The Different Kinds of Nurses in Australia

G’day～ Good afternoon, I'm Alice, and happy new year! Everyone in Taiwan and abroad, any new wishes for the year? Mine is... no more useless teammates, please!! As everyone knows, nurses in Taiwan are graded into levels (I won't go into detail, since I've never actually worked in Taiwan haha). Today let's talk about how Australia classifies its nurse-zombies.

The ones that formally have to register with AHPRA are the Registered Nurse (RN) and the Enrolled Nurse (EN). The Assistant in Nursing/ Personal Care Assistant (AIN/PCA) and the Undergraduate Student in Nursing (USIN) aren't registered with AHPRA, but they're all really important teammates of ours～

First, the difference between an EN and an RN.

1. Training:

An EN needs a 1.5-2 year diploma, while an RN needs a bachelor's of 2-3 years or more. Generally, ENs usually study at TAFE. The placement requirement for an EN is 400 hours; for an RN it's 800 hours. Both have to register with AHPRA, and the language requirement is the same for both

2. Skills:

In terms of scope in a hospital, there's a very clear skills gap between ENs and RNs. For example, an EN can't handle medications (unless they've done medication safety training) or controlled drugs, and an EN has to ask an RN before making any decision they can't make themselves. To put it bluntly, an EN is more like an RN's assistant, though still different from an AIN.

In aged care, ENs basically do much the same work as RNs and you can hardly tell the difference, but an EN still can't handle controlled drugs alone. Many aged care facilities hire EENs (endorsed enrolled nurse, EEN), who can give medications on their own. As far as I know, the difference between an EEN and an EN is the medication training; the exact scope of practice depends on the facility's policies.

3. Career progression:

Strictly speaking, ENs have to work under an RN's supervision, and there are many treatments an EN can't do alone, which is why RNs make up most of critical care (ICU, ED, OT). Once an RN has built up enough clinical experience and gone on to study a graduate diploma/certificate or a master's degree, they can apply to become a clinical nurse (CN), clinical nurse specialist (CNS), nurse educator, nurse practitioner (NP) or nurse unit manager (NUM). The only career progression for an EN is to become an RN.

4. Pay:

Now for pay and job opportunities. RNs invest more up front, but their starting pay is higher than ENs' and they have more job opportunities. A new-graduate EN working full time (76 hours) for Queensland Health earns around 70000 a year before tax (not including other loadings); an RN in the same situation earns around 80000 before tax (not including loadings). Pay grows as you put in more years, and it differs from state to state. Of course, if putting a lot of money into an RN degree all at once feels like too much pressure, many of my colleagues became ENs first, worked for a few years, then went on to study and become RNs. You can keep working while you study, and that also adds color to your future RN résumé!

5. Migration:

For migration, both ENs and RNs get their skills assessment through ANMAC, and both must register with AHPRA. EN is on the short-term list (STSOL) and can apply for the 190&491; RN is on the long-term list (MLTSSL) and can apply for the 189&190&491. RNs have different categories, but there are too many applicants for too few spots. ENs can only go for the 190/491, but compared with RNs they may find it easier to get invited and land PR.

Alice's ramblings: no kind of N is better or worse than another. Whether EN, RN, AIN or USIN, we're all good teammates working together in the clinical area, and every one of us is needed～ (even if some people really do drive me a little crazy) Treating people sincerely is the best way to get off shift on time～ See you next time!