Exploring the Development of Australian General Practice Nursing: Where We Have Come from and Where to from Here?
Halcomb, Elizabeth J., Davidson, Patricia M., Patterson, Elizabeth, Contemporary Nurse : a Journal for the Australian Nursing Profession
Significant development has occurred in the role and scope of Australian general practice nursing in the last decade. Although there has been a nursing presence in Australian general practice for many years (Linn 1977), current workforce shortages and the growing need JOT chronic and complex disease management and provision of preventive health care in the community have fuelled role development (Halcomb, Patterson & Davidson 2006). In an effort to explore and document the evolution of scholarship and professional development in Australian general practice nursing a content analysis of the proceedings of the four Australian practice nursing conferences was undertaken. This framework allows the mapping of the trajectory related to professional development issues, policy, research and scholarship. Content analysis revealed that the papers presented at each of the four conferences could be broadly divided into six major themes, namely: (1) role of the practice nurse, (2) education and training, (3) research, (4) legal, ethical and risk issues, (5) innovation in clinical practice, and (6) operational and management issues in general practice. Documenting the evolution of this emerging specialty is important in planning initiatives to maximise practice nurses' important contribution to primary health care.
general practice; practice nursing; primary health care; nursing workforce issues; office nursing
Received 31 January 2007 Accepted 19 June 2007
Despite the pivotal roles played by general practice nurses in health care delivery in the United Kingdom (UK) and New Zealand (NZ), the role of Australian practice nurses is much less apparent in the health care system (Halcomb & Davidson 2006). Whilst professional nursing organisations, such as the Royal College of Nursing, Australia (RCNA) and the Australian Practice Nurses Association (APNA) have demonstrated leadership in professional development, practice nurses are still not well represented within local Divisions of General Practice (Kalucy, Hann & Whaites 2004), or in discussions of general practice issues (National Expert Committee on Standards for General Practices 2005). Given the current critical stage of role development, it is important that Australian practice nurses have a clear understanding of the development of their specialty and are also able to identify strategic future directions.
A significant body of exploratory and descriptive research has been published by Australian authors to date reporting on practice nurse demographics, characteristics and consumer perceptions (Appleby et al. 1999; Armstrong 2001; Australian Divisions of General Practice Ltd 2001; Bonawit & Watson 1996; Cheek et al. 2002; Halcomb et al. 2007b; Halcomb & Davidson 2006; Le Sueur & Barnard 1993; Linn 1969; Lockwood & Maguire 2000; Patterson 2000, 2003; Patterson, Del Mar & Najman 1999a,b,2000; Patterson & McMurray 2003; Vincent, Hogan & Sweeney 2001 ; Watts et al. 2004; Whitecross 2000; Whitecross 1999; Willis, Condon & Litt 1998, 2000a,b).This literature has previously been extensively reviewed and critically analysed (Halcomb et al. 2004, 2005, 2006). Whilst such literature provides significant evidence of the professional development trajectory of the specialty many of these papers report findings from the period immediately before health system changes began to fuel rapid development of the specialty. Further, the published literature is often the domain of academic researchers and does not always reflect the attitudes, values and beliefs of practicing clinicians. In addition to the delay to publication experienced in many scientific journals, many conference proceedings are often not translated to peer-reviewed publications. As is the case in many specialty areas, papers presented at conferences, both as podium presentations and posters, often fail to progress to publication for a range of reasons including resource constraints, author experience, time and the perceived value of publication (Hopewell & Clarke 2001). …