Federal health minister Mark Butler has assured nurses that increasing scope of practice is on his agenda.
The federal health minister has recommitted to increasing registered nurse scope of practice, just as the peak body for practice nurses warns that nurses who feel underutilised are more likely to leave the workforce.
According to the Australian Primary Health Care Nurses Association workforce report, released on Thursday, nurses who rarely worked to what they felt was the top of their scope of practice were 59% more likely than their peers to report high levels of burnout.
APNA president Dr Stephen Duns told The Medical Republic a core reason for burnout went back to why people chose nursing as a profession in the first place.
“Nurses become nurses … [to] support people to be healthier, and so if they’re doing work that is not really relevant to supporting people to be healthier, they get stressed and burned out because they’re sort of wasting their time,” he said.
“It’s a sense of meaninglessness as opposed to meaningfulness.”
And it appears that nurses will not be waiting long for reform.
Speaking at the Australian College of Nursing parliamentary breakfast in Canberra this morning, Mark Butler assured nurses that the scope of practice report had not been forgotten.
“In primary care settings in particular, there are great opportunities to expand the work of [registered nurses],” he said.
“I’ve been pretty frank with the college and with the Primary Care Nurses Association, with the union, but also with doctors’ groups – particularly the College of GPs – about opportunities there.
“I think there’s much more shared acceptance of those opportunities across the sector.”
Mr Butler also listed some “niche areas” he would be exploring.
“[Registered nurses] can do x-rays in some areas outside of major cities, but even though there’s a crying need for that in urgent care clinics, for example, on the weekends, [they are] not able to do it in cities.
“Maybe that’s something we should be talking about as well. There’s a lot of work in the scope of practice report.
“There’s a lot of opportunity for GPs to lift the use of their scope, which is a little bit tempered by the work that non-GP specialists reserve to themselves.
“There’s a lot to go around there. But please, please take it that we’re very committed to continuing to expand the opportunities for nurses to work to the top of their scope of practice.”
Around 70% of the 2200 nurses surveyed for the APNA report said they regularly or often worked to their full scope.
Roughly half worked in a GP setting, with the balance distributed across community health, aged care and workplaces.
Close to 40% of the nurses working in community health or aged care reported “regularly” working to full scope; general practice was close behind, at 35%.
Less than one third of the nurses working in Aboriginal Community Controlled Health Organisations said they were regularly working to full scope, and nurses in institutional or workplace settings were the least likely to say they regularly worked to full scope.
Three quarters of respondents working in general practice said that multidisciplinary care planning and delivery was supported in their workplace.
Job satisfaction across all primary care nurses was relatively high across all domains except recognition and remuneration.
“Medicare billing … disincentivises nurses being anything but doctors’ assistants,” one respondent wrote.
“I have the qualifications and skills but because I technically need supervision and a doctor needs to see the patient, they do not see the point of nurses taking up more advanced practice roles.”
Related
Dr Duns acknowledged that the current Medicare settings, which primarily fund practice nurses via the Workforce Incentive Payment, “don’t make it … easy” to utilise nursing staff to their full scope, but said it was possible.
“The reality is, [care is] at least as safe [as general practice] with nurse delivered clinics,” he said.
“We’ve now, for over a decade, been supporting nurses to lead chronic disease management clinics and the depth of evidence is very clear that it is equally as safe for a nurse to lead those.”
In multidisciplinary clinics, Dr Duns said, nurses complement doctors rather than compete with them.
Nurses in general practice reported the lowest levels of burnout and stress, while those working in aged care reported the highest.
Responding to Mr Butler’s commitment this morning, Australian College of Nursing chief nursing officer Frances Rice said the workforce looked forward to continuing to work with the government.
“Australia’s half a million nurses are ready and capable to do more, and enabling them to work to the top of their scope will deliver real benefits for patients, particularly in primary care and rural and regional communities,” she said.
