Missed care or missed opportunities in general practice nursing

Abstract

BackgroundResearch into missed care has been conducted in various acute and some community healthcare settings; however, the experiences of general practice nurses (GPNs) are poorly represented in the literature. AimTo explore the role of the GPN and whether care activities are missed. MethodsA qualitative descriptive design was used, employing semistructured interviews with 10 participants. The participants were GPNs working in a metropolitan or regional general practice in Australia, with a minimum of three years of experience in the role. A six-step process for thematic analysis was utilised for the extraction and presentation of findings. FindingsGPNs rarely miss care; it is either delayed or rescheduled. Findings illustrate missed opportunities to provide care and enhance the role of the GPN. Factors contributing to missed opportunity are as follows: (i) difficulties navigating the GPN–general practitioner (GP) relationship, (ii) GPNs lack ongoing education commensurate with their scope of practice, (iii) Medicare policy fails to fund the GPN role, (iv) a rise in the number of salaried GPs leads to time pressures that limit the GPN role, (v) scope of practice constrained by time deficits, and (vi) communication problems within a siloed healthcare system limit GPN scope of practice. DiscussionThe initial aim was to identify missed care; however, findings suggest that GPNs rarely miss care, but they do miss opportunities to provide care and practice to their full scope. ConclusionInternal and external factors specific to the general practice context can contribute to missed opportunities for the work of the GPN.