The word regulation is often associated with detailed procedures, rules, and controls and over time it has come to be perceived in a negative sense, and sometimes self-serving. However, the International Council of Nurses (ICN) views regulation in a highly positive way. It is seen as being the legitimate and appropriate means—governmental, professional and private—whereby order, consistency, identity, and control are brought to the profession. Regulation defines the profession and its members, determines the scope of practice, sets the standards of education and ethical and competent practice, and establishes the systems of accountability.1 Additionally, for over 100 years, the ICN has advocated for professional self-regulation—a form of self-governance—whereby nurses govern nurses in the public interest.1 Self-regulation acts to protect the public from practitioners who are unqualified, incompetent, or unethical. Self-regulation supports and promotes modern professional practice frameworks, including promoting good practice, preventing poor practice, and intervening when practice is unacceptable.

Professional regulatory systems involve varying degrees of self-regulation. Empowering the profession through professional self-regulation is legitimate only if the primary purpose of regulation is concerned with improving the service and protecting the public. These are both linked to professional standards and behavior. Benefits to the profession and its practitioners are secondary considerations. Self-regulation is a privilege granted by governments, and that can be taken away, and to maintain this privilege, a profession must preserve the trust of the public.2

Professional self-regulation ranges from the pure form, where the profession alone regulates itself, to systems involving varying levels of collaboration with the government. Thus, professional self-regulation, other than the pure form, works within both professional and legal frameworks where legislation provides external controls, and the profession contributes the internal controls by way of standards, guidelines, and professional development.2

In Oman, systems and processes for professional regulation exist but lack consistency, rigor, and completeness. In the absence of proper mechanisms, the profession is unable to take responsibility and obtain the required authority to undertake important regulatory activities. These activities include taking action when practice is unacceptable, setting standards, monitoring and periodically reviewing and updating professional standards, and ensuring that the standards of education, practice, conduct, and licensing are applied and remain consistent with current and future developments and needs of the profession.

Profession and society have a special relationship, but it is one that becomes binding only if the terms are achievable and can be honored by both parties. Society expects the best from nurses and midwives individually, and as a profession collectively. Society anticipates that ‘caring’ lies at the heart of professional practice and that it will be ethical and infused with competence, effectiveness, and compassion.

The current model of regulation in Oman is under the authority of the Ministry of Health, which is also the largest health service provider. Such a model can generate a conflict of interest as the same body is acting as both service provider and regulator. Introducing a form of self-regulation involves other stakeholders such as individual practitioners, the public, employers and, other key stakeholders.

While the degree and form of self-regulation adopted is an area for further discussion, we would argue that nursing and midwifery professionals in Oman are sufficiently mature to exercise their duty for public protection, and have the special knowledge required to set professional standards and assess the conduct of its members. Thus, the time has come to create a modern and effective professional regulatory system where the government fulfills its mandate to protect the public through establishing legislation, which ensures a sufficient degree of self-regulatory powers and authority to the profession concerned in governing the profession and the practice of its members.

references

1. Styles MM, Affara FA. ICN on Regulation: Towards 21st Century Models. Geneva, International Council of Nurses, 1997 p2, 22-24.
2. International Council of Nurses. Professional Self-Regulation for Nurses: Issues and Opportunities, Geneva, International Council of Nurses, 2001, p.13-16.