Rwanda
Ministerial Order determining the Profession of Nurses and Midwives
Ministerial Order 20 of 2012
- Published in Official Gazette 21 on 21 May 2012
- Assented to on 18 April 2012
- Commenced on 21 May 2012
- [This is the version of this document from 21 May 2012.]
Chapter One
General provisions
Article One – Purpose of this Order
This Order determines the profession of nurses and midwives in Rwanda.Article 2 – Definition of terms
For the purpose of this Order the following terms shall have the following meaning:1°Accountability: the readiness or preparedness to give an explanation or justification to relevant others, for one’s judgments, intentions, acts and omissions, when appropriately called upon to do so;2°Autonomy: to a moral authority and attributes that enable a nurse or midwife to practice independently using his or her specialized knowledge, skills and ability to analyze nursing/midwifery care situation, take appropriate action while remaining accountable for that action;3°Profession: a range of roles, functions, responsibilities, activities and professional accountability for which a nurse, or midwife is educated, competent, and has the authority to perform within limits of a particular sphere of practice;4°Clinical judgment: process of arriving at a clinical decision after assessment of alternatives;5°Competence: ability of the nurse or midwife to practice safely and effectively to fulfill her/his professional responsibility within one’s own scope of practice;6°Delegation: transfer of responsibility for the performance of a task from one individual to another while the person whose task is being delegated retains accountability for the outcome;7°Supervision: active process of directing, guiding and influencing the outcome of an individual’s performance of a task;8°Direct supervision: refers to the situation when the supervisor is physically present when the task is being done;9°Indirect supervision: situation in which the supervisor is not physically present but communicates instructions, directives and guidelines through various forms of communication either written, verbal or electronic;10°Emergency: situation that poses an immediate risk to health, life, and property or environment requiring urgent intervention to save life or prevent worsening of the situation;11°Task: activities aimed at reaching a specific goal or objective involving a number of skills.Article 3 – Scope of this Order
The provisions of this Order shall be binding to all nurses and midwives registered with the National Council of Nurses and Midwives.Article 4 – Key factors in nursing and midwifing profession
The key determining factors that must be taken into account in deciding on the scope of practice of nursing and midwifery shall be the:1°competence;2°accountability and autonomy;3°continuing professional development;4°support for professional nursing and midwifery practice;5°delegation;6°emergency situation including disasters and accidents.Chapter II
Nursing activities
Article 5 – Nursing activities
The nurse shall perform among others, the following activities:1°reception and registration of patients/client;2°health education to the client/patient, family and community;3°provision of safe client/patient care;4°follow-up of client/patient;5°prompt reporting of client/patient information on condition as necessary;6°management of working environment;7°leadership and management of resources;8°collaboration with multidisciplinary teams;9°general safety of patients/clients, staff and working environment.Section One – Associate nurse
Article 6 – Health promotion
In order to promote health the associate nurse:1°uses communication skills for behavioral change of an individual, family and community;2°carries out home visits for delivery of health services to individuals, families and community including follow-up, education, monitoring of nutrition, hygiene and sanitation in conjunction with multidisciplinary teams;3°communicates appropriate information for effective behavior change and maintenance of sound health.Article 7 – Supervision
Under direct supervision or after a specialised training an associate nurse shall:1°provide psychosocial assistance according to individual needs;2°provide family planning services that conform to national health standards including education and administration of oral and injectable contraceptives according to prescription and existing protocols;3°sensitise the community on the management and financing of health care services in collaboration with relevant partners.Article 8 – Preventive care
As part of his/her role of prevention of illness, infection and accidents, an associate nurse shall:1°provide advice to individuals and groups on self care, protection from disease, accidents, other health problems and complications in order to maintain optimal health;2°participate in primary health care activities including education, immunizations, and other preventive programmes;3°after special training in the domain, he/she:i.provide voluntary counselling and testing and prevention of mother-to-child transmission of hiv/aids services to those who require them, ensuring client confidentiality;ii.carry out antenatal and postnatal check-ups, recognizing and referring an expertise if necessary;iii.provide family planning services namely oral, injectables and implants, with special attention to the needs of each individual or couple.Article 9 – Curative care
The associate nurse shall take good care of patients basing on their physical and psychological needs. He/she shall:1°provide basic patient care by maintaining patient hygiene, nutrition and comfort;2°monitor the patient’s condition and reports as necessary;3°perform sterile and clean procedures with specific focus on prevention and control of infection in the health facility environment according to established standards and protocols;4°administer diligently medication according to prescription and monitor the patient response;5°carriy out pre and post operative nursing care;6°educate and advise the client and other people on continued care and prevention of recurrence of the health problem;7°facilitate patient discharge and where necessary refers him/her to other health care providers;8°transmit verbal and written report and shares information with colleagues and the direct supervisor on the patient and care provided;9°contribute to physical and nutritional rehabilitation in preparation for patient discharge;10°provide comprehensive care to chronically and terminally ill patients who are referred back;11°perform last offices respecting the individual’s or family’s religious beliefs, local customs and values.Article 10 – Clinical consultation
The associate nurse shall provide clinical consultation services according to existing protocols.Article 11 – Conducting deliveries
The associate nurse shall carry out ante-natal care and delivery to women with no obvious detected risks.Article 12 – Nursing management
In the circumstances where the associate nurse finds him/herself in a situation where he/she is expected to act as a manager, he/she shall work under direct or indirect supervision of a registered nurse. In such case he/she shall:1°work closely with colleagues and share with them her/his knowledge and experiences;2°participate in management of personnel and conflict resolution;3°manage material resources and therapeutic products efficiently and effectively to ensure quality and safety of clients/patients;4°guide students, coache and supervise community health workers for improved of performance and patient/client care;5°plan, organize and evaluate the care for effective management in the work place;6°organise and participate in staff and multidisciplinary management meetings for good collaboration, improvement of services and smooth working relationship;7°participate in the provision of health information related to transmits the reports;8°share and encourage sharing of professional knowledge with staff members;9°delegate some of his tasks to nurses under her/his supervision;10°after a special training, manage all health information related to activities and transmit the reports according to established norms;11°ensure good management of financial resources.Section 2 – Registered nurse-diploma level
Article 13 – General duties
While executing his/her professional tasks, a registered nurse-diploma level assists individuals, families and the community to achieve health and prevent diseases. He/she shall care for the sick and respond to the needs of the population. He/she shall do so in accordance with the professional code of conduct and according to his/her training.Article 14 – Health promotion
A registered nurse-diploma level shall plan, lead, supervise and evaluate health promotional activities. He/she shall:1°communicate health information effectively to individuals, families and the community for change of behavior;2°participate in health programmes that promote individuals’, groups’ and community’s general wellbeing in collaboration with relevant multidisciplinary teams;3°carry out home visits for delivery of essential health services to individuals, families and community including patient follow-up in collaboration with multidisciplinary teams;4°participate in family planning services in conformity with national health standards and protocols;5°assess the health facility and community environment for hygiene and sanitation, and communicate it accordingly;6°collaborate with the community and involve them in the management and financing of health care services in partnership with relevant disciplines.Article 15 – Preventative care
Registered nurse-diploma level as part of his or her role in preventative care, must take part in the determination and implementation of preventive care standards. He/she must refer to modern evidence and best practices to ensure that the community he/she serves remains healthy. He/she shall:1°conduct family planning services with special attention to the needs of each individual and/or couples;2°provide health education to patients or clients on prevention of and protection against infections, communicable diseases, accidents and health complications with emphasis on vulnerable groups;3°carry out preventive care based on principles of primary health care including health education and immunization programmes of children under five (5) years and pregnant women;4°conduct pre-school and school checks for prevention of health problems;5°ensure epidemiological surveillance and reporting.After a special training the registered nurse-diploma level shall:1°conduct antenatal and post-natal services;2°conduct pre-marital and family planning services according to the needs of individuals and couples.Article 16 – Curative, rehabilitative and palliative services
Registered nurse-diploma level shall participate in Voluntary Counseling and testing or screening individuals and couples and in prevention of Mother to Child Transmission (PMTCT) of HIV/AIDS.In consistence with the nursing process and set standards a registered nurse-diploma level shall:1°implement and evaluate basic and extensive medical, surgical and gynecological care of patients;2°participate in treatment of minor illnesses in respect of existing regulations and protocols;3°administer medications as appropriate and observe for their effects;4°ensure comprehensive care of acutely, chronically and terminally ill patients;5°ensure control and prevention of infection in the health facility environment;6°prepare a patient or client and family for discharge or referral for expert intervention;7°conduct ante-natal care, normal deliveries and post-partum care;8°respect ethical principles in sharing patient information, transmission of verbal and written report on provided care;9°facilitate last offices in respect of religious beliefs, customs and values of the individual and family.Registered nurse-diploma level shall perform the following under direct supervision or specialized training:1°to engage in nutritional, physical and psychosocial rehabilitation of patients under double-reference or in preparation for discharge;2°to participate in diagnosing and treatment of illnesses in accordance with existing regulations;3°to implement and evaluate intensive care of patients.Article 17 – Managerial role
A registered nurse-diploma level shall remain accountable for his/her actions while executing his or her professional and managerial roles. He/she:At managerial level, he/she shall:1°manage material resources including equipment, consumables and drugs to ensure efficient and effective use for safe care of clients/patients;2°participate in management of personnel and conflicts;3°train and supervise students and community health workers for improved performance and safe client care;4°plan, organize and evaluate the management at the work place for effective care of clients/patients;5°organise and participate in staff and multidisciplinary management meetings for good collaboration and smooth working relationship;6°encourage and share professional knowledge with other staff members;7°delegate tasks to nurses under his/her supervision;8°promote and maintain a good working environment that encourages team spirit;9°conduct staff performance appraisals;10°manage and participate in the provision of health information related to activities in the work place and transmits the reports as necessary;11°ensure good financial management in close collaboration with the concerned department;12°encourage and participate in training, supervision and performance evaluation of students, interns and staff;13°may organize and chair staff meetings;14°take active role in nursing research activities and implementation of recommendations.Section 3 – Registered nurse-degree level
Article 18 – General duties
A registered nurse with a degree in nursing may carry out all activities as mentioned in Chapter II, but also actively involved, among others, in nursing research.He/she shall take lead in planning for services basing on the nursing process, principles of management and the code of ethics.As far as health promotion is concerned, the registered nurse at degree level takes lead in planning for nursing health promotion care and services.Article 19 – Health promotion
A registered nurse with a degree in nursing shall:1°communicate effectively to facilitate behavior change of individuals, families, and community;2°play an active role in project planning and implementation of health promotion activities in collaboration with multidisciplinary teams;3°supervise health promotion activities and evaluate their outcomes;4°advocate for support and advancement of the nursing profession;5°collaborate with relevant health authorities and community to plan and provide education sessions on current national and health related issues.Article 20 – Preventative care
The registered nurse with a degree must consult current data and best practice to prevent infections, diseases, accidents and other complications.In this way he/she shall:participate in the development of prevention and control of infection guidelines or standards;1°work with multidisciplinary teams to put in place measures for protecting patients, clients, families and health care providers against accidents, infection, communicable diseases and health complications with special focus on vulnerable groups;2°conduct pre-marital and family planning services in conjunction with midwifery counterparts;3°plan and supervise immunization activities ensuring maintenance of cold chain;4°ensure epidemiological surveillance and reporting findings to relevant health authority.Article 21 – Curative, rehabilitative and palliative care
In conformity with the national health standards and the health care facility norms, a registered nurse at degree level shall take lead in providing quality nursing care and services basing on the nursing process and professional code of ethics.In that way he/she shall:1°plan for and supervise ante-natal services including screening care in prevention of mother to child transmission of HIV/AIDS;2°take lead in assessment, planning and evaluation of provision of comprehensive care to patients with medical, surgical and gynecological conditions and complications including intervention in emergencies;3°participate in treatment of uncomplicated medical conditions and surgical trauma, monitor the response focusing on patient safety;4°participate in specialized and rehabilitative nursing care based on current evidence;5°plan for patient discharge or referral for expert intervention in collaboration with the family;6°communicate patient information, verbal or written while respecting the code of professional ethics;7°perform normal deliveries, post-partum care of the mother and newborn;8°ensure that the care of the dying and last offices is carried out with respect to individual, family’s religious beliefs, customs and values.Article 22 – Manager
A registered nurse at degree level shall execute his/her professional responsibilities and remain accountable for his/her actions.A registered nurse at degree level shall take a leading role in updating his/her knowledge and professional competencies for effective leadership and management of the healthcare unit.In that way he/she shall:1°supervise the staff and facilitate in creating a conducive working environment;2°ensure safety of patients/clients, their belongings and other resources in the health facility;3°ensure good utilization and safety of facility resources in collaboration with relevant services;4°participate in development of national nursing standards;5°plan and supervise unit activities and staff, and make reports;6°organise and chair staff meetings and participate in multidisciplinary management meetings for good collaboration and smooth working relationship;7°conduct staff performance appraisals and manage conflicts;8°take and apply disciplinary measures in accordance with existing rules and regulations of the health facility;9°delegate nursing and administrative tasks according to individual competence;10°advocate for the unit and welfare of clients/patients and staff;11°manage health information and related activities in the work place and transmit the reports as necessary;12°ensure effective implementation of voluntary counseling and testing of individuals and couples.Article 23 – Educational, training and research
The registered nurse at degree level shall play an active role in education and training those under his/her responsibility as well as in research.In that way he/she shall:1°train staff in their internship and in pre-ceptorship;2°engage in education, training, supervision and evaluation of students;3°ensure capacity building of the unit staff;4°encourage sharing of professional knowledge and experiences among staff members;5°take an active role and encouraging participation in nursing research activities, make recommendations for their implementation and follow-up;6°share research findings with colleagues and those under his/her responsibility.Section 4 – Midwives professional
Article 24 – Health promotion
The registered midwife with a diploma must:1°look after women, families and community throughout their reproductive life cycle. He/she shall use her/his competencies to provide safe and quality care to women and their families during preparation for and pregnancy, child birth and post-partum period;2°look after women, families and community as they prepare for their reproductive life and during their reproductive period with focus on family planning, pregnancy, labour and post-partum;3°take active role in health education discussions with women, their families and community on traditional and modern health practices that may be beneficial or harmful to pregnancy and health;4°use appropriate communication and listening skills across all domains of competencies;5°work in partnership with women and their families to enable and support them in making informed choices about their health, and maintain the confidentiality of all information shared by the woman in accordance with professional ethics;6°advocate for respect of human rights with focus on domestic and gender-based violence and their effects on health of the women and family.Article 25 – Preventive care
The registered midwife with a diploma shall act consistently in accordance with standards of practice using standard precautions, infection prevention and control strategies, and clean techniques including hand-washing to maximize client safety.She shall ensure accessible premarital, ante-natal and post-natal care, immunization, family planning services to the women and families and prevention of health conditions prevalent in the country.Article 26 – Midwifery care
The registered midwife with a diploma shall:1°provide care and services to women before, during and after child;2°assist women in child birth while remaining respectful of their culture, beliefs, values and customs;3°provide care to women and their newborn babies immediately after delivery and during post-partum;4°observe and respond appropriately when health care needs of the woman and/or baby exceed his/her abilities;5°manage obstetrical and neonatal emergencies by taking appropriate clinical decisions and making actions to save lives;6°work collaboratively with multidisciplinary teams to improve midwifery services to women, families, including the need for referral to other health care or service providers for continued care or intervention;7°participate in research and in the implementation of evidenced-based practice while remaining respectful of individual culture, customs and religious beliefs.Article 27 – Managerial role
The registered midwife with a diploma shall:1°communicate essential information between or among other health providers only with explicit permission from the woman and compelling need;2°assume leadership and managerial roles in the practice arena based on professional beliefs and values;3°participate in development of workplace policies, protocols and professional guidelines regarding reproductive health;4°record and interpret relevant findings for services provided across all domains of competency, and make the follow-up;5°register and keep records of all births and deaths in accordance with national reporting regulations;6°delegate responsibilities to junior midwives and other health care providers with due regard to client safety and dignity;7°supervise students midwives and other health providers under him/her responsibility;8°use and maintain appropriate equipment, supplies and other resources to the practice setting;9°ensure availability of equipment and materials at all times with special attention to emergency supplies;10°play active role in critical interpretation of professional literature, vital statistics and research findings.Section 5 – Registered midwife-degree level
Article 28 – Health promotion
Registered midwife–degree level shall plan for health education activities with other health care teams on various themes for promotion of women’s health and their family according to current national health priorities.Registered midwife–degree level shall collaborate with health development partners and other stakeholders in planning for reproductive health activities and other related health practices that are beneficial to women, families and community.Registered midwife–degree level shall develop and discuss guidelines for appropriate communication and listening skills across all domains of competencies.Registered midwife–degree level shall advocate for improvement of delivery of health care services to women, families and community, in collaboration with other disciplines.Article 29 – Preventative care
Registered midwife–degree level shall plan, organize, implement and evaluate pre-marital services, immunization and family planning activities and prevention of health conditions that are prevalent in new born babies, infants and women in child bearing age.Registered midwife–degree level shall ensure consistency in implementation of the standards of practice in conformity with universal safety standards/precautions, infection prevention and control strategies.Article 30 – Midwifery care
Registered midwife–degree level shall plan, implement, monitor and evaluate services rendered to women during ante-natal, intranatal and post-natal periods and treatment of health conditions.Registered midwife–degree level shall take appropriate action and report incidences and changes in midwifery service outcomes.Registered midwife–degree level shall take the lead and provide the necessary support in management of obstetrical and neonatal emergencies by taking appropriate clinical decisions and actions.Article 31 – Managerial role
Registered midwife–degree level shall:1°plan, organize, monitor and evaluate services rendered to the women, families and community and report accordingly;2°facilitate the referral to other health care or service providers/facilities for continued care or intervention when need arise;3°support colleagues to adhere to professional ethics mainly in maintenance of confidentiality and helping the women to make informed choices about their reproductive health;4°take a leading role in development of policies, protocols and professional guidelines regarding reproductive health and follow-up the implementation;5°conduct and promote research in midwifery and encourage implementation of recent evidenced-based practice.Section 6 – Registrered mental health nurse-diploma level
Article 32 – Health promotion
In her/his promotional activities, a registered mental health nurse-diploma level shall:1°advocate for the profession and rights of people living with mental health problems;2°advocate for the support of patients with mental illnesses to gain access to health or social services;3°advise and guide the community to the right educational practices for better mental development;4°participate in continuing professional development and conferences;5°participate in celebration of world mental health day and other related activities;6°conduct educational activities for health;7°raise awareness of importance of mental health in the community by means of communication for behavioural change to clients, community and colleagues.Article 33 – Preventive care
In her/his preventive role, the registered mental health nurse-diploma level shall help individuals, families, and communities to protect themselves against mental illnesses and their complications. In that way he/she is responsible to:1°identify mental health needs and risk factors for individuals, families and the community;2°propose and implement appropriate solutions to identified needs and risk factors;3°raise community awareness on issues related to mental health and care using behaviour change communication and involving the various participants in the community;4°participate in planning and implementation of preventive measures;5°participate in pre-school and school consultations;6°participate in pre-marital consultation;7°organize group therapy for vulnerable groups.Article 34 – Curative care
In accordance with the standards of health care facility and with multidisciplinary teams, the registered mental health nurse shall lead, plan, conduct, supervise and evaluate curative, rehabilitative and palliative care of clients with mental health disorders.In that way he/she shall:1°prescribe and administer psychotropic drugs in accordance with established standards and protocols;2°carry out curative consultations as appropriate;3°manage psychiatric emergencies;4°monitor the condition of mentally ill patients who are admitted or in outpatients’ department;5°carry out basic medical and surgical nursing care;6°provide care to patients with acute and chronic mental diseases;7°facilitate psychotherapeutic group sessions;8°conduct psychotherapeutic interviews;9°support the patient/client with mental illness to engage in occupational activities for the promotion of their mental wellbeing and self-reliance;10°engage families and community in support of the patient/client with mental illness;11°present clinical cases to colleagues for improvement of quality of customer care;12°refer and receive double-referenced patients;13°prepare client/patient for and manage his/her discharge;14°conduct home and hospice visits in collaboration with the family and community health workers;15°provide care for the dying and for last offices;16°provide comfort and support to the bereaved family.Article 35 – Palliative care
To ensure the patient’s palliative care, the registered mental health nurse-diploma level shall:1°ensure client hygiene and nutritional care;2°ensure patient and family psychological, psycho-social and spiritual support;3°prescribe and/or administer medication as may be appropriate;4°provide extensive nursing care according to the case;5°record and transmit report on care given to the patient.Article 36 – Psychosocial rehabilitative care
In accordance with the established standards of the health center, the registered mental health nurse-diploma level shall lead, plan, supervise and evaluate psychosocial rehabilitation activities.In that way he/she shall:1°carry out client, family and community psycho-education;2°organise and conduct rehabilitation team activities;3°support and encourage clients in initiating and developing income generating projects;4°participate in client skills development and elaboration of a socio-professional reintegration program;5°guide and support the client to join associations and organizations of people living with mental health problems;6°organise home visits in collaboration with families and community health workers.Article 37 – Managerial activities
The registered mental health nurse-diploma level shall, in her/his managerial role, work closely with colleagues and share with them his/her knowledge and expertise for the benefit to of clients acting as a role model. He/she shall collaborate with multisectoral services for a better client care.In that way he/she shall:1°ensure good management of staff and trainees under his/her responsibility;2°ensure good management and security of the unit’s resources;3°manage conflicts for a positive working environment;4°organise and participate in continuous training of staff;5°supervise various activities to enhance the quality of services;6°prepare necessary reports and transmit them on time;7°collaborate with the multidisciplinary team;8°plan, organize and coordinate departmental services.Section 7 – Registered mental health nurse at degree level
Article 38 – Health promotion
A registered mental health nurse at degree level shall carry out his/her promotional role focusing on mental health.In that way he/she shall:1°raise awareness of the community to understand the importance of mental health;2°initiate and maintain mental health programs;3°advise the community on appropriate practices for better mental health development;4°support and supervise hospitals and health center staff in the promotion of mental health;5°conduct health educational activities;6°advocate for the rights of people living with mental health problems;7°organise and participate in conferences, seminars, celebration of the world mental health day and other related activities.Article 39 – Preventive care
In his/her preventive role, the registered mental health nurse at degree level shall, help individuals, families, and community to protect themselves against mental illnesses and their complications by performing the following activities:1°to identify mental health needs for individuals, families and communities and risk factors, in collaboration with other health providers;2°to suggest and implement appropriate solutions to identified needs and risk factors;3°to communicate issues related to mental health and their care to clients and their families for behaviour change;4°to participate in activity planning and implementation of preventive measures;5°to participate in pre-school and school consultations in collaboration with multi-sectoral teams;6°to participate in the pre-marital consultation;7°to organize group therapy for vulnerable people;8°to plan and to organize the epidemiological and mental health disease surveillance in collaboration with the person in charge of mental health statistics.Article 40 – Curative activities
In accordance with the standards of the health system, registered mental health nurse at degree level, shall take lead in assessing, planning and provision of comprehensive care to patients with mental health conditions and complications including intervention in emergencies.In that way he/she shall:1°participate in treatment of uncomplicated mental conditions and monitor response focusing on patient safety;2°participate in skilled and rehabilitative mental health care based on current evidence;3°plan and involve the family for patient discharge or referral for expert intervention;4°provide mental health care to different special groups such as forensic patients, the elderly and children;5°provide care to mentally handicapped individuals in collaboration with multidisciplinary teams;6°communicate patient information, verbal or written while respecting the code of professional ethics;7°assist people dying and participate in the final acts perfomed after the death considering individual’s religious beliefs, customs and values;8°collaborate with psychiatrists to provide expert reports when required by competent authorities.Article 41 – Psychosocial rehabilitation activities
In accordance with the existing standards, the registered mental health nurse at degree level shall, lead, plan, supervise and evaluate the following psychosocial rehabilitation activities:1°to plan, lead and conduct client, family and community psycho education;2°to organise and coordinate rehabilitation teams;3°to develop programmes for income generating projects for clients;4°to organize home visits in collaboration with other professionals;5°to take lead in planning with the client on skills development that he had practiced;6°to guide and advise the patient towards joining associations and support organizations;7°to advocate for the rights and social welfare of patients with mental health conditions.Article 42 – Palliative activities
In the multidisciplinary team, the registered mental health nurse at degree level must lead, plan, monitor and evaluate activities below providing comfort care for patients with chronic and terminal disease:1°to provide hygienic and nutritional care;2°to provide psychological, psychosocial and spiritual support to the patient and family;3°to prescribe and administer medication and monitors the effect;4°to provide specialised nursing care according to the case;5°to record and transmit care reports given to the patient cares for the dying and the dead.Article 43 – Management activities
The registered mental health nurse at degree level shall work closely with all colleagues and share with them his knowledge and expertise in carrying out managerial activities.In that way he/she shall:1°supervise the staff and facilitate in creating a conducive working environment;2°ensure safety of patients/clients, their belongings and other resources in the health facility;3°ensure good facility resources utilization and safety in collaboration with relevant entities;4°participate in development of national mental nursing standards;5°plan and supervise unit activities and staff in the work place and in other attached health units, and make reports and recommendations according to findings;6°organise and chair staff meetings and participate in multidisciplinary management meetings for good collaboration and smooth working relationship;7°manage staff in his/her unit effectively to create a positive working environment and building team spirit;8°carry out staff performance appraisals and conflicts resolution;9°take and apply disciplinary measures according to the existing regulations and norms of the health facility;10°delegate nursing and administrative tasks according to individual competence;11°advocate for clients/patients, unit and staff welfare;12°manage health information and health related activities in the work place and transmit the reports as necessary.Article 44 – Educational, training and research roles
The registered mental health nurse at degree level shall play an active role in education and training those under his/her responsibility as well as research.In that way he/she:1°encourage and engage in education, training, supervision and evaluation of students;2°train staff in their internship and in pre-ceptorship;3°ensure capacity building of the staff in the unit.4°take an active role and encourage participation in mental nursing research activities, and make recommendations for their implementation and follow-up;5°share research findings with colleagues and those under his/her responsibility.Chapter III
Final provisions
Article 45 – Repealing provision
All prior provisions contrary to this Order are hereby repealed.Article 46 – Commencement
This Order shall come into force on the date of its publication in the Official Gazette of the Republic of Rwanda.History of this document
21 May 2012 this version
Commenced
18 April 2012
Assented to