The Role Of Nurse Practitioners In Australia
A Nurse Practitioner is a nurse who has been registered after having completed an advanced education in nursing (usually a degree or a doctorate) and training in the management and diagnosis of both complex and common medical conditions. These Nurse Practitioners are often licensed through the nursing boards rather than the doctor medical boards (Duffy 1999). Further more Nurse Practitioners have advanced their knowledge and skill to include traditional medical practices performed by early health professionals such as ordering diagnostic tests and prescribing medication. In Australia they are licensed by the Australian Board of Nursing.
Generally, the work of Nursing Practioners is to provide a range of medical and health care services. They provide support to the doctor team and treat both chronic and mild conditions by studying and understanding the medical history of their patients, physical exams and ordering therapies for their patience within the scope of medical practice (Hegney 1999).
In Australia the introduction of nurse practitioners has taken some time and the planning of the introduction has involved many groups of people such as; doctors, consumers, educators and nurses. The state government has carefully carried out pilot programs and trials to try and ensure that the services provided by meet the community’s expectations, are safe for consumption and the services are effective. The medical workforce shortage in Australia has been a major concern since the 90s. Recently, it is acknowledged that the shortage has extended throughout the health professions. The Productivity Commission released a report in 2005 that indicated that the situation needed to be solved urgently. They recommended a multi-pronged approach that was to be implemented nationally. The approach was to ease the structural pressures the health system was facing. This was cost by a mutating mix of diseases, ageing of the population, rising expectations of patients, various technological advances and the deteriorating health of the nations workforce. The Commission suggested the participation of workforce in the health planning process and the integration of new care models.
The analysis of literature in Australia and overseas revealed several models of practice: the doctor, the doctor assistant and the practitioner and the practitioner led by needs (responding to the various needs of the community). The first two professionals are based on a framework of medical care. The last two depict an expansion of the nursing framework focusing on the provision of services to meet the needs of the community (Philips 2006).
Since 1992, specifically New South Wales in Australia has been taking seriously the role of Nursing Practitioners role and had commenced the ten pioneer projects starting with remote and rural areas. The specific areas to be examined where competencies, diagnostic pathology, accountability, referral procedures, diagnostic imaging and prescription of medications. The research from these ten pilot projects revealed that Nurse Practitioners were safe, feasible and efficient in providing health care services to the general public. Access to health services by patients was improved and the expectations of the patients were satisfied (Association for Australian Rural Nurses 2000). On the other hand in Victoria- another state in Australia the development of the role of Nurse Practitioner has been in progress. In 1999, a task force from the ministry proposed a model on Nurse Practitioner for Victoria. Consequently eight pilot projects were set into motion. In Victoria the education level of masters is favored currently and it is likely that there would not be any restrictions to the number of Nurse Practitioners in the registrations on the specific areas where they might practice (Percival 1999). March 2000 saw the beginning of the Victorian Nurse Practitioner Task Force which conducted a state wide evaluation. The outcomes provided input into for the discussions by the Department Human Services for the legislative framework for Nursing Practitioners (Harulow 2000).
The legislative restrictions that are currently related to medication initiations and diagnostic services are being minimized with adequate training and education with professional standards being maintained. According to the government officials under the Ministry of Health, Nurse Practitioners scope of practice should be defined by a credited clinical practice context sought out by clinical guidelines developed and proposed by the multi-disciplinary team (Percival 99) . For example, in New South Wales according to officials of the Ministry of Health accreditation criteria for a Nurse Practitioner and the principle of the creation of clinical guidelines have been approved and implemented (Australia Nursing Federation 2000).
In addition the New South Wales department has been applauded for the introduction of laws to protect the title of the Nurse Practitioners. With this effect in Australia selected qualified and registered nurses will access the clinical privileges enabling them to take full responsibility for the care and management of their respective patients (Gunny 1998). Furthermore in Australia the Registration Board of Nursed will control the accreditation of nursed and the reforms to the Poison and Therapeutic Goods Act, the Pharmacy Act and the Nurse’s Act will enable the Nurse Practitioners to practice (Duffy 1998).
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