The AMA supports the integral role that nurses and other allied health professionals play in the delivery of health care in hospital settings. Many nurses and allied health professionals have a high degree of expertise in limited specific fields and as such are able to work as part of a team in roles which have significant responsibility and limited supervision. Nurses and other allied health staff play an essential role in complementing and supporting the work of doctors.
Proposed changes to the roles performed by health professionals however, must be not be introduced simply as a reaction to workforce shortages. Workforce shortages exist across most health professions. Attempts to address one area of shortage by utilising other health professionals simply make shortages in other areas worse. Workforce changes must be driven by quality and safety and enhance the efficiency of the health workforce. The ultimate solution to the workforce shortage is to train more health professionals and develop sound recruitment and retention strategies.
The AMA believes that nurses and other allied health professionals equally value the work of doctors and recognise the essential role that medical practitioners play in formulating diagnoses, overseeing the management of patients and providing timely interventions necessary to maintain the health of the patient. Medical practitioners have a thorough appreciation of the complexity of medical decision-making and are trained to consider the ‘whole person’ in developing management plans. It is imperative that the medical practitioner remains at the centre of the health care team and has ultimate responsibility for the care of the patient.
Work practices should ensure that the efforts of health professionals are focused on the delivery of clinical care, teaching and training, unburdened by unnecessary administrative and bureaucratic requirements. Adequate numbers of administrative and support staff should be employed to assist the work of the health care team, allowing more time to be dedicated to the delivery of care to patients.
The AMA recognises that over time the roles of doctors, nurses and other allied health professionals will evolve in response to the changes in the delivery of health care. The AMA supports nurses and allied health staff working in expanded roles, under the supervision of a medical practitioner, under the following principles:
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Proposals to expand the roles of nurses and other allied health professionals should only be considered where they will enhance patient outcomes;
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Role expansion and appropriate training programs for nurses and other allied health professionals should be achieved by consensus, with the involvement of doctors, nurses and allied health staff in determining the need for and type of job redesign and in the establishment of appropriate clinical guidelines;
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Rigorous and objective assessment processes are in place to closely monitor the progress and measure the impact of role expansion on patient outcomes and team function;
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A medical practitioner must remain responsible for coordinating the health care team and managing the care of patients;
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There should be a strong commitment to a team based approached to health care, rather than the creation of new independent roles;
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The expanded nursing and allied health roles, and training for these expanded roles, must not interfere with the opportunities for medical students and doctors to learn and practice clinical skills;
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All health professionals should have access to appropriate administrative support services; and,
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There should be a professional and courteous relationship between doctors, nurses and other allied health professionals with mutual acknowledgment of, and respect for each professions contribution to patient care.