Expanding nurse clinics across PHC settings

By Margaret Dempsey, RN, APNA Project Officer, Building Nurse Capacity
Source: APNA Primary Times Winter 2023 (Volume 23 Issue 1)

As the health-care needs of Australians continue to change, and we adapt to a post-pandemic health-care environment, the burden of chronic conditions is adding pressure to an already stressed and overwhelmed health care system. 

Current care-delivery models in acute and primary health care settings are struggling to meet the increasing demands, and health care providers are looking for new and innovative ways to deliver health care.

Nurse clinics are well placed to meet these demands, and while the format of these clinic models may vary, their positive benefits include improved patient health outcomes, better access to care, and decreased rates of hospital admission.

Nurse clinics can be described as ‘nurse-coordinated, team-based models of care’. The nursing services provided are holistic and patient-centred, with accountability and responsibility for patient care and professional practice remaining with the nurse. In the primary health care setting, nurse clinic models support a team-based approach to care delivery and involve other members of the health care team.

Many nurse clinics have been operating in general practice settings for several years, for example, immunisation (flu clinics) or chronic disease management initiatives. However, APNA has also been supporting nurses to establish clinics in other primary health care settings.

Teenage Mental Health Clinic, St Pauls College, Walla Walla, NSW

Staff at St Paul’s College in Walla Walla, NSW, identified that teenage mental health had been significantly impacted during the pandemic as students experienced social isolation and disconnectedness, and that they were dealing with the after-effects of increased anxiety, depression, and suicidal thoughts. In February 2023, with APNA’s support, school nurse and APNA member Angie Frohling set up a wellness clinic at the school to provide mental wellbeing support. The Teenage Mental Health Clinic is a free walk-in service provided to the secondary students.

The focus of the wellness clinic is to provide all students with timely access to mental health and wellbeing support services and this is achieved through a team approach. Internally, the school nurse is supported by a wellness team, including school counsellors and education providers, with external referrals to GPs, private counsellors, psychologists, or Child and Adolescent Mental Health Services as required.

Previously, the school’s existing medical facility had been a harsh, clinical environment more suited to a hospital ward. This area was remodelled during the end-of-school-year holiday period into a more welcoming space for young people. Signage was changed from a sickness-focussed medical centre to a wellness hub, which better reflects its purpose. Comfortable, casual seating in the newly designated ‘Reset Room’ replaced a stark trolley bed. Students attending the wellness clinic are offered a series of individualised regulation activities designed specifically for them to reset and regulate their current mindset. Regulation strategies may include a physical program (weights and other exercise activities) or digital activities, each designed to provide students with tools to implement self-regulation strategies to promote emotional stability and decrease anxiety.

Angie says, ‘The primary aim of the wellness clinic is to return the student to the classroom in a better mindset, rather than idly languishing in a “sick bay” for hours or being sent home.’ Funding for this refurbishment was provided through existing Department of Education channels and community wellbeing grants.