But don’t expect them to be a-knocking at the practice door tomorrow.
Registered nurses can now train for a prescriber endorsement to be added to their registration, but it’s unlikely that general practice will see any immediate change.
While the endorsement is technically in effect from today, only nurses who have completed an approved program of study can apply; there are currently no approved programs of study.
The first cohort of graduates is not expected until at least mid-2026.
Given the larger scale and established clinical governance protocol, AMA president Dr Danielle McMullen said big public hospitals would likely be the first settings to allow RN prescribers.
“[Larger hospitals] already have things like nurse-initiated medicines, where the rollout may feel more familiar,” she told The Medical Republic.
“For a GP audience – [while] I do expect it’s likely to be some time before we see this entering into private practice – we need to be preparing for it, and having a think about how and where our practice nurses could work together [with doctors] … on some delegated prescribing.”
In a similar manner to the previous settings applied to nurse practitioners and the PBS, RN prescribers will only be allowed to prescribe in partnership with an authorised health practitioner under a clinical governance framework.
“The real difference … between this and, say, pharmacy prescribing … is that this one is a delegated model where there’s a requirement for an ongoing, formal agreement between the RN prescriber and an authorised prescriber,” Dr McMullen said.
“It’s better at promoting comprehensive team-based care and collaborative care.”
Only nurses with at least three years’ full-time clinical experience who have completed an approved postgraduate qualification can apply for the endorsement.
“The scope of prescribing will align with each RN’s role, the clinical governance framework, the prescribing agreement, and relevant state and territory medicines legislation,” AHPRA said.
“Once endorsed, designated RN prescribers must also complete a six-month period of clinical mentorship with an authorised health practitioner.”
An authorised health practitioner is defined in the registration standard as an “authorised autonomous prescriber, for example a medical practitioner or nurse practitioner”.
Dr McMullen said the AMA was seeking clarity on whether this definition may ever include providers like pharmacists.
“We have again strongly advocated that it should only be a medical practitioner or a nurse practitioner who has got significant experience in prescribing in the Australian context,” she said.
“And yet, in the past few days as this has rolled out, there seems to be a bit of a lack of clarity as to whether other allied health [workers] with prescribing rights or pharmacists can – or could in future – be authorised prescribers.
“That’s not what we think the intent of these changes [is].”
The RN prescribing endorsement extends to schedule 2, 3, 4 and 8 medicines; Dr McMullen said the AMA continued to advocate against the inclusion of s8 medicines.
Australian Primary Health Care Nurses Association president Denise Lyons told TMR that the benefits of RN prescribers in primary care went beyond a general practice setting.
“You can imagine the implications if you have nurses in schools, in prisons and in community health, who have undergone extensive and thorough training to be able to provide prescriptions,” she said.
Ms Lyons anticipated widespread community demand for RN prescribing.
“Community access to prescription medicines can be improved, as long as we get the safeguards right,” she said.
“Just because those structures are partially already in place, it’d probably be easier to bring it into hospitals … but … it’s confusing to [the community], right?
“How can a nurse in hospital do this thing, but then a nurse I see at my general practice can’t do that.
“I think that hopefully people will say, ‘Can you do this? And why not?’ And that will hopefully drive some of that change forward.”
