Tens of thousands of registered nurses across Australia are now eligible to pursue training to prescribe medications following a landmark reform in the nation’s healthcare system. This significant change, heralded as one of the most substantial shifts in Australian healthcare in decades, aims to alleviate workforce shortages, reduce pressure on general practitioners (GPs), and enhance access to medications, particularly for patients in rural and remote areas.
Traditionally, only medical doctors, dentists, certain pharmacists, nurse practitioners, and endorsed midwives had the authority to prescribe medications. With this new policy, registered nurses can now step into this role, potentially transforming patient care across the country.
Addressing Healthcare Access and Wait Times
Australia’s primary healthcare system faces considerable challenges, including extended wait times for patients seeking GP appointments. According to Frances Rice, chief nursing officer at the Australian College of Nursing, this reform could significantly alleviate the workload of GPs.
“A good example would be a person who is stable on medication that they’ve been on for a long period of time and may need a repeat prescription,” Ms Rice explained. “Depending on the medication and the prescribing agreement, the registered nurse could handle the prescription, eliminating the need for a GP visit.”
For patients in rural regions, this change could be particularly impactful. Jane Mills, pro vice-chancellor of health innovation at La Trobe University, stated that many Australians currently “wait too long or travel too far for essential medicines.”
“Registered nurses prescribing will mean faster, local access to treatment and no more unnecessary delays or long journeys,” Professor Mills asserted. “In rural and remote areas, nurses are often the first point of contact for healthcare. This authority means quicker access to essential medicines and continuity of care.”
How Nurse Prescribing Will Function
Designated registered nurse prescribers will operate under a prescribing agreement with an authorized clinician, outlining the medications they can prescribe and the conditions under which they may do so. Marie Gerdtz, dean of nursing and midwifery at La Trobe University, emphasized that success hinges on “high-quality education, robust clinical supervision, strong collaboration across health professions, and clear, nationally consistent standards.”
Senior lecturer and practicing nurse Corinne Dunningham noted that registered nurses are uniquely positioned to advocate for their patients, being “at the bedside with patients 24/7.” She explained that the new prescribing pathway was designed to address barriers in practice and facilitate timely access to care.
Registered nurses interested in prescribing must complete a structured pathway to secure the necessary endorsement. This includes holding current registration, accumulating at least three years of full-time clinical experience, and completing a Nursing and Midwifery Board of Australia (NMBA)-approved postgraduate qualification.
Upon finishing their studies, nurses will undertake a six-month clinical mentorship under the supervision of an authorized health practitioner. Once endorsed, they can prescribe, administer, obtain, possess, and supply a wide range of medications, from over-the-counter drugs to tightly controlled substances like morphine and fentanyl.
Professor Gerdtz highlighted that empowering registered nurses to prescribe medications would enhance access to care and promote safer, more effective medication use, especially in communities where access to doctors is limited.
Ensuring Safety and Coordination in Care
While the reform has been generally well-received, some medical professionals have expressed concerns, particularly regarding the prescribing of Schedule 8-controlled drugs such as morphine and fentanyl. Michael Wright, president of the Royal Australian College of GPs, cautioned that expanding nurse prescribing could lead to challenges in maintaining coordinated and comprehensive care.
“Nurses and nurse practitioners can and should work to the top of their scope together as part of a multidisciplinary team, which includes a GP,” Dr Wright stated. “Good primary healthcare is co-ordinated, collaborative, and continuous. If not properly coordinated under GP supervision, extending the scope of practice can lead to confusion, unsafe prescribing or treatment, and duplication of services.”
The NMBA has released a registration standard for designated registered nurse prescribers, along with supporting guidelines that detail the qualifications, responsibilities, and scope of practice required for nurses to gain prescribing rights. Veronica Casey AM, chair of the NMBA, described this change as “one of the biggest alterations to nursing regulation in decades.”
“Designated registered nurse prescribing puts patients first without compromising public safety,” Professor Casey affirmed. An Implementation Oversight Group, co-chaired by the chief nursing and midwifery officers of New South Wales and South Australia, will oversee the rollout, ensuring clinical governance, managing risks, and maintaining consistent practices across the country.
Looking Ahead: The Future of Nurse Prescribing
By January 2025, the Australian Nursing and Midwifery Accreditation Council will publish NMBA-approved Registered Nurse Prescribing Accreditation Standards, establishing a consistent framework for educational programs. Tanya Vogt, chief executive of ANMAC, regarded these new standards as a major milestone for nursing in Australia.
“It equips registered nurses with the knowledge and skills to prescribe safely and support additional access to high-quality care for people and communities across Australia,” Ms Vogt explained. Four education providers have already submitted programs for assessment, paving the way for hundreds of students to begin training in early 2026, with the first graduates expected by mid-2026.
The phased rollout means the first prescribing nurses will likely emerge in 2026. Education providers, healthcare organizations, and regulators will monitor the program closely to ensure its success.
“Expanding the registered nurse scope of practice to designated prescriber does not take away from other medical and allied health clinicians,” Ms Dunningham emphasized. “Instead, it ensures patients receive around-the-clock access to medications in areas where they might not have been able to access them previously.”
As thousands of nurses prepare to train in this new role, the reform represents a significant step toward improving patient access to medicines under regulated safety standards.
