Practice nurses and general practitioners: Perspectives on the role and future development of practice nursing in Ireland

Abstract

Aims and objectives. To explore the role dimensions, competence and professional development needs of practice nurses in Ireland from both the general practitioner's and practice nurse's perspective and highlight any agreement/disagreement between the professions. Background. Economic pressure on healthcare delivery is promoting a re-evaluation of professional roles and boundaries. This coupled with a primary care sector that is evolving prompted an investigation into the role dimensions and competence of the practice nurse. There is a lack of empirical data comparing the general practitioner's and practice nurse's perspective on the current role of the nurse, clinical competence (existing and required), strategic direction for the role and continuing professional development. Design. A descriptive cross-sectional survey design was used. Methods. A random sample of general practitioners (n=414) and a purposeful sample of practice nurses (n=451) participated. Data from each profession were analysed and comparisons drawn. Results. General practitioners and practice nurses agree (±5%) that the nursing role is centred on immunisation, direct clinical care and elements of chronic disease management. However, in some areas such as preconceptual advice, family planning, advice on menopause, continence promotion and research, there was a 30% difference between the general practitioners perceptions of the nurse's involvement and the practice nurse's actual involvement in the role. Perceived competency differed in a number of areas with nurses more likely to indicate competency in health promotion activities. Both disciplines acknowledged that only a minority of practice nurses were competent in audit, research and dealing with 'problems with living' (relationship breakdown, addiction and parenting). Conclusion. There is some congruence of opinion among practice nurses and general practitioners in Ireland regarding the current role of the practice nurse. Divergent opinions on the nurses' involvement in a particular aspect of the role may be due to the general practitioners underestimating the nurse's involvement in the role. Training is required in the areas of audit, research and 'problems with living'. Relevance to clinical practice. This research provides data for role clarity and evidence-based role development for practice nurses within the context of evolving primary care services. It also indicates how general practitioners perceive the nursing role. © 2012 Blackwell Publishing Ltd.