On 5 May 2015 the Medical Board of Australia (MBA) announced a joint initiative with the Australian Medical Association (AMA) to deliver a national health program for doctors and medical students.
In noting the importance of improving services for doctors with health concerns Dr Joanna Flynn, MBA Chair said, “The Board is committed to supporting the wellbeing of all doctors and medical students in Australia. Creating health services that are accessible and fair to everyone – and are targeted to meet doctors’ needs – is a really important contribution we are proud to make.”
President of the AMA, Associate Professor Brian Owler, highlighted that: “Critically, the services will remain at arm’s length from the Medical Board to ensure that doctors and medical students trust these services and use them at an early stage in their illness”.
This is all good news - for our medical colleagues, but what about nurses and midwives?
Nurses and midwives care for the health needs of other people in their daily practice. They manage health crisis situations for other people. They support other people through vulnerable times in their lives. Sometimes, however, the strength and resilience needed to care for others, in the course of their work, impacts on their personal life. Either, pressure is added to underlying health issues, or, the ‘coping’ mechanisms they turn to actually damage their health and thus their ability to safely practice nursing or midwifery. The ANMF’s position is that as caring professionals, and in the interests of retaining these nurses and midwives in the workforce, it’s essential we (the professions) assist our colleagues to address their health challenges.
We have, therefore, been strong advocates for some years, for the establishment of a national nursing and midwifery health program, run by nurses and midwives. In our submissions on this issue we’ve argued that this national program should work closely with the Australian Health Practitioner Regulation Agency (AHPRA) and the Nursing and Midwifery Board of Australia (NMBA), to support impaired nurses, midwives and students seeking to restore their health, and assist their return to safe and competent practice. We agree with sentiments expressed by the MBA’s Dr Flynn that the regulator’s focus is, and should be, on public safety. While this means the regulator cannot directly provide these services, the ANMF maintains the NMBA can, and should, fund them and work with stakeholders to make them happen.
The overarching components in designing a support/management model for health professionals with a health impairment are that the model be based on principles of confidentiality, trust, respect and professional accountability. Key features of the model are for it to:
- be confidential and independent of the NMBA;
- be promoted, accessible and free of charge;
- enable and encourage self-referral;
- provide assessment and case management by nurses and midwives to enable profession specific understanding;
- refer as required to other health professionals and support services;
- include development of an individualised management plan;
- provide monitoring and ongoing support;
- focus on rehabilitation;
- support re-entry to employment;
- offer support and advice on the management of the notification processes;
- be an accessible resource for nurses and midwives, employers and the profession, and
- use advanced IT infrastructure to enable engagement with nurses, midwives and students in all areas of the country.
An excellent example of good practice of referral, assessment, treatment and rehabilitation of impaired health professionals is the Nursing and Midwifery Health Program in Victoria. This program is an evidence based model, providing an initial contact point for referral and case management support for nurses and midwives with alcohol and other drug problems and/or mental health concerns, in order to promote individual health and wellbeing. Overseen by nurses and midwives this program works well with the regulator – NMBA, and when required, the employer.
This service model demonstrates a valuable resource to all industry stakeholders, including employers, professional organisations, the NMBA, education providers and the general community, for advice on how to approach nurses, midwives and students who may have a health impairment. A service of this nature may effectively intervene before the health issue impinges on a nurse’s or midwife’s practice. Early contact and appropriate action can provide the individual with the assistance required to enable them to continue practising safely and feel supported in their work environment. This early intervention and treatment may then circumvent the need for a notification to the Board.
The ANMF participated in a project commissioned by the NMBA and AHPRA in 2014, to explore the role of the regulator in the referral, treatment and rehabilitation of nurses and midwives with a health impairment. The project report is now with the NMBA for consideration. Surely there is an obligation for the Board to support these nurses and midwives so they are retained within the professions, as safe, competent health professionals. We support the NMBA providing ongoing sustainable funding for an independent service overseen and conducted by nurses and midwives. The result will be a significantly positive outcome for the professions and the public.
Julianne Bryce, Elizabeth Foley and Julie Reeves
Federal Professional Officers