Australian Nurse Practitioner Practice: Value Adding through Clinical Reflexivity

Abstract

The role of the Australian Nurse Practitioner (NP) is in its infancy and at a crossroads where extensive research demonstrates effective quality care and yet the role remains underrecognised and underutilised. The translation of practice into “value” is critical for the sustainability of NP roles and requires the practitioner to adopt a systematic method of inquiry. Kim's (1999) “Critical Reflective Inquiry” (CRI) method was adapted by two Australian NPs who specialise in diabetes and chronic disease management. Kim highlights the intent of CRI as understanding the meaning of practice, delivering improvements to practice through self-reflection, and the critique of practice that can lead to practice changes and development of new models of care translated to “products” of value. Based on the thematically analysis of 3 years of CRI application, the authors formed 5 headings that represented the NP's practice as Specialised Care Access, Complications and Diagnostics Interventions, Pharmaceutical Treatment, Vulnerable Populations, and Leadership. The utility of CRI demonstrates how NP practice is integral to a continuous cycle of addressing health care services gaps, and the conversion of “products” into “value” and positions the NP to assimilate the role of the practitioner-researcher.

Exploring nurse practitioner practice in Australian rural primary health care settings: A scoping review

“…Most sources described NPs in terms of the educational and practice requirements necessary for endorsement by the Nursing and Midwifery Board of Australia 16,18,29–34 . They conceptualised NPs' role in terms of their scope of practice 8,16,29,30,33–36 .…”

Clinician experience, perceptions, and acceptance of paediatric complex care nurse practitioner roles

“…And while some roles are able demonstrate cost effectiveness by reducing the demands on senior medical staff, increasing the capacity of services to manage patients (KPMG 2019), others are not able to demonstrate these benefits (Jennings et al 2015). Compared to the USA and the UK, the economic rationalisation for NPs in Australia are not well substantiated through financial re-imbursement for services (Woods and Murfet 2015). These factors contribute to undervaluing of the NP role (Lowe et al 2012).…”

Concept Analysis of Nursing Wisdom

“…Furthermore, an effective ethical decision-making is an action that reflexes the nursing wisdom [42,44]. However, such reflexive action requires nurses to have the ability to reflect on their personal values [9,41].…”