Managing approaches to nursing care delivery

Contemporary healthcare systems are characterised by their complexity and also the pressures they experience due to increased demand, technological complexity and fiscal constraints. Nursing is a dynamic profession, delivered in a wide variety of settings and in a range of models and regulatory frameworks. The role, scope and function of nursing practice are driven by the social, political and economic contexts in which the care is delivered. For exan1ple, in countries such as the USA there is a greater emphasis on independent nursing practice, whereas in other countries (such as Australia) there is less of an emphasis on these roles because of opposition in introducing these roles. It is only in recent years in Australia that the nurse practitioner role has been included in healthcare delivety models4 Encouraging _a range of policy changes has enabled the enacttnent of the nurse practitioner role. In recent times funding and policy changes have seen the rapid development of the nursing role in Australian general practice. This represents an exciting time for the nursing role in primary care.