The status of Australian nurse practitioners: the second national census

Abstract

Objectives. To profile Australian nurse practitioners and their practice in 2009 and compare results with a similar 2007 census. Methods. Self-administered questionnaire. Results. A total of 293 nurse practitioners responded (response rate 76.3%). The majority were female (n = 229, 81.2%); mean age was 47.3 years (s.d. = 8.1). As in 2007, emergency nurse practitioners represented the largest clinical specialty (n = 63, 30.3%). A majority practiced in a metropolitan area (n = 133, 64.3%); a decrease from 2007. Consistent with 2007, only 71.5% (n = 208) were employed as a nurse practitioner and 22.8% (n = 46) were awaiting approval for some or all of their clinical protocols. Demographic data, allocations of tasks, and patterns of practice remained consistent with 2007 results. ‘No Medicare provider number’ (n = 182, 91.0%), ‘no authority to prescribe using the Pharmaceutical Benefits Scheme’ (n = 182, 89.6%) and ‘lack of organisational support’ (n = 105, 52.2%) were reported as ‘limiting’ or ‘extremely limiting’ to practice. Conclusions. Our results demonstrate less than satisfactory uptake of the nurse practitioner role despite authorisation. Barriers constraining nurse practitioner practice reduced but remained unacceptably high. Adequate professional and political support is necessary to ensure the efficacy and sustainability of this clinical role. What is known about the topic? The nurse practitioner is a developing new model of healthcare delivery that performs an advanced clinical role and is becoming increasingly important in the overburdened Australian healthcare system. Our census conducted in 2007 indicated that nurse practitioners perceived many barriers to their practice and were underutilised in the Australian healthcare workforce, specifically because of their inability to prescribe medications. What does this paper add? This paper provides a second census of Australian nurse practitioners in 2009. Similar to the results in 2007, the study indicates that nurse practitioners remain underutilised, with many unable to perform roles within their defined scope of practice because of limitations, such as inability to prescribe medications, lack of a Medicare provider number and awaiting approval for clinical protocols. Lack of support from within healthcare organisations and the nursing profession also were found. What are the implications for practitioners? Nurse practitioners are not being utilised to their maximum clinical capacity despite increasing pressures on the health system. Many of the barriers to nurse practitioner practice that were flagged in 2007 remained issues in 2009. It is hoped the current legislative reform through the Health Legislation Amendment (Midwives and Nurse Practitioners) Act 2010 (Cth) will adequately address these issues.