RIPEN Transitional Planning: Working together to ensure rural and isolated communities have access to, and quality use of, medicines

Michelle Gunn, Denise Breadsell, Michelle Garner


Registered nurses (RNs) holding the Nursing and Midwifery Board of Australia (NMBA) Endorsement for scheduled medicines for nurses (rural and isolated practice) (RIPEN) provide rural and isolated communities access to medicines when traditional prescribers are not available. The importance of this model of care cannot be overstated, as these nurses provide essential services, without which vulnerable people may go without care.

It was therefore a surprise to many that after an extensive national consultation by the NMBA in 2013 it was agreed that the endorsement would be discontinued.  This was because it was recognised that all RNs are adequately prepared in their undergraduate education to ‘supply and administer’ under protocol, and that most jurisdictions have arrangements to support this. However, the Medicines and Poisons legislative frameworks in Queensland and Victoria rely on the endorsement, and legislative amendments will be necessary to ensure that rural and isolated communities have ongoing access to, and quality use of, medications.

Queensland and Victorian Departments of Health have been working with the NMBA on strategic policy and transition away from RIPEN, with the NMBA agreeing to not remove the endorsement until alternative jurisdictional arrangements are in place. In Queensland the Office of the Chief Nursing and Midwifery Officer (OCNMO), the Queensland Nurses and Midwives’ Union (QNMU), and the rural Executive Directors of Nursing and Midwifery Services have worked in partnership to support consultation and collection of expertise to support the amendment of the legislative framework.  Each committed to ensuring rural and isolated practice nurses continue to supply and administer medications to the extent that they currently do.

This presentation will provide an overview of Queensland’s approach to RIPEN transitional planning, including discussion of the consultation process, key issues, policy options and what this means for the broader nursing workforce.  This presentation will highlight the importance of consultation, communication and collaboration when working to develop policy positions that are cogent, inclusive and patient focused.


Michelle Gunn RN, MACN, BN (Distinction), LLB (1 Hons), Grad Dip (Legal Pract), Solicitor of the QSC, Adjunct Lecturer UQ.

Michelle has been a registered nurse for over twenty years and holds academic qualifications in nursing and law.  She currently is employed as a Director of Nursing in the Queensland Office of the Chief Nursing and Midwifery Officer where she has responsibility for Professional Capability statewide. Over recent years she has lead unprecedented policy investments in nursing workforce development. She is a Member of the Queensland Nursing and Midwifery Executive Council, an Adjunct Lecturer at the University of Queensland and a Nursing Expert Panel Member for the Queensland Civil and Administrative Tribunal. Michelle was a scholar of the International Council of Nurses, Global Nursing Policy Leadership Institute (GNPLI) in 2017, and has presented at the World Health Assembly for the past three years.

Denise Breadsell RN., RM., B Hlth Sc Nrs., Grad. Cert. IControl., MPH.

Denise qualified as a Registered Nurse in Queensland in 1982 and a Registered Midwife in Queensland in 1985. Since this time Denise has gained a breadth of experience in nursing and midwifery across rural, remote and urban areas. Denise has worked across public, private and aged care sectors, predominantly in Queensland during the past 40 years. Her areas of practice have included; Public Health Nurse – Communicable Diseases/Immunisation, Sexual and Reproductive Health Nurse, Midwifery, Infection Control, Tuberculosis management, Refugee and Indigenous Health, Quality Management, Nurse Education, Operating Theatre, School Based Youth Health Nurse and Orthopaedics; before starting work with the QNMU 5 years ago as a Professional Officer responsible for codes and standards of practice. She is a passionate advocate of nurses and midwives across Queensland and in her role as Professional Officer at the QNMU has participated in EB9 and EB 10 negotiations and working parties.

Michelle Garner, BN, Grad Dip (Critical Care), RN, M(NP)

Michelle is an experience nurse practitioner and exceptional nurse leader. She is the Executive Director of Nursing and Midwifery for North West Hospital and Health Service and a powerful advocate for rural and isolated health.  She is passionate about removing barriers to nurses and midwives working to their full scope of practice and increasing access to care for rural and isolated communities.  Michelle is committed to the highest standards of care and is currently leading her health service on their journey towards Magnet recognition.  Michelle has a in depth understanding of industrial relations, regulatory and professional issues and is currently a Member of the Queensland Nursing and Midwifery Board of Australia.

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