On this page
Key facts for nurses and midwives
- Regulator
- Singapore Nursing Board (SNB)
- Law
- Nurses and Midwives Act 1999
- Main standard
- Code for Nurses and Midwives (in effect from 2 April 2018), with the SNB scope of practice and core competencies
- Who looks at it
- A Complaints Committee appointed by the Board, which reports its findings and recommendations to the Board
- Possible outcomes
- Written warning, censure, penalty up to S$2,000, conditions, suspension up to 2 years, cancellation
- Appeal
- To the High Court within 3 months of the Board's decision
Is this page for you?
This page is for registered nurses, enrolled nurses, registered midwives and Advanced Practice Nurses who need to show the Singapore Nursing Board, or their employer, that they understand a concern and have acted on it.
- A complaint to the SNB from a patient, a relative, a colleague or your employer, and a request for your response.
- An inquiry by a Complaints Committee appointed by the Board, which may hold a formal inquiry before reporting to the Board.
- An order from the Board: a written warning, censure, a financial penalty, conditions, suspension or, for APNs, action on your APN certification.
- A ward or hospital investigation after a medication incident, a fall, a missed deterioration or a complaint about how you spoke to someone, or a performance plan agreed with your nurse manager.
- A return to practice after a suspension, or practice under conditions.
Nurses are often asked to account for a single shift, handover or medication round. The Board and your nurse managers want the same things: an accurate account, a clear view of which part of the Code for Nurses and Midwives was engaged, and evidence that your practice is now safer. For routine CPE towards your annual practising certificate, see the ethics and professionalism courses for nurses and midwives.
The core set for nurses and midwives
Core course 1Ethics
Ethics for Nurses and Midwives
The SNB Code for Nurses and Midwives applied to refusal of care, family requests, restraint, covert medication, delegation, unsafe staffing and errors.
Core course 2Professionalism
Professional Standards for Nurses and Midwives
SNB registration and PCs, 2023 RN, EN and midwife competencies, delegation, APN prescribing, the Code's ten principles and midwifery escalation.
Which one do I need?
| Compare | Ethics for Nurses and Midwives | Professional Standards for Nurses and Midwives |
|---|---|---|
| Focus | Values, reasoning and ethical dilemmas | Conduct, standards, scope, records and accountability |
| The question it answers | What is the right thing to do here, and why? | What do my standards require, and how do I show it? |
| Choose it when | A decision, a dilemma or your judgement is in question | Behaviour, systems, scope of practice or records are in question |
Not sure? Many concerns and most CPD plans need both: take them together for a complete picture.
Whatever the concern, eight courses form the base. Two are written for nursing and midwifery in Singapore; six deal with how to respond and how to show that learning has happened.
Ethics for Nurses and Midwives is about the ethical side of nursing work: advocacy when a patient's wishes and the family's differ, consent and refusal, confidentiality, dignity for older and dependent patients, and what to do when you think care is unsafe. Professional Standards for Nurses and Midwives is about practice against the Code for Nurses and Midwives and the SNB's scope of practice: accountability, delegation between registered and enrolled nurses, records, competence and the practising certificate. A concern about what you did in a dilemma points to the first; a concern about how you practised points to the second.
- Responding to a Complaint or Board Inquiry: what to do when a letter arrives from the SNB or from your employer's investigation panel.
- Insight: Understanding, Developing and Demonstrating It: how to show you understand the effect on the patient, not only the rule you broke.
- Reflective Practice for Health Practitioners: a written reflection that also serves your CPE record.
- Remediation After a Concern: a plan with supervised practice, audits or competency checks someone can verify.
- Preventing Recurrence After an Error or Misconduct: checks that survive a short-staffed night shift.
- Rebuilding Trust After a Complaint: with the patient and family, your nurse manager, the team and the Board.
Core setComplete the set with these
Your board and its process: the SNB
| Your board | Singapore Nursing Board (SNB), which registers nurses and midwives, enrols enrolled nurses and certifies Advanced Practice Nurses |
|---|---|
| Law | Nurses and Midwives Act 1999 |
| Standards | Code for Nurses and Midwives (April 2018), in force for all nurses and midwives from 2 April 2018 |
| Complaints route | Written complaint setting out the facts, grounds and evidence; a Complaints Committee appointed by the Board inquires, may hold a formal inquiry and reports to the Board, which decides |
| Possible orders | Written warning, censure, financial penalty up to S$2,000, conditions, suspension of up to 2 years or cancellation; APN certification can be dealt with separately; costs |
| Appeals | To the High Court within 3 months of the Board's decision |
| Practising certificate and CPE | Annual practising certificate; CPE per qualifying period (1 September to 31 August): RN 15 points, EN and single-register midwife 10, APN 30. A pre-mandatory phase began on 1 September 2024 and the SNB says those short of points may still renew for 2027. APNs renew the RN and APN certificates together by 30 November |
| Also applies | The Healthcare Services Act 2020 licence conditions of the hospital, nursing home or clinic you work in, the Mental Capacity Act 2008 and the Personal Data Protection Act 2012 |
Always follow the process described in the letter you receive, and check the current Act on Singapore Statutes Online. Routine learning for your practising certificate is on the ethics and professionalism courses for nurses and midwives page.
When the concern starts on the ward
Concerns about nurses can surface first through an incident report, a family's feedback to the hospital, or a review by the nurse manager, rather than as a letter from the Board. An employer may then refer the matter to the SNB, and the Board may ask for the employer's findings. That means the statement you give your ward or your cluster's investigation is likely to be read again later.
- Ask for the terms of reference and the policy the investigation follows.
- Write facts, not feelings. Say what you did, saw and decided, and when. Separate what you remember from what the chart shows.
- Name system factors honestly, such as staffing, interruptions or similar patient names, without using them to avoid your own part.
- Keep copies of your statement, the incident report reference and any training records.
- Start learning early. Completing a relevant course while an internal review is still open shows initiative and gives you something concrete to describe.
RecommendedStart with these
Further relevantAdd if they fit the concern
Medication administration errors
Wrong patient, wrong dose, wrong time and omitted doses are familiar reasons for a nurse's practice to be reviewed. Singapore's National Guidelines on High Alert Medications (2021) name insulin, anticoagulants, opioids, concentrated electrolytes and cytotoxic drugs as core high-alert categories, so an error with any of these will be looked at closely even if the patient recovered.
A strong response explains which check was missed, why it was missed and what you now do every time, for example a personal two-identifier habit, refusing to be interrupted during high-alert preparation, or asking for an independent check. Courses on medication safety and human factors help you explain the error in a way that is honest about you and fair about the system.
RecommendedStart with these
Further relevantAdd if they fit the concern
Records, observations and handover
Nursing notes, observation charts and handover are how the team knows what happened. Concerns arise when observations were not recorded, a deterioration was charted but not escalated, a task was lost at shift change, or notes were completed later without being marked as late entries. Altering a record after an incident, even to make it more complete, can turn a clinical concern into an honesty concern.
Where a patient deteriorated, add the course on the deteriorating patient so your reflection can show how you now recognise and escalate early warning signs.
RecommendedStart with these
Further relevantAdd if they fit the concern
Communication, dignity and respect
Families sometimes complain less about a clinical outcome than about how they were spoken to: a curt reply at the nurses' station, a call bell left unanswered, an elderly parent left unwashed, or information given in English to a relative who mainly speaks Mandarin, Malay or Tamil. The Code for Nurses and Midwives expects respect for the values, customs and beliefs of the people in your care, without discrimination.
Choose courses that let you describe concretely what you would do differently: using an interpreter rather than a young relative, checking understanding, and explaining delays honestly.
RecommendedStart with these
Further relevantAdd if they fit the concern
Scope, delegation and the RN, EN and APN roles
The SNB's scope of practice and core competency documents, revised in 2023, set out what registered nurses, enrolled nurses, midwives and Advanced Practice Nurses are each expected to do. Concerns arise when an enrolled nurse carries out a task outside their role because the ward was busy, a registered nurse delegates without checking competence, or an APN acts outside the arrangements that support their practice.
APNs hold a separate APN practising certificate, renewed together with the registered nurse certificate. Practising as an APN on an expired APN certificate is an offence, and the Board can deal with APN certification separately from registration. If your concern involves an expanded role, the scope and supervision courses help you set out the limits you now work within.
RecommendedStart with these
Further relevantAdd if they fit the concern
Midwifery, maternity and family decisions
Midwives work with decisions that are personal and time-pressured: a woman who declines an intervention in labour, a family who want to make decisions on her behalf, or a newborn whose condition changes quickly. A complaint may concern consent, communication during an emergency, or how a poor outcome was explained afterwards.
Start with ethics and consent, then add open disclosure where the family feel they were not told what happened. Where there are concerns about a child's safety at home, the safeguarding course covers how child protection concerns are referred in Singapore.
RecommendedStart with these
Further relevantAdd if they fit the concern
Boundaries, online conduct and honesty
Boundary concerns for nurses include personal relationships with patients or their relatives, accepting gifts or money from long-stay patients or residents, contact through messaging apps or social media, and photographs or comments about patients posted online. Honesty concerns include inaccurate CPE or practising certificate declarations, timesheets, and records completed for care that was not given.
RecommendedStart with these
Further relevantAdd if they fit the concern
Match the concern to a course
The concerns that most often lead to complaints and investigations, how they are viewed, and the courses that address each one.
Insulin or anticoagulant given to the wrong patient
High-alert medications under the 2021 national guidelines; the committee will look for a missed identification check and what has replaced it.
Observations not done or deterioration not escalated
Usually examined through the chart and handover records; the question is what you saw, recorded and reported, and when.
Late or altered nursing notes
Late entries must be dated and marked; changing a record after an incident can turn a clinical concern into one about honesty.
Rude or dismissive manner with a family
The Code expects respect for patients' values and needs; a complaint can follow a poor first conversation rather than the care itself.
Enrolled nurse working outside their role
Judged against the SNB scope of practice and core competencies; the delegating registered nurse may also be asked about it.
APN practising outside agreed arrangements
APN certification can be cancelled, suspended or conditioned separately from registration.
Consent issues in labour or for a procedure
A signature is not enough if the woman or patient did not understand; advocacy and documented explanation matter.
Gifts or money from a long-stay patient
Boundary and honesty concerns overlap, especially with dependent or older patients.
Patient photo or comment posted online
A confidentiality and professionalism concern under the Code and, depending on the facts, the PDPA.
How the SNB deals with a complaint
Making the complaint
Complaints to the SNB must be in writing, setting out the facts and allegations, the grounds and supporting evidence. The grounds in the Act include registration obtained by fraud or a materially incorrect statement, registration cancelled or suspended outside Singapore, a conviction or misconduct or negligence that in the Board's opinion makes you unfit to remain on the register or roll, and inability to practise satisfactorily because of a mental or physical disability.
Complaints Committees
The Board may appoint one or more Complaints Committees to investigate. A committee may hold a formal inquiry and must report its findings and recommendations to the Board. Unlike the doctors' process, the decision on what happens next is made by the Board itself.
What the Board can order
| Order (s 19(2)) | What it means |
|---|---|
| Written warning | A recorded warning short of other sanctions |
| Censure | A formal expression of disapproval |
| Financial penalty | Up to S$2,000 |
| Conditions | Registration or enrolment subject to conditions the Board sets |
| Suspension | For up to two years |
| Cancellation | Removal of registration or enrolment |
The Board can also cancel, suspend or attach conditions to APN certification, and may order costs. It must tell you, and the complainant, of its decision.
Appeal
A nurse or midwife aggrieved by the Board's decision may appeal to the High Court within three months, or any longer period the court allows. There is no further appeal. If you are considering an appeal, take legal advice as soon as the decision arrives. Our guide to complaints and disciplinary inquiries in Singapore compares this process with the other boards.
What a Complaints Committee will be looking for
- Accountability: do you accept your part, even where the ward was short-staffed or another nurse was involved?
- Understanding of impact: can you describe what the error or behaviour meant for the patient and family?
- Safer practice now: what do you do differently on every shift, and who can confirm it?
- Consistency: does your account to the Board match your statement to your employer and the records?
- Evidence: certificates, competency sign-offs, supervised medication rounds, audit results and feedback from your nurse manager.
Presenting your evidence to the SNB or your employer
For a nurse or midwife, the strongest evidence usually comes from the ward as well as from study. A focused bundle might include:
- A reflective account for each course, written about the specific shift or incident and the part of the Code for Nurses and Midwives it engaged.
- A reassessment of the skill involved, such as a medication administration competency signed off by a nurse educator or clinical instructor.
- An audit of your own documentation over a set period, carried out or checked by your nurse manager.
- Feedback from your nurse manager or supervisor on the change they have seen in your practice.
- Your CPE record, showing that the remediation sits within ongoing learning rather than a single burst.
Each course is online and self-paced, with a 20-question final assessment, an 80 per cent pass mark (16 of 20), a structured reflective account and a certificate of completion. Three-hour courses are S$125; the two-hour reflection course is S$95.
A certificate shows that you studied a defined topic and passed an assessment; your reflective account shows what changed. Together they say more than a general promise to be more careful.
Only the SNB, or the committee or employer running a process, decides what it accepts.
Your annual practising certificate and CPE
Nurses and midwives renew their practising certificate every year. The SNB has set CPE expectations of 15 points a year for registered nurses, 10 for enrolled nurses and single-register midwives, and 30 for APNs, in a qualifying period from 1 September to 31 August, and is moving towards making CPE mandatory for renewal. We do not claim a CPE point value for our courses; your certificate shows the study hours, and a reflection on what you learned is worth keeping in your record either way.
From the letter to a certificate: five steps
- Get advice. Speak to your employer's designated contact, check whether your employer's insurance covers regulatory proceedings, and consider a lawyer for anything that could lead to suspension or cancellation.
- Match the concern. Pick two to four courses from the groups above alongside the core set.
- Study at your own pace. Nobody is told you have enrolled.
- Write the reflection. Link each course to the incident and to what you now do on every shift.
- Use it through the right channel. Your adviser or nurse manager can help decide what to include with your response.
Looking after yourself during an investigation
- National mindline 1771: call 1771, WhatsApp +65 6669 1771 or use the webchat at mindline.sg, any time.
- Your staff health or employee assistance service, if your employer has one.
- Your own doctor, especially if sleep, mood or stress is affecting your work. Seeking help early protects you and your patients.
- A trusted senior colleague or your professional association to talk through the clinical side.
Start your remediation set
Begin with Ethics for Nurses and Midwives and Professional Standards for Nurses and Midwives, then add the courses for your concern.
Questions
My hospital is investigating me. Has the SNB been told?
Not necessarily. Many concerns are dealt with within the employer's own process. An employer may refer a matter to the Board, and the Board may ask for its findings, so treat your internal statement as if it could be read later. Ask your nurse manager or HR what the policy says about referral.
Which courses should an enrolled nurse take after a medication error?
Start with Professional Standards for Nurses and Midwives, Medication Safety and Error Prevention, Human Factors and Patient Safety and Preventing Recurrence. Add Insight if you are writing a statement. Your reflection should name the check that was missed and the habit that now replaces it.
Who decides the outcome of an SNB complaint?
A Complaints Committee investigates and reports with recommendations, and the Board decides. The Board's orders range from a written warning or censure to a penalty of up to S$2,000, conditions, suspension of up to two years, or cancellation.
Can I appeal against an SNB decision?
Yes. A person aggrieved by the Board's decision may appeal to the High Court within three months, or a longer period the court allows. The High Court's decision is final. Take legal advice early, because the time limit is strict.
Will these courses count towards my CPE points?
We do not claim any CPE point value. The SNB sets annual expectations of 15 points for registered nurses, 10 for enrolled nurses and single-register midwives and 30 for APNs. Your certificate records the study hours so you can note the learning in your own record.
I am an APN. Is the process different for me?
The complaint goes through the same Board process, but the Board can deal with your APN certification separately, for example by suspending it or adding conditions while leaving your registered nurse registration in place. Concerns about prescribing or expanded roles often benefit from the scope of practice and prescribing courses.
The family complained about my attitude, not my care. Is that serious?
It can be. The Code expects respect for patients and families, and complaints about manner usually reflect how safe and listened-to people felt. Take Effective Communication with Patients and Families and Rebuilding Trust After a Complaint, and reflect on the specific exchange.
I was short-staffed when the incident happened. Should I say so?
Yes, accurately and without using it as an excuse. Committees understand that system factors contribute. What they also want to see is that you accept your own part and have changed what you can control.
Can I keep working while the SNB investigates?
An open complaint does not by itself stop you working. Your employer may restrict your duties for its own process, and the Board can impose conditions. Follow any restriction precisely and keep a record that you have done so.
Should I contact the family to apologise?
An apology is often appropriate, but once a formal complaint is open, do it through your employer's process or with advice, not privately. An unplanned contact can be misread. The open disclosure course explains how to apologise well.
Are these courses suitable for nurses trained outside Singapore?
Yes. They explain the Code for Nurses and Midwives, the SNB scope of practice, consent and capacity law and the PDPA in plain terms. Nurses new to Singapore often find family involvement in decisions and working with interpreters the most useful areas to study first.
How long should my reflection be?
Usually one to two pages for each concern: what happened, what you understand now about its effect, what you learned from the course, and what you now do differently. Keep patient details out and make sure it matches the records.
Official sources
Checked October 2026. Rules and processes change, so confirm the current position with the official source. This page is general information, not legal advice.
- SNB: Complaints
- Nurses and Midwives Act 1999 (Singapore Statutes Online)
- SNB: Code for Nurses and Midwives
- SNB: Revised scope of practice and core competencies
- SNB: Renewal of APN practising certificate
- SNB: Mandatory CPE for practising certificate renewal
- MOH: National Guidelines on High Alert Medications (2021)
- MOH: National mindline 1771
- MOH: Healthcare professionals regulation
- SNB: Continuing professional education for nurses and midwives
- MOH: Phase 3 implementation of the Healthcare Services Act
How these courses are built
Official sources only
Every legal and regulatory point comes from primary sources: the Acts that set up each professional board, the boards' own codes and guidance, and the Ministry of Health. Anything we cannot confirm is left out.
Original, edition by edition
Lessons, scenarios and assessment questions are written by us for each edition separately, then checked for accuracy, teaching quality and fair assessment before publication.
Reviewed when rules change
When a code, standard or law changes, the affected courses are reviewed and updated. Reported errors in legal or regulatory facts are corrected first.