Nurse practitioners are expressing frustration at discovering that a long-awaited law change still doesn’t allow them to complete all the paperwork at a patient’s death.

Dr Michal Boyd, an aged care NP and  nurse leader who last week was celebrating at last being able to issue death certificates for her patients’ families said it was a “terrible blow” to discover that NPs were still blocked from signing cremation certificates.

More than a decade in the making, the Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill was passed in late 2016 but the changes made only come into effect on January 31.

The complex Bill amended eight Acts to replace references to ‘doctors’ or ‘medical practitioners’ where nurse practitioners (NPs), and other health practitioners like pharmacists, registered nurses and physiotherapists are now qualified to carry out those roles – but did not amend the related Cremation Regulations. This means cremation certificates still have to be signed by a medical practitioner, which is a particular frustration for NPs working in aged care.

Ministry of Health chief nursing officer Jane O’Malley said the Ministry was aware of the oversight of not amending the Cremation Regulations to allow NPs to complete cremation certificates and was “working as quickly as possible to remedy this”.  She said the Ministry was currently in the process of informing stakeholders of its plan and timeline.

“In essence, not being able to do cremation certificates basically keeps in place the barrier to completing death certificates for over 80% of those I serve,” Michal Boyd said in a Facebook post to fellow Nurse Practitioners of New Zealand (NPNZ) members. “This development is so disappointing and frustrating. To feel that one of the last barriers to my practice in aged care was gone and to see it back again is very disheartening.”

She said apparently the cremation referee, who overseas cremation certificates, had let the Ministry of Health know of his concerns late last year about the regulations around cremation certificates being missed out.

NPNZ members shared Boyd’s frustration about the ongoing major barrier to NP practice,  with one reporting that it cost her practice $90 every time it had to ask an outside GP to sign a death or cremation certificate for her patients. There was a call for action on the issue and concerns were expressed whether NPs would again to have wait years for this barrier to be removed.

Nursing Review sought comment on the NPs concerns from the Health Minister Dr David Clark and Ministry of Health.  A spokesperson for the minister’s office said the Minister was aware of the issue and had asked the Ministry for a solution to the problem “which was inherited from the previous government”.

NB this article was updated on February 12 to include additional comment supplied in a revised response from the Ministry of Health and to clarify that it was the cremation regulations needed to be amended not the related legislation.





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