Nurse practitioners ready for a bigger role in health system
Nurse practitioners may well be the answer to Australia’s health concerns.
For Australians to see the benefits of real and sustainable health reform there must be major reform to the way health services are funded and delivered. This means putting nursing and midwifery at the centre of decisions in health and health reform.
Vital to a full and effective utilisation of the nursing and midwifery workforce is the role of nurse practitioner, yet they are unable to operate to their full scope of practice due to current funding barriers.
Nurse practitioners are registered nurses and midwives with advanced educational preparation and experience who are authorised to practice in an expanded nursing role. There are currently around 300 nurse practitioners in Australia who can be found working in illness prevention, chronic disease management, aged care, emergency care, wound care, diabetes education, sexual health and rural health.
These nurses and midwives seek candidacy through the nursing regulatory authority in their state or territory and must undergo rigorous review to be authorised to practice as a nurse practitioner. Most have at least five years in their chosen area of practice post-registration and at least seven to nine years study, inclusive of masters-level university qualification.
Nurse practitioners have been shown to bring immense benefit to areas of need, improving quality of and accessibility to health care services for all Australians whether in rural and remote Australia or in residential aged care facility. The benefits they bring have been well documented across Australia and indeed throughout the world.
Programs like the Walwa Bush Nursing Clinic and the ACT aged care nurse practitioner pilot provide evidence that nurse practitioners offer health care efficiency and improve patient care outcomes.
The Alfred Hospital in Melbourne recently conducted a study that demonstrated nurse practitioners operating out of the emergency department had reduced waiting times, staff stress, and patient returns and improved patient outcomes and satisfaction.
Nurse practitioners bring greater efficiency and quality of patient care to Australia’s health system, but are severely limited in their practice because of outdated funding structures.
While nurse practitioners are authorised to refer patients to other health professionals and prescribe some medications, there is currently no mechanism that allows patients to claim any subsidy from the Pharmaceutical Benefits Scheme (PBS) or Medical Benefits Scheme (MBS), as is the case for medical practitioners.
This is a massive disincentive for patients who can be forced to pay hundreds of dollars more for prescriptions or medical tests when they are ordered by a nurse or midwife practitioner as opposed to a GP. Subsequently they are currently under-utilised and left feeling under-valued.
Unless the Federal Government gives the patients of nurse practitioners access to pharmaceutical rebates they will continue to be under-utilised to the detriment of all Australians.
In addition to the obvious benefits to health care consumers in Australia, the role of nurse practitioner offers experienced nurses greater access to career opportunities in clinical practice. Some nurses do not want to move out of clinical nursing into education or management.
The opportunity to become a nurse practitioner offers an incentive to remain in the profession whilst providing expert nursing care. The regulatory process must be reviewed to facilitate advanced practice by suitably qualified nurses and midwives and improve community access to care.
Now that the Federal Government has put health reform on the agenda the time is right to better utilise the expertise of these skilled practitioners, enabling greater access to and equity within the public health system and offering nurses and midwives greater opportunity for career development, encouraging them to stay or if they have left, to return to the profession.
Ged Kearney is the federal secretary of the Australian Nursing Federation.