FAQs – broadleafhnpservices

What is a Nurse Practitioner?

A Nurse Practitioner (NP) is an autonomous health professional who holds the highest qualification available for a registered nurse as recognised by the Nursing and Midwifery Board of Australia (NMBA). NPs provide advanced and holistic assessments and treatment plans. NPs are also able to diagnose medical conditions and prescribe pharmacological and non-pharmacological treatments as indicated within their chosen scope of practice. The credibility, efficacy and safety of NPs in diverse healthcare settings have been demonstrated in Australia and internationally. Since the NP role’s birth in the United States in the 1960’s, health care models using the NP role have extended to approximately 70 countries worldwide, including the United Kingdom, Canada, New Zealand and Australia. The role of the NP is to improve access to treatment, provide cost-effective care, target at-risk populations, provide outreach services to rural and remote communities and provide clinical mentorship and expertise.

There are four core activities which define the advanced, extended and collaborative role of NPs in Australia:

Advanced knowledge, skills and expertise in diagnostic assessment and reasoning
The ability to independently prescribe medicines
The ability to independently request and interpret diagnostic tests (pathology, imaging studies, etc)
The ability to independently refer to medical specialists

NP’s use an approach that is nursing-based, focusing on the client’s sense of self and needs as a whole. NPs diagnose problems and treat those problems. However, NPs are unique because they provide meaningful care and support that incorporates everything that is important to the client, inclusive of their community, cultural and spiritual needs.

What kind of services do you provide?

My clinical speciality is mental health. The services Broadleaf rovides are listed under the ‘services’ page.

How old do I need to be to access your service?

I provide my services to clients 5 years and older.

I also provide my services to elderly clients; there is no age limit to people who can access my service.

Do you bulk bill? How am I charged?

Broadleaf is a mixed-billing practice. I appreciate financial hardship and I wish I could bulk-bill everything. Unfortunately, the Medicare system is designed to reimburse Medical Practitioners, not Nurse Practitioners.

The services Broadleaf provide are high quality, holistic and evidence based. I pride myself on providing the kind of service that I would want myself and my loved ones to receive.

Please refer to the Fees page to see which entities Broadleaf is a provider for (for example Victims of Crime/NDIS/Aged Care Package). If you are eligible for services under one of these pathways, you will not pay an out-of-pocket fee.

Please contact Broadleaf if you need advice to determine which healthcare pathway you are eligible for.

If you are a private client and you require support and care outside of your organised clinic appointments, these sessions will be bulk billed.

Broadleaf’s ability to provide services under each of these health care pathways is limited and subject to availability.

Broadleaf’s ability to provide services under each of these health care pathways is limited and subject to availability.

Who does a Nurse Practitioner collaborate with?

Nurse Practitioners have a collaborative agreement with a doctor of their choice. This enables Nurse Practitioners to be able to work privately and to be able to access Medicare billing. This collaborative agreement also enables the Nurse Practitioner to be able to consult with that doctor, if needed.

As a client of Broadleaf, you will receive a copy of the treatment plan that is agreed upon together.

Broadleaf sends all of the assessment and treatment plan notes to your GP with your consent. This process is in place so that your GP can also support you with your treatment plan.

Broadleaf can also send assessment and treatment plans to other people in your care team, including your carers with your consent.

Evidence-based practice demonstrates that collaborative care (sharing and utilising the knowledge and skills of different expertise) is more effective than working alone. Therefore, with consent, Broadleaf will refer clients to any organisation that will further support their care, as part of their treatment plan.

If I’m seeing you, do I need to see a Psychologist?

If you are seeing Broadleaf for therapy or counselling, then no, you do not need to see a Psychologist.

If you are seeing Broadleaf for depression and anxiety treatment optimisation, then you will likely need to be referred to a psychologist as a part of your treatment plan. This is because the assessment and treatment planning for depression and anxiety treatment optimisation that I provide is intensive and does not allow time for Broadleaf to also provide formal therapy sessions on top of these sessions.

If you have an existing Psychologist or Counsellor as a part of your treatment and you would like to see Broadleaf for other aspects of your mental health recovery, this can be facilitated.

If I’m seeing you, do I need to see a Psychiatrist?

Unlikely. However, if I feel that you need to see a Psychiatrist (or another health professional) then I will refer you to the appropriate health care professional.

If you have an existing Psychiatrist a part of your treatment and you would like to see Broadleaf for other aspects of your mental health recovery, this can be facilitated.

What can’t a Nurse Practitioner do?

Medicare doesn’t subsidise everything Nurse Practitioners are trained to safely and competently do. This is unfair and may result in higher out-of-pocket costs for healthcare consumers choosing a Nurse Practitioner as their provider. There are also restrictions at the State/Territory level which prevent Nurse Practitioners from working to their full scope of practice. Examples of these include:

Signing workers’ compensation forms
Signing driver’s licence medicals
Approval of formal “GP Chronic Disease” or “Mental Health Management Plans” that result in patient subsidies
The Inability to be able to prescribe particular medications e.g psychostimulants and clozapine.

Do the above restrictions sound ridiculous? We think so too!

These restrictions result in duplication of care and increasing healthcare expenditures. If you’d like to find out how to lobby your local member in order to advocate for Nurse Practitioners so we can provide these services, and for Nurse Practitioners to be paid equitably through Medicare to reduce gap fees, please contact Broadleaf.

What’s needed for new clients?

Private clients can book in to see me directly throughmessaging Broadleaf through the Contact tab on the Broadleaf website or directly via email: [email protected].

Private clients do not need a mental health plan or GP referral to be seen by Broadleaf.

Private clients are able to be seen by a Nurse Practitioner at Broadleaf for an unlimited number of sessions.

Clients who are eligible to be seen by Broadleaf under a Government funded health care pathway (for example, The Primary Health Network) have a limit to the number of sessions they can access and they need a GP referral. Please contact Broadleaf for more information.

GPs and other health professionals can refer clients to Broadleaf through messaging Broadleaf through the Contact tab on the Broadleaf website or directly via email: [email protected].
NDIS clients or Care Coordinators of NDIS clients can message refer clients to Broadleaf through messaging Broadleaf through the Contact tab on the Broadleaf website or directly via email: [email protected]. Please note that an NDIS agreement will need to be arranged between the NDIS client/NDIS care agency and Broadleaf. The number of sessions available for the NDIS client with Broadleaf will be dependent on the client’s existing NDIS funding package and client’s individual needs.
Victims of Crime ACT clients can be referred via Victims of Crime Support Services to Broadleaf through messaging Broadleaf directly via email: [email protected]

How many sessions might I need?

A lot of this depends on the needs and complexities of the individual.

For depression and anxiety treatment optimisation: I am to support the client to achieve remission with their depression symptoms within 3 months of entering the program (or less). After the initial assessment, review appointments are usually scheduled every 2-3 weeks. I will support the client in every way that I can. However, clients recover the quickest when the individual puts everything they can into their agreed plan. If the client reschedules appointments frequently and doesn’t take agency in their recovery, the recovery process will be disrupted. An agreed plan between the client and Broadleaf will be created/revised each session. The agreed plan entails recovery goals and strategies guided by the clients individual needs, and is supported by the expertise and care of Broadleaf.

For people who require Dialectical Behavioural Therapy (DBT): the frequency and amount of sessions will be outlined in their existing DBT plan. Most clients who are receiving DBT will require a weekly session of therapy for a period of 8 months. Evidence shows that some clients need to complete the whole DBT program twice to receive the best health outcomes.

For clinical supervision, mentoring and preceptorship: The number of sessions required again, really depends on the needs of the individual. Most people receiving this kind of service have a session once a month with a review of the clinical supervision/mentorship/preceptorship agreement and goals every 6 months. Some people require this service for one period in their career. Other people have long standing supervision/mentorship/preceptorship arrangements in place to enable them to have continuous support in their professional development.

What are some common treatment approaches that Broadleaf offers?

Your treatment approach will be based around your recovery goals and your individual needs.

You will find that within your assessment and treatment planning sessions for depression and anxiety treatment optimisation with that psychological therapy/counselling is intertwined within the sessions. Broadleaf’s psychological therapy/ counselling is underpinned by training in trauma-informed practice, Cognitive Behavioural Therapy, Acceptance and Commitment Therapy, Dialectical Behavioural Therapy and Motivational Interviewing.

I have undertaken yoga teacher training in Mysore in India, I meditate regularly and I am continuously learning and practicing different philosophical and spiritual approaches that support human wellbeing. I’m a volunteer running guide for people who are blind and/or have other disabilities and I’m also a volunteer boxing coach and athlete. You will find that my clinical practice is underpinned by what I have learned through all of this. Physical activity, meditation, philosophy and spirituality are after all, linked with happiness and wellbeing.

My clinical practice is guided by an approach that is not just evidence based but also innovative. This is why so much of my clinical work has been tied into research studies and quality improvement projects in the public sector. An example of this in practice is when I was the nurse consultant at a youth residential recovery program for mental health. The residents of the program identified that they desperately wanted a pet. Evidence shows that pet therapy is effective for emotional regulation and wellbeing. Subsequently, I trialled a quality improvement program for pet therapy for the residents which showed that the pet therapy was a proven therapeutic intervention for the residents. I then applied for funding for a pet therapy program to be put in place permanently for the residential program, and it was.

Throughout all of my services, I use SMART goals that are agreed upon between the client and myself. These goals will be based around the individual needs of the client. SMART stands for specific, measurable, achievable, realistic and time driven. SMART goals make recovery more achievable. This is because this framework has the client accountable for their progress and progress is also easier for the client and the Nurse Practitioner to be able to evaluate. If someone isn’t reaching their smart goal, it doesn’t mean that they are in trouble, it just means that the client and the Nurse Practitioner need to work out the barriers to achieving the goal and what needs to change to be able to make that goal happen.

Combat sports serological clearances, that's random. Why do you do you offer that service?

I am actively involved in the martial arts community. This community has given me so much, to help me be strong as a person, physically and mentally. At present, I am both a boxing coach and athlete. I am also supporting my gym to apply for a ‘Youth on Track’ boxing program to provide a program to deter underprivileged youth from entering or re-entering the justice system.

Nurse Practitioners aim to close gaps in the healthcare system. As it stands, when a combat sports athlete requires a serological clearance to compete, they need to go through a complicated and timely process to be able to make this happen. There is also a huge shortage of GPs in the community. This results in a lot of athletes not being able to have their serological clearances completed in time to compete, despite all the hard training that they invested. Therefore, I am trying to give back to the combat sports community through providing a serological clearance service for combat sports athletes with no out-of-pocket expenses. This process is time efficient and uncomplicated and also provides a screening assessment to be able to identify people who are at higher risk of obtaining blood borne viruses.

To support this service Broadleaf has completed the following modules through the Australasian Society for Viral Hepatitis and Sexual Health Medicine:

– Hepatitis C in Primary Care.

– Introduction to HIV.

– Hepatitis B for Primary Health Care Nurses.

Face to face sessions or video call?

Telehealth and video calls are available so that clients can access this service, no matter where they are.

Educational presentations and training can be provided to facilities across Australia face to face or via video call. Please contact Broadleaf to discuss fees.

Can Nurse Practitioners prescribe medicinal cannabis?

Nurse Practitioners have the authority to prescribe medicinal cannabis. Please note that a client’s request for medicinal marijuana does not equate to an automatic prescription of this medicine. All pharmacological therapies are only indicated when non pharmacological therapies have been considered and tried. Medicinal marijuana can be indicated in treatment as part of a holistic care plan when a comprehensive assessment has been completed and it’s firmly demonstrated that other first line treatment options (non pharmacological and pharmacological) have been trialled and have not been very effective. Broadleaf has completed training for safely prescribing medicinal cannabis through ‘The Doctor’s Guide to TGA Approved Medicinal Cannabis Indications’ via the Medihuanna program.

Can Nurse Practitioners Diagnose Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD)?

For people diagnosed with ADHD, first line treatment is considered to be psychostimulant medication. Unfortunately at the present time this can only be initially prescribed by a Psychiatrist. Nurse Practitioners in various states can provide continuing scripts for psychostimulant medication. Unfortunately Nurse Practitioners in NSW cannot provide continuing scripts for psychostimulants and Broadleaf is based in NSW. It’s clear that people with ADHD in Australia are facing extreme problems in finding available and affordable support through Psychiatrists to be able to access Psychostimulant treatment for ADHD. This current situation is not acceptable. Broadleaf, alongside the Australian College of Nurse Practitioners are advocating for change for Nurse Practitioners to be able to provide initial and continuing prescriptions of psychostimulant medication for people with ADHD who need this specific treatment. This advocacy has been provided to the Australian Government’s Senate inquiry into the barriers of consistent, timely and best practice assessment of attention deficit hyperactivity disorder (ADHD) and support services for people with ADHD. If you would like to also advocate for these changes, please contact Broadleaf.
All Nurse Practitioners can however prescribe second line medications for ADHD (non psychostimulants) which are also effective, especially for people who cannot tolerate psycho stimulant medication. Broadleaf provides initial screening for those who demonstrate potential traits of ADHD. Broadleaf has completed all modules required through the the CADDRA (The Canadian ADHD Resource Alliance) ‘Introduction to ADHD for Health Professionals’. CADDRA is a Canadian non-industry, not-for-profit, independent association. They are an alliance of healthcare professionals supporting patients with ADHD.
Nurse Practitioners are part of the treating team to help support diagnostic testing for ASD. Broadleaf provides initial screening for people who may show traits of ASD. An involvement of a Psychologist is needed to complete testing for ASD. Occupational Therapists and Speech Pathologists are other integral health professionals involved in testing for ASD and providing appropriate support strategies.

Do you provide Family Therapy and Couples Therapy?

Yes, Broadleaf provides Family Therapy and Couples Therapy.
Broadleaf has completed Intensive Family Therapy Training (inclusive of Couples Therapy) and Compassion Fatigue training through the Bouverie Centre (Family Therapy Institute, Melbourne).