Practice nurses

To the Editor: Proposals to manage the shortage of general practitioners by recruiting and training overseas-trained doctors and funding new medical schools will take years to take effect and be enormously expensive. The crisis is with us now.

Support for properly trained practice nurses by Medicare, either as a rebate or a salary, could rapidly ameliorate the shortage of GPs, and would deliver improved patient care. I do not refer here to nurse practitioners — that is a different issue.

Practice nurses in many developed countries undertake routine GP tasks.

Increasing specialisation requires GPs to have more time to evaluate patients. Nurses can complete an initial case summary: these are time consuming and are often missing. Nurses can measure blood pressure; perform Pap smears, breast examination, and vaccinations; counsel people (who will often reveal important information to a nurse); sterilise instruments; explain asthma plans and puffers; give simple dietary advice; and supervise diabetes protocols. This is not a second-class option — it will improve care: doctors who have worked with the system find it improves the quality of their practice and saves them a great deal of time to do other tasks.