1. Preamble

General Practice Nurses are defined as those nurses employed to work within a general practice setting as a member of a general practice team.

The AMA does not support the "independent nurse practitioner" as reflected in the variety of State/Territory legislated roles for nurses where levels of independence remove the general practitioner as central to delivery of primary care.

General Practice Nurses (GPN) make a valuable contribution to the profession of general practice and, while their role is complementary to that of the general practitioner, it is integral and adds value to the delivery of primary health care services in the general practice setting.

Within a practice, a positive and constructive relationship with general practitioners, based on mutual professional respect, establishes a GPN as an indispensable member of the health care and administration team.

Where practices employ GPNs there is an agreed responsibility to assist the practice to achieve best practice in patient care.

It is the role of the appropriate professional nursing bodies to develop and oversee education, training and continuing professional development of GPNs in consultation with general practice. In this context it is the role of the Royal Australian College of General Practitioners to work with the appropriate professional nursing body to represent general practice in the development of relevant curriculum The role of the GPN will vary according to the specific needs of the practice, the qualifications and specific skills of the GPN, and the needs of the local community that the practice serves.

The AMA is of the view, however, that the establishment of clear and agreed practice protocols, particularly those related to clinical care, must form the basis for the role of the GPN within the practice.

Special circumstances often give rise to a broader clinical role for some GPNs in some practices. Such situations serve to emphasise the vital importance of specific practice protocols in clearly outlining what a GPN within the practice may or may not do, most particularly in relation to clinical care.

In developing practice protocols the AMA suggests that these might be devised under four key headings:

• Clinical care
• Clinical organisation
• Practice administration (including practice systems and risk management processes)
• Integration (with other health providers).

The AMA is of the view that practice protocols that relate to the role of the GPN should be documented and developed in consultation with the practice's GPN.

2. AMA Policy Resolution

2.1 General Practice Nurses are a valuable part of general practice and an integral member of the general practice team.

2.2 The role of the General Practice Nurse is complementary to that of the general practitioner and general practice services.

2.3 General Practice Nurses do not substitute for general practitioners.

2.4 The responsibility of the General Practice Nurse is to assist the practice to achieve best practice in patient care. It is thus essential that the role of the General Practice Nurse is clearly established within the practice.

2.5 General Practice Nurses must not work independently of general practitioners.

2.6 The development of specific practice protocols outlining the role of the General Practice Nurse must be developed in consultation with the General Practice Nurse. Such protocols should be documented and in particular outline clinical care roles and responsibilities of the General Practice Nurse, required skills and qualifications to undertake specific roles.

2.7 The role of each General Practice Nurse will vary according to the specific needs of the practice and the community it serves.

2.8 The clinical roles of the General Practice Nurse may only be undertaken under the direction of the general practitioner in accordance with agreed practice protocols and where the General Practice Nurse is appropriately skilled and trained to undertake specific tasks.

2.9 The role of the General Practice Nurse must not include:

• Formulating medical diagnosis
• Referring patients to specialists
• Independent ordering of pathology or radiology
• Prescribing medication and issuing repeat prescriptions.