Practice nurses voice concerns over lack of career structure

Survey findings confirm the need for a national policy framework to support educational development, writes Linda Belardi.

Cost, release from work and time are the greatest barriers to further education, Australia's first national survey on the education and career pathways of practice nurses has found.Less than a quarter of practice nurses were studying for a qualification, despite nearly all having access to educational opportunities. The survery found 17 per cent had completed a postgraduate qualification relating to primary care. For 40 per cent of the nurses surveyed, geography was also identified as a significant issue. These figures provide a snapshot of the educational preparation of Australia's fast-growing practice nurse workforce, for which limited data is available. The research conducted by the Australian Primary Health Care Institute and Monash University surveyed 58 practice nurses from across Australia to examine their qualifications and attitudes to further study.Most of the practice nurses were women, aged in their mid-40s, hospital trained and working part-time in general practice, on average, for approximately four years. While the majority of nurses had not obtained post-registration qualifications, they expressed a strong desire for a career pathway, to be challenged by their work and to increase their scope of practise.Interestingly, nurses identified experience not further education as constituting advanced levels of practice, which is out step with the definition held by the RCNA.While over 40 per cent of surveyed nurses described their practice as advanced, only 17 per cent had completed postgraduate training."Most of the tasks respondents reported as comprising their practise do not appear to require advanced training and could not be regarded as core roles for advanced practice nurses," said the report.

Greater contact with professional bodies and clearer definitions of the scope of different levels of practice are required, it said.The survey also clearly identified a lack of a career pathway for this expanding area of nursing, with almost 85 per cent of nurses reporting that they did not have a career pathway in their organisation.Developing an appropriate career structure should be a priority area if Australia is to have a more professional primary care nursing workforce, said the report. Practice nurses also felt a strong sense of being regarded as less important than nurses working in the acute sector and that a career structure would lead to more recognition and professional respect."I love practice nursing but feel we are a long way from being accepted as a 'stream' of nursing accepted as equals by the acute 'stream' of nursing," said one respondent.Concerns were also raised about the need for tertiary education that was directly geared towards primary care and the particular needs of general practice.Nurses also strongly perceived that their role and career development in primary care needed to be better recognised and valued by GPs.The report said a comprehensive policy framework was needed to support the career development of nurses in primary care, which could include provision for mandatory training.

This would also help remedy the lack of an overt link between education and competency standards for practice nurses.

The survey by Rhian Parker, Helen Keleher and Laura Forrest appears in the September edition of the Australian Journal of Primary Health.

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