Success with expert nurses as GP backup

Last updated 09:00 12/10/2013

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MidCentral trial lauded for being ‘ahead of the game', Kelsey Fletcher writes.

A MidCentral District Health Board trial using an expert nurse to take on GPs' duties in hard-to-staff areas has been so successful it will likely be expanded.

But Massey University School of Nursing's Jenny Carryer says there is still room for improvement if the highly-qualified nurse practitioner role is to thrive across the country.

A nurse practitioner is a registered nurse who has completed a clinical masters degree in nursing, with a minimum of four years in a specialty area.

They provide a wide range of assessment and treatment interventions, and may prescribe medications within their specialty field.

Dr Carryer said the health board should be applauded for leading the charge using nurse practitioners in resthomes.

However, primary care was still an area of the sector where nurse practitioners were under-utilised and under-represented.

"In New Zealand we have over 1000 nurses who have finished the clinical masters degree and many of those are keen to become nurse practitioners, but until they can see valid employment opportunities they're not seeking the nursing council authorisation," she said.

"The two major areas where we should be rapidly using them is in primary health care and in this, aged care, because both those areas have major workforce deficits.

"In aged care the facilities have to bring a GP in once every three months to do full assessments or they call one if a resident becomes unwell - quite often because the GPs are not available they just send the resident to hospital."

There are 11 resthomes with about 490 residents in Horowhenua.

But with pressure increasing on an already short supply of GPs and locums, the trial has highlighted the benefit of employing the nurse practitioners.

Dr Carryer said the trial highlighted the health benefits of having a nurse practitioner on site.

"I'm totally applauding MidCentral, they're a little ahead of the game than the rest of the country and have continued to show that but there is still room for more improvement," she said. "The only other DHB that is really doing something is Waitemata DHB, other areas don't seem to have realised the potential and what a solution these practitioners are."

An independent evaluation of the trial said: "Given the success of this initiative, serious consideration should be given to the implementation of a model of care that enables more nurse practitioners and general practitioners to work in partnership in caring for older people in aged residential care facilities."

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The project has continued and is now likely to be replicated in other areas of the region.

- Manawatu Standard

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