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Specific goals for general practice

Primary healthcare nursing’s peak body takes over multifaceted approach to expanding and improving the workforce and its impact. 

APNA has been tasked by the government with implementing the full Commonwealth-funded Nursing in General Practice program.

The project was previously contracted to the Australia Medicare Local Alliance. APNA, the peak body for primary healthcare nurses, was brought on as a subcontractor on the project in 2013 and thus has extensive knowledge and background of NIGP and its goals.

APNA CEO Kathy Bell is excited for the times ahead, which will include the expansion of the organisation’s work program to better meet needs in general practice and other primary healthcare settings.

"It’s going to be a busy time for us but it’s an exciting time and it’s fantastic to be able to deliver more for our members and for the primary healthcare nursing profession," Bell says.

Education, leadership and workforce development will be the key areas of focus in the upcoming months. Bell says these factors are essential in building and supporting the primary healthcare nursing workforce.

"There are concerns that the nursing workforce as a whole will see shortages over the next couple of decades," she says. "What we have been concerned about is the ageing of the general practice and primary healthcare nursing workforce because we know that people are entering quite late – they are often coming in after many years in hospitals and even then it’s a part-time job for a lot of people.

"So what we need to see is young nurses coming in and aspiring to be a primary healthcare nurse."

Workforce development

NIGP includes a three-pronged approach to workforce development; one leg features active promotion and support for GPs and general practices that are introducing practice nurses.

Just over 60 per cent of Australian general practices employ at least one nurse – which means there is still a large minority that don’t.

"We know that general practice can work much better, that quality and safety and efficiency can be much better if you have nurses and if you are using them more," Bell says. "So we want to work with general practices to help them with the uptake and the optimal use of general practice nurses.

"We will also be developing a marketing campaign for general practices, promoting the profession of general practice nursing, again to improve uptake."

Nursing constantly rates as one of the most – if not the most – trusted profession, which Lynne Walker, APNA program director leadership and promotion, says clearly shows consumers identify positively with the value that nurses can provide for their healthcare.

"I don’t think nurses recognise that particularly well, and certainly GP owners and managers probably might not be able to recognise that and make the most of … the value that a nurse can provide," Walker says. "So we want nurses to recognise that within themselves and lead their profession to bigger and better things."

The other two legs of the workforce development area of NIGP include policy work on a transition to practice program for those entering the field and a clear education and career framework to inspire progression for those choosing primary healthcare nursing as a career.

Bell highlights the primary healthcare system in New Zealand as an example of a "fabulous" transition to practice program that is in place.

She says it creates an environment that supports nurses and primary healthcare organisations taking nurses in, and also drives competition for entry into the field.

"Unfortunately, in Australia, primary healthcare nursing has been seen almost as a default," Bell says. "It’s often somewhere you go for a change from another setting – if you want to change from hospital work you might go and try general practice – rather than it being seen as a vocation.

"We believe that if nurses coming into the profession can see a career pathway that will keep them there.

"We know that we are losing nurses from the workforce in very worrying numbers. In acute care you do have established pathways for nurses to move through. We don’t yet have clear pathways for development and career progression for nurses working in general practice and primary healthcare."

Education and support

NIGP will also focus on education.

As the Australian population continues to increase, so does the prevalence of chronic illnesses, including diabetes, heart disease, kidney disease and more.

APNA will focus on meeting the unique educational requirements of each discipline within the primary healthcare nursing setting.

Bell says the contribution nurses make to delivery of care in general practice and primary healthcare settings is already an important part of the solution to these challenges, as a cost-effective answer to mounting workforce concerns. But applying that solution will require a focus on education.

"Access to education for nurses in primary care is fundamental to their own development," APNA program director Bronwyn Morris-Donovan says, "not only in terms of progression of their career but also the profession of nursing in primary care more broadly.

"A lot of the nurses who move into the primary-care sector are established from the acute-care sector and are competent and knowledgeable in their own domains. But without [getting them] access to education that is appropriate for the primary care sector, then we can’t expect to expand that particular aspect of the workforce."

Morris-Donovan confirms the organisation has several education-based objectives that will form part of the organisation’s core business from now on.

Before June next year, general practice and primary healthcare nurses will be able to participate in six online learning modules. Five topics are settled: leadership and management; population health; healthy ageing; nurse clinics; and health literacy. The sixth is yet to be decided but will probably target asthma or wound care.

This year, APNA will also focus on a series of behavioural change workshops whilst 2015 will bring its first series of webinars for the program.

"We are looking to deliver education that has application across the whole of the primary care domain and not just for nurses in general practice," Morris-Donovan says. "The webinars are a good example of that. They are an opportunity for us to extend our education offerings."

Leadership across the board

During the next 12 months, APNA will also be moving to instil the concept of leadership across all programs.

"Based on some work we did last year with the Medicare Local Alliance, it was quite clear that nurses were able to take a leadership role in a variety of ways – and that could be clinical, professional or personal," Walker says.

"We want to build on that to give them the confidence to recognise that they have that ability and to be able to put their ideas and their actions [together] in a way that builds on their clinical care, on their professional practice, and contributes to the workplace."

Achieving great things will become a motto of sorts for APNA and the ongoing NIGP program. Walker confirms that the group will move to identify nurse leaders and help them establish their own networks and online forums.

Bell says an important part of improving leadership within the sector is mentoring, so developing this will be a clear objective.

"We want to expand the program of nurse leadership and we know the best way to develop leadership amongst nurses in primary healthcare is through peer-led professional networks and also through mentoring."


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