ANMF (Vic Branch) Assisstant Secretary Madeleine Harradence presenting at the 2025 VAADA conference.
Branch Assistant Secretary Maddy Harradence joined Alfred Health’s Senior Addictions Nurse Practitioner Megan McKechnie at the recent Victorian Alcohol and Drug Association (VAADA) 2025 conference. Together, they shared with conference goers a history of drug and alcohol nursing in Victoria, an overview of contemporary issues and barriers in the sector, and a vision of the solutions – current and future.
Megan began by charting the evolution of alcohol and other drug (AOD) nursing in Victoria. Touching on some key milestones – including Australia’s first clinic, at St Vincent’s, to care for people with alcohol problems; our first nurse practitioners, and our first AOD specialist nurse practitioners – Megan called 2014, when ANMF first recognised AOD nursing as a subspecialty distinct from mental health nursing, ‘a really important moment’.
In establishing an AOD specialist portfolio, the Branch laid the groundwork for many important initiatives helping provide solutions to ongoing challenges within the sector.
Among the key challenges are:
- limited AOD training in nursing education programs
- limited nurse practitioner roles available in AOD
- general workforce recruitment and retention issues
Among the solutions that Maddy highlighted are:
- ANMF & Turning Point government-funded training, and exploring how existing initiatives such as the registered undergraduate student of nursing (RUSON) employment model might be extended and adapted to the AOD sector
- More support for nurse practitioners, both in terms of funded positions (through health services) and improved Medicare rebates
- Reducing inequities in remuneration and conditions between public and private AOD employment.
AOD training
‘Unfortunately there is still very limited AOD training within the nursing undergraduate program,’ Megan said. ‘I had to jump up and down for a one-week placement at DAS West (now Western Health Drug Health Services), and that was the extent of my AOD training in my undergraduate degree. Not much has changed since that time.’
Madeleine, likewise, had to fight for an AOD specialist placement as well. ‘When I was finally able to do a private AOD clinic placement during my undergraduate degree, it floored me. It changed so much of what I thought AOD nursing was or could be.’
To help address this issue, since 2016 ANMF in partnership with Eastern Health Turning Point, and funded by the Victorian government, has presented specialist AOD training options including:
- five core AOD courses, targeted at general nurses and midwives
- seven masterclasses, for AOD specialist nurses and midwives
- 20 scholarships for nurses or midwives interested in doing a graduate certificate in addictive behaviours at Monash University
- And, more recently, dedicated nurse practitioner professional development.
Feedback on these courses has been consistently positive. Almost 90 per cent of participants say they will be able to apply the knowledge and skills from the training into their day-to-day practice. One of the participant quotes Maddy shared summarised the general tone:
‘It reminded me that it’s about reducing harm and not fixing. I understand the mechanics of drugs and withdrawals better and I’ve changed my approach, and I remember the basis of why I chose this field of work: to help people live their best life, and not the life that I think is best for them.’
Key to the success of this partnership, Maddy said, is that it’s developed, produced and delivered by nurses, and it’s highly accessible: it’s free of charge, thanks to Victorian government funding, and it’s offered online as well as in person, making it accessible to nurses and midwives in rural and regional Victoria.
One of ANMF’s other training focuses, Maddy said, is extending the registered undergraduate student of nursing (RUSON) model further into the AOD space. The Branch also continues to advocate for changes to the curriculum to include AOD training, and for wider access to quality AOD clinical placements and AOD rotations during graduate years.
Nurse practitioners
‘By 2019 we had 41 nurse practitioners in AOD nationally,’ Megan noted. ‘And even though that number has probably doubled nationally now, maybe even tripled, there’s still not many nurse practitioners specialising in the AOD workspace.’
Part of the issue, she explained, is that ‘there are a number of nurse practitioners already endorsed with NMBA who cannot move into nurse practitioner roles’ due to lack of funding for positions, among other things. In addition, ‘we have hundreds of nurses who have gone through AOD training with the intent of moving into the AOD workforce, but there are no positions available for them.’
The ANMF continues to advocate to government for more grants and supported candidacy to increase the number of AOD nurse practitioner positions in public health services, Maddy said.
There have been other promising developments, including legislative changes in 2024 that removed the collaborative care arrangements for nurse practitioners, and increased MBS rebates for nurse practitioners by 30 per cent. These changes were lobbied for by ANMF members.
Reducing inequities in remuneration and conditions
The union is also seeking to increase Award wages, which would benefit AOD nurses working in primary care, among other settings.
‘We have a serious inequity between the public sector and private sector wages,’ Maddy explained. ‘It is a huge problem when it comes to attracting people to work in AOD.
‘In 2021, ANMF applied [to the Fair Work Commission] to vary the Award that covers aged care nurses, and achieved between 15 to 28 per cent wage increases for those nurses. We now have a separate application with respect to the general nurses Award, and we’re hoping to get a similar recognition of those nurses.’
