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Nurse Practitioners (NPs) are registered nurses with an advanced scope of practice. 

Together the medical and nursing teams have recently developed a nurse practitioner program to complement our services. NPs are now part of the emergency care team at the Royal Melbourne Hospital (RMH) Emergency Department (ED).

NPs are educated and authorised to function autonomously and collaboratively in an advanced and extended clinical role.

The role includes assessment and management of clients using nursing knowledge and skills. It may also include, but is not limited to: 

• Direct referral of patients to other healthcare professionals
• Prescribing medications
• Ordering diagnostic investigations

The role is grounded in the nursing profession's values, knowledge, theories and practise.

The title "nurse practitioner" is protected, preventing the use of the title by anyone who is not endorsed by the Nursing and Midwifery Board of Australia (NMBA) as a Nurse Practitioner

In the RMH Emergency Department

The Emergency NPs' scope of practice at the RMH ED is currently developed to meet the needs of patients presenting to the ambulatory care setting. 

Within Victorian EDs, the mainstay of NP practice is minor injury or illness, treating patients deemed likely to be seen, treated and discharged within a four-hour time frame.

This NP model of care in emergency departments has been shown to:

• Reduce waiting times and delays to treatment
• Reduce ED length of stay
• Increase discharge stream National Emergency Access Target (NEAT) performance
• Increase patient safety
• Reduce the number of patients who did not wait for treatment
• Increase patient and staff satisfaction
• Provide a cost-effective and sustainable workforce

The department has a highly successful teaching program and examination success rates for registrars of the Australasian College for Emergency Medicine. This program includes multidisciplinary simulation team training. The department also has an extensive teaching involvement for University of Melbourne medical students and postgraduate nursing programs.

Medical

Our emergency department (ED) trainees are all enrolled in critical care ultrasound training during their term with us. Trainees performing bedside ultrasounds are always supervised by emergency physicians credentialed in bedside ultrasound.

• Didactic teaching - Trainees receive monthly lectures on ED ultrasounds covering echocardiogram, lung, Extended Focused Assessment using Sonography in Trauma (EFAST), abdominal aortic aneurysm, procedural ultrasound, abdominal and deep vein thrombosis ultrasound 
• Bedside teaching - Weekly bedside teaching with one of the ED ultrasound faculty enables trainees to practise and hone their skills
• Feedback - Scans are reviewed weekly and emailed feedback is provided including tips and tricks to improve imaging
• Supervision - We are able to supervise Certificate in Clinician Performed Ultrasound (CCPU) training in all modalities

It is expected that at the end of a 6 month rotation, trainees will achieve RMH accreditation or a CCPU in at least three modules. The RMH ED accreditation for bedside ultrasounds is recognised by all emergency departments in Victoria. 

Nursing

The ED ultrasound faculty provides ultrasound-guided intravenous access education to nursing staff to improve timely access to investigations and treatment to all patients. All nursing staff can enrol in this program and become accredited to perform ultrasound-guided intravenous access.

Critical Care Ultrasound Fellowship

We provide a 6 month part-time fellowship in critical care ultrasound to trainees who are post-fellowship. This is accredited by the Australasian Society for Ultrasound Medicine for CCPU in lung and cardiac US and EFAST. 

If you complete a fellowship with us, you will not need to complete expensive courses to qualify for CCPU. The fellowship entails weekly bedside sessions with a Diploma of Diagnostic Ultrasound-qualified emergency physician, dedicated teaching in critical care ultrasound and access to a bank of critical care ultrasound research. 

Ultrasound courses

The RMH ED provides CCPU-accredited courses in lung and cardiac ultrasound and EFAST. We teach you how to incorporate bedside ultrasound into clinical practice through didactic teaching, patient scanning and simulation. 

The Emergency Department has highly successful registrar teaching programs with protected teaching time each week. As an academic department there is a strong emphasis on research across the department. 

Registrars have the opportunity to rotate internally to anaesthetics, ICU, and psychiatry and externally to the Women's, Royal Children's, The Northern, the Royal Victorian Eye & Ear and Sunshine Hospitals. There are country anaesthetic rotations to Wangaratta and Ballarat Base Hospitals available.

The department is accredited for 2 years as a training post by the ACEM. The program includes:

• 38 hours a week + 5 hours (protected) teaching time
• Team training, simulation-based teaching, practical workshops and grand round discussion forums
• Participation in regional teaching programs
• In-house primary and fellowship exam preparation courses with high success rate
• Your training will be conducted under the supervision of 26 EFT of emergency physicians who have postgraduate expertise in toxicology, ultrasound, echo, retrieval medicine, research, pre-hospital care, medical education, infectious diseases and simulation.

Applications commencing in 2023 are yet to be advertised.

Register your interest on our recruitment website for notifications of upcoming vacancies.