Australian College of Nursing has developed an updated handbook titled Nursing in General Practice to reflect the ongoing development of roles of registered and enrolled nurses in general practice, as well as changes to the funding mechanisms available.
The handbook covers 6 sections as outlined below:
1. Nurses in General Practice
- Registered nurses (RNs) have a Bachelor of Nursing degree, provide evidence-based nursing care from care planning to delivery and evaluation.
- Enrolled nurses (ENs) have graduated from the Diploma of Nursing, with core responsibilities are assisting the RN with the delivery of nursing care and providing support and comfort to patients.
- Nurse practitioners (NPs) are highly experienced registered nurses who have completed post-graduate education and extensive clinical training, authorised to function in an advanced and extended clinical role.
- An enrolled nurse work under the direction of a registered nurse – it is not acceptable for other health practitioners to provide clinical supervision for ENs
- Nurses’ roles including provision and coordination of clinical care, management of clinical care systems, collaborative practice, and professional practice.
- Patients may not be aware of a nurse’s scope of practice or how nurses can assist them in achieving health outcomes. This perception can be improved by discussing their roles and providing written information.
2. Professional Accountability
- The Nursing and Midwifery Board of Australia defines a nurse’s scope of practice as “the full spectrum of roles, functions, responsibilities, activities and decision-making capacity that individuals within that profession are educated, competent and authorised to perform”. Nurses have to meet Continuing Professional Development (CPD) requirements as it is essential to maintain quality practice and registration as a nurse.
- Nurses in general practice have a right to work in health and safe environment, while also ensuring practise’s work health and safety policy. They have a responsibility to maintain a healthy workplace for others, managing documentation, using social media responsibly, adhere to open disclosure and confidentiality.
3. Opportunities in General Practice
- Nurses in general practice can be employed in specialist roles as clinical nurse specialists (CNS), clinical nurse consultants (CNC) or nurse practitioners (NP). Such specialist roles may be known as nurse immunisers, mental health nurses, diabetes nurse educators and in a much wider range of specialist roles, like providing sexual and reproductive health care.
- Nurses can be the primary provider of care for the patient in nurse clinics, where they have their own patient loads and operate within a collaborative model of care. Nurses can provide outreach services to patients in their homes, community settings, or aged care facilities.
- Nurse practitioners commonly specialise in caring for certain patient groups or providing specialist care in one area of nursing practice. Their roles including generalist nurse practitioners, wound management nurse practitioners, women’s health nurse practitioner, and aged care nurse practitioner
4. Positive Practice Environments
- Working in a collaborative practice as an approach to health care delivery, which emphasises interdisciplinary teamwork.
- The translation of evidence-based practice and nurse-led research.
- Having concrete support to develop leadership skills, provided with teaching, mentoring, and opportunity to undertake higher education and qualifications.
- Workplace culture that can support wellbeing at work and opportunities to develop professionally in career progression.
5. Maximising Practice Benefits
- Practice Nurse Incentive Program (PNIP) payments for activities including immunisation, wound management, preventative health programs, supporting self-care and self-management
- Coordinated Veterans’ Care Program – a focus on Gold Card holders who have chronic conditions and complex care needs and are often at risk of unplanned hospitalisation
- Medicare Benefits Schedule items for nurses
- Nurse practitioners can access specific items in the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS) as they are not eligible to participate in the PNIP
6. Human Resources
- Support to develop roles and responsibilities over time are important to ensure job satisfaction in general practice. Nurses who are not covered by an Enterprise Agreement protected by the safety net of wages and conditions which establishes the minimum rates of pay and conditions.
- In recruitment and induction, employers should determine which type of nurses would fit into the position, and whether the role require the skills of a nurse expertise or post-graduate qualifications.
- Regular performance reviews ensure that nurses meet the objectives of their role and performance standards. Reviews also provide an opportunity for nurses and employers to set goals, identify opportunities to improve nursing services within the practice and discuss the nurse’s professional development needs.
The guide also includes an employer’s checklist, which simplifies the process of recruitment and induction.
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