scholarly journals Clinical academic careers for general practice nurses: a qualitative exploration of associated barriers and enablers

2021 ◽  
pp. 174498712110243
Author(s):  
Sarahjane Jones ◽  
Andrew Bradbury ◽  
Sue Shortland ◽  
Fraser Hewett ◽  
Karen Storey

Background The delivery of research in healthcare in the UK is dependent on a subgroup of clinicians – clinical academics – who concurrently engage in clinical practice and academic activities. The need to increase access to such roles for general practice nurses has been identified, although the need for a robust career framework remains. Aims This study, with a qualitative interview and focus group design, aimed to explore the concept of clinical academic careers for general practice nurses by identifying barriers and enablers associated with pursuing and performing such roles. Methods General practice nurses ( n = 18) and general practitioners ( n = 5) engaged in either an audio -recorded interview or focus group. Verbatim transcripts were subjected to thematic analysis. Results Four themes were identified: awareness and understanding; career pathway; personal and professional attributes; and organisational factors. Awareness and understanding were generally poor. Participants suggested that the career pathway was unclear, although it was generally assumed that such roles were ‘out of reach’ and require a minimum of Master’s level education. An interest in research and the confidence to perform such duties were reported as the required personal and professional attributes. Organisational factors included the need for employers to understand the value and benefit of general practice nurse clinical academic roles, along with ensuring that the inevitable competing demands of such a role were appropriately managed. Conclusions This study highlights the difficulties faced by general practice nurses wishing to pursue a clinical academic career. Academia is seemingly placed on a pedestal, emphasising the need to embed research training early in nursing education to alter general practice nurse perceptions that clinical academic roles are unobtainable. The development of a robust career pathway for general practice nurse clinical academic roles may have a positive impact on the retention of experienced general practice nurses and attract newly qualified nurses. This research provides evidence as to the need for one.

2019 ◽  
Author(s):  
Sarahjane Jones ◽  
Andrew Bradbury ◽  
Sue Shortland ◽  
Fraser Hewett ◽  
Karen Storey

Abstract Background: The delivery of research in healthcare is dependent on a sub-group of clinicians – clinical academics – who concurrently engage in clinical practice and academic activities. The need to increase access to such roles for general practice nurses (GPNs) has been identified, though the need for a robust career framework remains. In order to generate evidence needed to contribute to the development of a career framework, this study aimed to explore the concept of clinical academic careers for GPNs by identifying barriers and enablers associated with pursuing and performing such roles. Methods: GPNs ( n =18) and general practitioners (GPs) ( n =5) engaged in either an audio recorded interview or focus group. Recordings were transcribed verbatim, with transcripts subject to a process of thematic analysis.Results: Four main themes were identified: awareness and understanding; career pathway; personal and professional attributes; and organisational factors. Awareness and understanding of clinical academic careers for GPNs was generally poor. Participants suggested that the career pathway for GPN clinical academics was unclear, though it was generally assumed that such roles were “out of reach” and would require a minimum of Master’s level education. Personal and professional attributes were reported as an interest in research and the confidence to perform such activities, though it was noted these elements should be encouraged during pre-registration training. Organisational factors included the needed for GPN employers to understand the value and benefit of GPN clinical academic roles, along with ensuring that the inevitable competing demands of such a role were appropriately managed. Conclusions: This study highlights the difficulties faced by GPNs wishing to pursue a clinical academic career. Academia is seemingly placed upon a pedestal, emphasising the need to embed research training early on in nursing education in order to alter GPN perceptions that clinical academic roles are unobtainable. Moreover, the development of a robust career pathway for GPN clinical academic roles may have a positive impact on the retention of experienced GPNs and attract newly qualified nurses.


2021 ◽  
Vol 32 (12) ◽  
pp. 468-472
Author(s):  
Peter Ellis

Chronic kidney disease is highly prevalent in the community. Peter Ellis looks at the role of the practice nurse in diagnosing and managing chronic kidney disease in general practice Chronic kidney disease (CKD) is defined as a reduction in kidney function, or damage to kidney structure, which has persisted for greater than 3 months and which is associated with other health-related issues. While there are many causes of CKD, the most prevalent in western societies, including the UK, are diabetes and hypertension. This article identifies the role of the practice nurse in applying the National Institute for Health and Care Excellence (NICE) guidelines for CKD.


2020 ◽  
Author(s):  
Caroline Gibson ◽  
Dianne Goeman ◽  
Dimity Pond

Abstract Background: The potential value of expanding the Practice Nurse role to include the recognition and management of dementia has been acknowledged and Practice Nurses are well-positioned to provide comprehensive dementia information and support so that people living with dementia are better equipped to self-manage their health and live well with dementia. The purpose of this review was to systematically examine published Australian and international literature to identify the existing and potential roles of Practice Nurse’s involvement in the delivery of care to people living with dementia or cognitive impairment and their support person(s) and also describe the characteristics and effectiveness of nurse interventions in dementia models of care in general practice. Methods: We systematically reviewed the evidence for roles and characteristics of the Practice Nurse in the delivery of dementia care. A comprehensive literature search identified relevant original research published in English between January 2000 and January 2019 and available in full text. Thirteen articles were included. Results: Characteristics of roles, undertaken by nurses working in the general practice setting, which were potentially beneficial to people living with dementia and their support person were identified. These included increased patient accessibility to the Practice Nurse, early recognition and management of cognitive changes, care management and collaboration with the General Practitioner. Limitations of the provision of dementia care by Practice Nurses included a lack of definition of the role, inadequate dementia specific training, time constraints and poor communication with General Practitioners. Conclusions Further research is required to define and evaluate the scope of practice and characteristics of the Practice Nurse role in dementia care provision. Embedding in usual general practice care an evidence-based model of care describing the role of the Practice Nurse in dementia care provision has the potential to increase early recognition of cognitive impairment and more appropriate primary care management of dementia. Systematic Review registration number PROSPERO 2018 CRD42018088191


2020 ◽  
Author(s):  
Caroline Gibson ◽  
Dianne Goeman ◽  
Dimity Pond

Abstract Background: The potential value of expanding the Practice Nurse role to include the recognition and management of dementia has been acknowledged and Practice Nurses are well-positioned to provide comprehensive dementia information and support so that people living with dementia are better equipped to self-manage their health and live well with dementia. The purpose of this review was to systematically examine published Australian and international literature to identify the existing and potential roles of Practice Nurse’s involvement in the delivery of care to people living with dementia or cognitive impairment and their support person(s) and also describe the characteristics and effectiveness of nurse interventions in dementia models of care in general practice. Methods: We systematically reviewed the evidence for roles and characteristics of the Practice Nurse in the delivery of dementia care. A comprehensive literature search identified relevant original research published in English between January 2000 and January 2019 and available in full text. Thirteen articles were included. Results: Characteristics of roles, undertaken by nurses working in the general practice setting, which were potentially beneficial to people living with dementia and their support person were identified. These included increased patient accessibility to the Practice Nurse, early recognition and management of cognitive changes, care management and collaboration with the General Practitioner. Limitations of the provision of dementia care by Practice Nurses included a lack of definition of the role, inadequate dementia specific training, time constraints and poor communication with General Practitioners. Conclusions Further research is required to define and evaluate the scope of practice and characteristics of the Practice Nurse role in dementia care provision. Embedding in usual general practice care an evidence-based model of care describing the role of the Practice Nurse in dementia care provision has the potential to increase early recognition of cognitive impairment and more appropriate primary care management of dementia. Systematic Review registration number PROSPERO 2018 CRD42018088191


2015 ◽  
Vol 21 (1) ◽  
pp. 96 ◽  
Author(s):  
Melanie Attard ◽  
Alexa McArthur ◽  
Dagmara Riitano ◽  
Edoardo Aromataris ◽  
Chris Bollen ◽  
...  

Quality service provision and patient safety and satisfaction in encounters with health-care professionals relies on effective communication between the practitioner and patient. This study aimed to identify effective practices for improving communication between clinical staff in general practice and patients with limited English proficiency, and to promote their implementation in general practice. Effective interventions and strategies were identified from a review of international research. Experiences with their use in practice were explored via focus group discussions with general practitioners and practice nurses. The results suggest that, wherever possible, communication in the patient’s primary language is preferable; use of a qualified medical interpreter should be promoted, and practices should have a standardised and documented procedure for accessing interpreter services. General practice staff must increase their awareness about services that are available to facilitate communication with patients with limited English proficiency, and also develop attitudes, both individual and organisational, that will maximise the effectiveness of these strategies. These findings were used to develop brief, evidence-based practice guidelines that were disseminated to focus group participants for evaluation of utility and general feedback. This evidence-based guidance is now available to assist clinical and administrative general practice staff across regional and metropolitan South Australia.


2020 ◽  
pp. 174498712095426
Author(s):  
Andrew Bradbury ◽  
Sue Shortland ◽  
Sarahjane Jones ◽  
Fraser Hewett ◽  
and Karen Storey

Background Clinical academics are health professionals who provide direct patient care alongside engaging in health research. Despite the generally agreed consensus that such roles enhance evidence-based care, availability and uptake has been sporadic in non-medical professions. With no data readily available regarding general practice nurses undertaking clinical academic roles, there is a need to understand the barriers and enabling factors that impact general practice nurses considering or pursuing a clinical academic career. Aims This review aims to address the question ‘What are the barriers and enablers relevant to general practice nurses in the UK pursuing clinical academic careers?’ by providing an overview of the relevant existing literature and drawing out the implications for policy and practice. Methods Literature published in the past 10 years was systematically searched. Using agreed inclusion criteria, papers were first screened on titles and abstracts, with papers included at this stage reviewed as full texts. Results Thirteen papers met the criteria for inclusion. The extraction and synthesis of findings allowed for the development of three themes: roles and responsibilities; embarking on a clinical academic career; and organisational research culture. Conclusions Findings suggest that infrastructure developments are required across higher education institutions and general practice organisations to bring about a cultural change to equip and empower general practice nurses to consider and pursue clinical academic careers.


2021 ◽  
Author(s):  
Sharon Parker ◽  
An Tran ◽  
Shoko Saito ◽  
Carmel McNamara ◽  
Elizabeth Denney-Wilson ◽  
...  

Abstract Background: Australian rates of obesity are increasing. General practice has a definite role to play in addressing obesity and preventing further chronic disease but relatively few encounters focus primarily on weight management. The HeLP GP trial assisted overweight and obese patients to make positive lifestyle changes to diet and physical activity and increase the capacity of practice nurses to deliver comprehensive weight management. The nurse led intervention comprised a health check and access to a lifestyle app and/or telephone coaching. Within this paper we describe the experience of implementing this intervention through the lens of organisational readiness with specific emphasis on the role of the practice nurse. Methods: Routinely collected research data, quantitative practice surveys, and qualitative field notes from research officers and facilitators were mapped against a recognised organisational readiness framework. Motivation to implement, general capacity and intervention-specific capacity were assessed. Results: The level of organisational readiness within the participating practices was observed to vary considerably, particularly the domain of intervention specific capacity. The level of practice nurse turnover negatively impacted the implementation of the intervention, affecting half of the intervention practices. Within this study we observed a general lack of practice-based support for the practice nurse regarding intervention delivery and varying levels of interest, skill, and confidence in delivering the program to patients. Nurses struggled to complete the health checks and subsequently to conduct timely follow up appointments. Risk assessment and referral to telephone coaching were generally not problematic, although we noted lower confidence with the setup of the lifestyle app and with instructing patients to use it.Conclusions: Using an organisational readiness checklist is valuable for determining specific capacity issues prior to commencing research but should also assess the capacity of those individuals responsible for the intervention. We found a lack of general ‘readiness’ inherent in the practice nurse role. If they are to fulfil their potential in supporting patients to reduce risk and adopt healthier life choices, our study indicates that more could be done to improve their workforce positioning and remuneration, which may, in turn, improve continuity of care, retention, and individual motivation.Trial registration:The HeLP GP trial is registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR - ACTRN12617001508369). The trial was registered 26/10/2017 http://www.ANZCTR.org.au/ACTRN12617001508369.aspx


2011 ◽  
Vol 17 (3) ◽  
pp. 227 ◽  
Author(s):  
Rhian Parker ◽  
Helen Keleher ◽  
Laura Forrest

There is little understanding about the educational levels and career pathways of the primary care nursing workforce in Australia. This article reports on survey research conducted to examine the qualifications and educational preparation of primary care nurses in general practice, their current enrolments in education programs, and their perspectives about post-registration education. Fifty-eight practice nurses from across Australia completed the survey. Over 94% reported that they had access to educational opportunities but identified a range of barriers to undertaking further education. Although 41% of nurses said they were practising at a speciality advanced level, this correlated with the number of years they had worked in general practice rather than to any other factor, including level of education. Respondents felt a strong sense of being regarded as less important than nurses working in the acute care sector. Almost 85% of respondents reported that they did not have a career pathway in their organisation. They also felt that while the public had confidence in them, there was some way to go regarding role recognition.


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