Nurse practitioner busts prescribing myths

Leanne Boase

writer

Leanne Boase

CEO, Australian College of Nurse Practitioners (ACNP)

Leanne Boase

By Leanne Boase – CEO of the Australian College of Nurse Practitioners

CEO of the Australian College of Nurse Practitioners dispels misinformation about NP prescribing powers…

I read with great interest, the article published on the 6th April about NPs and endorsed midwives ‘independently prescribing’ and having an ‘expanded role’.

While I speak for nurse practitioners in my role as CEO of the Australian College of Nurse Practitioners, the draft laws tabled in parliament affect endorsed midwives in much the same way.

More accurately, I need to clearly state, these draft laws do not affect nurse practitioners and endorsed midwives directly. To understand this, we need to address some of the myths being perpetuated by some groups.

Myth No 1. – This increases prescribing rights

Nurse Practitioners and Endorsed Midwives prescribing is not governed by, or controlled by the PBS. Actually, this applies to all prescribers. The Pharmaceutical Benefits Scheme, or PBS, is in fact a scheme that allows people to receive a subsidy for a prescribed medicine.

Prescribing, and the scope of prescribing, is covered by legislation in each State and Territory, such as Drugs and Poisons Legislation. In most States and Territories, nurse practitioner prescribing rights allow broad prescribing across Schedule 4 and 8 medicines.

So, this draft law that relates to the PBS will not expand prescribing rights, it simply can’t. What it will do, is greatly reduce the number of private prescriptions being written for people who cannot afford them, and improve access to affordable health care – a big win for people who need health care.

Myth No 2. – Nurse Practitioners cannot work without ‘medical supervision’

Nurse Practitioners have always worked without medical supervision. This draft law simply removes the requirement for an agreement with a medical practitioner (who you do not even have to work with), to allow patients to claim their entitlements under PBS and MBS – another big win for people who need health care.

Myth No 3. – Nurse practitioners lack adequate training to prescribe

Nursing training prepares nurses for safe, evidence-based practice, and like other health care professionals, nurses continue their learning throughout their career. To become a NP, nurses must enter an approved Master’s program which focuses on diagnostics, assessment and prescribing across the lifespan, and meets accredited national standards. The prerequisite for the approved Master’s is a postgraduate diploma in a clinical nursing field, plus at least 2000 hours of advanced practice. Even after completing the Master’s program, they must provide additional evidence of advanced clinical decision-making and at least 5000 hours of advanced practice, rather than just evidence of specific skills. Nurses are not simply learning content: our clinical practice and education develops practitioners who not only provide safe and effective complex care, but also understand our health systems, and work collaboratively across health care teams.

Myth No 4. – Collaborative Arrangements kept people safe

The Collaborative Arrangements requirement has never been shown to add anything in regard to safe or quality health care, remembering that they relate solely to MBS and PBS access. Instead, they have been misunderstood, and in my experience, often intentionally. They have been used to exert some control over the practice of nurse practitioners in Australia, when in fact they do not relate at all to supervision or oversight.

The perception that nurse practitioners are a competitor to general practitioners and other medical care is without basis, but unfortunately drives a lot of hyperbole and fallacious dialogue. Unfortunately, this has driven a lot of opposition to the role, and quite successfully, influenced policy makers to the detriment of people trying to access health care.

As a health care professional, I welcome this time of change, let’s talk in real terms, base our arguments on fact, and most of all, we should put people first. Decades of building a health care system in the interests of health care professionals rather than better health has led us to this complex, competitive and inefficient system we have today.

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Leanne Boase

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Leanne Boase

CEO, Australian College of Nurse Practitioners (ACNP)

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