Practice nurses make a difference

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When the general public thinks about nurses, it is most often the uniformed nurse in the hospital ward that will come to mind. However, health consumers are more likely to engage with a nurse when attending their local medical centre or general practice for a consultation with their family doctor.

Practice nurses – get involved in your reference group All practice nurse members are invited and encouraged to join the Practice Nurse Reference Group (PNRG). If you are a QNU member working in a general practice and have not received an invitation to the PNRG, please ensure that your contact details with us are up to date, including your current email address, as invitations are circulated via email.

With the advent of national health reform and new Medicare Locals shifting the focus of health care delivery away from the hospital system and into the community, it is the ‘practice nurse’ who will play an integral role in improving the health of the nation.

Although a relatively new area of nursing in Australia, general practice nursing is now one of the fastest growing fields within the health sector. There are currently nearly 9000 practice nurses employed in general practices across the country. Around 60 per cent of practices employ at least one practice nurse.

Practice nurses have a wide variety of roles and responsibilities, ranging from immunisation, maternal and child health, and cardiovascular care, to chronic disease education and management, mental health, and general health promotion. This expansive role requires the practice nurse to maintain skills and competence in all aspects of primary health care, creating a considerable burden on them to comply with registration standards and nursing competencies, especially compared to nurses working in specialty areas.

Unfortunately, it is often the case that practice nurses are undervalued and under-supported by their employers. There is no defined career structure or pathway for practice nurses, nor is there a consistent definition of their role

The role of a practice nurse: Help patients manage their condition and provide referrals for further treatment Provide confidential counselling and education about a patients’ condition Treat wounds and provide follow-up care Immunisations and vaccinations Pap smears General health assessments Advice on healthy living Audiometry Phone consultations

and responsibilities. Similarly, the remuneration and employment conditions of practice nurses vary, but most fall far short of public sector entitlements. Practice nurses also receive little, if any, education and professional development opportunities.

Practice nurses deserve greater recognition for the service they provide to the Australian community. This recognition needs to come not only from the government and employers, but also from the community at large. To help gain the recognition they deserve, and to improve their position both industrially and professionally, QNU practice nurse members need to be united as one voice. This is why the QNU recently established a Practice Nurse Reference Group (PNRG), where practice nurse members can get together in person or by teleconference every six to eight weeks.

The PNRG has had three meetings so far and has been a vital tool for practice nurses across the state to come together and share their experiences and their professional and industrial issues.

Currently under consideration by the PNRG is how we can engage with employers in an effort to convince them to negotiate enterprise bargaining agreements that will deliver fair and consistent wages and conditions of employment, introduce a new classification and career path that rewards increased responsibilities, and provide support for practice nurse education and professional development.

At a time when the spotlight is being fixed on general practices and primary health care, practice nurses have an important opportunity to work together in the QNU to achieve the recognition they deserve.

Practice nurses and national health reform

The country’s renewed focus on primary health care provides new opportunities to expand the role and responsibilities of practice nurses. As part of its historic reform of Australia’s health system, the Commonwealth Government has committed to take full responsibility for primary health care including community care.

These services now fall under the realm of new Medicare Locals, which in Queensland were formed from the existing network of Divisions of General Practice.

These Medicare Locals offer practice nurses an opportunity to redefine and recontextualise primary health care in Australia, and the role they play within it.

For this reform to be truly successful, Medicare Locals need to develop long term recruitment and retention strategies to ensure that working as a practice nurse remains attractive. It is well recognised that wages and working conditions are fundamental to positive recruitment and retention outcomes in any sector of the workforce, along with an attractive career structure, which in this case must meet the needs of practice nurses. At present, there is a huge disparity in practice nurse wages across Queensland and there is little, if any, career structure.

The reality of a practice nurse

Wendy Litchfield took up a practice nurse position about a year ago, after more than 40 years’ work in the public sector.

Wendy now works in a large general practice in Brisbane’s north – a significant change from the busy hospital emergency department she left.

"This is a career that many nurses probably wouldn’t think about, but it’s definitely worthwhile," she says.

"I contribute to keeping people healthy and out of hospital, not just caring for the ill. Our patients are genuinely appreciative of what I do here. While I support the work of doctors and other health specialists, I am a constant presence for our patients and am able to provide holistic care that really does achieve tangible results."

Wendy says she plays an important role in the practice team, where her skills and experience complement those of the other health professionals working there.

"It’s very much a team approach in general practice, and here everyone is open to new ideas and innovations. I have an opportunity to be an innovative leader here," says Wendy.

"My role is so varied that no day is ever the same. I’ve seen as many as 42 patients in one day with treatment including wound care, immunisations, health assessments and counselling.

"We have a lot of services running from our practice, so I am required to be across all of facets of health care delivery in this role," she says.

Wendy is a member of the QNU’s Practice Nurse Reference Group, which she says has provided her with an important opportunity to network with her practice nurse colleagues from across the state.