue to a registered nurse or midwife a duplicate certificate—

(a) where the Council is satisfied as to the identity of the applicant; and

(b) on production by the applicant of an affidavit certifying that his certificate has been lost or destroyed.

9. Refusal to register

The Council shall not register an applicant who—

(a) fails to meet the requirements specified in regulation 3; or

(b) has been convicted of an offence; and

10. Suspension of registration

The Council may suspend the registration of a nurse or midwife who—

(a) is found guilty under the Nurses and Midwives (Professional Ethics) Regulations;

(b) criminal investigations are being carried out against; and

(d) is not practicing, for the period that they are not practicing.

11. Revocation of certificate

The Council may revoke a certificate where—

(a) the nurse or midwife is convicted of an offence; or

(b) it reasonably believes that it is in the interest of the public to do so.

12. Re-registration

(1) The Council shall re-register a nurse or midwife whose certificate has been revoked in terms of regulation 11 or has not been practicing for a period of less than five years, on application to the Council, in writing, by such nurse or midwife.

(2) Where a nurse or midwife who has not been practicing for a period of more than five years, applies under subregulation (1) the nurse or midwife shall—

(a) be issued with a provisional certificate of registration in Form 7, set out in Schedule 1;

(b) be attached for a period of six months to all units within a hospital; and

(c) ensure that a report from each unit of a hospital is submitted to the Council, through his supervisor, after a period of six months.

(3) Where the Council is satisfied with the report submitted to it in terms of subregulation (2), it shall re-register the nurse or midwife.

13. Removal from register

(1) The Council shall remove from the register—

(a) the name of a nurse or midwife who has requested that his name be removed from the register and has lodged an affidavit stating that no disciplinary inquiry under the Nurses and Midwives (Professional Ethics) Regulations, or criminal proceedings are being, or are likely to be, instituted against him or her in connection with his practice as a nurse or midwife;

(b) the name of a nurse or midwife who has been convicted under the Nurses and Midwives (Professional Ethics) Regulations;

(c) an entry which is proved, to the satisfaction of the Council, to have been made in error or through fraudulent representation or concealment of material facts or in circumstances not authorised by the Act; or

(d) the name of a nurse or midwife who has been declared by a medical doctor to be mentally incapacitated.

(2) The Council shall, where it—

(a) removes from the register, the name of a registered nurse or midwife; or

(b) enters, in the register, the suspension of a registered nurse or midwife, enter, in the register, a record of the reasons for the removal or suspension, and notify the nurse or midwife, in writing, of the reasons for the removal or suspension.

(3) A certificate issued to a registered nurse or midwife whose name has been removed from the register in terms of subregulation (1) shall be deemed to have been cancelled on the date of the removal and the nurse or midwife shall be deemed not to be registered with effect from that date.

14. Restoration of name to register

(1) Where the name of a nurse or midwife has been removed from the register or the registration of a nurse or midwife has been suspended, the Council may either of its own volition, or on the application, in writing, of the nurse or midwife concerned, and after holding such inquiry as the Council may consider necessary, direct that the name of the nurse or midwife be restored to the register.

(2) Where an application for the restoration of a name to register is done by the nurse or midwife who was declared mentally incapacitated, he shall—

(a) apply to the Council in Form 1 set out in Schedule 1;

(b) pay a fee prescribed in Schedule 2; and

(3) A nurse or midwife applies under subregulation (2) shall work under a supervisor for a period of six months, and the Council may, if it is satisfied with the report sent by the supervisor after a period of six months, restore the name of the nurse or midwife concerned to the register.

15. Appeal against refusal to register

(1) Any person aggrieved by a decision of the Council to—

(a) refusing to register him or her as a nurse or midwife;

(b) suspending his registration as a nurse or midwife; or

may, after giving notice of his intention to appeal in writing, and within 30 days of the date on which notice is given to him or her by the Council of the refusal, suspension or removal, appeal to the Minister against such decision.

(2) A person aggrieved by the decision of the Minister may, within 30 days of the date of the decision, appeal to the High Court against such decision.

16. Return of certificate of registration to Council

(1) A nurse or midwife whose name has been removed from the register under regulation 11 shall return, to the Council, his certificate within 30 days of the date upon which he is directed in writing by the Council to do so.

(2) A nurse or midwife who refuses to return a certificate of registration in contravention of subregulation (1) shall be guilty of an offence and liable to a fine not exceeding P1 000, or a term of imprisonment not exceeding one year, or to both.

17. Register to be prima facie evidence

(1) The register shall be prima facie evidence of the matters set out in it.

(2) Notwithstanding the generality of subregulation (1), a certificate purporting to be signed by the Registrar to the effect that—

(a) the name of a person does not appear in the register, shall be prima facie evidence that the person is not a registered nurse or midwife;

(b) the name of a person appears in the register, shall be prima facie evidence that the person is a registered nurse or midwife; or

(c) a registered nurse or midwife has been suspended from practice as such for the period specified in the register, shall be prima facie evidence that the registered nurse or midwife has been suspended from practice for that period.

(3) A copy of an entry in the register, a document in custody of the Council or an extract from the register, shall be admitted in evidence in all courts without further proof or production of the original.

18. Offences in connection with register

Any person who—

(a) makes or causes to be made an unauthorised entry, alteration or deletion in the register;

(b) procures or attempts to procure for himself or another person, registration or a certificate by means of fraud, false pretence or concealment of a material fact;

(c) makes or causes to be made in connection with an application for registration, a false declaration in a document used for the purpose of establishing his identity;

(d) wilfully destroys or renders illegible an entry in the register;

(e) wilfully destroys or renders a certificate illegible;

(f) forges a document purporting to be a certificate; or

(g) possesses a certificate knowing the same to be forged,

commits an offence and is liable to a fine not exceeding P 1 000, or a term of imprisonment not exceeding one year, or to both.

19. Fees payable under the Act

The fees payable under the Act shall be as set out in Schedule 2.

SCHEDULE 1

FORM 1
Application for Registration of Nurses and Midwives trained in Botswana

Nursing and Midwifery Council of Botswana

(regs. 3(1) and 13(2))

Personal Particulars of Applicant

Title : Miss	Mrs	Mr	Dr.	other
Surname: …………………………………………………………………………………………………………
Name: …………………………………………………………………………………………………………….
Maiden Name: ………………………………………………………………………………………………….
Gender: M	F
ID Number: ………………………………………………………………………………………………………
Expiry date: ……………………………………………………………………………………………………..
Nationality: ……………………………………………………………………………………………………..
Date of Birth: Day …………………………….Month ……………….. Year ……………………….
Place/Country of Birth: ……………………………………………………………………………………….
Permanent Address: ………………………………………………………………………………………….
……………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………..
Telephone: Home ……………………………………………………. Work ……………………………….
Mobile: …………………………………………………………………. Fax: ………………………………..
Registration applied for (tick as appropriate)
General Nurse
Midwife
Nurse Specialist
Other (specify) …………………………………………………………………………………………………..
Student Number …………………………………………………………………………………………………
General Nursing Number (as applicable) …………………………………………………………………..
Other Qualifications (specify as applicable) ……………………………………………………………….

Date of Initial registration Day ……………………….. Month …………….. Year ………………………
Status of Registration:
Active ……………………………. Lapsed ……………………………. other ………………………………..
Education and Professional Preparation of Applicant:
Level of highest general education (specify)
……………………………………………………………………………………………………………………….
Nursing/Midwifery education and other
Training	Institution	Dates	Qualifications / Awards obtained

Name and contacts of employer (as applicable).
……………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………….
Particulars of next of kin:
Name ………………………………………………………………………………………………………………
Address …………………………………………………………………………………………………………..
Telephone …………………………………………………………………………………………………………
Any Nurse or Midwife who trained in Botswana (Locally) shall submit the following prior to his name being entered into the appropriate register.
1. Completion of course form submitted by the Institution
The Principal of each school shall send to the Council the appropriate completion of course form in respect of each student nurse or student midwife who has successfully completed the nursing or midwifery programme.
2. Registration form to be completed by each applicant
Each applicant shall complete the Council application form for registration and submit it for scrutiny prior to the name being entered into the register.
3. Initial Registration fees
The form shall be checked by officers of the Council after which an appropriate initial registration fee, according to the cadre, shall be paid by the applicant.
4. Documents.
1. National identity (omang), certified by the appropriate authorities.
2. Transcript of training from the training institution sent directly to NMCB.

3. Qualification certificate, certified by the appropriate authorities.
4. Two (2) references from your training institution.
5. Marriage certificate (if applicable), certified by the appropriate authorities.
6. Current practicing certificate (for post basic students).
7. Typed curriculum vitae.
8. One recent coloured passport size photograph.
For further information contact:
Postal address: The Registrar Nursing and Midwifery Council of Botswana Private Bag 0038 Gaborone. Botswana.	Physical address: The Registrar NMCB Ministry of Health Headquarters 6th Floor. Office 6A 32 Government Enclave Gaborone. Botswana.
Tel: 00267 — 3632705/3632575/76 Fax: 00267 — 3184781
Declaration.
I, the undersigned, certify that I am the referred to in the foregoing application for registration as a general nurse/midwife/nurse specialist in Botswana and that the statements therein are true to the best of my knowledge and belief.
I hereby authorise all hospitals, institutions or organisations, my referees, personal physicians, employers (past and present) to release to the Council any information, files or records requested by the Council on connection with the processing of the application.
Applicant’s Signature: ……………………………..	Date: ……………………………………..

FORM 2
Application for Registration of Nurse and Midwives Trained Outside Botswana

Nursing and Midwifery Council of Botswana

(reg. 3(2))

Personal Particulars of Applicant

Name: …………………………………………………………………………………………………………….
Surname: …………………………………………………………………………………………………………
Title : Miss	Mrs	Mr	Dr.	other
Maiden Name: ………………………………………………………………………………………………….
Gender: M	F
ID Number: ………………………………………………………………………………………………………
Expiry date: ……………………………………………………………………………………………………..
Nationality: ……………………………………………………………………………………………………..
Date of Birth: Day …………………………….Month ……………….. Year ……………………….
Place/Country of Birth: ……………………………………………………………………………………….
Permanent Address: ………………………………………………………………………………………….
……………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………..
Telephone: Home ……………………………………………………. Work ……………………………….
Mobile: …………………………………………………………………. Fax: ………………………………..
Registration applied for (tick as appropriate)

General Nurse	Midwife	Nurse Specialist
Other (specify) ………………………………………………………………………………………………….
Student Number ………………………………………………………………………………………………..
General Nursing Number (as applicable) ………………………………………………………………….
……………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………..
Other Qualifications (specify)
……………………………………………………………………………………………………………………..

Date of Initial Registration (Day) ……………………. (Month) ……………………….. (Year) ………
Status of Registration: Active:		Lapsed:
Other: ……………………………………………………………………………………………………………
Registration With Your Nursing Council:
Date of Initial Registration: (Day) ……………………. (Month) ……………………….. (Year) ………
General Nurse:		Midwife:
Other:
……………………………………………………………………………………………………………………..

Education and Professional Preparation
Training	Institution	Dates	Qualifications / Awards obtained






Practice (clinical and others)
Area of Practice	Position held	Dates




DECLARATION
I, the undersigned, certify that I am the referred to in the foregoing application for registration as a general nurse/midwife/nurse specialist in Botswana and that the statements therein are true to the best of my knowledge and belief.
I hereby authorise all hospitals, institutions or organisations, my referees, personal physicians, employers (past and present) to release to the Council any information, files or records requested by the Council in connection with the processing of this application.
Applicant’s Signature: ………………………………….	Date: ……………………………

NOTES: Admission to the Nurses and Midwives Register kept by the Council under section 8 of the Nurses and Midwives Act (Cap. 61:03)
The application should be accompanied by the following documents:
1.	Application letter clearly stating what you are applying for.
2.	Marriage certificate (if applicable), birth certificates, passport (certified copies).
3.	School leaving certificates e.g. General Certificate of Education, “O” Level Certificate or its equivalent (certified copies).
4.	Nursing/Midwife specialty certificates (certified copies).
5.	Certified copy of initial registration certificates from your nursing council.
6.	Certified copy of current practicing certificates from your nursing council.
7.	Typed curriculum vitae clearly outlining work experience and qualifications.
8.	Two references (sealed and stamped) from supervisors sent directly to Nursing and Midwifery Council of Botswana.
9.	Transcripts of training e.g. general nursing, midwifery etc. shall be sent directly to the Nursing Council by the principal of the nursing school or his/her representative. The stamp or seal shall be attached to the transcript and signed by the principal or his/her representative. It must be on a letterhead.
10.	Verification of registration from your nursing council.
	— Signed by appropriate author
	— Have seal, date stamp and signature of appropriate authority
	— Sent directly to NMCB by appropriate authority
	— Be authentic and verified by your nursing council
11.	Original nursing and midwifery or other qualification certificates and other documents will be required once the Council has approved the application.
12.	All copies must be certified by the appropriate authority, e.g. a Commissioner of Oaths, not an officer in the Police Service.
13.	All documents sent must be in English.
14.	Translations from other languages to English must be done by the appropriate authority.
15.	Two years minimum experience, post qualification.
16.	Submit two passport size photos.

17.	Application to be sent to the following address:
Postal Address: The Registrar Private Bag 0038 Gaborone	Physical Address: Ministry of Health Private Bag 0038 Gaborone Plot No. 54609 Government Enclave
NOTE:
• A non-refundable fee should be paid with your application, ONLY upon submission of ALL required documents. NMCB will not accept an application with incomplete submission of required documents.
• Documents with the following will be immediately disqualified:
— Hand written information
— Overwritten information
— Discrepant and unidentifiable information
— Not originating from the appropriate authorities or source

FORM 3
APPLICATION FOR REGISTRATION OF STUDENT NURSES AND STUDENT MIDWIVES

NURSING AND MIDWIFERY COUNCIL OF BOTSWANA

(reg. 3(3))

I wish to apply for registration as a: Student nurse Student midwife
1.	Surname …………………………………………………………………………………………………
2.	First name ……………………………………………………………………………………………….
3.	Maiden name ……………………………………………………………………………………………
4.	Date of birth (Day) ………………………….. (Month) …………………….. (Year) ……………..
5.	Educational standard …………………………………………………………………………………..
6.	Whether registered with the NMCB as a general nurse/midwife. If so, the registration number and date of registration ………………………………………………………………………
7.	Name and address of training school:
	……………………………………………………………………………………………………………….
	……………………………………………………………………………………………………………….
8.	Date of commencement of training: (Day) ……………… (Month) ……………. (Year) ………
	I certify that the above information is true and correct.
	……………………………………… ……………………………… Signature of Application Date
NOTE: The marriage certificate or other proof of marriage must be scrutinised by the Principal tutor so that he or she can verify the educational certificate produced by the applicant. Application for registration must be made within twelve weeks of commencement of training.
CERTIFICATE TO BE COMPLETED BY THE PRINCIPAL TUTOR.
I HEREBY CERTIFY THAT: To the best of my knowledge, all information given by the applicant is correct. I have scrutinised the Education Certificate of applicant. The applicant has submitted a certificate of good character which has been medically examined and found to be in good health, and in my opinion, is now ready to commence training.
……………………………………… ……………………………… Signature of Principal/ Lecturer Date

FORM 4
CERTIFICATE OF REGISTRATION OF NURSES AND MIDWIVES TRAINED IN BOTSWANA

(reg. 5(1))

……………………………………………………………………………………………………………………..

NURSING AND MIDWIFERY COUNCIL OF BOTSWANA
NURSES AND MIDWIVES ACT (CAP. 61:03)

……………………………………………………………………………………………………………………..

PRACTISING CERTIFICATE

This is to certify that:

Registration number:

is entitled to practice as a:

Until:

Registrar …………………………………………………………………………………………………………

FORM 5
PROVISIONAL CERTIFICATE OF REGISTRATION OF NURSES AND MIDWIVES TRAINED OUTSIDE BOTSWANA

(reg. 5(2))

……………………………………………………………………………………………………………………..

NURSING AND MIDWIFERY COUNCIL OF BOTSWANA
NURSES AND MIDWIFERY ACT (CAP. 61:03)

……………………………………………………………………………………………………………………..

PROVISIONAL PRACTISING CERTIFICATE

This is to certify that :

Registration Number :

Is entitled to practice as a :

Until

Date: Registrar ………………………………….

FORM 6
CERTIFICATE OF REGISTRATION OF NURSES AND MIDWIVES TRAINED OUTSIDE BOTSWANA

(reg. 6(2))

……………………………………………………………………………………………………………………..

NURSING AND MIDWIFERY COUNCIL OF BOTSWANA
NURSES AND MIDWIVES ACT (CAP. 61:03)

……………………………………………………………………………………………………………………..

PRACTISING CERTIFICATE

This is to certify that :

Registration Number :

Is entitled to practice as a :

Until

Date: Registrar ………………………………….

FORM 7
PROVISIONAL CERTIFICATE OF REGISTRATION OF NURSES AND MIDWIVES TRAINED IN BOTSWANA AND HAS NOT PRACTISED FOR A PERIOD OF FIVE YEARS

(reg. 12(2)(a))

……………………………………………………………………………………………………………………..

NURSING AND MIDWIFERY COUNCIL OF BOTSWANA
NURSES AND MIDWIFERY ACT (CAP. 61:03)

……………………………………………………………………………………………………………………..

PROVISIONAL PRACTISING CERTIFICATE

This is to certify that :

Registration Number :

Is entitled to practice as a :

Until

Date: Registrar ………………………………….

SCHEDULE 2

FEES PAYABLE TO THE COUNCIL

(regs. 7(b), 14(2), 19)

NO	ACTIVITY	LOCAL	FOREIGN
1.	INITIAL REGISTRATION
	(i) All Basic Nursing Qualifications (BSN GN Diploma)	P100	P250
	(ii) Post Basic Qualifications (Midwifery, CHN, FNP, Psychiatric etc.)	P100	P100
	(iii) Enrolled Nurse	P100	P100
	(iv) Nurse Specialist	P100	P250
2.	NON REFUNDABLE APPLICATION
	Handling Fee	—	P500
3.	VERIFICATION OF REGISTRATION	P250	P500
4.	REINSTATEMENT TO REGISTER	P250	P500
5.	LOST INITIAL REGISTRATION CERTIFICATE	P100	P250
6.	DUPLICATE PRACTICING CERTIFICATES	P30	P30
7.	LOST CERTIFICATES — letter in lieu of certificates for	P30	P30
	BNC certificates only
8.	ANNUAL RENEWAL OF REGISTRATION
	(i) Registered General Nurse (Diploma/Degree)	P50	P50
	(ii) Registered Midwife only	P50	P50
	(iii) Registered Psychiatric Nurse only	P50	P50
	(iv) Enrolled Nurses	P50	P50
	(v) Post basic qualification Midwifery, CHN, CMHN, ICU, FNP, Ophthalmic Nursing, Theatre Nursing, Anesthetic Nursing etc.
	(vi) Nurse Specialist	P50	P50
	Even on transfer to another specialty
9.	LATE REGISTRATION
	Late registration renewal	P250 every three months after 31st January	P250 every three months after 31st January
Late registration following completion of training	P 500	N/A
Documents approved by full council at their special full council meeting held at Nurses Association of Botswana Hall on 7th November 2002.

NURSES AND MIDWIVES (EDUCATION) REGULATIONS

(under section 12)

(23rd October, 2015)

ARRANGEMENT OF REGULATIONS

REGULATION

Part I
Preliminary

1. Citation

Part II
Approval of Schools or Institutions

2. Prohibition against operating a school or institution without approval

3. Application for approval of school or institution

4. Requirements for approval of school or institution

5. Approval of a school or institution

6. Validity of certificate of approval

7. Renewal of certificate of approval

8. Transfer of certificate of approval

9. Suspension, revocation or cancellation of certificate of approval

Part III
Approval of Programme

10. Prohibition against conducting programme without approval

11. Application for approval of programme

12. Requirement for approval of programme

13. Approval of programme

14. Validity of approval

15. Renewal of approval

16. Transfer of approval

17. Periodic evaluation of programme

18. Reports on programme

19. Suspension, revocation or cancellation of approval

20. Reinstatement of approval for a programme

PART IV
Qualification of teaching staff, teaching nurses or midwives, etc

21. Academic qualification of teachers

22. Teaching nurses or midwives

23. Student-teacher ratio

Part V
Training and Examinations

24. Admission to training

25. Examination by school or institution

26. Notice of completed students

27. Professional examinations by Council

28. Examination centres

29. Examiners and moderators

Part VI
Registers

30. Submission of student list for register

31. Removal from register

32. Reinstatement into register

Part VII
Miscellaneous

33. Right to inspect and call for information

34. Closure

35. Custody of records

36. Appeals

37. Offences and penalties

38. Revocation

39. Transitional provisions

40. Savings

SCHEDULES

S. I. 101, 2015.

PART I
Preliminary (reg 1)

1. Citation

These Regulations may be cited as the Nurses and Midwives (Education) Regulations.

PART II
Approval of Schools and Institutions (reg 2-9)

2. Prohibition against operating a school or institution without approval

(1) A person shall not operate a nursing and midwifery school or institution unless that school or institution is approved by the Council in accordance with these Regulations.

(2) A person who contravenes subregulation (1) commits an offence and is liable to a fine of P1, 000.

3. Application for approval of school or institution

(1) An application to operate a nursing and midwifery school or institution shall be made to the Council in accordance with Form A as set out in Schedule 1.

(2) An application under subregulation (1) shall be accompanied by a non-refundable fee of P250.

4. Requirements for approval of school or institution

An applicant under regulation 3 shall not be successful unless the applicant demonstrates that it consists of—

(a) a nursing school or institution which provides education and training of student nurses in the theoretical and practical aspects of nursing for specified periods during their course of training in accordance with Form B set out in Schedule 1;

(b) a training school or institution comprising of an affiliated hospital or group of hospitals which hospital or group of hospitals have been approved by the Council as forming part of the training school;

(c) education and training of student midwives programme in the theoretical and practical aspects of midwifery for specified periods in accordance with Form B set out in Schedule 1; and

(d) a maternity ward of acceptable standards or affiliated to a hospital with maternity facilities, where it wishes to operate a midwifery school or institution.

5. Approval of a school or institution

(1) Where the Council, after inspection of the school or institution, is satisfied that the requirements of these Regulations are met, it shall approve the school or institution as a nursing and midwifery school or institution and shall, on payment of a fee of P1, 000 issue to the school or institution a certificate of approval for a nursing and midwifery school or institution in accordance with Form C set out in Schedule 1.

(2) The Council may—

(a) withhold the approval and direct an applicant to satisfy certain requirements as it may specify in writing; or

(b) reject an application, where it is satisfied that the application does not meet the requirements under these Regulations.

(3) A holder of a certificate of approval for a nursing and midwifery school or institution in accordance with subregulation (1) shall conspicuously display the certificate at the place of operation.

6. Validity of certificate of approval

A certificate of approval for a nursing and midwifery school or institution shall be valid for a period of five years unless earlier revoked or cancelled in accordance with these Regulations.

7. Renewal of certificate of approval

(1) A holder of a certificate of approval for a nursing and midwifery school or institution may, within six months prior to the expiry of the certificate of approval, apply in writing, to the Council for a renewal of the certificate of approval.

(2) The Council shall, upon receipt of the application under subregulation (1), carry out an inspection at the expense of the applicant, of the nursing and midwifery school or institution to determine whether it meets the requirements for approval.

(3) Where the Council is satisfied after inspection that, an applicant meets the requirements, and upon a payment of a renewal fee of P1, 000, it shall endorse on the certificate of approval for a nursing and midwifery school or institution that the certificate of approval is renewed for a further period of five years.

8. Transfer of certificate of approval

(1) A holder of a certificate of approval for a nursing and midwifery school or institution who wishes to transfer the certificate of approval to another may apply in writing to the Council for the transfer of the certificate of approval.

(2) The Council shall, upon considering the application under subregulation (1), satisfy itself that the intended transferee meets all the requirements necessary to operate a nursing and midwifery school or institution and may, in so doing, request for any related additional information.

(3) Where the Council is satisfied that an applicant under subregulation (1) meets the requirements, it may, upon payment of a fee of P1, 000 approve the transfer and shall, in so doing, endorse the particulars of the transferee on the certificate of approval.

9. Suspension, revocation or cancellation of certificate of approval

(1) The Council may suspend, revoke or cancel a certificate of approval for a nursing and midwifery school or institution where the Council—

(a) determines that the nursing and midwifery school or institution fails to meet the requirements set out in these Regulations; or

(b) has reasonable grounds for believing that the provisions of these Regulations are being contravened in which case the Council may, at any reasonable time and without notice, enter the nursing and midwifery school or institution to investigate.

(2) A nursing and midwifery school or institution that continues to operate after the suspension, revocation or cancellation of the certificate of approval commits an offence and shall be liable to a fine not exceeding P1, 000.

PART III
Approval of Programme (reg 10-20)

10. Prohibition against conducting programme without approval

(1) A person shall not conduct training on a programme in nursing and midwifery unless the programme is approved by the Council in accordance with these Regulations.

(2) A person who contravenes subregulation (1) commits an offence and is liable to a fine of P1, 000.

11. Application for approval of programme

(1) An application to conduct training on a programme in nursing and midwifery shall be made to the Council for approval in accordance with Form A set out in Schedule 2, six months before the intended commencement of the programme.

(2) An application under subregulation (1) shall be accompanied by a non-refundable fee of P250.

12. Requirement for approval of programme

An applicant under regulation 11 shall, together with the application form, submit—

(a) a statement of intent to establish the programme;

(b) a feasibility study which provides information on the—

(i) purpose, classification and need for the programme,

(ii) availability of teachers who are qualified to teach the programme in accordance with Schedule 3 to these Regulations,

(iii) the adequacy of facilities such as—

(aa) classrooms;

(bb) laboratories;

(cc) offices;

(dd) conference rooms; and

(ee) recreational facilities that meet the purposes of the programme and the needs of the students, the faculty, administrative and academic staff, and

(iv) the evidence of financial resources adequate for the planning, implementation and continuation of the programme; and

(i) conceptual framework,

(ii) consistency with the law governing nursing and midwifery practice,

(iii) course description,

(iv) course objectives,

(v) minimum entry requirements,

(vi) duration of training, and

(vii) credits allotted for each course.

13. Approval of programme

(1) The Council shall, on receipt of the application under regulation 11, and before approving the programme, carry out a physical inspection of the facilities at the applicant’s cost, to determine the suitability of the facilities for the programme.

(2) The Council shall approve the application for a programme where it is satisfied that the—

(a) information submitted is adequate as a basis for the academic and administrative organisation of the programme;

(b) applicant has effectively organised adequate human, physical, financial and other resources; and

(3) Where an application is approved in terms of subregulation (2), the Council shall, upon the payment of a fee of P1, 000, issue a certificate of approval for the programme in accordance with Form B set out in Schedule 2.

(4) The Council may—

(a) withhold the approval and direct an applicant to satisfy certain requirements as it may specify in writing; or

(b) reject an application, where it is satisfied that the application does not or is unable to meet the requirements under these Regulations.

(5) A holder of a certificate of approval for a programme shall conspicuously display the certificate of approval at its place of operation.

14. Validity of approval

The certificate of approval for a programme shall be valid for a period of five years unless earlier revoked or cancelled in accordance with these Regulations.

15. Renewal of approval

(1) A holder of a certificate of approval for a programme may, within six months before the expiry of its certificate, apply in writing to the Council, for a renewal of the certificate of approval for a programme.

(2) The Council shall, upon receipt of the application under subregulation (1), consider the application being guided by whether the applicant—

(a) still has capacity to carry out the programme; and

(b) is compliant with the provisions of these Regulations.

(3) Where the Council, after inspection is satisfied that an applicant meets the requirements for renewal, and upon payment of a renewal fee of P1, 000, it shall endorse on the certificate of approval for a programme that the certificate is renewed for a further period of five years.

16. Transfer of approval

(1) A holder of a certificate of approval for a programme may apply in writing to the Council, for the transfer to another, of the certificate of approval for a programme.

(2) The Council shall, upon considering the application under subregulation (1), satisfy itself that the intended transferee meets all the requirements necessary to conduct the programme and may, in so doing, request for any related additional information.

(3) Where the Council is satisfied that an application for transfer of approval meets the requirements, it may upon payment of a fee of P1, 000, approve the transfer of a certificate of approval and shall, in so doing, endorse the particulars of the transferee on the certificate of approval for a programme.

17. Periodic evaluation of programme

(1) The Council shall evaluate a programme approved under these Regulations every five years to determine compliance with the programme requirements.

(2) A nursing or midwifery school whose programme is being evaluated in terms of subregulation (1) shall prepare and submit to the Council, a detailed report three months prior to the evaluation, of the steps it has taken to achieve the objectives of the programme.

(3) The Council shall, before carrying out the evaluation in accordance with subregulation (1), give a 30 days’ written notice of the intended evaluation and shall in the process, inspect the facilities where the programme is being carried out at the cost of the nursing and midwifery school or institution whose programme is being evaluated.

(4) The Council shall, within 30 days after the evaluation, prepare and avail the evaluation report to the nursing and midwifery school or institution whose programme was being evaluated.

(5) The Council may, in the evaluation report—

(a) make recommendations to assist the nursing and midwifery school or institution comply where it is found defaulting; or

(b) determine to suspend, revoke or cancel the approval for a programme.

18. Reports on programme

(1) A person may report to the Council for appropriate action, a nursing and midwifery school or institution that is—

(a) acting contrary to the programme as approved by the Council; or

(b) contravening these Regulations.

(2) The Council may, upon considering the report made under subregulation (1) make a determination of compliance with the programme requirements and may—

(a) carry out spot-checks on the nursing and midwifery school or institution;

(b) give instruction for action by the nursing and midwifery school or institution within a stipulated time; or

19. Suspension, revocation or cancellation of approval

(1) The Council may suspend, revoke or cancel an approval for a programme where the Council—

(a) determines that the programme fails to meet the requirements set out in these Regulations; or

(2) The manager, principal and staff of the nursing and midwifery school or institution shall, during an investigation, furnish the Council with information which the inspector may require with regard to the—

(a) tuition of the students;

(b) qualification of staff members;

(d) condition of buildings; and

(e) general management of the nursing and midwifery school or institution.

(3) Where the Council has suspended, revoked or cancelled a certificate of approval for a programme in accordance with subregulation (1), the relevant nursing and midwifery school or institution shall return the certificate of approval for a programme to the Council within 14 days of such suspension, revocation or cancellation.

(4) A nursing and midwifery school or institution that continues to offer a programme after the suspension, revocation or cancellation of the approval for the programme commits an offence and shall be liable to a fine not exceeding P1, 000.

20. Reinstatement of approval for a programme

(1) A nursing and midwifery school or institution whose approval for a programme is suspended and wishes to have the programme reinstated shall make an application in writing, to the Council, for reinstatement.

(2) The Council shall, upon receipt of an application for reinstatement—

(a) in the case of suspension, carry out an assessment to determine whether the applicant has rectified its status so as to meet the requirements for the approval for that programme and where satisfied, return the certificate of approval to that applicant; or

(b) in the case of revocation or cancellation, direct that the applicant make a fresh application in accordance with these Regulations,

PART IV
Qualification of teaching staff, teaching nurses or midwives, etc. (reg 21-23)

21. Academic qualification of teachers

A person shall not qualify to teach a nursing and midwifery programme unless he or she meets the requirements in Form A set out in Schedule 3.

2″/>2. Teaching nurses or midwives

In addition to the requirements under regulation 21 of these Regulations, a person shall not qualify to teach a nursing and midwifery programme unless he or she has been registered as a nurse or midwife and has demonstrable teaching experience commensurate to the programme.

23. Student-teacher ratio

A nursing and midwifery school or institution shall have a student-teacher ratio that is in accordance with Form B set out in Schedule 3.

PART V
Training and Examinations (reg 24-29)

24. Admission to training

A person shall not be admitted to train as a nurse and midwife unless he or she—

(a) has successfully completed the Botswana General Certificate of Secondary Examinations (BGCSE) or its equivalent and submitted a certified copy of the certificate as evidence; and

(b) is in good health and produces a certificate to that end.

25. Examination by school or institution

(1) Where a nursing and midwifery student completes training in a nursing and midwifery programme, in a nursing and midwifery school or institution not affiliated to the University of Botswana, that nursing and midwifery school or institution shall conduct an examination on that student.

(2) The nursing and midwifery school or institution shall set the examination and classify the grades of the examination in accordance with a programme.

26. Notice of completed students

(1) A nursing and midwifery school or institution shall notify the Council, in writing, of the students who have successfully completed training.

(2) The notice in accordance with subregulation (1) shall be accompanied by a detailed transcript with all components of the programme including theory, practical and where applicable, internship.

27. Professional examinations by Council

(1) A student who successfully completes a programme shall apply in writing, to the Council to be admitted to a professional examination.

(2) An application under subregulation (1) shall be accompanied by a non-refundable fee of P50 and a certified copy of transcript as evidence of completion of the programme.

(3) The Council shall conduct professional examinations twice a year in the months of July and January respectively and an application for admission or re-admission shall be lodged with the Registrar by 30 June and 30 November respectively.

28. Examination centres

(1) A nursing and midwifery school or institution not affiliated to the University of Botswana shall have as its examination centre, its premises or a venue of its choice.

(2) Notwithstanding the provisions of subregulation (1), the Council may determine an examination centre for practical examinations at a place other than a centre chosen by the nursing and midwifery school or institution.

29. Examiners and moderators

(1) The Council shall appoint examiners and moderators for a school or institution not affiliated to the University of Botswana.

(2) A person shall qualify to be appointed in accordance with subregulation (1) as an examiner or moderator if, he or she—

(a) has proven qualifications in the area of examination or moderation; and

(b) has not less than five years experience in the area to be examined or moderated.

(3) The examiner or moderator shall conform to any rules as the Council may from time to time make for the conduct of examinations.

(4) An examiner or moderator shall be remunerated at a rate as may be fixed by the Council.

PART VI
Registers (reg 30-32)

30. Submission of student list for register

A nursing and midwifery school or institution shall submit a list of students admitted to a nursing and midwifery programme, to the Council, within three months of their admission, for entry in the register for student nurses or student midwives as relevant.

31. Removal from register

(1) The Council may remove a name of a student from the register where the training of a nursing or midwifery student is terminated before completion.

(2) The nursing and midwifery school or institution shall, where a student has terminated his or her studies, submit the name of such student to the Council of such termination to enable the Council to remove that student from the register.

32. Reinstatement into register

Where a student whose name is removed from the register is re-admitted to the nursing and midwifery school or institution, the nursing and midwifery school or institution shall, within six weeks of such student resuming studies, submit the name of the student for reinstatement in the register.

PART VII
Miscellaneous (reg 33-40)

33. Right to inspect and call for information

The Council or a person appointed by the Council for the purpose, shall have the right to inspect a nursing and midwifery school or institution at any time and to call for such information as may be necessary for the inspection.

34. Closure

(1) A nursing and midwifery school or institution shall not close a programme before—

(a) it has ensured that all the students enrolled into the programme have been transferred to another school or institution that has been approved to offer the programme; or

(b) students due to complete their studies have obtained their qualifications.

(2) Where a nursing and midwifery school or institution is closed and students are transferred to another school or institution, the transferring nursing and midwifery school or institution shall submit to the Council, a list of the transferred students.

35. Custody of records

(1) Where a programme is closed, but a nursing and midwifery institution continues to function, the nursing and midwifery school or institution shall safely keep the records of the students and graduates of that programme.

(2) Where a nursing and midwifery school or institution offering an approved programme is closed, the nursing and midwifery school or institution shall transfer to the Council, the academic transcripts and any other records that the Council may specify.

36. Appeals

A person who is not satisfied with a decision of the Council to do anything which the Council is authorised to do under these Regulations, may, within a month of the decision being made, in writing, appeal to the Minister.

37. Offences and penalties

A person who contravenes any provision of these Regulations commits an offence and is liable, where no provision is made for a penalty, to a penalty not exceeding P1, 000.

38. Revocation

(1) The General Nurses (Training, Examination and Student Registration) Regulations, S.I. 96 of 1969, are hereby revoked.

(2) The Midwives (Training, Examination and Pupil Registration) Regulations, S.I. 97 of 1969, are hereby revoked.

(3) The Enrolled Nurses (Training and Examination) Regulations, S.I. 98 of 1969, are hereby revoked.

39. Transitional provisions

Notwithstanding any other provision of these Regulations, a person who, at the commencement of these Regulations, is carrying out nursing and midwifery related training shall, within six months from the date of commencement of these Regulations, comply with the requirements of these Regulations or cease to carry out such operations.

40. Savings

All valid licences, certificates, permits or approvals issued or granted by the Council before the commencement of these Regulations shall remain valid until they expire or are revoked.

SCHEDULE 1

Form A

(regulation. 4(1))

Application for approval of school or institution

Section A : Institutional Information

Name of the School/ Institution: …………………………………………………….

Date…………………………….

Governance : Public/Private

Postal Address:………………………………………………………………………………

………………………………………………………………………………………………………

Physical Address……………………………………………………………………………..

……………………………………………………………………………………………………….

District……………………………………………………………………………………………..

Telephone:…………………………………….. Fax :………………………………………..

E-mail :……………………………………………………………………………………………

Section B : Business Registration Details

Registration Name:……………………………………………………………………………

Registration Number:…………………………………………………………………………

Dates of Registration:………………………………………………………………………..

Section C : Contact Person’s Details

Name of Head of School/Institution:……………………………………………………..

Designation:……………………………………………………………………………………..

Qualification:…………………………………………………………………………………….

(Attach Curriculum Vitae and Copy of Nursing and Midwifery Practicing License)

Address:…………………………………………………………………………………………..

E-Mail Address:………………………………………………………………………………….

Telephone:(Work)…………………………………………. Cell…………………………….

FORM B

(regulations 4(a) and (c))

PART I

The total minimum number of credits of instruction for theory and practice in nursing and midwifery shall be as set in the second column—

PROGRAMME	MINIMUM CREDITS	DURATION IN SEMESTERS
Basic Diploma	60	4-6
Higher Diploma	90	4-6
Degree	120	8-10
Post – Basic Diploma	60	2-4
Masters	55	2-4 (full time) 4-6

50% of total credits should be earned in the core nursing and midwifery.

1 lecture hour = 2-3 practical hours

PART II

The content of the programmes listed below shall include, but not be limited to those listed under each programme—

NON-DEGREE COURSES

A. DIPLOMA IN GENERAL NURSING

Core courses

Human Anatomy and Physiology

Applied Chemistry for the Health Sciences

Applied physics for the Health Sciences

Foundations of Nursing

Professional basis for Nursing Practice

General Microbiology

Foundations of Nursing Practice

Introduction of Sociology and Social Anthropology

Introduction to Psychology

Health Assessment

Introduction to Adult Health Nursing

Parent and Child Health Nursing

Introduction to Pharmacology

Introduction to Epidemiology

Introduction to Demography

Introduction to Community Health and Psychiatric Nursing

Adult Health Nursing

Child Health Nursing

Introduction to Community Health Nursing

Introduction to Research

Introduction to Statistics

Psychiatric Nursing

Critical Care Nursing

Adolescent Health Nursing

Community Health Nursing

Leadership and Management

Practicum courses

Introduction to Computer Skills

Human Anatomy and Physiology

Applied Chemistry for the Health Sciences

Applied Physics for the Health Sciences

Foundations of Nursing

General Microbiology

Foundations of Practice

Health Assessment

Introduction to Adult Health Nursing

Parent and Child Health Nursing

Introduction to Community Health and Psychiatric Nursing

Adult Health Nursing

Child Health Nursing

Introduction to Community Health Nursing

Psychiatric Nursing

Critical Care Nursing

Adolescent Health Nursing

Community Health Nursing

Leadership and Management

General Education Courses

Communication and Study Skills

Introduction to Computer Skills

Optional Courses

Public Health Nutrition

Group Dynamics

Sexual and Reproductive Health

Water Sanitation

Infection Control

Quality Assurance

Politics and Health

Introduction to Nursing Theories

Nutrition in Health and Illness

Introduction to Environmental Health

Control of Communicable Diseases

Introduction to Public Health Administration

Introduction to Counseling

Introduction to Public Relations

Trans-Cultural Nursing

B. MIDWIFERY PROGRAMME

Core Courses

Community Midwifery Care

Family Planning

Ante-Partum Care – Low Risk

Intra-Partum Care – Low Risk

Neonatal Care -Low Risk

Post-Partum Care – Low Risk

High Risk Peri-Natal Care

Research

Neonatal Care – High Risk

Practicum Courses

Community Midwifery Care

Family Planning

Ante-Partum Care

Intra-Partum Care

Post-Partum Care

Neonatal Care

High Risk Peri-Natal Care

Leadership and Management

Computer Application in Health Care

General Education Courses

Computer Application in Health Care

Communication Skills and Public Relations

Optional courses

Leadership and Management

Professionalism

Counseling for Child-bearing Family

Minimum clinical programme requirements

Practicum

Family planning -20

– initial -5

– subsequent-15

Ante-partum low risk -50

– initial visit -15

– subsequent-35

High risk antenatal cases -10

– Pelvic assessment -35

Intrapartum

– Observed normal deliveries -50

– Observed complicated deliveries -5

– Assisted complicated deliveries -5

– Conducted deliveries -35

Postpartum

– Low risk postpartum mothers inpatient -20.

– High risk postpartum mothers inpatient -10

– Domiciliary mothers -5.

– Postpartum mothers (6-8 weeks) -10

Neonate

– Low risk neonates inpatient -30

– Domiciliary babies -5

– Neonates (6-8 weeks) -10

– High risk neonates -10

C. FAMILY NURSE PRACTITIONER PROGRAMME

Core Courses

Health Assessment

Family Nursing

Health Promotion across the Life span

Pathophysiology

Pharmacotherapeutics

Children and Adolescents in Health and Illness

Sexual and Reproductive Health

Statistics

Research

Role Development

Disease Diagnoses and Management in Adults and Older Adults

Disease Diagnoses and Management

Research

Epidemiology

Practicum courses

Health Assessment

Family Nursing

Health Promotion across lifespan

Primary Care of Children and Adolescents in health and illness

Sexual and Reproductive Health

Research project

Disease Diagnoses and Management

Primary care of Children and Adolescents

Application of Principles and Practice of Sexual and Reproductive Health Care

Primary Care of Adults and Older Adults

Computer Applications in Health Care

General Education courses

Communication and Study Skills

Computer Applications in Health Care

D. NURSE ANAESTHETIST

Core Courses

Applied Anatomy and Physiology for Nurse Anaesthesia

Basic Principles of Pharmacology for Nurse Anaesthesia

Integrated Health Sciences for Nurse Anesthesia

Basic Principles of Nurse Anaesthesia Practice

Computer Application in Health care

Communication and Public relations

Basic Principles and use of Anaesthetic Equipment

Professional aspects of Nurse Anaesthesia Practice

Principles of Nurse Anaesthesia Practice

Research

Statistics

Practicum Courses

Clinical Anaesthesia

Management of Medical Emergencies

Anaesthesia for General Surgery

Anaesthesia for Obstetrics

Anaesthesia for Paediatrics

Critical Care

Optional Courses

Basic principles in diagnosis of surgical and medical patients

Basic principles in diagnosis of surgical paediatric patients

Radiological basics for Anaesthetist

ECG basics for Nurse Anaesthetist

E. PSYCHIATRIC MENTAL HEALTH NURSING

Core-Core Courses

Psychopharmacology

Foundations of Psychiatric Mental Health Nursing

Nursing Management of clients with Functional and Organic Mental Health Disorder

Therapeutic Modalities in Psychiatric Mental Health Nursing

Nursing management of clients with Psychiatric Mental Health Disorders

Community Mental Health Nursing

Leadership and Management

Research

Practicum

Management of Psychiatric Mental Health Facility

Computer Application in Health Care

Foundations of Psychiatric Mental Health Nursing

Nursing Management of clients with Functional and Organic Mental Health Disorder

Therapeutic Modalities in Psychiatric Mental Health Nursing

Nursing management of clients with Psychiatric Mental Health Disorders

Community Mental Health Nursing

Application of Nursing Practice to the management of clients with Psychiatric Mental Health Disorders

Application of Principles of Community Mental Health Nursing

General Education Courses

Computer Application in Health Care

Communication Skills and Public Relations

F. COMMUNITY HEALTH NURSING

Core courses

Community Health Nursing

Community Assessment and Diagnosis

Epidemiology

Statistics

Demography

Introduction to Personal Computers and Nursing Informatics

Research

Programme Design

School Health

Family Health Nursing

Planning, Implementing and Evaluating Community Health Care

Application of Management Principles in Community Settings

Advanced Computers

Advanced Computer Application to Community Health Nursing

Application of Concepts and Principles of Community Nursing

Research Project

Managing Community Health Care settings

Practicum courses

Community Assessment and Diagnosis

Programme Design

School Health

Family Health Nursing

Planning, Implementing and Evaluating Community Health Care

Advanced Computers

Advanced Computer Application to Community Health Nursing

Application of Concepts and Principles of Community Nursing

Research project

Managing Community Health Care settings

Optional courses

Total Quality Management

Health Promotion

Clinical Counselling for individuals and families

Reproductive Health

G. OPHTHALMIC NURSING

Core courses

Anatomy and Physiology of the Eye

Assessment of the Eye

Principles and Practice of Ophthalmic Patient Care

Nursing Management of Clients with Anterior Segment Ocular Conditions

Management Principles in Eye Services

Introduction to Computer Studies and Nursing Informatics

Ophthalmic Pharmacotherapeutic

Application of the Principles of Refraction in the Management of Clients with Refractive Errors

Nursing Management of Clients with Posterior Segment Ocular Conditions and Ocular Emergencies

Epidemiology, Statistics and Research

Community Ophthalmic Nursing

Practicum courses

Assessment of the Eye

Principles and Practice of Ophthalmic Patient Care

Nursing Management of Clients with Anterior Segment Ocular Conditions

Management Principles in Eye Services

Introduction to Computer Studies and Nursing Informatics

Application of the Principles of Refraction in the Management of Clients with Refractive Errors

Nursing Management of Clients with Posterior Segment Ocular Conditions and Ocular Emergencies

Community Ophthalmic Nursing

Application of the Principles and Practice of Community Ophthalmic Nursing

Application of the Principles and Practice of Ophthalmic Inpatient Care

Application of the Principles and Practice of Ophthalmic Theatre Nursing

Managing an Eye Unit

Optional courses

Health Promotion

Quality Assurance in Nursing

Clinical Counseling for Individuals and families

Project Design

DEGREE COURSES

A. BACHELOR OF NURSING (GENERIC)

Core courses

– Principles of Biology

– General Chemistry

– Introductory Mathematics

– Hiv/Aids Prevention and Control In Botswana

– Chemistry

– Mathematics

– Human Anatomy

– Parasitology for Health Sciences

– Elementary Statistics

– Physics for Nurses

– Introduction to Professional Nursing

– Basic Nursing Concepts and Skills in Health and Wellness

– Cell Biology

– Human Physiology

– Microbiology

– Basic Nursing Concepts and Skills in Health and Illness

– Pathophysiology

– Nursing Management of Low Risk Child Bearing Families

– Introduction to Community Health Nursing

– Basic Nursing Knowledge and Skills in Care of well and Ill Adults

– Biochemistry

– Introduction to Nutrition

– Pharmacology

– Health Assessment

– Community Mental Health Nursing

– Introduction to Nursing Research

– Traditional and Alternative Medical System

– Principles of Management and Education in Nursing

– Advanced Knowledge and Skills in Adult Health

– Nursing Management of High Risk Child Bearing Families

– Principles and Practice of Community Health Nursing

– Psychiatric Mental Health Nursing

– Adolescent Health And Development

Practicum

– Community Based Nursing Care

– Institution Based Nursing Care

– Internship

– Parent and Child Health Nursing

– Adult Health Nursing

– Community Health Nursing

– Psychiatric Mental Health Nursing

General Education Courses

– Communication and Study Skills

– Computing and Information Systems

Optional Courses

-Introduction to Educational Psychology

-Introduction to Group Work

-Counseling Over Lifespan

-Theories and Techniques Of Counseling

-Demographic Aspects of HIV/AIDS Epidemic

-Social Policy

-Introduction to Working with Families and Individuals

-Social Problems in Southern Africa

-HIV/AIDS Counseling

-Issues in Food and Nutrition

-History of Fertility, Mortality and Migration

-Theories of Fertility, Mortality and Migration

-Urbanisation, Migration And Development

-Gender, Reproductive Health and Development

-Demographic Dimensions of Poverty

-Ethics, Law in Health Care

-Interpersonal Communication

-Behavioural Modification

-Group Dynamics

B. BACHELOR OF NURSING (COMPLETION)

Core Courses

-Human Anatomy

-Introduction to Chemistry for Nursing Sciences

-Physics

-Elementary Statistics

-Introduction to Professional Nursing

-Human Physiology

-Introductory Microbiology

-Introductory Biochemistry

-Pathophysiology

-The Individual in Health and Illness

-Introductory Psychology

-Health Assessment

-Community Mental Health Nursing

-Introduction to Nursing Research

-The Nursing Process in Family Health

-Traditional and Alternative Medical System

-Principles of Management and Education In Nursing

-Advanced Knowledge and Skills in Adult Health Nursing

-Nursing Management of High Risk Child Bearing Families

-Principles of Community Health Nursing

-Adolescent Health and Development

Practicum

-Community Based Care

-Institution Based Nursing

-Internship

-Parent and Child Health Nursing

-Adult Health Nursing

-Psychiatric Mental Health Nursing

-Community Health Nursing

-Psychiatric Mental Health Nursing

General Education Courses

-Computer and Information Skills

Optional Courses

-Interpersonal Communication

-Behaviour Modification

-Group Dynamics

-Introduction to Working with Families and Individuals

-Introduction to Development Studies

-Introduction to Educational Psychology

-Introduction to Group Work

-Counseling Over Lifespan

-Theories and Techniques of Counseling

-Demographic Aspects of HIV/AIDS Epidemic

-Social Policy

-Social Problems in Southern Africa

-Counseling Persons with Special Needs

-Issues in Food Nutrition

-History of Fertility, Mortality, and Migration

-Theories of Fertility, Mortality and Migration

-Urbanisation, Migration and Development

-Gender, Reproductive Health and Development

-Demographic Dimensions of Poverty

-Ethics and Law in Health Care

C. MASTERS OF NURSING SCIENCE

Core Courses

-Family Health Nursing

-Health Assessment

-Normal Physiology and Patho-Physiology

-Health Promotion across the Life Span

-Medical Statistics

-Theoretical Foundations of Nursing

-Research Methods in Nursing

-Nursing Leadership and Management

Practicum

-Advanced Community Health Nursing

-School Health Nursing

-Occupational Health Nursing

-Mental Health Nursing

-Advanced Skills in Family Nurse Practice

-Advanced Clinical Practice in Children and Adolescents

-Midwifery

-Internship

-Research Project or Research Proposal

Form C

(regulation 5(1))

Certificate of approval of a nurses or midwives school or institution

SCHEDULE 2

Form A

(regulation 11(1))

Application for approval of programme

Section A: Institutional Information

Name of the Institution: …………………………………………………………………………………

Date …………………………………………………………….

Postal Address: …………………………………………………………………………………………..

Physical Address : ………………………………………………………………………………………

Telephone: …………………………………………………………………………………………………

Fax: ……………………………………………………………

E-mail: ………………………………………………………..

Section B: Business Registration Details

Registration Name: …………………………………………………………………………………….

Registration Number: ………………………………………………………………………………….

Dates of Registration: …………………………………………………………………………………

Section C: Contact Person’s Details

Name: ………………………………………………………………………………………………………

Designation: ………………………………………………………………………………………………

Qualification: ……………………………………………………………………………………………..

(Attach Curriculum Vitae)

Postal Address: …………………………………………………………………………………………

Physical Address: ………………………………………………………………………………………

E-Mail Address: ………………………………………………………………………………………….

Telephone: (Work)……………………………………. Cell …………………………………………

Section D: Program Details
Programme/s for Approval	Qualification to be Awarded	Entry Requirements (pre-requisites)	Duration of Programme (in Weeks/ Months/ Semesters as appropriate)	Proposed Commencement Date	Total Credits To be earned









i : Individual Programme/s Descriptions ii: Programme Objectives iii: Course Coverage for the Programme/s iv: Individual Course Descriptions and objectives v: Mode of Assessment (Theory & Clinical) NB : State where Clinical practice will be done vi: Qualification of Lecturers, Evidence of Licensure with the Nursing and Midwifery Council of Botswana and experience N.B.: The above details should accompany an application letter requesting for approval of a Nursing and Midwifery Programme. The application should be addressed to: The Registrar Nursing and Midwifery Council of Botswana Private Bag 0038 Gaborone Botswana

Form B

(regulation 6(4))

Certificate of approval of programme

SCHEDULE 3

Form A

(regulations 12(b)(ii) and 21)

MINIMUM QUALIFICATIONS OF PERSONS TEACHING IN NURSING AND MIDWIFERY PROGRAMME

The programmes listed in the first column shall be taught by persons who hold the minimum qualifications stated in the second column, in relation to each programme.

Programme	Minimum Qualification
Diploma programme	Basic Degree
Baccalaureate programme	Masters Degree
Masters programme	Doctorate

Form B

(regulation 23)

RATIO OF TEACHERS TO STUDENTS

Programme

Theory

Practice

General Nursing

1 : 100 +

1 : 10

Midwifery

1 : 25 – 60

1 : 5

Anaesthesia

1 : 10

1 : 1

Family Nurse Practitioner

1 : 25

1 : 5

Community Health Nursing

1 : 15

1 : 5

Opthalmic Nursing

1 : 15

1 : 2

Mental Health Nursing

1 : 25

1 : 5