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Nurse practitioners in Australia: strategic errors and missed opportunities

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Urgent reform is required to make nurse practitioners responsive to Australian health needs and priorities

The Australian nurse practitioner (NP) movement was envisioned as an innovative solution to challenges in Australian health care. But more than a decade after the first NPs were authorised, growth has been slow and there is a real risk that they will fade into obscurity. Enrolment in some NP courses is plummeting, few new NP positions are being created, and nearly a third of NPs remain in their previous nursing positions despite completing a course.1 The nursing profession may blame this situation on opposition from doctors, but the NP movement has made strategic errors and missed many opportunities to create a flourishing workforce today. Without an uncompromising examination of these factors, the Australian NP role will continue on its troubled trajectory.

Nurse practitioners as clinical specialists

The Australian NP role originated as a career pathway for nurses who wished to formalise their advanced clinical skills.2 Essentially, a specialist nurse (clinical nurse consultant [CNC]) with expertise in an area such as colorectal cancer screening, remote health or sexual health would complete postgraduate studies leading to authorisation to practise as an NP.3 The NP title was borrowed from the advanced nursing practice…