Nurses will quit in droves if scope of practice not widened

4 minute read


Almost a third of primary healthcare nurses are not getting the chance to stretch their wings, and 10% may opt to leave the profession.


Almost one-third of Australia’s primary healthcare nurses are being “held back” by policy and funding limitations, systemic and structural barriers that stop them working to their full scope of practice.

Responses to the Australian Practice Nurses Association’s 2022 workforce survey revealed more than one in four primary care nurses were considering leaving their current job within the next two to five years, with nearly one in 10 considering leaving within the next 12 months. 

Over 65% of nurses surveyed reported working overtime and having an excessive workload, with three-quarters saying they felt exhausted and stressed while at work.

APNA president Karen Booth said revising policy to expand primary health care nurses’ scope of practice would not only improve access to primary care services but also address workforce shortages across the healthcare system.      

“PHC nurses are safe, highly skilled, regulated and trusted. They are also ready, willing, and able to do more for the health of Australia if they are supported by the right policy changes,” Ms Booth said. 

“Nurses have a sophisticated skill set and we know that enabling them to work to their full scope of practice will improve access to care and help tackle health workforce shortages across Australia.

“APNA looks forward to working with the Albanese Government to implement policies that enable nurses to work to their full scope of practice to support and improve the health of the Australian community.”

The Australian College of Nursing also highlighted the need for expanding the scope of practice for nurses across the healthcare sector to address emerging patient needs in its recent submission to the latest National Nursing Workforce Strategy consultation.

“Rather than following a traditional medical model, nurses will increasingly be required to use their extensive critical analysis skills to manage the emerging needs of patients,” the ACN submission read.

“Nurses are primed to redesign their role within the scope of their knowledge, education and competence to meet the needs of the community and setting in which they work.

“There needs to be recognition of the importance of ensuring that training and education frameworks support health professionals to work to their full scope confidently.

“This will require a significant investment in training and education, particularly for nurses who currently are not able to access the same benefits as their medical colleagues to support their ongoing training and education needs.”

Expanding nurses’ scope of practice was particularly crucial for addressing the emerging needs of regional and rural communities, with nurses working in these communities often requiring skills in prescribing, vaccination, public health and disaster management, the ACN said. 

“In regional, rural and remote areas, there needs to be a focus on redesign rather than substitution, and the regulatory frameworks must support the portability of scope between jurisdictions and services. This includes supporting registered nurse prescribing to provide holistic care,” the submission read.

“ACN supports The National Rural and Remote Nursing Generalist Framework 2023-2027 which contextualises the comprehensive skill set necessary for nurses to work to their full scope of practice as rural and remote nursing generalists.”

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In addition, the submission underlined the potential for nurses to fill gaps in post-natal care and breastfeeding support for new mothers.

“ACN Members highlighted the need to increase post-natal care or consider increasing length of stay post-partum again to provide more support to new mothers for breast feeding; this is a role nurses should play.

“People in our society who can least afford baby formula seem to be the highest users due the lack of support for new mums establishing breast feeding routines.

“The increased services for new mothers and babies are available for those living in the ACT and Queanbeyan with families being able to access a Maternal and Child Health nurse/midwife up until the child is 5 years old. This is a service that would benefit many in other parts of Australia. “

The submission also included recommendations for increasing and sustaining nursing workforces in regional and rural areas and aged care, ensuring healthcare environments are culturally sensitive, expanding the First Nations nursing workforce and building nurses’ research capacity.

DoHAC is currently analysing results from the initial round of consultations, with a second consultation phase planned for the second half of 2024.  

The Australian Primary Health Care Nurses Association (APNA) is the peak professional body representing around 96,000 nurses working in primary care. The 2023 APNA workforce survey recorded around 3500 responses in 2023, compared to around 4000 submitted in 2022. 

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