Can a clinic hire an ANM? Nurse registration in a small clinic What the Indian Nursing Council Act, 1947 and the NNMC Act, 2023 say about who may work as a nurse, and what the clinic must check.

A clinic may hire a nurse or an ANM, provided she holds a qualification recognised by the Indian Nursing Council and is enrolled in the state nursing register, and provided she works under the doctor's supervision within the scope her qualification carries. The clinic's part is to see the registration certificate before the first shift, write the duties down, and keep every prescription in the registered medical practitioner's name. This post covers the registration law and what to put in writing; it does not list clinical procedures, because the law does not, and the state council and the training syllabus do.

Which law governs nurse registration in 2026?

The Indian Nursing Council Act, 1947 still does, with the National Nursing and Midwifery Commission Act, 2023 waiting in the wings. The 2023 Act was published in the Gazette of India on 12 August 2023 as Act No. 26 of 2023, and section 1(2) says it "shall come into force on such date as the Central Government may, by notification in the Official Gazette, appoint; and different dates may be appointed for different provisions of this Act". Section 56(1) repeals the 1947 Act and dissolves the Indian Nursing Council "with effect from such date as the Central Government may appoint in this behalf". Section 26 (licence to practise and enrolment) and section 27 (bar to practice) likewise operate only from the date notified for them. On 30 October 2026 the Indian Nursing Council's website still describes the Council as "constituted by the Central Government under section 3(1) of the Indian Nursing Council Act, 1947" and runs the Nurses Registration and Tracking System as "A Live Register of Nurses". Until a notification brings sections 26, 27 and 56 into force, a clinic reads the 1947 Act and the state Nurses Act.

What registration must a nurse or ANM have?

Enrolment in the State register under a recognised qualification. Section 2(d) of the 1947 Act defines the "State register" as "a register of nurses, midwives or health visitors maintained under the law of a State". Section 11(1)(a) says "any recognised qualification shall be a sufficient qualification for enrolment in any State register", and section 11(1)(b) that "no person shall ... be entitled to be enrolled in any State register as a nurse, midwife, auxiliary nurse-midwife, health visitor, or public health nurse unless he or she holds a recognised qualification". So the ANM, the GNM and the BSc nurse are all registered persons under the same Act, each under her own qualification, and the State register entry shows which.

Verify with the state council, not with the candidate's photocopy alone. Most state councils publish a search or verification page; the Indian Nursing Council's list of state councils is the index. Keep a copy of the certificate and the verification in the staff file with the appointment letter; our post on the employment contract for clinic staff covers the letter.

What may a nurse or ANM do in a small clinic, and what may she not?

The law we read does not list procedures. The 2023 Act, in its definition of a nursing associate, says such a person "provides care for the sick and injured including those in need of nursing care in varied health settings within his authorised scope of practice", and defines a nurse as one who "has completed a formally recognised programme of basic, generalised nursing education" and "demonstrates competency in the practice of nursing". The scope is set by the qualification, the Indian Nursing Council's syllabus for that course and the state council's rules, and it is narrower for an ANM than for a GNM or BSc nurse. The clinic does not widen it by writing a longer duty list.

What the clinic can and must settle is supervision and the line around the doctor's own acts. Regulation 6.4.2 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 permits "payment of salaries by a qualified physician to other duly qualified person rendering medical care under his supervision"; the words "duly qualified" and "under his supervision" are both conditions. Regulation 1.4.1 requires "every physician" to display his registration number "in all his prescriptions, certificates, money receipts given to his patients", so prescriptions and certificates are written and signed by the registered medical practitioner. A nurse's notes in the record are hers; the diagnosis, the prescription and the certificate are the doctor's.

• Write the duties from the qualification outward: what the ANM or GNM syllabus and the state council say she is trained for, and nothing the clinic would like her to do beyond it. If in doubt, ask the state nursing council in writing.
• Name the supervising doctor in the appointment letter and the hours the doctor is present. A nurse alone at the clinic with no doctor reachable is the situation the "under his supervision" condition exists to prevent.
• Keep prescribing, certifying and the clinical decision with the doctor. The nurse may record, prepare and carry out what the doctor has ordered within her scope; the record shows who ordered and who carried out.
• For any task the clinic is unsure about, read the Indian Nursing Council's syllabus for the course and ask the state council. Do not take the answer from a job portal or a vendor blog.

The employment side

A nurse or ANM on the clinic's rolls is an employee for every labour-law count: the state minimum wage order's category for the job (several states list nurses and compounders by name), the Shops Act leave, the appointment letter, and the ten- and twenty-head thresholds for ESI, gratuity and provident fund. Our posts on minimum wages for clinic staff and PF and ESI for small clinics have the figures. She also signs the same confidentiality undertaking and attends the same privacy briefing as the front desk, because she sees more of the record than they do.

If the clinic is run by a doctor who has only just registered, the question of what the clinic itself may do comes first; our post on whether an MBBS doctor can open a clinic covers registration of the doctor and the establishment.