Australia is currently in the grips of a healthcare crisis. Ageing workforces, increasing demands of an ageing population and increasingly diverse treatments and disease processes, are draining the already stretched public healthcare systems of Australia. The current systems of healthcare delivery need to evolve to meet the increasing demands from the society they serve. They need to be flexible and organic in nature to suit the ever changing healthcare environment.
Nurse practitioners are in an extremely fortunate position, as they are able to offer expert clinical skills which focus on client needs. Worldwide literature suggests that nurse practitioners are able to offer quality care, delivered within a multidisciplinary framework of practice, which complements other healthcare providers and allows seamless approaches to healthcare provision.
Canada has spent $8.9 million in a visionary bid to its health systems, and is optimising the use of nurse practitioners as essential providers of quality care in areas which are not adequately serviced by medical staff (Canadian Nurse Practitioner Initiative 2005).
Nurse Practitioners are able to diagnose, prescribe certain medications and work within an extended scope of practice which allows them to provide holistic, quality care and negotiate a seamless pathway through the health system for their patients.
They work in a variety of rural and remote settings, as well as in the mainstream city hospitals, to meet both patient and service demands. This is particularly important as they deliver expert nursing care which is both cost effective and is able to reach those in need. It is purely for this reason we have seen a proliferation of roles for nurse practitioners worldwide.
On the Indigenous, rural and remote front, current services do not stretch to meet the unique requirements of these populations. Australia’s shameful healthcare statistics for Aboriginal health reflect these inadequate services. Life expectancy for Aboriginal people is estimated to be 59.4 years for males, and 64.8 years for females. This is startling in comparison to the fact that non-Indigenous males are expected to live a further 17 years (ABS 2005).
The mortality rates for Indigenous infants are three times higher than non-Indigenous infants. Australia can no longer afford to continue losing its Indigenous children in this way. Aboriginal people are twice as likely to be referred late for treatment of chronic diseases, and this in itself, increases their mortality risk by up to 50 per cent.
In contrast to the general medical workforce, which is seeing a significant decrease in numbers, nurse practitioners are increasing in numbers and are willing to work in geographic and clinically challenging areas that are often inadequately serviced by doctors.
Through identifying these issues, it becomes evident we need to be more creative in our approach to healthcare. There are many talented healthcare personnel who can be utilised to fulfill their potential.
Nurse practitioners must possess a Masters degree to register with their nursing boards and many more have existing doctoral qualifications. Most have spent a significant number of years as senior nursing staff within their chosen specialty.
They negotiate patients through specific care pathways and can offer longer consultation times; they are more accessible, and know when to refer the patient to a doctor when the established limitations of their role is reached.
A healthcare staffing evolution which enables all workers to adopt more flexible and innovative methods of working, will hopefully serve to meet the public demand for quality care, as well as the service demands for clinical efficiency and cost effectiveness.
The new governing bodies need to be more creative in their thinking, and determine how best to utilise talented health care providers to their full potential. Changes are required to produce a sustainable and responsive workforce which will overcome the current systems of fragmented service delivery. Nurse practitioners are a fundamental component to this staffing revolution.
The article is based on a paper presented at the recent 3rd International Congress on Innovations in Nursing 2007 held in Perth.
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