Professional News 2005

July 2005

Licensing of unregulated assistants urgent

Because assistants in nursing and personal care assistants (however titled) provide aspects of nursing care and work closely with nurses, the nurse regulatory authorities in each state and territory should be involved in regulating them.

The national executive of the ANF recently endorsed a position statement on licensing assistants in nursing and personal care assistants (however titled).

The statement calls on governments in all the states and territories to introduce a licensing system for workers who provide direct care and aspects of nursing care to people who are frail, aged, have disabilities or illnesses.

While the title is a little clumsy because it needs to encompass the myriad titles used all over the country, it is a very important statement for the ANF.

It acknowledges that with assistants in nursing and personal care assistants working in the community and in residential aged care facilities, closer attention needs to be paid to the standard of care provided in these settings.

The ANF position is that because assistants in nursing and personal care assistants provide aspects of nursing care and work closely with nurses, the nurse regulatory authorities in each state and territory should be involved in regulating them.

Competency standards are also needed in order to identify the boundaries of practice for assistants in nursing and personal care assistants. These elements would assist registered nurses and enrolled nurses (RN Div 2 in Victoria) because they delegate work to and work with assistants in nursing and personal care assistants.

The ANF is also calling for a system which provides for action to be taken against all workers providing direct care who put the public at risk because they are incompetent or are working outside the scope of practice for which they are prepared.

The Australian public desperately needs an effective system that provides information about the competence of workers who care for them in either residential facilities or in their own homes.

Copies of the statement, along with all the recently reviewed policies, position statements and guidelines, can be found in the policy section on the ANF web site (www.anf.org.au) or by telephoning the ANF on (03) 9639 5211.

Other relevant ANF documents are the position statement on assistants in nursing and other unlicensed workers (however titled) and the guidelines on delegation by registered nurses.

Medical assistants
Assistants in nursing working in hospitals are one group of workers being considered as part of the review of the health training package. Another group is medical assistants.

This role is currently being established by one of the Divisions of General Practice in Queensland.

Apparently it is used in medical rooms in the USA and involves medical receptionists being trained to undertake clinical tasks such as venipuncture, ECGs, wound dressings and assisting with procedures.

The title, medical assistant, is also found in the defence forces where the role ranges from an advanced paramedic on a battlefield to assisting in primary health care clinics on military bases around the country.

The latter role has been around for a long time and the ANF does not oppose it, but the medical assistant in general practice role does appear to be replicating a nursing role.

The venture in Queensland is very disappointing as many of the doctors' organisations and professional nursing organisations such as the ANF, the Royal Australian College of General Practitioners, the Australian Divisions of General Practice and the Australian Practice Nurses' Association have worked cooperatively with the Australian Government to find ways to assist general practices to employ nurses.

There have been practice incentive payments for general practices in areas of need and more recently the government has established Medicare item numbers so that some nursing services can be reimbursed.

Primary health care in the general practice setting is the way forward and it is in everyone's best interests to be working toward the establishment of an effective multi-disciplinary team in general practice so the health and well being needs of Australians can be met.

This multidisciplinary team involves doctors, nurses, and allied health care professionals.

The medical assistant role is a short-sighted cheap option, which is not in the best interests of general practice, the community served by the general practice or the medical assistants themselves.

The ANF is calling on the Australian Government to work with general practices to develop a funding system that encourages general practices to employ nurses and prepare for the workforce that will be required in the future.

Victoria Gilmore
ANF Federal Professional Officer