By Denise Irvine
(Many thanks to Catherine Beazley, a Nurse Practitioner who is employed by Hauora Hokianga who gave me time to explain the role of the Rural Nurse Practitioner )
The Nurse Practitioner role was introduced in 2001 by Nursing Council New Zealand, the regulatory body of nursing in New Zealand. The role was developed to offer a new access arrangement to health care. This role offers a unique blend of nursing and medical knowledge, clinical leadership scholarship, research planning and advocacy. As of March 2024, there were over 750 nurse practitioners in New Zealand.
Nurse Practitioners are registered nurses with advanced education and experience. They are authorised to practice in an expanded nursing role in clinical settings. The role may include things traditionally performed by another health professional, such as prescribing medicines or ordering diagnostic tests. They work within a specific area of practice using advanced knowledge and skills gained from their extended education. They may, for example, work in the area of older people. In this area, they will have wide and deep knowledge. The variety of settings they work in may include pain management, school children, teenagers, chronic conditions, obstetrics/midwifery, postpartum care and men’s health, to name a few.
Catherine works in a rural health service alongside a healthcare team including doctors, community nurses, and KMT (Kaimanaakitangata). The staff all have their roles, but the model is focused on the delivery of the best for the patient close to home.
Catherine runs her own clinics in remote peripheral clinics predominantly via face-to-face consults. Having worked in Hokianga for 23 years, she has gotten to know her patients and their whanau. Nurse Practitioners can work alongside both doctors and nurses, offering a variety of services. They are able to request laboratory tests, complete driver’s license assessments, and assist with Work and Income applications. Additionally, they handle ACC45 and ACC18 forms, submit radiology requests, provide referrals to specialists, write prescriptions, conduct cervical screenings, and manage long-term conditions. Additionally, when the nurse gets busy, she can also assist with wound dressings and venepuncture. While Catherine manages most day-to-day presentations, she can always consult with one of the doctors in the team if necessary.
Home visits are not usually made due to time constraints, but the KMTs may go out and bring the patients in if there are some difficulties in asking the patients to travel. At present all KMTs are Māori. Once they have entered the facility, they are offered training in specific areas. They are of great value as they usually come from the district and know their community.
Using technology such as Telehealth to provide access to a doctor in peripheral clinics has become part of business as usual, including the use of a Tyto device to enable the virtual doctor to carry out an examination of the patient. The KMTs set the technology up in the clinics and support the patient for GP virtual appointments. This process has been widely recognised by patients as a valuable method of consultation.
Nurse Practitioners are continuing to improve health outcomes for patients in rural communities by providing much-needed expert health care and support. By using technology such as Telehealth to link isolated populations with consultants and to provide other education, providing pivotal topics such as antenatal education, reducing unnecessary travel for patients and communicating with the major hospitals regarding professional education or updates on patients’ conditions.
Because of their knowledge, skills and passion for rural nursing, Nurse Practitioners in rural have a pivotal role to play.