Nursing has opened numerous doors for Melanie Dunstan throughout her career. But it was becoming a nurse practitioner that truly enabled her to deliver the greatest amount of care to clients, particularly reducing delays and increasing access to healthcare.
As the current president of the Australian College of Nurse Practitioners, she remains committed to advocating for the specialty so that others can also strive to do more.
The ANMJ chats to Melanie about her role with ACNP and the way forward for NPs in Australia.
Tell us a little bit about your nursing/midwifery journey?
As a child, I wanted to be a teacher but found during work experience that this wasn’t for me. Nursing was something lower down my list of university choices but gee what a ride!
From my early days being a general medical nurse in a metro Melbourne Hospital, moving to midwifery, then moving to the country and being able to expand into community roles and explore both primary health care and Aboriginal Health led me into Child Health Nursing while working at an Aboriginal Medical Service, then into flying with the Royal Flying Doctor Service in Rural and Remote Qld as a Primary Health Care Nurse, before becoming a Nurse Practitioner. And I have continued to expand and evolve my scope as needed. My nursing career has brought me so much joy and taken me more places than I ever imagined.
What motivated you to become a Nurse Practitioner?
I was working in remote communities and could see delays in access to healthcare and started to explore how I could improve and change this for my clients.
I was inspired by another Nurse Practitioner but thought I didn’t have the skills, but she encouraged me and a couple of friends to do the NP course. I was driven to change healthcare and use my skills to improve access and reduce delays for my clients and this was clearly the next step I needed to take in my career.
What does your role as a Primary Health Care Nurse Practitioner involve?
My role is very broad and continues to change and evolve based on the needs of my clients. I am a generalist, but I have sets of skills that I use to manage and treat my clients.
The health outcomes I am hoping to achieve are that when I review a client, I hope that I have addressed their presenting concern but that I have considered a holistic nursing view of what is the situation for this client, as well as covering preventative health and health promotion topics relevant to them.
You became president of ACNP last year. What are your key objectives for the specialty?
It is a privilege to be in this role and one of my key objectives is for Australians to have access to a Nurse Practitioner as a part of their healthcare team. But for this to occur, many things need to happen, including increasing the number of Nurse Practitioners, a greater understanding [of the role] in the general community, within governments and with policymakers, and improvements to the funding models and barriers for NP’s to enable them to work to their full scope of practice.
How do NPs add value to healthcare?
Nurse Practitioners have the unique ability to bring a team together in a way that is sometimes hard to put into words.
Most Nurse Practitioners have worked in a high-level of either clinical or management roles before they complete their Masters training, which gives them unique skills to be able to manage teams like no other profession.
They can think about clients’ situations in a holistic manner that is unique to the NP role, due to the skills that a NP has gained over years of experience. Case Management and pulling together of teams is something that NPs do extremely well.
What are the major challenges and opportunities facing NPs in Australia?
MBS – working to advocate with the federal government and the Strengthening Medicare Taskforce to make changes to the MBS to increase access for clients of Nurse Practitioners – for greater equity and improving the system.
Numbers of Nurse Practitioners – increasing the number in Australia – Through scholarship opportunities, mentorship and support for advanced practice nurses, education, and events.
Funding for NPs in Private Practice – advocating for the profession to make this an equitable model for NPs choosing to work in this space. Highlighting models that work and promotion of NPs working in these areas.
So many to mention – Lots of things happening in the public and state health systems too. Credentialling and transition of skills between services, appropriate funding for NP Models. Career Progression and support for transition into NP roles.
What has ACNP contributed to the current Scope of Practice Review?
The ACNP has been very active in contributing and encouraging members to contribute to the scope of practice review. The barriers and limitations that exist currently that restrict Nurse Practitioner practice are frustrating to not just NPs but our clients.
My hope is that with removal of these barriers, we will have improved access to care for clients and healthcare that is timely and equitable, available close to the clients’ homes, with a suitable provider of their choosing.
What key projects is ACNP focused on this year?
We are working on progressing the Nurse Practitioner Workforce plan that was released last year. This sets the roadmap for progressing our profession into the future and is a guiding document for the steps to be taken to advance the NP role.
The board has been working on the strategic plan and looking at ways to innovate and expand the benefits to members.
List one key takeaway from last year’s ACNP annual conference.
The one key takeaway for me was that Nurse Practitioners are valuable and needed in the Australian healthcare landscape. We are innovative, adaptable, and able to flex and bend to support the needs of our clients and we make things work, and we do it in a way that is like no other profession.
Our numbers are consistently growing, our future is bright, and our voices are being heard. We are asking for change to allow us to work to the best of our ability to meet the needs of our clients and we won’t give up.
What advice would you give to a nurse who wants to become a Nurse Practitioner?
We need more nurse practitioners in Australia and if you believe that you can make a difference to your clients and can make a difference to the healthcare landscape in Australia, we would love to have you. It’s a steep learning journey but the rewards are great, and the clients appreciate the role.
