In Australia, nurse practitioners are becoming increasingly critical in providing health care to at-risk populations – especially those in rural and remote regions. But some challenges must be overcome to realise this important role's full potential.

President of the Australian College of Nurse Practitioners (ACNP) Leanne Boase, a practising nurse practitioner, says the most significant difficulty is being misunderstood, which leads to exclusion from policy development and broader health care decision making.

"It's not specific to any one group, but it's common that people think we have just done a course and start thinking we can be doctors. 

"The truth is we do not want to be doctors. We are nurses, and as nurses, what we offer is incredibly valuable and unique."

Nurse practitioners are the most experienced nurses with extensive training, a master's degree, and the ability to satisfy additional criteria – it's a process Ms Boase describes as rigorous.

Even so, in Australia, nurse practitioners are behind the rest of the world when it comes to recognition for their critical role in health care. So, what are the biggest myths that need to be busted? According to Ms Boase, there are many!

"That we wish we were doctors.  That we want to compete with doctors.  That our practice, or value to the health system in general, is lesser in some way. 

"There is so much benefit to the nurse practitioner role worldwide that we already know about, and it needs to be recognised here in Australia.  The evidence that nurse practitioner care is safe and of high quality is extensive!"

Nurse practitioners have an extensive nursing background to treat patients for a broad range of health conditions across the lifespan.  However, this is not well recognised in Australia.

"We are often viewed as specialists, and some certainly do specialise, but they still have a breadth of education and experience that extends beyond one speciality. 

"I'd like to see a transition where we … stop limiting nurse practitioners' practice to very specific and limited areas unnecessarily. 

"We frequently see demands for us to limit what we do, which is such a waste of skills, experience and training, and ultimately a loss to the patient and health care more broadly."

The decision to become a nurse practitioner came about when Ms Boase worked in a rural health setting as she needed to work autonomously.

"I often called doctors in for things I knew I could manage. They knew I could manage it too! 

"I was looking for a pathway to consolidate my experience and prior education so that I could do more."

Education and management are the other pathways to advancing in a nursing career, but these traditional avenues didn't appeal due to the lack of patient contact, explains Ms Boase.

"I appreciated the challenges of those roles, but I missed the patient contact and making a direct difference to a patient. 

"Finally, there was an opportunity to advance my career in a clinical capacity."

What is a nurse practitioner?

A nurse practitioner (NP) is a registered nurse with the experience, expertise and authority to diagnose and treat patients across their lifespan with various health conditions.

Nurse practitioners have a master's degree level qualification and are the most senior and independent clinical nurses in our health care system.

The title Nurse Practitioner can only be used by a person who has been endorsed by the Nursing and Midwifery Board of Australia.

Nurse practitioners provide high quality, patient-centred care and can work in clinical research, education and leadership roles as applied to clinical care and health service development.

Why become a nurse practitioner?

Becoming a nurse practitioner means realising your full potential as a nurse, explains Ms Boase.

"Many nurses often feel like they could be taking a more advanced role in decision making for their patients, and also want to follow through to patient outcomes and ongoing care. 

"Becoming a nurse practitioner gives you the opportunity to do all of those things." 

"While it's a greater responsibility, the role certainly brings greater satisfaction and the opportunity to use all of your experience, education and skills."

A question Ms Boase gets asked often by nurses considering a career as a nurse practitioner is whether it's too late in their health care journey to begin.

"I always say if you can spend your last five or ten years as a nurse practitioner, being able to use all of your skills and knowledge, then it will be the best and most rewarding part of your career, so it is never too late!"

What's it like to be a nurse practitioner?

Juggling her roles as ACNP President, nurse practitioner, and educator means there's no typical day for Ms Boase, but every day is rewarding.

"I work in my own clinic and have a great team of nurse practitioners, medical specialists and allied health professionals – I also have a lot of patients!

"Every day is a juggling act, but every day is fulfilling!

"Today, I have seen seven patients. It doesn't sound like a lot, but my consult times for a new patient range from 35 to 90 minutes." 

Patients book an appointment with a nurse practitioner for a health concern or issue, just as they would with any professional. But the point of difference is a focus on delivering patient care holistically.

"We assess the whole person, discuss the presenting issue, their history, any other concerns, and any risk factors. 

"We look for opportunities for a preventative approach."

Families make up most patients in Ms Boase's clinic, so an appointment will include discussions and education on family dynamics, parenting skills, and mental health.

"We spend a lot of time enabling the patient, parent or carer to manage their own health through education.  

"Today, I arrived a bit late after attending a meeting, then was running late all day with my patient appointments, but by the time each left, they were happy and had forgotten about the wait. 

"Now it is 4 pm on a Friday, and I still have a lot of ACNP work to do. But I feel like it's been a good day of helping and empowering patients and families to care for their health and navigate the health system. 

"Each day next week will be a bit different, but it keeps me on my toes!"

How to become a nurse practitioner

If you are a registered nurse, there are several minimum requirements that are necessary to become a nurse practitioner, including:

• Two years of advanced practice nursing before seeking application for a Nurse Practitioner course of study
• A postgraduate qualification in an area of clinical specialty

For further information, refer to the Nursing and Midwifery Board of Australia for approved courses and apply directly with universities. You can also find valuable career education advice at the Australian College of Nurse Practitioners.