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Sara Howard, PHC RIS
If the general practice workforce is to effectively manage the increasing demands that an ageing population place on it, then the involvement of other health professionals in primary health care delivery, such as practice nurses, is crucial. The Practice Nursing in Australia report documents the development of practice nursing in Australian general practice as well as identifying potential obstacles that could restrict the extended application of practice nurses in this context.
Compared to the United Kingdom and New Zealand, the specialisation of nurses into general practice nursing in Australia is in its infancy. Following on from this, it is only recently that practice nursing has been recognised as a career in its own right, requiring special skills, training and education. In recent years, the Australian Government has promoted the practice nurse profession by implementing several strategies to improve general practice engagement with practice nurses (eg. Nursing in General Practice Initiative, Medical Benefits Schedule items for practice nurses).
However, widespread acceptance of practice nurse employment appears to be largely contingent on clear role differentiation with general practitioners. For example, practice nurses are endorsed to carry out immunisation, wound care, and chronic disease management tasks but the suggestion to extend this to prescribing rights is decidedly less welcome. The latter is perceived to be associated with a bigger agenda - task substitution. The Australian Productivity Commission and the Australian Medical Association are at odds as to whether a redesign of job competencies will lead to more efficient and safer delivery of health care services. Other issues discussed which are believed to be hindering the broader use of practice nurses include: legal consequences (professional indemnity); workplace culture (traditional view that nurses are subservient to doctors); and funding (currently, unless through a fee-for-service system, nursing duties do not attract payment).
Reference
Jolly R. (2007, 17 September 2007). Practice Nursing in Australia . Research Paper no. 10 2007-08. Canberra: Parliamentary Library, Parliament of Australia. Retrieved 15 October, 2007, from <www.aph.gov.au/library/pubs/RP/2007-08/08RP10.htm>
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