F A Q
Who/What is a Nurse Practitioner?
A nurse practitioner is a registered nurse who has been highly trained beyond their initial nursing qualification; having the experience, expertise and authority to autonomously diagnose and treat people of all ages who present with a variety of acute or chronic health conditions. A nurse practitioner has completed additional supervised university study at Master’s Degree level and Board-endorsed to have met National Standards for Nurse Practitioner practice. Nurse Practitioners have undergone advanced extensive preparation and their clinical performance have been tested against defined set criteria.
Is a Nurse Practitioner ‘just a nurse’?
No. A nurse practitioner is not just a nurse. Please see below section that addresses the key differences between nurses and nurse practitioners. The Nurse Practitioner title is a legally protected title under the Health Practitioner Regulation National Law (The National Law) (2009).
What are the key differences between a nurse and a nurse practitioner?
Nurses conduct assessments and identify symptoms.
Nurse Practitioners conduct advanced head-to-toe assessments, apply rigour, synthesis and formulation to global symptoms and internal consistency with differential diagnoses.
INVESTIGATIONS (ordering):
Nurses are not authorized to order investigations.
Nurse Practitioners go beyond just identifying symptoms. Nurse Practitioners are authorized to order various clinical investigations, e.g. (pathology/blood work, electrocardiogram (ECG), magnetic resonance imaging (MRI), computed tomography (CT) scans, etc).
INVESTIGATIONS (interpreting):
Nurses can interpret some results but cannot take autonomous action.
Nurse Practitioners are authorized to autonomously analyse and interpret investigation results, which affords them the capability to rule in or rule out various differential diagnoses and take immediate autonomous action.
DIAGNOSIS:
Nurses cannot diagnose. Nurses may have clinical impressions but these are not diagnoses.
Nurse Practitioners can diagnose conditions, having been rigorously trained in using advanced synthesis, critical and diagnostic reasoning and in using the Diagnostic Statistical Manual (DSM 5-TR).
PRESCRIPTION:
Nurses cannot prescribe medication.
Nurse Practitioners can prescribe medication. In the year 2020, The Victorian Department of Health and Ageing (DHHS) removed all restrictions to medication prescribing for Nurse Practitioners in Victoria. For certain scheduled medications, Nurse Practitioners are required to have Specialist Support arrangements with other professionals and request approval numbers for authority prescriptions for certain medicines. Nurse Practitioners must prescribe medications within their identified scope of practice (area of specialization).
ADMISSIONS & DISCHARGE AUTHORITY:
Nurses cannot authorize admissions or discharges.
Nurse Practitioners can authorize admissions and discharges.
Link:
AUTONOMOUS TREATMENT PLANNING:
Nurses can formulate safety plans but cannot autonomously modify them.
Nurse Practitioners are authorized to autonomously formulate, review, modify and manage individual treatment plans, as well as evaluate treatment outcomes.
ACCESS TO MBS & PBS:
Nurses do not have access to the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS). Nurse Practitioners have access to the Medicare Benefits Schedule (MBS) for various Medicare services (provider numbers) and the Pharmaceutical Benefits Scheme (PBS) in order to ensure that patients can access subsidized prices of the medications they prescribe.
What can Nurse Practitioners do?
Nurse Practitioners can diagnose, prescribe, investigate and formulate treatment plans autonomously. Nurse Practitioners can also collaborate with other professionals (e.g. consultant psychiatrists). Please see the section above: ‘Difference between a nurse and a nurse practitioner’.
What is the difference between a Psychiatric Nurse Practitioner and a Psychiatrist?
The essential difference to note between a nurse practitioner and a psychiatrist is in the foundation.
A Psychiatrist is a trained medical doctor who can assess, diagnose, prescribe, investigate and manage mental health conditions. A Nurse Practitioner is NOT a medical doctor. A Nurse Practitioner is an advanced level nurse who has been trained to assess, diagnose, prescribe, investigate and manage mental health conditions autonomously and collaboratively. Psychiatrists have a DR title prefixed before their name, whilst a Nurse Practitioner does not (except for PhD, in the case of a nurse practitioner with a doctor of philosophy qualification, unrelated to the qualification in medicine).
In addition to the above (specifically with respect to Scheduled Medications), Nurse Practitioner may be required to apply for a Permit to prescribe some Controlled Drugs and/or to obtain Authority/Approval numbers for certain Authority Prescriptions. In those instances, the Nurse Practitioner will be required to contact the PBS Authority Approvals Service via 1800888333 or the Department of Poisons Regulation.
What are the similarities between a Psychiatric Nurse Practitioner and a Psychiatrist?
Psychiatrists assess, diagnose, prescribe, investigate, make referrals and manage mental health conditions autonomously.
Nurse Practitioners assess, diagnose, prescribe, investigate, make referrals and manage mental health conditions autonomously.
How long have Nurse Practitioners existed as a legal entity in Australia?
Nurse Practitioners were first introduced in Australia in December 2000. The first two nurse practitioners were Sue Denison (specialized in rural/remote health) and Jane O’Connell (specialized in Emergency).
How many Nurse Practitioners are there in Australia?
According to the Australian College of Nurse Practitioners (ACNP), as at Nov 2023, there are 2,250 endorsed nurse practitioners in Australia.
What is the history of Nurse Practitioners? How did it originate?
In August 1965, the Nurse Practitioner Profession originated in the United States of America by Drs Loretta Ford and Henry Silver, who developed the first Nurse Practitioner program at the University of Colorado.
The first convention in Australia occurred in October 1990, the first Nurse Practitioner Committee in New South Wales, which marked the beginning of the Nurse Practitioner movement at the NSW Nurses’ Association Annual Conference.
In January 1994, Nurse Practitioner Pilot Projects were established and by September 1994, the pilot projects evaluated Nurse Practitioner models in several areas, e.g. rural/remote, midwifery, women’s screening, emergency services, urban homeless men’s services and general medical practices. The outcome of the evaluation found that the nurse practitioners were feasible, safe and effective in their roles and that they provide quality health services.
By December 1999, the Nurse Practitioner Trial commenced in the Australian Capital Territory (ACT). Models included: wound care, sexual health, mental health liaison and military. In the year 2000, the first two Nurse Practitioners (Sue Denison & Jane O’Connell) were authorized to practice. In May 2001, Olwyn (Ollie) Johnson was the first nurse practitioner approved to work in remote NSW. Ollie Johnson paved the way for nurse practitioners nationally. The development work that began in NSW was quickly followed by other jurisdictions and within nine years (2000 – 2009), all Australian States and Territories had achieved official recognition and a legislative framework for nurse practitioner practice.
The recently completed Australian Nurse Practitioner Study (AUSPRAC) was a further landmark in the development of the nurse practitioner project in Australia. This Australia wide study is the first national research project on nurse practitioner service globally. The study had three phases, which were implemented over three years and investigated the profile, work processes and practice outcomes of Australian Nurse Practitioners. Multiple publications from the study findings contributed important knowledge to the international community on Nurse Practitioner service and baseline data was used in informing governments and service planners for ongoing research by Australian Nurse Practitioners.
Can Nurse Practitioners make referrals to other professionals?
Yes, Nurse Practitioners can make referrals to other professionals using Medicare Item numbers (e.g. Item 291).
Who can make a referral to a Nurse Practitioner?
Anyone can make a referral to a Nurse Practitioner. The Nurse Practitioner will decide if the referral is appropriate for their scope of practice.
Are Nurse Practitioners authorized to run a clinic independently?
Yes, Nurse Practitioners are authorized to run a clinic independently. Nurse Practitioners are registered, endorsed and regulated by the Australian Health Practitioner Regulation Agency (AHPRA).
