Are you getting the most out of your nursing workforce?

Stop the revolving door by fully utilising the skills of primary care nurses

4 June 2018

Australia faces a shortfall of 38,000 nurses in the primary health care sector by 2030, if industry stakeholders remain apathetic about workforce retention and recruitment.¹ 

With an ageing population and increase in chronic disease, the demand for nurses is growing. To ensure we can keep our nurses, we need employers to give nurses the opportunity to work to their full potential – to optimise the full scope of their practice. This can be done in two ways. One, by letting them take on more complex tasks and responsibilities. And two, by supporting their development in workplace specific skills using mentoring and education activities. 

Findings from the 2017 APNA Primary Health Care Nurses Workforce survey indicate that 29% of the 807 respondents felt they could do more in their practice, while 11% said they didn’t use the full extent of their knowledge and skills. Almost 50% of respondents suggested to their employer that they could undertake more complex clinical activities within their scope of practice. However, only less than half of them were able to negotiate more responsibilities or extended roles.

Are your nurses working to their full scope of practice 

Empowerment = productivity = better patient outcomes  

A strong primary health care nursing workforce that is supported and enabled to work to their fullest capacity will better contribute to positive patient outcomes. Because when we empower our nurses, we also enhance productivity, reduce costs by providing greater value for health services; facilitate increased access to healthcare; and increase patient satisfaction regarding their care.² 

APNA already has several initiatives in place to support nurses entering primary health care. This includes the Transition to Practice Pilot Program, which aims to provide an accessible, flexible and structured program for increasing the confidence, competencies, skills and knowledge of both recently graduated and experienced nurses starting work in primary health care settings. For more information on this program, visit www.apna.asn.au/transitiontopractice. 

While evaluation of the 2016-2018 Transition to Practice Pilot program is still on-going, preliminary evaluation indicates that this program provides; increased role clarity and job satisfaction, fuels a passion for primary health care and expansion of the nursing scope; which will open the pathway for primary care nurses to be educated, competent and authorised to perform to the full scope of their practice. But we need the support of employers and managers.

7 ways to increase productivity

• Conduct regular clinical team meetings to provide opportunities for learning.
• Allocate time each week to listen to and provide feedback on workplace specific skills.
• Identify mentors to provide nurse support within the practice.
• Use the Nurses Performance Review to identify mutually beneficial Continuing Professional Development for both the nurse and the practice.
• Pay for nurses to attend educational courses during work hours.
• Review the Position Description to update job role and responsibilities. 
• Evaluate the financial and non-financial value of nurses when considering remuneration. 
• When there is inadequate support for nurses in primary health care, there is a significant risk that they will leave the sector, at the cost of staff turnover borne by the workplace and our health system. The hidden cost of lost productivity, lost engagement, low morale, client service and errors often outweigh the hard cost in fiscal terms. It is a huge cost that our healthcare system cannot afford.

References

1. Health Workforce Australia, Health Workforce 2025 – Doctors, Nurses and Midwives. https://www.health.gov.au/internet/main/publishing.nsf/Content/34AA7E6FDB8C16AACA257D9500112F25/$File/AFHW%20-%20Nurses%20detailed%20report.pdf
2. Macinko J, Starfield B, Shi L. The contribution of primary care systems to health outcomes within Organization for Economic Co-operation and Development (OECD) countries, 1970–1998. Health Serv Res 2003; 38:831-865. 

This article was featured in APNA Connect 4 June 2018.