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The Forum > General Discussion > Nurse Practitioners - Access to PBS and MBS

Nurse Practitioners - Access to PBS and MBS

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On the 16th March 2010, the Senate passed legislation to provide nurse practitioners and midwives access to the Medical Benefits Scheme (MBS) and to PBS. This has put the Rudd Government on a collision course with the powerful Australian Medical Association (AMA) which has campaigned to retain doctors’ monopoly on prescribing subsidised medicines. The Australian Nursing Federation (ANF) blames the slow up-take of nurse practitioner prescribing rights on the result of effective lobbying from the medical profession, who argue that such a move would result in compromised patient care. However, nurse practitioners have proved feasible, safe, and effective in their roles providing quality services in a range of settings. Extending prescribing rights to nurse practitioners will allow them to make better use of their skills and to provide an improved service for their patient group.

Nurses have always been integral to the Quality Use of Medicines (QUM) and a literature review undertaken by the Victorian nurse practitioner task force identified the following benefits for patients associated with extending prescribing rights to nurse practitioners:

improved patient care
increased convenience for patients
improved nurse-patient relationships
improved collaborative practices within the healthcare team
potentially reduced costs

The key to successful integration of nurse prescribing to the health care system is to ensure a collaborative arrangement amongst health care professionals involved in prescribing medications to patients. Nurse practitioners and midwives must collaborate in a meaningful way with doctors about the care of the patient. The AMA concur that nurse practitioners and midwives providing MBS funded services or prescribing PBS subsidised medicines should enter into a ‘collaborative care agreement’ with the patients usual GP, or a doctor nominated by the patient, to ensure that patient care does not become fragmented.

Nurse practitioners contribute to improved patient outcomes by providing improved access to healthcare, better nursing assessment and treatment, and a high level of patient acceptance and satisfaction. These benefits are likely to be extended when nurse practitioners are able to prescribe
Posted by nursep, Monday, 3 May 2010 8:08:15 AM
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Firstly, Nurses do an awesome job, I hope they sort out their pay for them soon.
I dont know a lot about nurses, my understanding is there are basically 3 kinds- Enrolled nurses, registered nurses, and the older ones who trained under the old system of hospital boards.
The difference between an EN and an RN is that one is a university degree and the other is a Tafe course (unsure which is which).
I would have confidence in a degree trained nurse or very experienced older nurse administering drugs and stuff, but maybe not so confident in a Tafe background.
Of course, the nurses should be paid properly for doing the extra work, and would need medical indemnity insurance same as a doctor. In which case, its probably no cheaper and so why not just keep things as they are.
Posted by PatTheBogan, Monday, 3 May 2010 11:05:12 AM
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Hi Nursep: Are these Nursing Practitioners who may be given the rights to prescribe subsidized medicines chosen with nursing backgrounds that are long term and recent,working through Psych Units, Intensive Care and Paediatrics primarily, and up to date with all of the changes regarding medications, as opposed to Nurses working casually or part-time.

There is a reason for my inquiry.

Over the years [working in hospitals]I have observed on many occasions, serious differences of opinions have existed between various Nursing Sisters and General Practitioners over medications prescribed or not prescribed to babies under 12 months. Differences of opinions exist between General Practioners and Paediatricians also relating to babies and toddlers' medical treatment.

For instance, many babies presenting with gastro-oesophageal reflux symptoms are to date completely missed by Nursing staff within Baby Clinics, or worse, misdiagnosed as some other condition. The parent discovers 6 months down the track, through a GP and Paediatrician, that their baby's oesophagus has burned away for 6 months, increasing the likelihood of their baby having oesophageal cancer at a later date. Flu like symptoms misdiagnosed, initial signs of meningococcal misdiagnosed. As you would be aware, this also occurs within A&E on occasions.

Second query: what guarantees are the ANF prepared to give parents of babies and toddlers, that Nursing Practitioners will have all recent knowledge and experience in prescribing medications to babies and toddlers presenting with a range of symptoms that could be the latest strain of some new superbug from o/seas not viewed in the latest Medical Journal that the GPs or Paediatricians read up about?

The concern I also have is that by the time a baby toddler or teenager with meningococcal type symptoms has presented at a Nursing Practitioner Clinic, time is wasted by that child then being despatched to a GP or the Hospital for a second opinion or admission.

I have the utmost confidence in Nurse Practitioners treating adults; yet not babies and children, most of whom, cannot communicate effectively or clearly their symptoms.

Not to be taken personally Nursep.

Kindest wishes
Posted by we are unique, Monday, 3 May 2010 9:59:05 PM
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