Addressing nurses' needs

In 2017 APNA played an active role in addressing the challenges nurses in primary health care experience.

Policy and advocacy

APNA has recently developed a position on primary health care nurse scope of practice¹. This paper outlines the advantages of nurses working to their full scope of practice which includes not only benefits to the health and wellbeing of the Australian community but also improves the healthcare system as a whole.

Where possible APNA has been advocating on behalf of members and the broader profession to ensure that the primary health care nursing workforce is better utilised.

APNA advocated for primary health care nurses to be represented on various committees and working groups to guide the policy and implementation framework for the Australian Government’s Health Care Homes model.

As a result APNA is now represented on the following working groups:

• Health Care Homes Clinical Reference Group
• Health Care Homes Guidelines, Education and Training Working Group
• Health Care Homes Project Advisory Group
• Health Care Homes Resource Development Group

It is apparent that APNA representatives and members have been a strong voice for primary health care nurses as various Health Care Homes resources showcase the breadth of nursing practice within
primary health care. APNA Board Members Jane Bollen and Melissa Cromarty featured on a Department of Health/AGPAL webinar series2 on Health Care Homes focusing on the role of nurses in transformation as part of the Health Care Homes trial.

A nurse practitioner can also be an enrolled patient’s nominated clinician under the Health Care Homes model. Nurse practitioner and APNA member Chris Helms, with the support of APNA, played an instrumental role in advocating for this. APNA responded to the Government of Western Australia’s Sustainable Health Review. The written submission3 emphasised the diversity of the primary health care nursing role and that the workforce is well positioned to address emerging healthcare challenges.

Education, training and professional support

APNA provides a variety of professional development opportunities to strengthen and optimise an individual nurse’s scope of practice. The Transition to Practice Pilot Program, funded by the Australian Government Department of Health, supports nurses transitioning into a variety of primary health care settings through increasing knowledge, skills and confidence.

Transition to practice programs are seen as valuable in supporting both the graduate nurse’s professional adjustment into nursing as well as facilitating the experienced nurse’s movement from one clinical setting or speciality to another.

Many nurses have reported that the program has increased role clarity and job satisfaction. Nurses intending to access education to assist them in working to their full capacity are often hindered due to financial constraints. This doesn’t just include not being able to afford the education itself but also the fiscal impact of time away from work to attend and complete professional development.

To offset some of the financial considerations, the Transition to Practice Pilot Program has provided funding to both the external experienced nurses who provided support to the transitioning nurses as well as their workplaces.

The funding is for the workplace to provide protected time, to enable the transitioning nurses to undertake some education, clinical and professional mentoring during work hours, and provide financial support for professional development. All nurses in the program were also provided with unlimited access to a variety of both core (considered core to a primary health care nurse’s foundational knowledge and skills) and optional educational activities. This supports improvements in clinical and non-clinical areas of care – competence, confidence, knowledge, skills – all required when determining an individual’s scope of practice.

APNA is supporting nurses in primary health care to establish nurse clinics with seed funding from the Australian Government Department of Health. Nurse clinics are innovative models of care which provide an opportunity for primary health care nurses to strengthen and optimise their scope of practice. APNA is currently working with 11 pilot sites across general practice, aged care, community health and corrections to improve care delivery and patient health outcomes across a range of clinical areas, including diabetes, dementia, mental health and hepatitis. The broad range of nurse clinics being implemented demonstrates the breadth and scope of the primary health care nursing role. A toolkit and resources are currently being developed to increase knowledge, skills and confidence in the broader primary health care nursing sector to establish and implement nurse clinic models of care.

...many nurses seek assistance in understanding their scope of practice because they struggle with role ambiguity, conflicting expectations from employers and managers, and a lack of clarity regarding how to define scope of practice outside of the acute setting.

APNA’s Career and Education Framework is an opportunity to improve the perceived value and professionalism of the nursing role in primary health care. It also provides a platform to promote and describe the breadth of the primary health care nursing role. By completing the self-assessment tool, embedded in the My Nursing Future website – www.mynursingfuture.com.au – a personalised report will assist individuals to:

• Identify your level of practice
• Identify areas you would like to progress, set career goals, and optimise your individual scope of practice
• Assist you to actively plan your CPD Showcase your skills, knowledge and experience, and demonstrate to managers or employers how your skills can be better utilised
• Results can be built into your nursing role and key performance indicators with your employer or manager.

APNA’s Nurse Support Line is a member-only service that assists nurses to determine their professional scope of practice. A review of APNA’s nurse support and enquiry database indicates that many nurses seek assistance in understanding their scope of practice because they struggle with role ambiguity, conflicting expectations from employers and managers, and a lack of clarity regarding how to define scope of practice outside of the acute setting.

APNA is aware that a lack of understanding of a nurse’s scope by some employers may translate into a lack of recognition and acknowledgement of performance. APNA empowers its members via the Nurse Support Line to have a conversation with their employers about specific working condition issues to bring about positive change.

You can read more about all of these initiatives and programs on the APNA website at www.apna.asn.au or get in touch with our policy and advocacy team by emailing policy@apna.asn.au.

References

1. APNA Position Statements: https://www.apna.asn.au/profession/APNA-position-statements
2. Practice nurse’s role in transformation (October, 2017). Australian Government Department of Health and Australian General Practice Accreditation Limited (AGPAL). https://vimeo.com/239768568/24fbddd3bc
3. APNA’s response to the Western Australian Sustainable Health Review (October, 2017). https://www.apna.asn.au/profession/consultations-and-submissions

Source: Primary Tmes Summer 2017: (Volume 17, Issue 4)