Gone are the days when the job of a practice nurse was solely to be at the doctors' bidding. Now they are often the first, and only, medical professional a patient will see when they visit their GP.



This Saturday is International Nurses Day, to recognise and celebrate the role nurses play in the medical and care professions. That includes practice nurses, who are taking an increasingly significant part in the delivery of primary healthcare in this country despite sometimes being a forgotten group.



Ministry of Health figures show the number of consultations by practice nurses throughout New Zealand rose from 1.4 million in 2008 to more than 2.3 million last year.



Health Minister Tony Ryall believes that increase has given New Zealanders better access to care and has enabled more people to be seen by general practices.

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"Many practice nurses run their own clinics and have appointment schedules as full as their GP colleagues'," he says.



General Practice New Zealand executive member Ros Rowarth, a senior practice nurse, says there has been a huge change in her role over the past 20 years.



"When I first started we were very much being told what to do by the doctors," she says. "It's a much more autonomous role now."



She says today's practice nurses need a broad knowledge of a lot of things, have to be able to treat many of them and, crucially, must be able to recognise when to refer a patient to a doctor or a specialist.



"On any given day I could be vaccinating babies and adults, dressing a wound, giving advice on diabetes and asthma, doing STD checks and educating people on diet and lifestyle."



Rowarth believes the expanded role of the practice nurse has many advantages for patients.



"The first thing is they get seen in a more timely way with less waiting," she says.



"Secondly, nurses are taught how to help people and how to manage things in a different way to doctors."

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She says practice nurses develop longer-term relationships with families, which help them identify underlying issues and recognise when the presenting problem is, in fact, a manifestation of something deeper.



In addition, some people will readily tell nurses things they may not want to "bother" a doctor with.



Rowarth says nursing graduates are now coming out of college and choosing to go into practice nursing - it's no longer seen as the cruisy option for nurses. "We have full-on days and we never know what we are going to be dealing with, so it's exciting. I can't imagine being any other sort of nurse."