Homeworks academic service

Contemporary issues in nursing leadership in nursing practice nursing essay

Expansion of the role of Practice Nurses PNs is one way in which this demand may be met. To date the Federal Australian government has played a significant role in encouraging growth in the PN workforce. If PNs tend to be GP directed, with little autonomy, care must be taken to consider whether to expand existing scopes of practice.

In contrast, if PNs rely on their own independent clinical judgment and skill, this would support potential expansions to the scope of the PN role. Understanding these issues is important to inform the development of future workforce policy. This paper examines the structural policy dimensions within which these changes are occurring, and makes recommendations for future research on PNs.

Keywords health policy; practice nurses; primary care; work preferences Article Text In Australia, as well as internationally, there is growing acceptance that we cannot continue to provide health care services in the same manner as we have. Rapidly rising health care costs, increasing demand for services, increasing prevalence of chronic and complex conditions, and workforce shortages in most health disciplines are some of the challenges facing governments today.

There is an international recognition that primary health care offers strategic and cost-effective opportunities to address systemic health system challenges World Health Organisation 2008; Prime Minister's Commission on the Future of Nursing and Midwifery in England 2010. Further impetus for the increased focus on primary health care provision comes from the fact that the patient groups being managed by health care providers are changing.

In a pattern that is typical of many countries, health care service providers in Australia are treating a greater number of older patients Britt, Miller, Charles, Henderson, et al 2009 and patients with a broader range of chronic health care issues.

  1. National Program Guide, Canberra.
  2. BMC Public Health 8, 270.
  3. Moral distress in the neonatal intensive care unit. GP Review 12, 15.
  4. John Wiley; New York. Pediatric Critical Care Medicine.

In Australia, governments at both the State and Federal level are developing and implementing policies which will impact on primary care service delivery Agvall, Borguist, Foldevi, and Dahlstrom 2005; Australian Medical Workforce Advisory Committee 2005; Australian Bureau of Statistics 2006. These policies address what Kringos and co-workers 2010 refer to as the structural dimensions of primary care: In line with the goals set out in the primary health care strategy the Federal Government has committed to investment in health professional education and training, reexamining and streamlining funding mechanisms, and to establish 36 General Practitioner GP Super Clinics Australian Government Department of Health and Ageing 2010a.

The re-examination of primary health care funding includes increasing and targeting funding for the provision of multi-disciplinary care arrangements for people with chronic illness. The Super Clinics will provide general medical practice services, along with procedural and specialists' rooms to provide child health, chronic disease, mental health, sexual health, dental, and Aboriginal Health services Roxon 2010a.

An aim of the Super Clinics is to create multidisciplinary community and primary health care teams, and to therefore shift service provision away from hospitals Australian Government Department of Health and Ageing 2010a,b.

It is expected by co-locating GPs, PNs, and other health professionals, the Super Clinic initiative will achieve efficiencies of scale, enhance access to primary care services, build primary care capacity, and reduce the utilization of tertiary care services. It has also been argued that the Super Clinic will provide a catalyst for the development of new ways of delivering services, or models of care Australian Government Department of Health and Ageing, 2010b.

There are also Australian state-based initiatives that aim to expand the provision of primary health care. Similarly, the South Australian government implemented the GP Plus program which resulted in several multidisciplinary clinics providing primary care in outer suburban locations South Australia Department of Health 2009.

  1. Qualitative interviews with nurses on the frontlines would provide us with more nuanced data about the process of and problems associated with advocating for patients' rights in different practice settings.
  2. Australian Government 2010b A national health and hosptials network for Australia's future Minister P ed. Primary care and why it matters for U.
  3. A comparative study of organisational characteristics, work characteristics and nurses' psychological work reactions in a hospital and nursing home setting.

These programs, along with initiatives in other states and territories, identify the direction of Australian health policy towards greater prevention, risk management and treatment in primary care settings Phillips, Pearce, Dwan, Hall, et al 2008. Workforce supply and organisation in primary care. Cost of heart failure in Swedish primary healthcare. Scandinavian Journal of Primary Health Care 23, 227-232.

Maintain the role of the practice nurse in general practice. Journal of Advanced Nursing 24, 498-505. Commonwealth of Australia, Canberra. Australian Divisions of General Practice 2005 National practice nurse workforce survey report.

Australian Government 2010b A national health and hosptials network for Australia's future Minister P ed. Australian Government, Canberra, p. National Program Guide, Canberra. Australian Institute of Health and Welfare 2009 Health community services labour force. National health labour force. Australian Institute of Health and Welfare, Canberra. Australian Nursing Federation 2005 Competency standards for nurses in general practice. Australian Practice Nurse Association, Canberra.

General practice series no. Australian Institute of Health and Welfare. Practice Nurses working with GPs. GP Review 12, 15. Organizational attributes of practices successful at a disease management program. Journal of Pediatrics 154, 290-295. Job strain, effort-reward imbalance and employee well-being: Journal of Occupational Health Pyschcology 8, 282-305. Economic evaluation of nurse practitioner versus GPs in treating common conditions. British Journal of General Practice 60, e28-e35.

Australian Health Review, 29, 201-09. Mentoring nurses in general practice: Journal of interprofessional care 19, 50-64.

Everyday Ethics: Ethical Issues and Stress in Nursing Practice

Nurse staffing and quality of care in UK general practice: British Journal of General Practice 60, e36-e48. Promoting leadership and management in Australlian general practice nursing: Journal of Nursing Management 16, 846 - 852. Validation of the professional practice environment scale in Australian General Practice.

Journal of Nursing Scholarship 42, 207-213. Nursing in Australian general practice: Australian Health Review 29, 156. Job demands, job decision latitude, and mental strain: Administrative Science Quarterly 24, 285-308. Journal of Advanced Nursing 48, 68-75. A Generational Accounting Analysis. Health Services Research, 10. Experiences of the new role of advanced practice nurses in Swedish primary health care- A qualitative study.

International Journal of Nursing Practice 16, 69-74. Defining the role of primary health care nurses practitioner in rural Nova Scotia [Definir le role des infirmieres practiciennes en soins primaires dans les regions rurales de la Nouvelle-Ecosse]. Canadian Journal of Nursing Research 42, 30-47. Journal of Advanced Nursing 68, 614-624. Journal of Applied Psychology 90, 399-406.

Global measure of satisfaction with psychosocial work conditions versus measures of specific aspects of psychosocial work conditions in explaining sickness absence. BMC Public Health 8, 270. Practice nursing in Australia: A review of education and career pathways. BMC Nursing 8, 1-6. The changing face of nurses in Australian general practice.

Australian Journal of Advanced Nursing 23, 44-50. Collaborative practice between registered nurses and medical practitioners in Australian general practice: Australian Journal of Advanced Nursing 20. Primary care and why it matters for U.

Health Affairs 29, 806-810. Roxon N 2010b Media Release: South Australian Government, Adelaide. Inter-Governmental and Funding Services Branch: NSW Department of Health. Journal of Advanced Nursing 54, 751-759. Learning new behaviour patterns: Nurses in urban and rural practice- who are they and what do they do?

Australian Family Physician 33, 185-188. A role-theoretic analysis of customer work. Work and Occupations 27, 406-427. A comparative study of organisational characteristics, work characteristics and nurses' psychological work reactions in a hospital and nursing home setting. International Journal of Nursing Studies 43, 491-505. Effectiveness of nurse-delivered cardiovascular risk management in primary care. Evidence Based Nursing 13, 40-46. J Hum Hypertens, 17, 689-95.

World Health Organisation 2008 The world health report 2008: World Health Organisation, Geneva.