The non-medical surgical assistant in Australia: who should contribute to governance?

Abstract

Objective: This paper focuses on the role of the Non‑Medical Surgical Assistant (NMSA) in Australia. Registered Nurses predominately perform this role. This paper will articulate a position to:

• validate this role as an Advanced Practice Nursing (APN) role in Australia through regulation and governance by the Nursing and Midwifery Board of Australia (NMBA) who sit under the umbrella of the Australian Health Practitioner Regulation Agency (AHPRA);


• lobby AHPRA to recognise, regulate and protect the title of Advanced Practice Nursing (APN) roles other than the Nurse Practitioner (NP) in Australia; and


• as a result of sanctioned regulation, facilitate APN (including NP) to seek appropriate remuneration for undertaking this role in the private sector in Australia.

Setting: The Australian Healthcare system.

Subjects: Clinicians performing the role of the NMSA in Australia.

Primary Argument: The NMSA is well established with clear mechanisms for governance internationally. This role has been practiced in Australia for more than 20 years, and while clinicians function under the guise of advanced practice, the role is not clearly defined, standardised or regulated. This is partially attributed to lack of sanctioned governance from AHPRA.

Conclusion: While the AHPRA via the NMBA are reluctant to formally recognise and regulate this role, the overwhelming majority of clinicians in Australia are nurses. Without regulation, it is difficult to quantify the role as APN. Lack of governance excludes NMSA (including the NP) from access to the Medicare Benefits Schedule and private health funds for intraoperative reimbursement thereby rendering a potentially cost-effective role unsustainable to many clinicians.