Should nurses be performing endoscopies?
It is often the case that we should ask ourselves not whether we could, but whether we should, be involved in certain aspects of clinical care. Where nurses are involved in performing endoscopy, this complex clinical skill should be embedded in the scope of practice of a nurse practitioner.
The ANF is represented on the Project Advisory Group for the Health Workforce Australia Expanded Scopes of Practice Program: Advanced Practice in Endoscopy Nursing Project. The impetus for this work is the expected demand emanating from the introduction of the National Bowel Screening Program. Currently the pilot program involves two possible pathways: one in Queensland which supports the nurse practitioner pathway; and one in Victoria, which doesn’t.
Nursing has fought against the deconstruction of the holistic nature of our role to allow for lesser qualified or unqualified workers to provide components of nursing care. In turn, we don’t want to take on clinical tasks as segments of care. Rather, this should be as a component of a comprehensive nursing role that provides better access to safe and competent health care.
Our medical colleagues and consumers are more likely to be supportive of nurses’ involvement in endoscopy, when they can be assured that this is undertaken by experienced and highly qualified nurses having completed the nurse practitioner pathway. Unless the care, both nursing and medical, is coordinated and provided under a professional practice framework, the risk of fragmentation remains, and safety and quality of care is compromised. We already have a framework for this advanced practice nursing – the nurse practitioner.
If we are serious about retention of nurses, which predicted shortages tell us we must be, then we need to support nurses undertaking endoscopy. How do we do this? By investing in their ability to follow a nurse practitioner pathway and creating positions for them once endorsed. This is not only important for the individual nurse, but is of national significance. It will ensure shared understanding of the role and portability for employment.
Let’s not set ourselves up to be accused of being morally inconsistent. We need to do what is in the best interests of consumers, nurses themselves and our health professional colleagues.
For more information on the Health Workforce Australia Advanced Practice in Endoscopy Nursing Project go to: www.hwa.gov.au/work-programs/workforce-innovation-and-reform/extended-scopes-of-practice-project/practice-in-endoscopy-nursing
Federal Senior Professional Officer