Start by sorting the actual tasks, not the job titles
List what the day actually involves: meals, mobility support, company, appointments, medication reminders, wound care, monitoring a changing condition. Mark each one as household support, hands-on personal care, or a clinical task requiring judgment.
A domestic helper’s reasonable scope covers the first two categories, within what your household has shown her and can supervise. The third category — where a task requires assessing a condition or making a treatment decision, not just carrying one out — is where a home nurse’s training becomes the relevant qualification, not a domestic helper’s.
- Household and daily-living tasks: reasonable domestic-helper scope, with clear instructions.
- Hands-on personal care your household can supervise: often reasonable, if trained and agreed.
- Clinical assessment or treatment decisions: the point at which a home nurse’s training is the relevant qualification.
What “registered nurse” actually means, legally
The Nurses Act 1950 is a registration statute for the title “registered nurse,” not a scope-of-practice law listing which tasks belong to a nurse. Its offence provision makes it a crime to use that title, or imply you hold it, without being registered.
The practical upside for a household is that this is independently checkable: a genuine registered nurse, or a home-nursing service claiming that title, can be verified against the Nursing Board’s own Register. Ask for that confirmation directly rather than taking a business name or a marketing description at face value.
Where the law stays silent, and why that’s not a green light
No specific law was found reserving acts like giving an injection or dressing a wound to a registered nurse, and the Poisons Act 1952 governs who may supply medicine, not, generally, who may subsequently give an already-dispensed dose at home. That legal silence describes what isn’t prohibited — it says nothing about what’s a good idea without training.
The official JTKSM/ILO employer guide makes this distinction directly: it describes a household training its own helper to support medication and equipment for a family member recovering from a stroke, but under family supervision and with a physiotherapist’s input — not as something to attempt alone. For a serious illness or specialised need, the guide recommends a trained nurse or caregiver, framed as a matter of competence and safety.
Many households need both roles, not one instead of the other
A common, workable structure is a domestic helper covering household routines and daily support, with a home nurse or a periodic nursing visit covering the clinical tasks the situation actually requires — rather than expecting one role to stretch across both.
Whichever combination fits, put the boundary in writing: which tasks the domestic helper handles, which are reserved for a nurse, who is contacted when the person’s condition changes, and where the responsible clinician’s instructions are kept. Revisit that boundary as the care need changes, rather than assuming today’s arrangement still fits in six months.
What to ask a home-nursing service or agency directly
Ask to see the specific registration of anyone presented as a “registered nurse” or “home nurse,” and ask what training a “caregiver” placement actually holds, since that title carries no equivalent legal certification requirement.
Ask, too, how the service documents a handover — written instructions from the responsible clinician, a defined escalation contact, and a review point as the person’s needs change — rather than relying on a verbal description of what’s covered.