Conflicting rules hamper role of nurse practitioners
URSE practitioners — an advanced type of nurse qualified to diagnose illness and prescribe drugs — are being held back by discordant state and federal laws, new research has found.
While state legislation authorising nurse practitioners specifically allows them to prescribe drugs and refer patients for tests or to receive specialist assessment, these rights are not recognised under federal laws.
The lead author of the latest study, professor Glenn Gardner from Queensland University of Technology’s Institute of Health and Biomedical Innovation, said as at September last year there were just 238 nurse practitioners in Australia, although that number would have since risen slightly as newer graduates had received their qualifications.
However, the lack of a harmonised legal framework meant that number was growing much more slowly than the demand for their services might otherwise warrant.
The study — the first phase of the threeyear research project funded by the Australian Research Council — surveyed all nurse practitioners in the country, and achieved a 90 per cent response rate.
Two-thirds said their role was limited’’ by the misaligned laws.
The nurse practitioners are reporting that — although they are employed to reduce pressure on health care systems and waiting lists, in emergency departments and community clinics — they can’t fully function in this role that they are legally set up to perform,’’ Gardner said. There needs to be better policy consistency between the states and the commonwealth, so nurse practitioners are able to practise according to their scope.’’
In practical terms, the lack of legal harmonisation means that while a nurse practitioner is permitted under state law to prescribe a drug for a patient, the script will not be eligible for a Pharmaceutical Benefits Scheme subsidy, as the PBS falls under commonwealth legislation, which does not recognise the nurse practitioner role.
As a result, the patient bearing a nurse practitioner’s script would have to pay the full cost of the drug at the chemist’s counter.
Likewise, if a nurse practitioner refers a patient for X-ray or blood test, or to a specialist, those referrals are not recognised by Medicare — again a federal area of responsibility — because no nurse practitioner has a Medicare provider number.
In such a case, a patient referred for a test would have to pay the full cost of that test. If referred for a specialist’s assessment, the consultation would qualify only as an Continued inside - Page 19