STEPHEN CENATIEMPO: This week, the final report of what’s called the Unleashing the Potential of Our Health Workforce – Scope of Practice Review was released by the Health Minister Mark Butler, and look, it seems to be mixed reviews to it. The Australian College of General Practitioners say that some of the recommendations could make it harder to get people into a GP office, while the Australian College of Nursing has welcomed the findings and recommendations of this report. Karen Grace is the National Director Professional Practice at the Australian College of Nursing. Karen, good morning.
KAREN GRACE: Morning, Stephen.
STEPHEN CENATIEMPO: What – so, tell us what’s good about this before I get into it. And there’s always a stoush between nurses and doctors over this kind of stuff, and I never understand why you guys can’t get on the same page, but what’s, what are the benefits of this so far?
KAREN GRACE: Well, we’ve been saying for a while at the College that some serious reform is required if we’re going to be able to meet the ever increasing healthcare needs of our community across Australia. And what this report does is it actually provides us with a blueprint for what we believe is very much needed and that is genuine reform to the healthcare system. And it looks at it from a system lens, so considers what we need to do in terms of educating each of the health professions about each other’s scope, as well as the community about what all health professionals are capable of. At the same time, it talks about funding models, being more flexible in order to introduce more innovative models of care, and then it also talks about what we need to do from a regulatory and legislative perspective to enable that.
STEPHEN CENATIEMPO: So, in a nutshell, if I – to put it in layman’s terms, what the College has always been at is that nurses are capable of doing a lot more than they are, and if we give them the flexibility to do that, we can take pressure off other parts of the health system. And if we change the funding models, they can actually do it autonomously, for lack of a better way of putting it.
KAREN GRACE: Absolutely spot on and safely, because the regulation will support that.
STEPHEN CENATIEMPO: So, I’ve always said, you know, we hear from the GPs all the time that there’s not enough GPs, they’re short of resources, they’re overworked. Why are they so reluctant to let your members take some of the pressure off them?
KAREN GRACE: Well, I think fundamentally it comes back to some of the initial recommendations in the report around how well we understand what each other do. And I think we need to learn together more. This report recommends interdisciplinary training and learning and I think that would help all of us actually to get a better understanding. But I think in terms of general practice, they’re concerned that their coordination of care role will change. We don’t see that that’s the case. We see that the nursing role is very much complementary to the role that general practice, general practitioners play, and that role is not replaceable and shouldn’t be, and we have no desire to substitute general practice, but we believe we can provide better care to the general community within our scope, in models that work with general practice.
STEPHEN CENATIEMPO: Do you understand the frustration of the average Australian out there who says, how is it that doctors and nurses don’t know what each other do?
KAREN GRACE: Yeah, I think definitely at a sort of fairly high level. And I think it goes to the report in terms of we’re talking about advanced scope, we’re talking about additional skills and qualifications. The report says very clearly that the minimum standard regulation for health professionals in this country is sound. What we’re advocating for is where nurses have done advanced training, where they do have advanced skills, that there is a regulatory framework and a funding model that actually enables them to use them. And I think that’s where we’re not necessarily on the same page. And I think in order to do that we’ve got to work together differently and change is never easy for anybody.
STEPHEN CENATIEMPO: So, Karen, are we talking mostly about nurse practitioners as opposed to nurses? And I don’t want to use the word standard because that’s not what I mean here, but nurse practitioners do have a higher level of training. So, is that what we’re talking about, opening that scope up?
KAREN GRACE: Not necessarily, because nurse practitioners have an advanced scope and are registered to a higher scope than a registered nurse. But there are many, many registered nurses working, particularly in primary care settings and in regional and rural Australia, where they are able to do, provide care that is beyond what some other registered nurses are able to do because have the appropriate skills and education, and they’ve undertaken competency based assessments to demonstrate that they are safe.
STEPHEN CENATIEMPO: So, give us a common example of where that might actually manifest itself.
KAREN GRACE: So, if we think about the assessments that are required in regional settings, for example, where the nurse is working in a primary care setting, there are going to be occasions where they’re going to have to do a full assessment of the patient and be able to make some decisions about what’s required and administer IV fluids, for example, if somebody is severely dehydrated. So, there’s a fairly simple example, but that isn’t possible in every setting at the moment.
STEPHEN CENATIEMPO: Yeah, see, to me it sounds like a no brainer and I never understand why the GPs get their back up about this stuff. Karen, I think this is a good move forward. But what happens now? Now that this report’s been handed down, I guess the government’s got to accept the recommendations, don’t they?
KAREN GRACE: Yeah, they do and we’ve been really happy with the government’s response. Actually their initial response and Minister Butler’s speech yesterday was very supportive of the recommendations. We are heading into an election next year. So, we would call on both sides of government to really consider this report very seriously when it comes to election commitments and setting policy direction for the new term of government next year, the timing is actually spot on, in my view.
STEPHEN CENATIEMPO: Well, let’s hope that you get the result you want, Karen, because I think it’s, as I say, I think it’s a no brainer. Thanks for your time this morning.
KAREN GRACE: Thank you.
media-transcript-scope-of-practice-national-director-professional-practice-karen-grace.pdf (180KB, PDF)
