Employing a nurse practitioner
This page provides information to public and private sector employers of nurse practitioners.
There are two methods to employ a new nurse practitioner within your practice. You may either:
- hire a registered nurse practitioner through an open recruitment
- develop an existing registered nurse into a nurse practitioner role.
Open recruitment
There are over 50 different specialty areas in which nurse practitioners in the ACT practice that you could advertise for in an open recruitment.
To attract the right candidate, we recommend you consider including a statement in job advertisements that “experience in [a specific specialty area] is highly desirable, but not required for the right candidate who is willing to expand their practice through mentoring and a supportive work environment”.
If a candidate does not have experience in the advertised area of practice, you will need to carefully review the nurse practitioner’s capability and the time required to expand their practice to meet job requirements.
You are able to identify whether your nurse practitioner holds the Nursing and Midwifery Board of Australia (NMBA) endorsement by checking the national register, which is maintained by the Australian Health Practitioner Regulation Agency (AHPRA).
It’s important to note the NMBA no longer issues physical registration and endorsement certificates.
The online register is the single point of truth relating to whether nurses are registered and/or are endorsed with the NMBA, and whether they have conditions or undertakings on their practice.
Nurse practitioners who are endorsed by the NMBA may use the Decision-Making Framework for Nursing and Midwifery to help make practice decisions relating to their intended scope of practice and independently expand their knowledge and skills into new areas.
In addition, the Nurse Practitioner Clinical Learning and Teaching Framework uses the concept of “metaspecialties” to help guide the development of clinical learning and teaching goals for NPs wanting to expand into different areas of clinical practice.
Ultimately, scope of practice is jointly determined by the nurse practitioner, their employer, and the intended requirements of the role.
A nurse practitioner going into a different area of practice must determine, in collaboration with their employer, what additional education, training, and clinical governance will be required to safely expand their clinical scope of practice.
A good way of expanding the nurse practitioner’s practice is by starting them in their scope of practice comfort zone, with a mutually agreed upon plan, milestones and timelines for expanding practice into different facets of their new practice area.
This plan should include appropriate review and oversight by the employer and an experienced clinician mentor, who should be a medical practitioner or nurse practitioner.
Developing a registered nurse into a nurse practitioner role
Registered nurses employed within your practice can be developed into nurse practitioners.
A registered nurse must demonstrate 5000 hours working at an advanced level of practice in the previous six years, and have successfully completed a Master’s degree from an accredited Australian university before they are able to demonstrate the registration standard required for endorsement by the NMBA.
In order to gain entry to an Australian Master of Nurse Practitioner program, the registered nurse must demonstrate the following:
- current registration as a registered nurse
- a postgraduate qualification (Graduate Certificate or Graduate Diploma) in a clinical field relevant to the registered nurse’s intended clinical field
- a minimum of two years’ full time equivalent (FTE) as a registered nurse in a specified clinical field
- a minimum of two years’ FTE working at an advanced level of practice in that same clinical field.
A list of universities offering the Master of Nursing (Nurse Practitioner) degree is available on the Australian Health Practitioner Agency website.
The determination of an advanced level of practice does not relate solely to, or require the ability to undertake technical procedural skills (for example, suturing, plastering, insertion of contraceptive devices).
The demonstration of advanced practice requires the nurse demonstrate a high level of nursing practice across five domains:
- clinical care
- optimising health systems
- education
- research
- leadership.
The ADVANCE Tool can assist nurses and employers determine if the registered nurse is working at an advanced level of practice or highlight areas for future professional development.
Once enrolled in a Master of Nurse Practitioner course, the student should expect to graduate in 2-3 years, depending on the program and their progress.
Standard salaries for nurse practitioners
Salaries for nurse practitioners depend on whether they are employed in the public or private health sectors.
The public sector has Enterprise Agreements that determine an employed nurse practitioner’s salary and work conditions in the ACT.
Minimum work conditions for nurses employed in the private sector have been established by the Fair Work Commission through the Nurses Award 2010.
Employers should note salary rates listed in the Award are far below that of public sector enterprise agreements and nurse practitioners in the private sector must determine their own salaries in negotiation with employers.
Funding models to support nurse practitioner positions
There are two primary funding models that support nurse practitioner positions: public or private funding.
Both funding models benefit from a needs assessment, development of a relevant business case, and consideration of supporting outcomes measures that will promote growth and long-term sustainability of nurse practitioner roles.
Public sector
It’s highly recommended public health services explore the advantages and disadvantages of ‘Block Funding’ vs ‘Activity Based Funding’ (ABF) using Tier 2 Non-Admitted Services for nurse practitioner roles.
Currently, the use of ABF funding to support nurse practitioner roles in outpatient clinics would appear to better support the growth and sustainability of the nurse practitioner workforce in the public sector.
Public sector nurse practitioners are not eligible for a Medicare provider number.
This may create unique issues for nurse practitioners in the ACT public sector, as employers will need to identify funding mechanisms that enable nurse practitioners to freely undertake core activities required of their roles.
These core activities include requesting diagnostic pathology and imaging, prescribing medicines, and referring to medical specialist and allied health services to their full scope of practice.
It is critical public employers identify how these core activities will be funded and facilitated, to appropriately enable their nurse practitioner workforce.
Private sector
Eligible nurse practitioners working in the private sector may obtain a Medicare provider number and use the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) to help subsidise the cost of care provision.
The MBS and PBS work to subsidise the costs of performing the core activities discussed above.
Importantly, to be eligible for MBS and PBS support the nurse practitioner is required to demonstrate collaborative arrangements.
Nurse practitioners working in the private sector, who do not use MBS or PBS subsidies in their clinical practice, are not required to demonstrate a collaborative arrangement.
Occasionally there are additional funding pools in the primary healthcare sector, including through non-governmental organisations and primary health networks when there are demonstrable gaps in service provision.
More information
Find out more about nurse practitioners’ scope of practice and how to gain endorsement from the following resources on the Nursing and Midwifery Board of Australia website: