The Independent Weekly
DANIELLE FORSYTH
05 Feb, 2010 12:19 PM

Calls for the next state government to expand the number and role of nurse practitioners to improve an overburdened health system have coincided with an interstate debate on independence for the specialist nurses.
The Australian Nursing Federation wants independent nurse clinics established if an agreement cannot be reached with local general practices.

The AMA and Royal Australian College of General Practitioners strongly oppose a plan in the ACT for nurse practitioners, who are highly trained and specialised nurses, to operate independently at pharmacies.

Professor Nigel Stocks, chair of the college's SA and NT faculty, said the state should be wary of changes to the general practitioner system.

"General practice has served Australia well for more than 50 years and we have a very good health system in Australia with very good health outcomes," he said.

"That's not to say that things could not be improved, but the basis for our success is in primary care - that is, GPs."

A member of the Australian College of Nurse Practitioners board and a nurse practitioner at Queen Elizabeth Hospital, Cassandra Ryan said her colleagues relieved over-worked doctors.

"We're saying the doctors are unable to cope with the increasing burden and we are willing to step up to the plate and help with that burden," she said.

In the emergency department where she works, Ms Ryan said nurse practitioners often cared for of patients who had been unable to make an appointment with their local GP.

The success of nurse practitioners in decreasing waiting times has prompted the nursing federation's SA branch to call for nurse practitioner clinics here.

The ANF also recommends round-the-clock nurse practitioners in hospital emergency departments.

SA branch secretary Elizabeth Dabars said nurse-run clinics were popular and useful in the UK and Canada.

"There is a chronic underuse and failure to recognise the value of nurse practitioners in SA," she said.

"There have been some groups that have made outlandish claims about safety being compromised (under nurse practitioner care), but there is no evidence to suggest that is the case."

Ms Dabars said nurse practitioners are "maxi-nurses not mini-doctors" and always knew when to refer patients who had problems outside their area of expertise.

"Absolutely, unequivocally, SA would benefit no end to better support and better enabled advanced practitioners," she said.

"Nurse-run clinics give people choice and access to services that are safe and are effective."

Professor Stocks said a concern with nurse practitioners was a disruption in the continuity of care, with patients potentially having to see a different person for each ailment.

However, Ms Ryan says the structure of many metropolitan GP centres mean patients often see a different doctor each visit.

RACGP president Dr Chris Mitchell has said he supports an expanded role for nurse practitioners within general practice, but not the concept of a parallel and independent service.

Professor Stocks said the college's opposition to the nurse practitioner plan was not about protecting jobs.

"It's not protective when we have the best interest of the patients and our communities at heart."

There are 31 nurse practitioners in SA, but the ANF has requested scholarships provide for 100 candidates a year for the next four years.