Elizabeth Mary Chiarella AM (born 15 August 1952) is an Australian academic who specialises in issues relating to nursing, midwifery and the law. She is Professor Emerita at the University of Sydney, Australia and has been at the forefront of many regulatory changes to nursing practice and the nursing workforce and midwifery. These include the introduction of nurse practitioners into Australia, the move from a state based to a national regulatory system and, for midwifery, the introduction of the world's first Doctor of Midwifery and the establishment of the framework for state funded home birth midwifery in New South Wales (NSW), Australia. She is a nurse and midwife, who specialised initially in anaesthetic nursing and later in palliative care.
Chiarella grew up as a farmer's daughter in Sutton, near Macclesfield, in the North of England, the only daughter of Cyril and Marian Bullock. [1] She attended Sutton St James Primary School and Macclesfield High School. She became interested in nursing by accident, because she wanted to do Voluntary Service Overseas and was advised she needed some skills. She commenced her training in 1970 at Macclesfield General Hospital. [2] She transferred at the beginning of second year to the United Bristol Hospitals nurse training school. [3] On graduation she worked in a medical ward in Bristol before transferring to the United Oxford Hospitals group in 1974 to undertake a graduate certificate in anaesthetic nursing at the Nuffield Department of Anaesthesia. She returned to Bristol to work as a senior staff nurse prior to moving to Australia at the beginning of 1976 to undertake midwifery at Crown Street Women's Hospital in Sydney. She completed midwifery and went to work as the first anaesthetic sister at Royal Prince Alfred Hospital, before being invited to work in the school of nursing there, firstly as a clinical teacher and then as a sister tutor without diploma whilst undertaking her nurse tutor's diploma by correspondence through Armidale College of Advanced Education. At that stage of her career she became politicised through the Operating Theatre Association of NSW, who were lobbying for supernumerary status for nursing students and greater recognition of the expertise of clinical nurses. [4]
Chiarella returned to the UK and worked as a sister tutor at the Cumberland Infirmary, Carlisle, Dudley and Stourbridge School of Nursing, at Fazakerley Hospital, part of South Sefton School of Nursing and later at Liverpool University, as a lecturer, in the Department of Nursing in the Faculty of Medicine. The latter position was her introduction to degrees in nursing. During her time in Liverpool she read law part-time and undertook her Honours thesis, graduating from Liverpool Polytechnic (now John Moores University) with LLB (Hons). [5]
Chiarella returned to Australia in 1988 and went to work initially at the NSW College of Nursing as a Senior Tutor. She then obtained a position teaching law for nurses in the Department of Legal Studies at the Kuring-gai College of Advanced Education, which merged with the University of Technology, Sydney (UTS). She returned to the NSW College of Nursing as a Director and remained there for nine years, being involved in much policy and political lobbying at that time, including all stages of the NSW Nurse Practitioner project. [6] She left to complete her PhD, prior to taking up a position as associate professor at UTS to introduce the Professional Doctorates in nursing and midwifery. [7]
She later became the first Professor of Nursing in Corrections Health and worked there until she was invited to become the Chief Nursing and Midwifery Officer (CNMO) for NSW Health. She resigned in 2004 to return to the UK. On her return to Australia she took up a professorial position at UTS funded by NSW Health to complete and oversee many of the projects she had introduced as CNMO. Following that position she moved to the University of Sydney in 2008 to an invited position where she worked until her retirement in 2020. During this time she was originally the chair of the Australian Nursing and Midwifery Council then the peak regulatory body for nurses and midwives in Australia. She resigned from that role in 2009 to become the NSW practitioner member on the newly established Nursing and Midwifery Board of Australia (NMBA), where she served for the next six years, also serving as Chair of the Policy Committee for NMBA. [8] She also served as one of the Federal Minister for Health's independent Board members on the Board of Health Workforce Australia (HWA) and was Chair of the Health Professions Standing Advisory Committee to HWA. [9]
Chiarella is the co-author of 6 of the 9 editions of Law for Nurses and Midwives (originally Nursing and the Law) with Patricia Staunton. [10] She is also author of The Legal and Professional Status of Nursing [11] and Policy in End of Life Care. [12] She has co-authored two case books of disciplinary decisions, one with Amanda Adrian [13] and one with Diana Keatinge. [14] She is the author of 97 peer refereed journal articles and reports, and over 100 blogs, editorials and newspaper articles. She has given over 400 keynote and plenary addresses, both nationally and internationally [15] and has spoken on radio and television over the years. Currently she is a regular panellist on The Drum for the ABC. [16]
Chiarella was married for 30 years to Laurie Chiarella, an Italian Australian architect, with whom she had 2 children - Ben and Hugo Chiarella. Laurie died at age 60 in 2008 and she later married Martin Christie, a neurosurgeon, who died in 2014. She has four stepchildren from that marriage. [17]
A registered nurse (RN) is a nurse who has graduated or successfully passed a nursing program from a recognized nursing school and met the requirements outlined by a country, state, province or similar government-authorized licensing body to obtain a nursing license. An RN's scope of practice is determined by legislation, and is regulated by a professional body or council.
The Australian Nursing and Midwifery Federation (ANMF) is the largest union in Australia, with 274,956 members in 2018. The union is run by nurses, midwives and assistants in nursing to advance the industrial, political and professional interests of its members.
A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans. NP training covers basic disease prevention, coordination of care, and health promotion.
In the United States, a Certified Nurse-Midwife (CNM) is a nurse midwife who exceeds the International Confederation of Midwives' essential competencies for a midwife and is also an advanced practice registered nurse, having completed registered nursing and midwifery education leading to practice as a nurse midwife and credentialing as a Certified Nurse-Midwife. CNMs provide care of women across their lifespan, including pregnancy and the postpartum period, and well woman care and birth control. Certified Nurse-Midwives are recognized by the International Confederation of Midwives as a type of midwife in the U.S.
Nursing in the United Kingdom has a long history. The current form of nursing is often considered as beginning with Florence Nightingale who pioneered modern nursing. Nightingale initiated formal schools of nursing in the United Kingdom in the late 19th and early 20th centuries. The role and perception of nursing has dramatically changed from that of a handmaiden to the doctor to professionals in their own right. There are over 700,000 nurses in the United Kingdom and they work in a variety of settings, such as hospitals, health centres, nursing homes, hospices, communities, military, prisons, and academia, with most working for the National Health Service (NHS). Nurses work across all demographics and requirements of the public: adults, children, mental health, and learning disability. Nurses work in a range of specialties from the broad areas of medicine, surgery, theatres, and investigative sciences such as imaging. Nurses also work in large areas of sub-specialities such as respiratory, diabetes, cancer, neurology, infectious diseases, liver, research, cardiac, women's health, sexual health, emergency and acute care, gastrointestinal, infection prevention and control, neuroscience, ophthalmic, pain and palliative, and rheumatology. Nurses often work in multi-disciplinary teams but increasingly are found working independently.
The Frontier Nursing Service (FNS) provides healthcare services to rural, underserved populations since 1925, and educates nurse-midwives since 1939.
Mary Carson Breckinridge was an American nurse midwife and the founder of the Frontier Nursing Service (FNS), which provided comprehensive family medical care to the mountain people of rural Kentucky. FNS served remote and impoverished areas off the road and rail system but accessible by horseback. She modeled her services on European practices and sought to professionalize American nurse-midwives to practice autonomously in homes and decentralized clinics. Although Breckinridge's work demonstrated efficacy by dramatically reducing infant and maternal mortality in Appalachia, at a comparatively low cost, her model of nurse-midwifery never took root in the United States.
Nursing in Australia has evolved in training and regulation since the 19th century.
Dr Rhodanthe Grace Lipsett OAM was an Australian midwife and author. Throughout her professional life she specialised in infant and maternal health.
Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses can be differentiated from other healthcare providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialties with differing levels of prescription authority. Nurses comprise the largest component of most healthcare environments; but there is evidence of international shortages of qualified nurses. Nurses collaborate with other healthcare providers such as physicians, nurse practitioners, physical therapists, and psychologists. There is a distinction between nurses and nurse practitioners; in the U.S., the latter are nurses with a graduate degree in advanced practice nursing, and are permitted to prescribe medications unlike the former. They practice independently in a variety of settings in more than half of the United States. Since the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.
Flora Jean Cameron was a New Zealand nurse, nursing instructor and administrator.
The timeline of nursing history in Australia and New Zealand stretches from the 19th century to the present.
Mary Francis Hill Coley was an American lay midwife who ran a successful business providing a range of birth services and who starred in a critically acclaimed documentary film used to train midwives and doctors. Her competence projected an image of black midwives as the face of an internationally esteemed medical profession, while working within the context of deep social and economic inequality in health care provided to African Americans. Her life story and work exist in the context of Southern granny midwives who served birthing women outside of hospitals.
A midwife is a health professional who cares for mothers and newborns around childbirth, a specialization known as midwifery.
A nurse midwife is both a nurse and a midwife, having completed nursing and midwifery education leading to practice as a nurse midwife and sometimes credentialed in the specialty. Nurse midwives provide care of women across the lifespan, including during pregnancy and the postpartum period, and well woman care and birth control.
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Margaret (Maggie) Fraser Myles, née Findlay, was a Scottish midwife, midwifery tutor and lecturer and author. She is globally known for her Textbook for Midwives, first published in 1953, which has been considered a reference midwifery textbook for decades.
Caroline Susan E. Homer is an Australian midwifery researcher and international advocate for women's health rights. She is Co-Program Director, Maternal and Child Health at the Burnet Institute in Melbourne and Visiting Distinguished Professor of Midwifery at the University of Technology Sydney.
Mary Kirkpatrick was a pioneer of women's healthcare and the first trained midwife on the Mid North Coast of New South Wales. She established the first private maternity hospital, eventually establishing three more. Kirkpatrick worked with and mentored many of midwives and nurses who followed her to the coast.