Abstract
BackgroundNursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care. There are limited data about how this expansion has impacted on the nursing role, scope of practice and workforce characteristics. This study aimed to describe the current demographic and employment characteristics of Australian nurses working in general practice and explore trends in their role over time.MethodsIn the nascence of the expansion of the role of nurses in Australian general practice (2003–2004) a national survey was undertaken to describe nurse demographics, clinical roles and competencies. This survey was repeated in 2009–2010 and comparative analysis of the datasets undertaken to explore workforce changes over time.ResultsTwo hundred eighty four nurses employed in general practice completed the first survey (2003/04) and 235 completed the second survey (2009/10). Significantly more participants in Study 2 were undertaking follow-up of pathology results, physical assessment and disease specific health education. There was also a statistically significant increase in the participants who felt that further education/training would augment their confidence in all clinical tasks (p < 0.001). Whilst the impact of legal implications as a barrier to the nurses’ role in general practice decreased between the two time points, more participants perceived lack of space, job descriptions, confidence to negotiate with general practitioners and personal desire to enhance their role as barriers. Access to education and training as a facilitator to nursing role expansion increased between the two studies. The level of optimism of participants for the future of the nurses’ role in general practice was slightly decreased over time.ConclusionsThis study has identified that some of the structural barriers to nursing in Australian general practice have been addressed over time. However, it also identifies continuing barriers that impact practice nurse role development. Understanding and addressing these issues is vital to optimise the effectiveness of the primary care nursing workforce.
Highlights
Nursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care
The general practice nurse is not as well recognised as an independent nursing specialty in Australia [3], as it is in the United Kingdom (UK) and New Zealand (NZ) [4,5]
A major distinction between the current state of nursing in general practice within the UK and NZ and the current Australian role is the presence of career frameworks, comprised of salary structures and levels of nursing practice which articulate roles based on the nurses experience, education and scope of practice [7]
Summary
Nursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care. A practice nurse (PN), is a registered or an enrolled nurse who provides nursing services within a general practice setting. Practice nurses can be either registered nurses (RN), who are baccalaureate prepared, or enrolled nurses (EN), who have undertaken diploma level training [1,2]. These differences in educational preparation impact on the regulated scope of the nurses clinical practice. A major distinction between the current state of nursing in general practice within the UK and NZ and the current Australian role is the presence of career frameworks, comprised of salary structures and levels of nursing practice which articulate roles based on the nurses experience, education and scope of practice [7]. In Australia, there remains no defined career pathway [7] and PN roles have been demonstrated to often be linked to funding schemes that provide reimbursement for specific activities [8,9]
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