Do you have an impairment?

By Annmaree Nicholls, Professional Officer

Renewal and those questions

Each year I renew my professional registration and answer some questions, but do I really understand what they are asking me?

The questions are declarations which I’m professionally bound to answer truthfully. Making a false declaration may be considered a breach of the code of conduct.

So what are the questions asking?

Let’s look at the question around impairment. What does that even mean?

Under the Health Practitioner Regulation National Law (NSW), impairment is defined as:

impairment, in relation to a person, means the person has a physical or mental impairment, disability, condition or disorder (including substance abuse or dependence) that detrimentally affects or is likely to detrimentally affect—

(a)  for a registered health practitioner or an applicant for registration in a health profession, the person’s capacity to practise the profession; or

(b)  for a student, the student’s capacity to undertake clinical training—

(i)  as part of the approved program of study in which the student is enrolled; or

(ii)  arranged by an education provider.


I have diabetes. I don’t really follow the guidance of my doctor or dietitian. I don’t have a care plan or strategies in place at work to manage any changes in my health or blood sugar levels (BSL). I haven’t told my colleagues that I have diabetes. At work I check my BSL if I feel I need to but I’m so busy, I usually don’t have time. It’s really no big deal. I know I go a bit vague when my blood sugar levels aren’t right, I can’t concentrate, and my decision making is slower but I’m fine. I manage - so what’s the big deal?

In this case the practitioner has a health condition that detrimentally affects or is likely to detrimentally impact upon their fitness and safety to practise. They meet the definition of impairment as defined by the Law. They should therefore make a declaration that they do have an impairment.


What happens next:

AHPRA who manage registrations on behalf of the Nursing and Midwifery Board of Australia will seek further information and make a determination if further action is required. This action will be dependent on the type of health matter and your management of your health. Remember it’s about the potential your health has to impact upon your fitness to practise (safety and competence).

In the above scenario, if the practitioner was engaged in treatment, had strategies in place to manage their blood sugar levels when at work, had a prevention plan or care plan that their colleagues were aware of so they could recognise early warning signs and intervene, then the potential for the practitioner’s health condition to impact upon their ability to safely and competently practise is mitigated or managed. Thereby keeping the public safe.


Don’t forget…

The Code of Conduct for both Nurses and Midwives Principal 7 refers to the professional obligation of all nurses and midwives to manage our own health and the health of our colleagues. We must maintain physical and mental health to practise safely and effectively, including seeking expert, independent, objective advice if we are ill or impaired in our ability to practise safely.

As practitioners we must remain aware of the risks of self-diagnosis and self-treatment and act to reduce these.

Refresh yourself on the Code of Conduct here.


For discussion - Imagine if...

What if I drink a bottle of wine after work? I mean doesn’t everyone?

Sometimes if it’s been a really hard shift I’m surprised to find I’ve had maybe two bottles of wine to help me unwind. On my days off and when I’m socialising, I might drink a bit more.

I don’t drive to work in the mornings because I have previously had a low-range drink driving charge on the way to work. But I’m not intoxicated and I’m fine to work.

Talk about this situation at work and with your colleagues.

  • What are the effects of alcohol consumption on the brain and body? (Short term and long term)
  • What does intoxicated mean?
  • What does it mean to be under the influence of a substance?
  • Does this practitioner meet the definition of impairment? Could their alcohol consumption potentially affect their competency and safety to practise?
  • What should they do?
  • What as colleagues should you do?
  • What as colleagues and professionals are you required to do?

In the next newsletter we will share some thoughts about this and talk about professional obligations.