Advanced Nursing Practice in Australia

This evolution in advanced nursing practice in Australia and other countries is because of increasing demands on the health care system and changes in the delivery of health care which include the growing cost of acute health care. the increasing number of specializations in health care. the greater avoidance by medical practitioners of particular client groups suchas rural and remote communities, those with chronic illness, and low socioeconomic groups. and the extensive upgrade of nursing education and training. These factors fuel the development and extension of the scope of nursing practice and the consequent increase in the allocation of clinical discretion, responsibility, and autonomy to nurse practitioners (Pearson Peels, 2002).The nurse practitioner is defined as “a registered nurse with appropriate accreditation who practices within the professional role. The nurse practitioner has autonomy in the work setting and has the freedom to make decisions consistent with his/ her scope of practice, and the freedom to act on those decisions” (NSW Health Department, 1998).By the turn of the century after several years of struggle and conflict with the medical profession to crystallize the importance of the nursing role in health care, legal recognition was proclaimed for nurse practitioners in New South Wales, Australia. This brought about legislation, authorization, acceptance, and implementation of the advanced professional role and status of nurse practitioners (Appel Malcolm, 2002).The nurse practitioner role was initially developed in the area of primary health care, with nurses implementing complete and direct management of health care. In the primary care sector they are providers of care in their own right. they work in collaboration with general practitioners, carrying out preventative care, health education, screeing and counselling. This essentially means that rather than performing as a doctor substitute, nurse practioners in the primary care setting have their own case load, and they retain the autonomy to admit, discharge and refer from and to their caseload. “The role is clearly health focused, patient centred, and theoretically informed” (Cahill, 1999: 11). Thus it is