Independent Nurse Practitioners - 2005

The AMA does not support a role for the independent nurse practitioner.

The AMA's support for the role of General Practice Nurses (GPN) is outlined in a separate AMA position statement and policy resolution.

The Australian community wants and deserves the best quality medical care regardless of their geographical location or economic circumstances. The AMA supports a model of primary care that places the general practitioner as pivotal in the primary care team.

Nurses are an essential part of the primary care team adding value and enabling the primary health care providers to deliver more services to patients. In the primary care setting the role of nurses is complementary to that of the general practitioners. Nurses do not substitute for general practitioners.

The role of a nurse in the primary care setting does not include:

• Formulating medical diagnosis;
• Referring patients to specialists;
• Independent ordering of pathology or radiology;
• Prescribing medication and issuing repeat prescriptions; and
• Deciding on the admission of patients to, and discharge from, hospital.

A debate on the issue of nursing career paths and recognition of nurses' specialist training is valid. It is not, however, a valid argument for models of legislated roles for independent nurse practitioners where levels of independence remove the general practitioner as central to delivery of primary care.

Governments throughout Australia are looking to reduce costs and providing the opportunity for substitution of medical care with independent nurse practitioners is one strategy. There is no evidence that this will improve outcomes particularly when such a strategy is pursued outside a collaborative model of primary health care delivery.

The demands of the Australian community have to be met by strategies that combine recognition for the need for an injection of more funding balanced with collaborative approaches to primary care delivery that do not compromise quality of care. The legislated capacity to substitute independent nurse practitioners represents unwillingness or inability of Governments to address the underlying issues related to general practitioner workforce shortages.

The AMA does not accept that medical practitioners should be legally responsible when errors of omission or commission by medically unsupervised independent nurse practitioners warrant subsequent medical intervention. Medical practitioners are not responsible for professional acts over which they have no control.