Trabalhar na Holanda
Com uma forte economia, os seus campos verdejantes e imponentes moinhos aliado a uma tradicao de tolerancia e simpatia, a Holanda comeca a ser crescentemente encarada como um bom destino de vida e trabalho para alguns colegas Portugueses. Aqui fica o que conseguimos apurar gracas aos nossos contactos e a sempre util Wikipedia! Enjoy your reading!
Introduction
In the Netherlands there are two levels of nurses, the first and second level nurses. The first level nurse is a higher level nurse who is capable of assessing the whole nurse situation and deciding the appropriate level of nurse care. The first level nurse will also direct the second level nurses.
Nurses of both levels (first level and second level) are expected to recognise and analyse “actual threatening consequences of physical, mental pathological processes, disabilities or develop mental disorders on the individuals vital functions as well as counselling and assisting the individual in such conditions”.1 There is now a new “nurse profile” but it still treats the Dutch nurse as a single entity.
The regulation of nursing in the Netherlands
For many years the law of 1921 for the Diploma Van Verpleegkundige2 regulated nursing practice. It was last revised in 1977 and regulated the five basic nursing diplomas before its abolition in 1993.
The original 1865 law on the art of practice of medicine reserved all medical acts to qualified medical doctors. This in principle, would prevent nurse from giving injections. But since long time it was common law that nurses gave injections without direct supervision of medical doctors.
The 1993 Wet BIG (the individual Health Care Professions act) thoroughly overhauled this area of law. This law, amongst other things, annulled the actual ban on the unqualified practice of medicine thus paving the way to allow alternative medicine.
Field of activity
Theoretically in the Netherlands anyone can in fact practice some types of nursing as it is neither legally defined nor protected in law as an activity as such. However the Wet BIG does designate certain activities as reserved.
For example:
Puncture and injections / General anaesthetic/ Endoscopies and similar procedures
Nurses can only undertake these procedures under orders from an authorised professional (i.e doctor, dentist). Midwives, which in the Netherlands in not a specialisation of nursing but an other profession, are directly authorised to perform some of the acts
The law however does not indicate that only registered nurses can undertake such acts based on the relevant professional’s order. Anyone competent can be authorised to commit such an act, the onus being on the primary professional to make sure that the person so ordered is in fact competent to perform the procedure.
Title
According to the Wet BIG, only those registered as Verpleegkundige can use the title and such registration only takes place once the registrar knows that the candidate has an appropriate diploma. This system came into force in 1995, and the registration requirements are set out below.
In law the diploma of Verpleegkundige used to allow five additional annotations. That is:
The community nurse/ The social psychiatric nurse/ The paediatric nurse/ The obstetric and gynaecological nurse/ The intensive care nurse.
The duration of each of these post-basic training is variable and specialist nurse training is currently no longer legally regulated or recognised, though there are provisions in the Big Wet, outlined below, that allow it to be regulated. All these nurses are currently added to the Big Register as plain nurses and not as specialised nurses.
Article 3 of the Wet BIG states that designation of nurse Verpleegkundige only applies to professional practitioners who have firstly undertaken the training required to gain a certificate from the Ministry of Health, Welfare and Sport recognised institution and have registered with the BIG register. The BIG register registers nurses and does not distinguish titles amongst specialised areas of practice.2 Employers and others can enquire from the BIG register whether the practitioner has the right to use a title. The employment market in fact is what demands and sorts types of nurse, as in many professions in the Netherlands.
Under article 14 of the Wet BIG regulation can be made recognising the legal titles of Nurse specialist. (ref.: ICN definition of Nurse Specialist). These have not yet been made. There are organisational criteria that must be met by the nursing organisations (associations of specialists) before such a regulation will be made. Such titles will only be usable by those registered as such in the Big Register.
Registration
This is the responsibility of the Ministry of Health, Welfare and Sport. Once awarded the title of Verpleegkundige is for life, with no further requirements for periodic registration. However, the Wet BIG, is creating the possibility to implement a periodic registration. At this moment discussion are taken place whether one should take advantage of this possibility. The education of nursing is regulated by governmental orders from the Ministry of Education, Culture and Science. The law on nursing in this area was finally reformed with the WET BIG at the end of 1993.6 The WET BIG regulates eight health care professions. As a result of this law registration of nurses commenced on 1st December 1995. The educational rules are now contained in the law relating to education and professional education of 10th March 1999 (WEB) and the Higher Education and Research Act (WHW, 8th October 1992) .
Training
In the Netherlands education is divided into several streams. The general secondary educational system has three main options, the MAVO (four years), the HAVO (five years) and the VWO (six years), the latter being the entry requirement to university degrees. Professional education has two main options: the MBO (secondary professional education) and the HBO (higher professional education). Training of nurses is provided through both these systems (MBO and HBO). Situation before 1997
Before 1977 a nurse had the possibility to enter a post-basic course after an In service training : general nurse, (A), psychiatric nurse (B) or nurse for the mentally handicapped (Z) or after a higher professional education programme (four years full-time), HBOV.
These programmes allow the different types of nurses to enter the post basic training.
From 1972-1988 there was also a secondary professional education programme (MBOV) of three years full-time, which led to a nursing qualification based upon which the nurse could follow a post-basic programme. The MBOV stopped at 1988.
The MBOV, the HBOV and the inservice training for general nurses A are accepted under the EC sectoral directives.
Since 1997 the inservice training for nurses has ended. There are now two educational routes for nursing education, namely secondary professional education and higher professional education. The secondary professional nursing programme can be followed after four years secundary school (MBOV), the higher professional nursing programme can be followed after five years secondary school. Both programmes fullfill the criteria for being acepted under the EC sectoral directives.
Specialisation
All registered nurses, HBO-trained as well as MBO-trained, are entitled to enter specialist training courses (post-basic nurse training). As pointed out before, since the introduction of the Wet BIG, no specialist nurse training is legally regulated. But most specialist nurse training programmes are recognised by both the nursing associations and the employers. Specialist nurse training is aiming on obtaining extra competencies and qualifications on professional specific skills. It is not possible to obtain those skills with clinical experience only. A substantial theoretical training and clinical training is necessary.
The recognised specialist nurse training are all aiming on a specific category of clients. The following specialist training are recognised by both the nursing associations and the employers at this moment:
Please be Aware!
Only the basic nurse, Verpleegkundige, is currently recognised in law. Article 14 of the big Wet will eventually be used to designate new post basic specialist nurses, but this has not yet been done. The pre-existing specialisations thus are not “legally regulated” or recognised in “registration” procedures under the big Wet.
The general nurses (Verpleegkundige) are recognised under the EC sectoral directives on nursing.
In the Netherlands there are two levels of nurses, the first and second level nurses. The first level nurse is a higher level nurse who is capable of assessing the whole nurse situation and deciding the appropriate level of nurse care. The first level nurse will also direct the second level nurses.
Nurses of both levels (first level and second level) are expected to recognise and analyse “actual threatening consequences of physical, mental pathological processes, disabilities or develop mental disorders on the individuals vital functions as well as counselling and assisting the individual in such conditions”.1 There is now a new “nurse profile” but it still treats the Dutch nurse as a single entity.
The regulation of nursing in the Netherlands
For many years the law of 1921 for the Diploma Van Verpleegkundige2 regulated nursing practice. It was last revised in 1977 and regulated the five basic nursing diplomas before its abolition in 1993.
The original 1865 law on the art of practice of medicine reserved all medical acts to qualified medical doctors. This in principle, would prevent nurse from giving injections. But since long time it was common law that nurses gave injections without direct supervision of medical doctors.
The 1993 Wet BIG (the individual Health Care Professions act) thoroughly overhauled this area of law. This law, amongst other things, annulled the actual ban on the unqualified practice of medicine thus paving the way to allow alternative medicine.
Field of activity
Theoretically in the Netherlands anyone can in fact practice some types of nursing as it is neither legally defined nor protected in law as an activity as such. However the Wet BIG does designate certain activities as reserved.
For example:
Puncture and injections / General anaesthetic/ Endoscopies and similar procedures
Nurses can only undertake these procedures under orders from an authorised professional (i.e doctor, dentist). Midwives, which in the Netherlands in not a specialisation of nursing but an other profession, are directly authorised to perform some of the acts
The law however does not indicate that only registered nurses can undertake such acts based on the relevant professional’s order. Anyone competent can be authorised to commit such an act, the onus being on the primary professional to make sure that the person so ordered is in fact competent to perform the procedure.
Title
According to the Wet BIG, only those registered as Verpleegkundige can use the title and such registration only takes place once the registrar knows that the candidate has an appropriate diploma. This system came into force in 1995, and the registration requirements are set out below.
In law the diploma of Verpleegkundige used to allow five additional annotations. That is:
The community nurse/ The social psychiatric nurse/ The paediatric nurse/ The obstetric and gynaecological nurse/ The intensive care nurse.
The duration of each of these post-basic training is variable and specialist nurse training is currently no longer legally regulated or recognised, though there are provisions in the Big Wet, outlined below, that allow it to be regulated. All these nurses are currently added to the Big Register as plain nurses and not as specialised nurses.
Article 3 of the Wet BIG states that designation of nurse Verpleegkundige only applies to professional practitioners who have firstly undertaken the training required to gain a certificate from the Ministry of Health, Welfare and Sport recognised institution and have registered with the BIG register. The BIG register registers nurses and does not distinguish titles amongst specialised areas of practice.2 Employers and others can enquire from the BIG register whether the practitioner has the right to use a title. The employment market in fact is what demands and sorts types of nurse, as in many professions in the Netherlands.
Under article 14 of the Wet BIG regulation can be made recognising the legal titles of Nurse specialist. (ref.: ICN definition of Nurse Specialist). These have not yet been made. There are organisational criteria that must be met by the nursing organisations (associations of specialists) before such a regulation will be made. Such titles will only be usable by those registered as such in the Big Register.
Registration
This is the responsibility of the Ministry of Health, Welfare and Sport. Once awarded the title of Verpleegkundige is for life, with no further requirements for periodic registration. However, the Wet BIG, is creating the possibility to implement a periodic registration. At this moment discussion are taken place whether one should take advantage of this possibility. The education of nursing is regulated by governmental orders from the Ministry of Education, Culture and Science. The law on nursing in this area was finally reformed with the WET BIG at the end of 1993.6 The WET BIG regulates eight health care professions. As a result of this law registration of nurses commenced on 1st December 1995. The educational rules are now contained in the law relating to education and professional education of 10th March 1999 (WEB) and the Higher Education and Research Act (WHW, 8th October 1992) .
Training
In the Netherlands education is divided into several streams. The general secondary educational system has three main options, the MAVO (four years), the HAVO (five years) and the VWO (six years), the latter being the entry requirement to university degrees. Professional education has two main options: the MBO (secondary professional education) and the HBO (higher professional education). Training of nurses is provided through both these systems (MBO and HBO). Situation before 1997
Before 1977 a nurse had the possibility to enter a post-basic course after an In service training : general nurse, (A), psychiatric nurse (B) or nurse for the mentally handicapped (Z) or after a higher professional education programme (four years full-time), HBOV.
These programmes allow the different types of nurses to enter the post basic training.
From 1972-1988 there was also a secondary professional education programme (MBOV) of three years full-time, which led to a nursing qualification based upon which the nurse could follow a post-basic programme. The MBOV stopped at 1988.
The MBOV, the HBOV and the inservice training for general nurses A are accepted under the EC sectoral directives.
Since 1997 the inservice training for nurses has ended. There are now two educational routes for nursing education, namely secondary professional education and higher professional education. The secondary professional nursing programme can be followed after four years secundary school (MBOV), the higher professional nursing programme can be followed after five years secondary school. Both programmes fullfill the criteria for being acepted under the EC sectoral directives.
Specialisation
All registered nurses, HBO-trained as well as MBO-trained, are entitled to enter specialist training courses (post-basic nurse training). As pointed out before, since the introduction of the Wet BIG, no specialist nurse training is legally regulated. But most specialist nurse training programmes are recognised by both the nursing associations and the employers. Specialist nurse training is aiming on obtaining extra competencies and qualifications on professional specific skills. It is not possible to obtain those skills with clinical experience only. A substantial theoretical training and clinical training is necessary.
The recognised specialist nurse training are all aiming on a specific category of clients. The following specialist training are recognised by both the nursing associations and the employers at this moment:
- Adult intensive care nursing
- Paediatric intensive care nursing
- Neonatal intensive care nursing
- Cardiac care nursing
- Emergency nursing
- Dialysis nursing
- Paediatric nursing
- Obstetrics/gynaecology nursing
- Burns nursing
- Oncology nursing
- Cast technician
- Anaesthesia nursing
- Operating room nursing
- Ambulance nursing
- Community nursing
- Occupational health nursing
- Social psychiatric nursing
- Psychiatric specialist nursing
- Clinical geriatric nursing.
- Middle and higher management training
- Nurse teacher training
- Master training.
Please be Aware!
Only the basic nurse, Verpleegkundige, is currently recognised in law. Article 14 of the big Wet will eventually be used to designate new post basic specialist nurses, but this has not yet been done. The pre-existing specialisations thus are not “legally regulated” or recognised in “registration” procedures under the big Wet.
The general nurses (Verpleegkundige) are recognised under the EC sectoral directives on nursing.