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 12 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 private-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. For more information on medicare billing available to nurse practitioners, click here: https://www.bridginghealth.com.au/resources/Nurse-Practitioner-MBS-Items-August-2015.pdf
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). 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, if you request this.
Evidence-based practice demonstrates that collaborative care (sharing and utilising the knowledge and skills of different expertise) is more effective than working alone. Therefore, Broadleaf refers 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 me for therapy or counselling, then no, you do not need to see a Psychologist.
If you are seeing me 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 me 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 an NP as their provider. There are also restrictions at the State/Territory level which prevent NPs 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 through Halaxy via the ‘book here’ section under the Services tab on the website.
- 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 specialists can refer clients to Broadleaf through messaging Broadleaf through the Contact tab on the website.
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. A tip sheet of ways to ensure the best chance of recovery will be provided and discussed with each client entering the clinic.
- 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 supportive counselling is intertwined within the sessions. My counselling is underpinned by my training in trauma-informed practice, Cognitive Behavioural Therapy, Acceptance and Commitment Therapy and Dialectical Behavioural Therapy.
- 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. Please contact Broadleaf to discuss fees.