Getting nursing care through the NDIS often feels like navigating a maze with a blindfold on, so much paperwork, approvals, and questions required to still not be entirely clear about what’s covered. Add to your disability support needs a layer of health complications and the last thing you want is to add more uncertainty on how to access the help you need.

The reality, however, is that many NDIS participants eventually require some clinical support. But it’s not always clear, either in your plan or to new providers, how nursing care falls under your plan.

Support vs. Nursing Care

This is where it gets vital. A support worker assists with daily tasks, personal care, community engagement, etc., and is incredible at what they do. But when medical intricacies get involved, that’s where a different level of expertise comes into play.

We’re talking about responsibilities that could become overwhelming for support workers if they’re outside their scope of expertise, as well. Complicated medication administration. Wound assessments and treatments. Feeding tubes and catheters and diagnoses that change from appointment to appointment. NDIS nurses are qualified professionals who have the clinical expertise to address the nuances that your average support worker cannot, they’re registered professionals tasked with work outside a support worker’s specialization.

But the problem is that many people assume all assistance is created equal. It’s not. The NDIS understands that some participants have legitimate medical needs in addition to their disability needs and when justified properly, the funding agrees.

How Nursing Services Fit into Your Plan

Nursing services typically fall under either your Capacity Building budget or Core Support budget. For example, if a nurse is briefly engaged during the day to help with personal care, it might fall under Core Supports relative to daily supports. However, if it’s more nuanced nursing care or over the course of multiple days/weeks/months, it typically falls under Capacity Building supports.

However, receiving approval has much to do with medical documentation from your team. Your GP needs to clarify the necessity of nursing care; specialists and allied health professionals should provide commentary that either says “nursing care needed” or “nursing care needed for these clinical tasks with the rationale that only an RN can perform said RN-required duties.”

Most people don’t realize how in-depth this justification has to be until they’re deep into the application process. Medical justification makes a world of difference in securing approval.

What’s Involved with Nursing Support

The breadth of what’s included under NDIS nursing support is quite wide. Wound management is a great example, pressure sores or chronic wounds that require dressing and redress need someone who knows what to look at to assess problems early on.

Medication administration is another, especially if there are adjustments based on symptoms, or certain medications need administration via certain routes.

Clinical assessment as well, some people need regular vital sign checks; others must meet consistent blood sugar levels; others require ongoing assessment as symptoms change based on disease trajectories that nurses can help assess and talk to doctors about to change plans of care without recourse.

Respiratory care, tracheostomy, suctioning, all requires RN ability as does feeding systems, PEG tubes, gastrostomy care and nutritional support, all require a set of clinical abilities that cannot be passed off for good intentions by support workers (unless they’re otherwise certified).

Pain management often requires nursing expertise as well, whether adjusting pain levels through medication or combining clinical interventions with other efforts. Nurses can assess pain levels and talk to physicians about what’s truly effective.

How to Start the Process

The first thing you need is a proper conversation with your support coordinator or LAC about what’s going on medically before they can guide you about documentation. You want as much going in your favor to save time later. Most planners ask for relatively recent medical reports; letters from specialists; detailed care plans that ascertain what your nursing needs are and why.

It’s better NOT to wait until your annual review, either. That’s months spent without any required support if you’re going through transition. The NDIS allows for frequent assessment if your health situation changes significantly since you do not have to wait for scheduled reviews if something has drastically changed.

Get anyone involved in your care to help you, your nurse included, to properly highlight any faults or inadequacies of other supports that complicate clinical concerns. If your support worker attempts to do what’s required but health situations are worsening without nursing intervention, support this with evidence (hospital admissions, complications have resulted from not getting help previously).

Budgeting for Nursing Care

Let’s face it, nursing services are more expensive per hour than general supportive work, and that’s okay when it’s someone with those qualifications providing necessary help. But you have to think about how nursing hours fit into your overall plan budget.

Some people need daily visits from nurses. Some require three sessions a week OR regular clinician evaluation but only on a biweekly basis for hands-on work (because that’s what’s required); it all depends on assessed health needs and what’s deemed safe and effective.

Many participants find that merging their nursing care with the assistance from a support worker helps balance things out more effectively, wherein the nurse does the clinical part and monitors recommended health status while the support worker manages the daily living aspects.

Finding A Nursing Match

Not every nurse has experience with NDIS funding or knows much about disability at all. It’s important to find someone who understands both sides of the coin as it makes everything easier, proper documentation for NDIS means less headaches down the line because you’ll need it at some point. A provider who knows how planners want information organized and what care can shift over time makes all the difference.

Not to mention, nursing treatment becomes part of everyday life, and if rapport isn’t right (someone isn’t open-minded to discussion, doesn’t want to hear about concerns, doesn’t respect preference), treatment can falter. But when everything fits well together, health outcomes emerge effectively for quality improvement across the board.