scholarly journals Symbiotic relationships in patients' engagements with practice nurses

2021 ◽  
Author(s):  
◽  
Elsa Lally

<p>Practice nurses engaging with patients is a daily activity in general practice. However, there is little research to assess these relationships from a primary health care, general practice standpoint. The purpose of this new and original research was to explore from patients' perspectives what occurs in general practice, and to establish how the engagements patients have with practice nurses influences patients' health and well-being. The conceptualisation of symbiotic relationships between practice nurses, general practitioners receptionists and patients described in this study, shows how these relationships work in practice, and how they shaped patients' perspectives of their engagements in the general practice setting. Although each person’s role was independent and capable of existing without the other, a mutually beneficial close association was developed.  From the experiences of 15 patients from seven rural and urban general practices in New Zealand, using Narrative Inquiry methodology informed by life course theory and White’s (2010) dimensions of well-being, the co-constructed stories gathered from the participants were analysed applying a modification of McCormack’s (2001) multiple lens model. Findings from the individual participant stories revealed three major themes – general practice activity, health focused practice, and professional comforting. Each of these themes described aspects of the participants' relationships and engagements with practice nurses that contributed to their health and well-being. The co-constructed stories described participants' relationships and engagements, not only with practice nurses but also with general practitioners and receptionists. The presence of the (often unseen) overarching doctor and of practice nurses filling the gap in patients' care was evident. Patients described practice nurses as both support for the doctor and as autonomous practitioners. Ease of access to practice nurses significantly contributed to patients obtaining competent health promoting care. Particularly cogent were the findings that practice nurses directly contributed to patients' health and well-being through nurses' skilled compassion and skilled companionship. Nurses actively listened to patients' concerns, suggesting strategies to move patients forward, while at the same time, providing space for them to move at their own pace. Receptionists were viewed as the 'fronts people' of the practice who triaged patients' health concerns, making decisions relating to whom the patient consulted, the doctor or the nurse.  By building on existing theories in Narrative Inquiry methodology, data collection and analysis, this research makes an important contribution to nursing knowledge. It provides new perspectives about nurse-patient relationships, as well as other relationships within general practice. The research also demonstrates that while there has been a significant increase in collaboration between nurses and general practitioners over time, this collaboration is distinct from the symbiotic relationships described. The findings have implications for health professionals' everyday practice, and for Primary Health Organisations and District Health Boards when undertaking health professional education and funding reviews. Future research into patients' relationships with practice nurses, doctors and receptionists, and how these relationships contribute to patients' health and well-being is necessary.</p>

2021 ◽  
Author(s):  
◽  
Elsa Lally

<p>Practice nurses engaging with patients is a daily activity in general practice. However, there is little research to assess these relationships from a primary health care, general practice standpoint. The purpose of this new and original research was to explore from patients' perspectives what occurs in general practice, and to establish how the engagements patients have with practice nurses influences patients' health and well-being. The conceptualisation of symbiotic relationships between practice nurses, general practitioners receptionists and patients described in this study, shows how these relationships work in practice, and how they shaped patients' perspectives of their engagements in the general practice setting. Although each person’s role was independent and capable of existing without the other, a mutually beneficial close association was developed.  From the experiences of 15 patients from seven rural and urban general practices in New Zealand, using Narrative Inquiry methodology informed by life course theory and White’s (2010) dimensions of well-being, the co-constructed stories gathered from the participants were analysed applying a modification of McCormack’s (2001) multiple lens model. Findings from the individual participant stories revealed three major themes – general practice activity, health focused practice, and professional comforting. Each of these themes described aspects of the participants' relationships and engagements with practice nurses that contributed to their health and well-being. The co-constructed stories described participants' relationships and engagements, not only with practice nurses but also with general practitioners and receptionists. The presence of the (often unseen) overarching doctor and of practice nurses filling the gap in patients' care was evident. Patients described practice nurses as both support for the doctor and as autonomous practitioners. Ease of access to practice nurses significantly contributed to patients obtaining competent health promoting care. Particularly cogent were the findings that practice nurses directly contributed to patients' health and well-being through nurses' skilled compassion and skilled companionship. Nurses actively listened to patients' concerns, suggesting strategies to move patients forward, while at the same time, providing space for them to move at their own pace. Receptionists were viewed as the 'fronts people' of the practice who triaged patients' health concerns, making decisions relating to whom the patient consulted, the doctor or the nurse.  By building on existing theories in Narrative Inquiry methodology, data collection and analysis, this research makes an important contribution to nursing knowledge. It provides new perspectives about nurse-patient relationships, as well as other relationships within general practice. The research also demonstrates that while there has been a significant increase in collaboration between nurses and general practitioners over time, this collaboration is distinct from the symbiotic relationships described. The findings have implications for health professionals' everyday practice, and for Primary Health Organisations and District Health Boards when undertaking health professional education and funding reviews. Future research into patients' relationships with practice nurses, doctors and receptionists, and how these relationships contribute to patients' health and well-being is necessary.</p>


2014 ◽  
Vol 20 (1) ◽  
pp. 2 ◽  
Author(s):  
Catherine G. A. Pendrey ◽  
Marion Carey ◽  
Janet Stanley

This letter responds to the article by Cusack et al., ‘Extreme weather-related health needs of people who are homeless’ (Australian Journal of Primary Health, 2013, 19(3), 250–255), which addressed the impacts of extreme weather on the health of the homeless population in inner city Adelaide. We compare the findings of Cusack et al. to our own original research, based on interviews with service providers to the homeless in urban and rural Victoria. We further place this issue in the broader context of climate change, which is crucial given the expected increase in extreme weather events and associated health impacts.


2021 ◽  
Author(s):  
◽  
Jean Ross

<p>This study, which is methodologically grounded in qualitative research and philosophically informed by critical social science, explores important aspects of the socio-political context in which practice nurses and general practitioners (core primary health care team) work within a team environment. It is indicated in the literature that there are benefits for improved health care through the development of collaborative teamwork. However, there have been many barriers identified which prevent collaborative teamwork. Amongst the many barriers, is the lack of role clarity and attitudinal differences. Role clarity and attitudinal differences are the topic of this thesis. This thesis explored and highlighted whether the lack of role clarity and attitudinal differences do indeed impede the team's success, and are barriers to teamwork. The views and opinions of practice nurses and general practitioners understanding of their own and each other's current roles within the general practice setting were explored. The participants had the opportunity to discuss together, in focus group meetings, their thoughts on the topic. This raised their awareness of their taken for granted ideas on role and teamwork. Focus groups offered the participants the added opportunity to question each other which allowed for a deeper and more fulfilling understanding of role. New understandings that emerged could lead to alternative models of health care and influence the future delivery and planning of general practice. The thesis concludes by offering a potentially suitable model/framework which has been developed to further the understanding of teamwork in the future.</p>


2021 ◽  
Author(s):  
◽  
Jean Ross

<p>This study, which is methodologically grounded in qualitative research and philosophically informed by critical social science, explores important aspects of the socio-political context in which practice nurses and general practitioners (core primary health care team) work within a team environment. It is indicated in the literature that there are benefits for improved health care through the development of collaborative teamwork. However, there have been many barriers identified which prevent collaborative teamwork. Amongst the many barriers, is the lack of role clarity and attitudinal differences. Role clarity and attitudinal differences are the topic of this thesis. This thesis explored and highlighted whether the lack of role clarity and attitudinal differences do indeed impede the team's success, and are barriers to teamwork. The views and opinions of practice nurses and general practitioners understanding of their own and each other's current roles within the general practice setting were explored. The participants had the opportunity to discuss together, in focus group meetings, their thoughts on the topic. This raised their awareness of their taken for granted ideas on role and teamwork. Focus groups offered the participants the added opportunity to question each other which allowed for a deeper and more fulfilling understanding of role. New understandings that emerged could lead to alternative models of health care and influence the future delivery and planning of general practice. The thesis concludes by offering a potentially suitable model/framework which has been developed to further the understanding of teamwork in the future.</p>


2012 ◽  
Vol 4 (2) ◽  
pp. 150 ◽  
Author(s):  
Mary Finlayson ◽  
Antony Raymont

INTRODUCTION: Teamwork in primary health care has been encouraged in New Zealand and in the international literature. It may improve work satisfaction for staff, and satisfaction and outcomes for patients. Teamwork may be classified as being multi-, inter- or transdisciplinary and is likely to be influenced by the nature of the work and the organisational context. AIM: To describe and analyse teamwork between general practitioners and practice nurses in New Zealand. METHODS: Data were drawn from a survey of general practices and from interviews with primary health care staff and management. RESULTS: Doctors and nurses in general practice in New Zealand see themselves as a team. Evidence suggests that the nature of the work and the business context most often leads to a multidisciplinary style of teamwork. Some providers have adopted a more intense teamwork approach, often when serving more disadvantaged populations or in caring for those with chronic illnesses. DISCUSSION: Concepts of teamwork differ. This article provides a classification of teams and suggests that most general practice teams are multidisciplinary. It is hoped that this will help personnel to communicate their expectations of a team and encourage progressive team development where it would be of value. KEYWORDS: Teamwork; primary care; practice nurses; general practitioners


Author(s):  
Kevin Sleigh

Background: General Practitioners complete around 91% of compensable certificates, and play a significant role in promoting the awareness of the health benefits of work. The Australasian Consensus Statement on the Health Benefits of Work developed by the Australasian Faculty of Occupational and Environmental Medicine (AFOEM) has been endorsed by 100 organisations including the Royal Australian College of General Practitioners (RACGP). The Victorian WorkCover Authority and TAC has undertaken a program of work focussing on the delivery of a general practice education and awareness raising program.Objectives: The objectives of the program were to; engage Medicare Locals to undertake a general practice education and awareness raising program, develop training materials for Medicare Local staff to undertake practice liaison visits, recruit and train General Practice peer educators to deliver in-practice education and develop and deliver content for continuing professional development events in selected Medicare Locals.Methods: A suite of educational resources were developed and tailored to suit delivery in a General Practice setting. The Medicare Locals were targeted if they had high certification rates, the educational events were delivered in-practice settings and Principal findings The practice target was reached in all Medicare Locals, a total of 457 general practices across the five Medicare Locals were visited. The program was successful in raising awareness of the health benefits of work amongst GPs and practice staff.Discussion: The education has given general practitioners the impetus to talk to patients early about the health benefits of work and has the potential for GPs to be more confident in their clinical management of compensable patients.Conclusion: That the educational program continue with the Victorian WorkCover Authority and TAC working with key peak bodies and medical colleges to ensure education about the Health Benefits of Safe Work become a mandatory component of all GP postgraduate training.


2011 ◽  
Vol 17 (2) ◽  
pp. 202 ◽  
Author(s):  
Lana J. Mitchell ◽  
Lesley MacDonald-Wicks ◽  
Sandra Capra

General practice is an ideal setting to be providing nutrition advice; however, it is important that the role of general practitioners (GPs) and practice nurses in providing nutrition advice is acknowledged and defined. This article aims to discuss the role of GPs and practice nurses in the delivery of nutrition advice. Ten general practitioners and 12 practice nurses from a NSW urban Division of General Practice participated in questionnaires and a Lifescripts© implementation study, as well as their consenting patients receiving Lifescripts© (n = 13). An online survey was conducted with 90 Australian private practice dietitians. Semi-structured telephone interviews were conducted with 52 Australian private practice dietitians. The provision of basic nutrition advice is acknowledged to be part of the role of GPs and practice nurses, as they are the first point of contact for patients, allowing them to raise nutrition awareness. However, it is important that this advice is evidence based and able to be delivered in a time-efficient manner. Increased nutrition education and the availability of appropriate resources and nutrition-related best practice guidelines will assist in this process.


2021 ◽  
Author(s):  
◽  
Hemaima Mariana Hughes

<p>Alcohol and other drug (AOD) use, abuse and addiction are destructive to Māori and are an urgent problem; wairuatanga, cultural identity and tino rangatiratanga (self determination) are key to successful recovery ffom AODs for Maori. Kaupapa Māori AOD services have better success rates because they provide what is essential for Māori such as tikanga, core beliefs, values and practices of Maori re health, illness, wairua, tapu, noa and life. There are strategies for addressing the problem of AOD addiction for Māori such as positive stories of recovery. This thesis explores the shared experiential journeys of four Pūkōrero (participants) who successfully completed detoxification and recovery programmes from AOD addiction. Three questions were used to guide the research process to enable the Pūkōrero to identify positive aspects of their individual detoxification and recovery programmes, surface any barriers and issues they experienced, and clarify the support they received throughout the process. Kaupapa Maori and Narrative Inquiry was adapted to undertake this study to capture the essence of Maori thinking and reality regarding AOD. Through the use of thematic analysis the data findings of the study reflect the views from each Pūkōrero of Wairua, Whakapapa and Whānau as key to their successful recovery. This supports the notion that a pathway of detoxification, recovery and hope exists to enable Maori and others to take the journey to reclaim their own health and well-being, and the health and well-being of Whānau, Hapū, Iwi, and Māori community. In honour of these Pūkōrero, Kāumatua, Tipuna, Whānau, Hapū, Iwi, Māori katoa, and to celebrate Kaupapa Maori and Narrative Inquiry [as the preferred methodological approach], the use of our tino ataahua reo integrated with English throughout the thesis demonstrates the interwoven connections between the two cultures enshrined in Te Tiriti o Waitangi that comprise the nation of Aotearoa me Te Waipounamu of New Zealand.</p>


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