The nurse practitioner will see you now

Nurse practitioners are filling the gap in the health care system and in aged care they play a pivotal role in residents health care.

“The accessibility to GP’s (general practitioner) from an aged care point of view is quite difficult,” says Kate van Duuren, clinical care coordinator and nurse practitioner at DutchCare’s Overbeek Lodge in Kilsyth, Victoria.

“In aged care there is an expectation that the doctor comes every couple of months so drug charts are reviewed, and they’re available for family meetings or phone conversations if there is an acute health issue or a chronic flare up.”

According to Ms van Duuren GP’s often don’t want to take on more aged care clients because of the paperwork and because they have to be much more involved.

“It’s a lot more time consuming than just a person coming into the doctors surgery for five minutes. With that in mind I think there certainly is a huge role for nurse practitioners in aged care.”

Ms van Duuren has worked as a nurse in aged care for more than twenty years and became a qualified nurse practitioner 12 months ago.

“I work in close collaboration with the GP’s. We still need a GP in the aged care setting but I’m the back up for when we can’t reach someone’s doctor or if there’s a sudden change of health that we need to act upon more promptly.

“Instead of waiting for a locum to come in when the GP is not available, I can assess residents and transcribe the medication charts.”

Although Ms van Duuren hasn’t personally come across any hurdles in her role of nurse practitioner, some doctors can be highly negative and are of the opinion that nurses should just nurse and let the doctors do the medical management.

“Our doctors have been fantastic and if I can’t reach a GP they’re happy for me to implement common sense and make changes as needed, based on clinical assessments. There is a mutual respect.”

A residents regular GP might still come in to review any changes made by Ms van Duuren but after that they might not see the resident again for another week.

“And because I’m on site I can constantly review a resident and provide constant medical support for the care staff, which is invaluable.”

Having access to a nurse practitioner on site also gives peace of mind to residents and their family.

“They know that if mum is not well it’s ok if the doctor can’t come in because Kate’s here and she’ll actually review and work in place of the doctor.”

There are currently not many nurse practitioners working in a nursing home setting although according to Ms van Duuren interest is growing.

“Aged care is not considered highly glamorous by a lot of people,” Ms van Duuren says.

“I think there is a general view that people go into aged care because they don’t need to be astute and they don’t quite appreciate that we do it because we love it.

“I started working as a PCA during my nursing training to pay for uni and I fell in absolute love with the older person.

“I like the relationship that you develop with residents and their families in a real home environment. The holistic care from an aged care perspective is really important to me. Meeting the social and emotional wellbeing and not just the actual ailment that brings a person into fulltime care.”

Ms van Duuren is one of the speakers at the upcoming Aged Care Nurse Managers Conference in Melbourne, where she’ll present a general snapshot of her day-to-day work as a nurse practitioner at Overbeek Lodge.

She’ll give examples of what’s she’s presented with on a regular basis and speak about her approach, what she can and can’t do in her role, how quickly she can make changes and how she can make a difference in terms of transfers to hospitals or emergency departments.

“To transfer an elderly person at 10 o’clock at night because they’re acutely unwell and you couldn’t get a doctor in, the confusion that goes with it, the stress on the family and the elders, I can’t even put that into words.

“Nobody wants to be transferred to hospital. The families and the elders are aware that if I make some changes medically it could prevent them from deteriorating or potentially having to be transferred elsewhere.”

Kate van Duuren is speaking on day one of the Aged Care Nurse Managers Conference, held on 20 and 21 April in Melbourne. The conference coincides with the Dementia + Community Care Conference and Facilities Management in Aged Care Conference and a combined trade expo, at Caulfield Racecourse.

Visit Total Aged Services for more information, a full program or to register for any of the conferences.