Abstract
Introduction: Family practice nurses (FPNs) have been integrated into family medicine groups (FMGs) to improve access to primary care and services. However, FPN workforce development was operationalized without a clear definition of its scope of practice, leading to misunderstandings regarding the achievement of an optimal interdisciplinary teamwork. Objective: To describe the perceptions of the expected role of FPNs by FMG nurses and head physicians in order to better understand the influence of such perceptions on the enacted and desired role of FPNs in FMGs. Methods: Using a descriptive interpretive qualitative approach (Thorne, 2016), 8 registered nurses and 4 head physicians in FMGs were interviewed individually between December 2018 and February 2019. Data were analyzed using the Miles, Huberman and Saldana’s (2014) method. Results: Both groups believe that the expected role of FPNs is to facilitate access to care, as FMGs are one of the entry points into the healthcare system. While several nurses and head physicians perceive that they work collaboratively, hierarchical organizational relationships still continue to shape the enacted role of nurses. Task delegation and subordination activities are more prevalent than integrated collaboration and complementary activities within the interprofessional team. Both groups express different strategies to promote a more effective interdisciplinary teamwork. Discussion and conclusion: All stakeholders must support an optimal interdisciplinary teamwork and maximize the contribution of FPNs to increase patient access to primary care and services.
Highlights
Les infirmières ont été intégrées dans les groupes de médecine de famille (GMF) pour faciliter l’accès aux soins et services de première ligne
Only in September 2019 was the Guide pratique à l’intention des infirmières cliniciennes qui travaillent dans un groupe de médecine de famille ou un groupe de médecine de famille universitaire published. Both documents suggest that Family practice nurses (FPNs) function as generalists: in partnership with family physicians, nurse practitioners and other health professionals, they provide a broad range of primary care and services, including health promotion and disease prevention (Canadian Family Practice Nurses Association [CFPNA], 2019)
The majority of family medicine groups (FMGs) were integrated into a University family medicine group
Summary
Les infirmières ont été intégrées dans les groupes de médecine de famille (GMF) pour faciliter l’accès aux soins et services de première ligne. Only in September 2019 was the Guide pratique à l’intention des infirmières cliniciennes qui travaillent dans un groupe de médecine de famille ou un groupe de médecine de famille universitaire (i.e. guidelines for the expected practice of nurses in FMGs) published (ministère de la Santé et des Services sociaux [MSSS], 2019b). Both documents suggest that FPNs function as generalists: in partnership with family physicians, nurse practitioners and other health professionals, they provide a broad range of primary care and services, including health promotion and disease prevention (Canadian Family Practice Nurses Association [CFPNA], 2019). FPNs take care of and followup on patients according to health needs, but medical assistance does not fall within their role (MSSS)
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