• Case in point 1Primary care nursing in practice

    No need to fly solo: a lateral approach to navigating general practice

    Thirteen years ago, Dr Andrew Kirwan recognised that his busy one-man general practice, servicing the Woori Yallock region on the outskirts of Melbourne, needed to expand. He initially searched for another GP but eventually turned to Ellen Rowatt, a nurse at an aged-care facility housing a number of his patients, to take on the role of primary care nurse. The duo have not looked back since.

  • Case in point 2Primary care nursing in practice

    Realising their potential: a strategic approach to primary care nursing

    Being directly responsible for a team of 18 people across four sites is no mean feat. But that’s not all that experienced registered nurse Kathy Godwin relishes about her role as Strategic Manager for Shoalhaven Family Medical Centres. She also ensures that the nursing team collaborates with the other practice staff, including 16 GPs, in servicing 25,000 patients in the local area.

  • Case in point 3Primary care nursing in practice

    Graduating to the frontline of healthcare – general practice

    When Jennifer Willis finally decided to pursue a long-held dream of becoming a nurse, she raised a few eyebrows. But after graduating five years later with a Bachelor of Nursing degree at age 51, no one was left doubting her commitment. There was also no question in Jennifer’s mind about where to begin her career – at the forefront of primary care, general practice.

  • Case in point 4Primary care nursing in practice

    Seeing the light: why it pays to employ a primary care nurse

    In the words of Dr Gary Kilov, ‘a general practice without nurses is unimaginable to me’. So when Gary returned to Tasmania to establish The Seaport Practice in Launceston with colleague Dr Maxine Manifold, he placed as much importance on finding the right nurses as he did on finding the right doctors. Nurse Suzanne Marshall was specifically sought out for one of the positions.

  • Case in point 5Primary care nursing in practice

    Enrolling for additional practice support

    Situated in Tamworth, Peel Health Care has adopted an innovative general practice model offering comprehensive medical and allied health services to patients and a collaborative work environment for staff. So when the non-profit organisation first opened its doors, a team of nurses was ready not only to work with the GPs, but also to lead specific services within the practice. Enrolled nurse (EN) Ros Dart brought 25 years’ experience with her when she joined in 2009.

  • Case in point 6Primary care nursing in practice

    All roads lead to primary healthcare

    After 30 years of nursing, Alison Logan is constantly amazed by the range of opportunities that her chosen career has afforded her – hospital nurse, paediatric nurse, midwife, district nurse, aged-care nurse, practice nurse and, for the last 2 years, Senior Chronic Disease Care Coordinator for the Western NSW Medicare Local. She leads a team of ten care coordinators across the Bathurst and Orange regions in ensuring that indigenous patients with complex health requirements receive essential care.

  • Case in point 7Primary care nursing in practice

    Community healthcare: the
    co-operative way

    As the only indigenous student at the Australian Catholic University’s Ballarat campus in Victoria, Faye Clarke sometimes felt isolated. However, the determined mature-age student didn’t let this interfere with her nursing studies, which she completed in 2003. Faye has maintained close links with the local indigenous population through her current role as Community Health Nurse at the Ballarat and District Aboriginal Co-operative (BADAC).

Other sources of support and advice

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Click through to these partner websites for further information

For further information about the role of nurses in Australian general practice visit the resources section on the APNA website

Frequently asked questions

1.  How can a nurse contribute to my practice?

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.

2.  What is the ideal ratio of nurses to doctors?

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.

3.  How can I fund a nursing position in my practice?

Nursing roles can be supported financially through the Practice Nurse Incentive Program (PNIP), the Medicare Benefits Schedule (MBS), the Practice Incentives Program (PIP) and patient payments.

Accredited general practices are eligible to seek funding via PNIP, 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:

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 PNIP can be found at www.humanservices.gov.au/health-professionals/services/practice-nurse-incentive-programme/.

4.  What MBS items are nurses working in general practice eligible to claim?

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.

A Medicare fact sheet on general practice nurse items is available to assist GPs and practices.

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

Refer to Healthy Practices resources:

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

5.  If a nurse undertakes work outside the practice, how does the practice generate income?

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 PNIP, 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 (PIP), 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.

6.  Where can I find a nurse to work in my practice?

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 – www.primaryhealthcarenurses.com.au
  • 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:

7.  How do I know what to pay the nurse we employ?

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 the summary for the 2014 survey here.

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

8.  How do I create a good partnership with a general practice nurse?

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.

9.  How can nurses assist with unexpected emergency calls and walk-ins?

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.

Welcome to Healthy Practices, where you can access information about the role of nurses in general practice. This site is an initiative of the Australian Primary Health Care Nurses Association (APNA).

For more about the benefits of having a nurse in your practice, complete this form to order your FREE resource kit.