A career framework for nurses in primary health care

18 April 2016

A new project will cement a career and education pathway for nurses working in Australia's primary health care settings. The initiative is one of several key measures designed to strengthen primary health care as a nursing career destination, writes Karen Keast.

Nursing in primary health care is a growing specialty area, with an estimated 80,000 nurses working in settings from general practice to aged care, schools and detention centres.

The demand for nursing in this field is only expected to increase in line with the rapidly ageing population and the burden of chronic and complex disease that's projected will inundate the nation's health care system.

Yet, despite the demand, Australia faces a projected shortfall of 27,000 nurses working in primary health care by 2025 due to the high number of nurses exiting primary health care and a lack of nurses moving into the field.

The Australian Primary Health Care Nurses Association (APNA) is now working to develop an Education and Career Framework to better define and shape the career pathway in a bid to recruit and retain more nurses in primary health care.

Under the Commonwealth-funded Nursing in General Practice program, the first stage of a framework for the more than 12,000 nurses working in general practice was completed in 2015.

Now, through the Commonwealth-funded Nursing in Primary Health Care program, APNA is creating a new framework and toolkit designed to cover all nurses working in primary health care, expanding on the framework designed specifically for nurses in general practice.

Emily Wheeler, project manager for the education and career framework and toolkit, says primary health care is a newly defined and accelerating area of practice, and the nursing profession is now working to catch up.

"We haven't been able to keep up regarding the educational structures around it, articulating what the roles and scopes and all of the supporting documents that you have in other elements of nursing, they don't necessarily exist in primary health care yet but now we are trying to provide those frameworks that nurses can use to underpin their practice."

"We know that it's a very positive and challenging career option. A lot of nurses in primary health care report that they have wonderful autonomy and job satisfaction but we really need to get the idea out there that this is a possibility as a career."

"An education and career framework is a formal way of doing that. It's something tangible that nurses who may never have heard of a role in primary care could pick up and work through themselves so that they have an understanding of what their potential role and career could be."

"I think there's a huge gap there currently in just describing and articulating what it is that primary health care nurses do and hopefully the education and career framework fills that gap."

Ms Wheeler says most nurses have been trained for a career in hospitals, and the framework will be an important asset in introducing many nurses to a new field of nursing.

"The aim of the framework is really to expose nurses to a potential career that is as fulfilling as a tertiary career and then once they decide to make the jump, if that's what they are interested in, the framework should support them to transition," she says.

"For example, a nurse moves into a job within the local general practice, there can be an assumption then that the experience and clinical expertise within the tertiary setting is applicable for the primary care setting."

"Although many skills and much of the clinical knowledge is transferable, it has to be acknowledged there's a lot of contextual factors that are quite different."

The framework will support nurses to advance their careers within primary health care, outlining a range of education, career development and progression opportunities.

It will detail learning and development pathways for nurses wanting to move into the field, amid a growing number of postgraduate specialty courses launching in primary health care.

The framework will also equip nurses to either progress their career or to review their career.

"This framework is not meant to be a very linear framework that kind of propels nurses unwillingly along a pathway they may not want to take," Ms Wheeler says.

"It will allow nurses to mark what core knowledge and skills they have at that point, just as a reflective process or as part of their annual performance review.

"It will be a practice and peer-endorsed tool that can be used by any nurse within any primary health care setting to assess their current place in their career, to reflect on their pathway to date, to plan their career trajectory and also to guide their professional development opportunities, like courses or mentoring or qualifications that they need to do to be able to support that next career move or to consolidate their skills."

Work on the new framework started in February. A comprehensive consultation process recently began with members and key stakeholders, ranging from peak bodies in nursing and general practice to employers and education providers.

The consultation process will last for about a year with the completed framework expected to be launched in mid-2017. A toolkit will also be developed during the consultation phase and will include resources to support the implementation of the framework across the range of primary health care settings.

Ms Wheeler says nurses can participate and contribute to the framework as part of the project's consultation phase.

"We really welcome people approaching us and offering to be involved in some of the discussion because I think it will really ultimately support the work of existing nurses and allow them to support new nurses coming into the setting."

While some hospital-experienced nurses transition into primary health care nursing for benefits such as fewer night shifts or more family-friendly hours, Ms Wheeler says the framework will strengthen the nursing profession within primary health care, cementing it as an attractive career choice for nurses in its own right.

"It's a very diverse and growing professional network, there are many specialty areas of practice within primary health care," she says.

"We want nurses to consider or re-engineer primary health care as their first choice."

This article first appeared in Health Times.