A burning desire to do more for his patients was the driving force behind Jason Walters’ 20-year quest to become one of South Australia’s first Nurse Practitioners.
“I’d been working as a Registered Nurse, primarily in acute emergency settings, when I started my advanced practice training,” Jason says. “It was back in 1996 when there was a lot of talk about Nurse Practitioners but no real clarity about what the role actually meant.”
“I always had an interest in emergency care and found myself thinking ‘I could be doing so much more to help my patients’ beyond the scope of practice of a Registered Nurse’.”
“Outpatients would come in and you’d know what they needed, but you’d have to wait for one of the doctors to do it.”
He says he had no interest in pursuing a career in medicine.
“I never wanted to be become a doctor and still don’t, but certainly wanted to see how much more I could do in nursing.”
“I moved into management for seven years, but I felt the administration side of things detracted me too much from the clinical care work that I loved.”
As a prerequisite to his advanced practice studies, Jason had completed a graduate diploma in emergency critical care, covering areas such as cardiac care, trauma management, suturing, plastering and x-ray interpretation.
Next, he undertook Masters studies (including more than 5,000 hours of advanced practice), graduating in 2013.
Three years later, Jason became one of South Australia’s first nurses to be endorsed and credentialled for both public and private sector to operate within the broadest scope possible within the profession.
Study steps to becoming a Nurse Practitioner
1. Bachelor of Nursing degree – 3 years
2. Graduate diploma – 2 years
3. Masters – 3 years and 5000 hours of advanced practice experience
“I’ve been an endorsed and credentialled Nurse Practitioner since 2016,” he says. “I can admit, prescribe and discharge. I see everything, I assess everything and then I work out which patients I can manage myself, who needs to go to a specialist and who needs a GP to look after their overall care.
Jason is now one of South Australia’s only Nurse Practitioners credentialled to perform the role both in an acute setting, at the Lyell McEwin Hospital emergency department, and as a private fee-for-service practitioner in regional South Australia.
“At the Lyell McEwin Hospital, I work within the within the scope of an emergency department Nurse Practitioner and as a generalist practitioner with a much broader scope of practice in the Riverland.”
“I largely balance my time between the Lyell McEwin and private clinics,” he says, adding, “I’m also credentialled to work as a Nurse Practitioner at Karoonda Hospital and Mannum Hospital in an emergency and general primary health capacity.”
“I handball things when they’re too complex, and when they’re out of scope or outside of my comfort zone I seek advice or refer the patient to a specialist.”
Setting up a collaborative arrangement with a medical practitioner is a requirement to access Medicare billing and PBS prescribing in a private capacity.
“You have to get a good supportive general practice behind you. At least in that collaborative arrangement, have someone who’s going to teach you and support you.”
“I used to call my collaborative GP partner every day for advice, but now I’d be lucky to ring him once a fortnight.”
“If patients have more complex health issues and have multiple systems going on, I’ll tell them I’m happy to share their care, but they’ll need a GP to oversee their whole care. For example, if I saw someone with renal failure, hypertension, diabetes and chronic heart disease, I would be happy to give them a script and refer them to a specialist.”
He says the barriers he once faced for essentially sitting ‘between camps’ are now starting to break down.
“Some medical staff felt threatened by the increased scope of practice of a Nurse Practitioner, and some needed reassurance that I wouldn’t be competing with them, which is understandable.”
“I’m not here to replace a doctor, I do my own thing.”
Jason says some practices also used to knock back his referrals for services.
“Occasionally I would get a call from a medical practice manager questioning whether my provider number was real, as they were concerned they weren’t going to get paid by Medicare. There aren’t a lot of us in the state, and it’s a relatively new system, so many practice managers hadn’t come across the role and its scope.”
“Many doctors know me now and they know what I’m capable of, so those issues—for me at least—are largely a thing of the past.”
In fact, Jason now provides education and training in emergency medicine for rural GPs, paramedics and nurses.
It is this diverse mix in his working life that Jason loves most.
“I wanted to keep my hand in emergency care at Lyell McEwin Hospital, so I work there part-time,” he says. “But I also do four education sessions a month, work fortnightly at Karoonda Hospital, have bulkbilling clinics in Barmera each month and I’m the only visiting health practitioner servicing Morgan each week.”
“It’s challenging, it’s fulfilling, and it really does give me the best of both worlds.”