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Open Access Highly Accessed Research article

The evolution of nursing in Australian general practice: a comparative analysis of workforce surveys ten years on

Elizabeth J Halcomb1*, Yenna Salamonson2, Patricia M Davidson3, Rajneesh Kaur4 and Samantha AM Young5

Author Affiliations

1 School of Nursing & Midwifery, University of Wollongong, Sydney, Australia

2 School of Nursing & Midwifery, University of Western Sydney, Sydney, Australia

3 Johns Hopkins University School of Nursing, Baltimore, USA

4 University of New South Wales, Sydney, Australia

5 University of Newcastle, Sydney, Australia

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BMC Family Practice 2014, 15:52  doi:10.1186/1471-2296-15-52

Published: 25 March 2014

Abstract

Background

Nursing 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.

Methods

In 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.

Results

Two 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.

Conclusions

This 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.

Keywords:
Practice nurse; Nursing workforce; Survey; Office nurse; General practice; Primary care, Australia