To maximise efficiency and manage workload, it is recommended that a nurse make and manage appointments for nurse consultations using the practice appointment schedule or booking system. This enables a nurse to plan their workload to meet patient and practice needs.

A practice policy on the management of unexpected emergencies and enquiries will support all practice staff to follow a prepared, documented and workable procedure. This ensures appropriate access for patients, management of workload, and risk management for your practice.

Partnership in general practice relies on communication based on respect for, and trust in, our colleagues to provide the best possible outcomes for the practice population. Two-way engagement and joint learning, decision making and actions improve collaboration and help build a good partnership between nurses and other members of the practice team.

For a better understanding of the role of nurses in primary health care, see Teamwork in primary care: a guide to roles, responsibilities and accountabilities.

Each nurse’s education, experience, competence and additional skills and training should be considered in conjunction with the position description and key selection criteria when determining the rate of pay.

Registered nurses complete a Bachelor level degree or equivalent. Enrolled nurses complete a Certificate IV or diploma level qualification. Pay is expected to reflect the difference in education.

APNA conducts an annual salary and conditions survey of general practice nurses, which provides an indicative average to assist you to determine the pay for your nurse employees. Read summaries for past workforce surveys here.

Industrial questions can be directed to the Fair Work Commission or the Australian Nursing and Midwifery Federation.

Once you have developed a position description for a nursing position appropriate to the needs of your practice, you need to advertise to attract the best candidate for the role. To do this, advertise as widely as possible within budget and use a variety of channels, such as:

• Australian Primary Health Care Nurses Association (APNA) career portal – https://www.apna.asn.au/profession/jobs
• Commercial job sites: seek.com.au and adzuna.com.au (formerly mycareer.com.au), which are broadly popular, or nursing-specific sites such as nursingjobs.com.au
• Newspapers: nurses seeking positions will often refer to the health recruitment section in major weekend and local papers
• Primary health care organisations: Primary Health Networks, Medicare Locals, professional networks
• Word of mouth.

Refer to Healthy Practices resources:

• Advertising for a nurse
• Developing a position description
• Position description RN
• Position description EN
• Interviewing, recruitment and probation

Though the majority of nursing care takes place within the practice, there are opportunities for nurses to provide care outside of the practice, such as:

• Completing health assessments in the home, particularly if the patient is elderly
• Providing assessments in an aged care facility
• Providing immunisations at external locations like child care centres, schools and workplaces.

Income for such services can be obtained through:

• Contribution to consultation and assessment on behalf of a GP, claimed through the MBS
• Part of funding received through WIP, available to all accredited practices
• A private fee payable for services rendered by the nurse
• Part of incentive funding available to the practice via initiatives such as the Practice Incentives Program Quality Improvement (PIP QI), Service Incentive Payments (SIP) and the Coordinated Veterans’ Care (CVC) program.

If nurse employees are working outside the practice facility, it is important to consider workplace health and safety in the patients’ homes, the cost of travel, professional indemnity, public liability and vehicle insurances, planning and processes, emergency contacts, etc. Information can be found in Nurse home visit guidelines.

There are MBS items which can be claimed for services provided by a nurse on behalf of a GP, providing direct financial benefit for the practice. When combined with collaborative care provided to patients, indirect financial gains are also possible.

Nurse items for which a practice can claim include:

• Monitoring and support for patients with a chronic disease
• Healthy kids check
• Follow-up service for Indigenous patients who have received a health check/health assessment
• Antenatal service provided in regional, rural or remote area
• Provision of clinical support to a patient participating in a telehealth (videoconference) consultation with a specialist, consultant physician or psychiatrist
• Provision of clinical support to a patient in a residential aged care facility participating in a telehealth (videoconference) consultation with a specialist, consultant physician or psychiatrist.

Information on MBS items claimable for services provided by nurses is available to assist GPs and practices from the Department of Human Services.

Additional MBS items may apply to practising midwives who meet eligibility criteria and eligible nurse practitioners.

Refer to Healthy Practices resources:

• Multiple funding sources which provide financial benefits to your practice
• Workforce Incentive Program (WIP) funding
• Indirect funding available to support nurse employment in general practice
• The role of the nurse within Australian general practice

Further information can be found at MBS Online – www.mbsonline.gov.au.

Nursing roles can be supported financially through the Workforce Incentive Program (WIP), the Medicare Benefits Schedule (MBS), the Practice Incentives Program Quality Improvement (PIP QI) and patient payments.

Accredited general practices are eligible to seek funding via WIP, which provides incentive payments up to $125,000 per year for the employment of Registered Nurses and Enrolled Nurses.

Nurses can attract considerable MBS revenue working alongside GPs, performing clinical activity that contributes to services that can be claimed through the MBS on behalf of a GP.

Refer to Healthy Practices resources:

• Workforce Incentive Program (WIP) Funding
• Indirect funding available to support nurse employment in general practice

This booklet shows you how general practice nurses, in collaboration with doctors and other health workers, can boost healthcare services in the community by recognising, meeting and improving access to comprehensive and effective health services – Creating opportunity.

Guidelines on eligibility and application for the WIP can be found at https://www.servicesaustralia.gov.au/organisations/health-professionals/services/medicare/workforce-incentive-program-wip-practice-stream.

In 2012, the estimated ratio of nurses to GPs in general practice was 1 to 1.78, an increase from 2009 when there was one nurse to every 2.01 GPs.

This increase suggests that more general practice teams have identified the value of increasing the ratio of nurses to GPs on staff.

The ‘ideal’ ratio depends on the needs of each practice, which includes the practice population and health needs of patients, the structure of the practice and the role nurse/s are engaged to perform, as well as each nurse’s scope of practice.

Further information can be obtained from the 2012 General Practice Nurse National Workforce Survey.

More than 60% of Australian general practices employ at least one nurse. Six core roles of the general practice nurse have been identified:

• Patient Carer
• Organiser
• Quality Controller
• Problem Solver
• Educator
• Agent of Connectivity

Activities within these roles that nurses can perform in your practice can be found here.