Con­flict­ing rules ham­per role of nurse prac­ti­tion­ers

The Weekend Australian - Travel - - Health - Adam Cress­well Health ed­i­tor N

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

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