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ACNP President Leanne Boase . Picture : Supplied
“ I think we ’ re still very much seen as a subservient profession .
Out in the cold
Nurse practitioners left out by ‘ medico-centric ’ health department .
By Conor Burke
Nurse practitioners are calling on the federal government to stop ignoring them and make use of a valuable resource to help fight the pandemic .
As the vaccine rollout continues to become unbearably complicated , the Australian College of Nurse Practitioners ( ACNP ) and its President , Leanne Boase , say that they should be included in the planning of COVID-19 responses .
“ We are not at the table that really counts , where there ’ s discussions within the department or with the Minister for Health to talk about how services are delivered , or how care should be delivered , or those big decision-making groups ,” Boase told Nursing Review .
“ It seems to be the Department of Health , the AMA , the RACGP and the Minister , and the Chief Medical Officers ... it seems to be them that are driving all of this . And nurses in general and nurse practitioners are not generally at those tables .”
Boase says that having nurses involved at a policy level is imperative when planning any health response . She points to the issue surrounding NPs administering the COVID-19 vaccine as a problem which could be solved with their input .
Nurse practitioners are currently only able to administer the vaccine if supervised by a general practitioner or “ suitably qualified health professional ”.
Additionally , NPs working outside the public health system are not covered by the Medicare Benefits Schedule ( MBS ) for the vaccines , and therefore will not have access to a rebate .
In some regional and remote areas there is often only a NP available , including in clinics where there is only a GP for very short periods of time , further slowing down any access to vaccines in those areas .
Additionally , these provisions prevent NPs from being able to deliver vaccines in aged care facilities unless engaged by the states , who rarely get involved in aged care .
Boase points to an example of a NP-owned and operated clinic in a rural town with thousands of patients on the books and which is the only health provider for several towns in the area . The NP is currently approved for government-funded vaccines , meaning that they can order and administer all of the childhood vaccines under the program . They also meet all the requirements for storage in cold chain . She currently visits aged care , but is not able to deliver the COVID vaccine .
Boase says that because of this , “ somebody is going to have to send a team out to rural Victoria and South Australia because [ that NP ] is not allowed to do it ”.
“ We do have the legal authority to prescribe [ the COVID vaccine ],” Boase says . “ We also have the qualifications to administer it and manage any reactions . But it ’ s the federal response we ’ ve been excluded from .
“ And it ’ s not just that we can ’ t claim that Medicare rebate , we ’ ve been told that a Medicare-specific COVID vaccine Medicare rebate must be claimed every time it ’ s given in primary care . And because we ’ ve been excluded from it we ’ re blocked in both directions .”
Boase believes that the federal government and its state counterparts have not adequately activated the nursing workforce during the vaccine rollout , in particular the approximately 2200 NPs who have a high level of skill and training .
“ Nurse practitioners have done their qualifications . So , it ’ s not just a piece of paper ; we have to actually jump through hoops of experience and advanced level experience before we can even get into the nurse practitioner masters . So these are the people you want out there doing [ vaccinations ].”
There are around 450,000 registered nurses and midwives in Australia , making it the largest clinical workforce in the country , but Boase , along with her counterparts at the ANMF , APNA and the ACN , consistently call for greater input at a policy level .
The ACNP has sent a letter to Lt General John Frewen , the Commander Defence COVID-19 Task Force to detail their concerns . They have yet to hear back .
“ We ’ ve got a well-established medical profession and sitting alongside that the nursing profession developed so significantly in the last 50 years , it has come an awful long way ,” Boase says .
“ My theory is the government hasn ’ t moved with that . The Department of Health is still very medico-centric . All of our policies very medic-centric .
“ But here we are now seeing the effects of it , and I think we ’ re still very much seen as a subservient profession .
“ At this point , I do have to say , it feels a lot like hitting your head against a brick wall .
“ Unless someone stands up and puts an end to this , it ’ s going to continue to hold back our health response in this country .” ■
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