4 Aug 2022

Nurse practitioners 'part of the solution'

From The Detail, 5:00 am on 4 August 2022

The Detail visits a nurse practitioner clinic.

A woman sits at her desk in a medical office. The desk is strewn with papers, equipment, with a computer desktop sitting in the centre. The woman is facing the camera in her chair, smiling.

Michal Noonan runs the Family Health Matters nurse practitioner clinic in Glen Innes. Photo: Jean Bell / Newsroom

How long do you have to wait to see a doctor these days? 

If the answer is only 'several days', you're lucky - some GPs are so snowed under their patients are waiting for weeks. 

Like the rest of the health sector, they're under pressure, overburdened, exhausted and many are leaving - they're also an ageing workforce so many more are retiring. In many areas of the country the ratio of GPs to patients has blown out. In some cases the Royal College of GPs has had reports of one GP to 3000 patients - something it describes as 'not sustainable'. 

Health Minister Andrew Little this week announced some relief, including an increase in the number of GP trainees from 200 to 300 a year. 

But there's another answer to help ease the primary care crisis - nurse practitioners. 

Their numbers are being boosted too, but who are they - and what can they do? 

Today on The Detail Jean Bell visits a nurse practitioner clinic in Auckland to talk to one of these specialist nurses who can do nearly as much as GPs do. They're not doctors - and don't pretend to be - but they are hugely experienced and can handle a wide range of issues. 

Nurse practitioner Michal Noonan runs the Family Health Matters clinic in Glen Innes. It used to be a lawnmower repair shop. 

"Rather than repairing lawnmowers we're now - hopefully - repairing people." she says. 

There are two other practices in the immediate area, but Noonan says they are getting busier, and sometimes don't have the capacity for new patients. 

Her clinic opened at the start of 2020 and has about 600 patients on the books - less than half of the 1300 or so it could have. Noonan says some people prefer to see a GP, and that's fine. 

"We are not the solution, but we are part of a solution," she says. And to those who say they're not as good as GPs, she points out they're not comparing apples with apples. "We're not the same - I very definitely am not a GP."

Noonan has been a nurse for more than 30 years. She's worked around the world, from New York City to Vietnam, and got her nurse practitioner qualification in 2009.

To qualify, you have to be a registered nurse, with four years of experience on the job. You also need a masters degree, with 300 hours of clinical learning. 

To top it off, you need to pass a vigorous test in front of a panel.

Michal is a bit of a pioneer, being among the first people to be trained in New Zealand. There are now more than 650 nurse practitioners in the country. 

"It's been a great role and I love it - but it's been hard work," she says. "You're having to prove yourself all the time." 

During the last decade or so, the Ministry of Health has been paring back limitations on what nurse practitioners can legally do. 

For example, they can now hand out sickness or death certificates - just like a medical practitioner. They can also prescribe medicines.

The President of the Royal NZ College of General Practitioners, Dr Samantha Murton, says all allied health professionals have a role to play and no one's replacing anyone else. 

"What's happening is we are just increasing the volume of workers ... so that we can do the increasing volume of work." 

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