Nursing Regulation
Domain overview
Nursing Regulation tests how the NNC governs education, registration, practice standards and discipline. Regulation is not the same as employer management: a hospital can appoint staff, but only the NNC can register a nurse or remove a name from the register.
Functions of the NNC
- Maintain the nursing register and issue licences.
- Recognise nursing and midwifery programmes, approve curricula and monitor educational standards.
- Conduct licensing examinations and set standards of practice and conduct.
- Receive complaints, investigate alleged professional misconduct or impairment, and impose sanctions such as caution, conditions, suspension or cancellation.
- Require continuing professional development and audit compliance at renewal.
The Nepal Health Professional Council regulates other allied health professions, and the Medical Council regulates doctors; nurses fall under the NNC. Employers must not create local rules that authorise unregistered practice.
Delegation and accountability
An RN may delegate tasks according to the person’s competence, the nurse’s supervision capacity, patient stability and institutional policy. The RN retains accountability for the delegation decision. Reserved nursing acts and medicines administration cannot be delegated to an unregistered helper.
Worked example. At night, no RN is rostered, and the nurse manager tells an unregistered ward helper to give an IV antibiotic. Reasoning: administering an IV medicine is a nursing act requiring registration and competence. The RN must refuse, explain the legal risk, escalate to the manager or medical officer, and arrange registered staff. The refusal and escalation should be documented. The helper must not be placed in that role, even temporarily.
Traps that cost marks
- Believing a senior manager’s instruction overrides the NNC Act.
- Treating delegation as transfer of accountability.
- Confusing NNC registration with hospital credentialing.
- Discussing a complaint investigation outside authorised channels.
- Ignoring CPD audit requirements until renewal is due.