How general practice nurses view their expanding role

Abstract

Objective: The purpose of this research was to explore the barriers and enablers that nurses working in general medical practice experience in relation to the Australian Government driven expansion of their roles (nurses working in general medical practice are titled general practice nurses in Australia). The study design was part of a Masters of Public Health course. The research was conducted as part of employment with the Greater South Eastern Division of General Practice (GSEDGP), Victoria, Australia.
(now called the Greater Monash General Practice Network, Victoria, Australia). The Executive Director of the GSEDGP gave permission for the study to be undertaken.

Design: The study used an exploratory descriptive design.

Setting: The setting was general medical practices.

Subjects: The subjects were 22 registered and enrolled nurses working in general medical practices in Victoria, Australia (registered nurses are titled RN Division 1 and enrolled nurses are titled RN Division 2 in Victoria, Australia).

Main outcome measures: The main outcomes measures were: attitudes of the nurse’s toward role expansion; number of nurses moving into expanded roles; adoption of government expansion initiatives; and barriers and enablers.

Results: Over 90% of the respondents identified their role as a practice nurse had expanded since the introduction of the Australian Government general practice initiatives. 86.4% were happy with the expansion of their roles and positive about government plans for further role expansion. General practitioners (GPs) were seen as supportive of the nurses’ role expansion, however half the sample identified that it was up to the nurses to initiate their own role expansion. Variables were compared with attitudes toward expansion between registered nurses and enrolled nurses; nurses over and under 40 years of age; and those who had been in general practice differing lengths of time. No significant differences (p> 0.01) were found when any of the variables were compared.

Conclusions: The majority of practice nurses have experienced role expansion and are positive about this. Most practice nurses indicated they were the driving force behind the expansion. Nurses felt that role expansion had improved the quality of care provided to patients and enhanced their job satisfaction. The major inhibitors were lack of physical space within general practices and lack of time. The major enablers were physical space within the general practice office for a nurse to see patients and agreement from the GPs working within the practice for the nurse to expand into new areas.