Great idea on utilising often academically well prepared nurses. However the Masters requirement has left many very experienced nurses out. They are aged in their mid forties and up, often the primary income earner in their household and were denied an opportunity to study due to family & financial committments.
I am finding the swing towards the perceived better qualified nurse is leaving many clients harmed because of their lack of experience. Nursing is one place you get NO, repeat NO RECOGNITION OF PRIOR LEARNING. I have an Intensive Care Certificate but that was hospitalised based, hard work fitting in intensive study, working fulltime, including nightshift and juggling a small child!! I cannot even get into a university to study.
I am a good foot soldier and prepared to put in the hours these flighty nurses only stay until the going gets tough or they have to start justifying their clinical practices the text book wont help them then!!
Bring in RPL and start valualing an important part of the workforce.

It is difficult to understand why so little attention is paid to the potential contribution of Nurse Practitioners to the health workforce in Australia. As the writer points out, the Canadians, faced with the same shortages of doctors as ourselves, have invested heavily in building up the role of nurse practitioners. While NPs play a key role in Canada’s innovative multi-disciplinary primary health care services, they also provide general medical care in nursing homes (the EverCare group) and in remote areas. The ability to qualify as a nurse practitioner provides registered nurses with a challenging career path – the frustrating lack of which causes many RNs to quit nursing through lack of job satisfaction. Perhaps the major hurdle to be overcome in seeing numbers of NPs increase is the opposition of the AMA, which fails (or refuses) to see how NPs complement their members’ own role.

If there is so much requirement etc why not just put them thru med school? A junior doctor with academic and clinical theoretical knowledge PLUS nursing practical, life skills is a lot safer and more cost effective than a highly qualified nursing (non-medical)staff (with Masters and non-medical doctorate degrees)doing a NP course. Not ignoring that life skills and nursing experience being important, the reason why we still need doctors to make certain decisions because when dealing with life and death it is clinical skills AND theoretical evidence based knowledge that counts!

Another thought:If a NP is acting as a pseudo doctor, what will the liability be? Right now in clinical practice the team leader (doctor) is the point man of law suits for all clinical errors, regardless if it is the nursing staff that initiates it. What will the indemity insurance be like? Will it raise the cost of ALL health practitioners in the country?

The history of modern health care evolved to the current structured approach for patient safety. Are we going backwards in allowing pseudo-doctors and sub-standard clinical care? The answers lie in training more doctors AND nurses to keep up with population growth and ageing populations (everyone in the healthcare stuture has a role and each role is important). Not band aid measures of half-baked clinical fill-ins. We will spend more time mopping up this mess in the future. History has certainly taught us many of these lessons! It is time we learn from our past mistakes!

Why with medicine are we so focussed on heaps of training and intelligence?

I find doctors, especially specialists, are so over worked ( due to lack of training of more doctors ) that they cant even take down a basic compaint.

I find myself reporting a sore knee, and find later they recorded a sore ankle. Or a persistent cough, to find they recorded my birth date but then calculated my age on what I look to be. Or that they cannot even align a clean fracture despite being surgeons.

Training and intelligence must be accompanied by a clear mind which means more doctors and less workload. Nurse practitioners would be less money-hungry and thus more suited to accomodate for this.

Why with medicine are we so focussed on heaps of training and intelligence? > Should that quetsion even warrant an answer?

Yes you will get mistakes made by individuals, whether a nurse or doctor. A GP or a specialist. That's called being human. That's why there is a role of a nurse to counter-check things.

Risk minimalisation thru reducing human error is done thru a team appraoch (doctor-nurse). Each has an important an defined role. Once you start cutting corners (reduce staff) and mixing up roles and responsibility is when potential disasters can occur. What we need is MORE doctors AND nurses to cope with MORE patients. Not pseudo-roles and reduced staffing! NP or doctors, still human. ie still human errors!

Training and intelligence must be accompanied by a clear mind which means more doctors and less workload. Nurse practitioners would be less money-hungry and thus more suited to accomodate for this.>>

Yes better work distribution between more healthcare staff (of both doctors AND nurses). It is false economics to think that having a half-trained staff is just as good as a fully trained one. You get out what you put in. We may not pay the price now,and it may even seem cheaper, but what happens in the future when things go wrong? What is the price we have to pay? How much is your life worth?

Having re-read the article in view of some of the posts, I cannot see where "half-trained" practitioners or "pseudo-doctors" are advocated?

It appears to me that what is proposed here is a new strand to our health-care. The creation of an entirely different structure to the existing one and one which, it would appear, will provide care to those who are missing out on medical care in our over-extended system.

Yes, admitted, we need more doctors and nurses. But we are not getting them. Many factors contribute to this: it's a situation which has been devolving for decades with no steps taken until we have reached our current impasse. It will taken time, money, re-structuring, research, reform...there's no overnight fix. In the meantime the population's health problems are not going to go away and the aged population is increasing.

From what I can see no-one is talking about "life and death" situations. A large part of a GP's practice deals with innoculations, colds, coughs, impacted toe-nails, pre and post-natal care etc., and, in rural aboriginal communicaties, basic hygiene, birth control, nutrition and health education. Nurse-practitioners could alleviate a lot of this work-load thus freeing up harrassed GPs for those visits which do, indeed, involve "life and death", surely?