Palliative care as with many other specialties has nurses working in advanced practice roles. The Nurse Practitioner role in palliative care has gained significant momentum over the last 10 years. To work as a Nurse Practitioner (NP) the nurse must demonstrate qualifications including three years full-time experience at the clinical advanced nursing practice level within the past six years, completion of a Masters level qualification and be registered with the Australian Health Practitioners Regulation Agency (AHPRA). [1]
As for all nurses practicing in Australia, registration with the Nursing and Midwifery Board of Australia (NMBA) is mandatory for NPs and they must meet the NMBA professional standards for:
- codes of conduct
- standards for practice
- codes of ethics.
Nurse Practitioner Standards for practice reflect the broadened scope of practice.
NP role in palliative care
Nurse Practitioners provide a unique and highly advance nursing skill set, their roles within palliative care are commonly aimed at working with primary care providers to facilitate timely, equitable access to care for those living with a life limiting illness. They are trained and skilled to perform advanced duties including: [2]
- examinations
- diagnose illness
- prescribe medications
- offer referrals, and
- follow-up care as appropriate.
The extended clinical role of NPs within palliative care is growing in Australia, with reports from individuals and single organisations suggesting improved continuity of care, likelihood of dying in a person’s place of choice, and reduced hospitalisation costs. [2-4]
The NP may be based in the acute care sector, residential aged care or the community. Furthermore, NPs may work as sole practitioners or as part of a wider palliative care team. [5] However, collaborative practice in multi-professional environments is a key part of the NMBA definition of NPs within the Nurse practitioner standards.
A word on prescribing
Endorsement as a NP by the NMBA does not give automatic access to the Medicare Benefits Scheme (MBS) or Pharmaceutical Benefits Scheme (PBS). Only Medicare Australia has the authority to provide access.
Authority to prescribe is governed by state and territory governments and the conditions and scope of permissions may vary between jurisdictions. More information on this is provided in the Nursing and Midwifery Board’s Registration standard: Endorsement as a nurse practitioner.