Renegotiating roles as part of developing collaborative practice: Australian nurses in general practice and cervical screening

Abstract

This paper reports the fi ndings from an action research study that used a refl ective group method to work with nurses in general practice recently credentialed as cervical screeners. The research aimed to develop a new model of practice nurse service delivery within a multidisciplinary team. Findings demonstrated that poor interdisciplinary collaboration created barriers to changing the role of the practice nurse. Key themes identifi ed were: renegotiating their roles, identifying and negotiating gendered patterns of cervical screening, and the effect of multidisciplinary teams and interdisciplinary collaboration on practice nurse retention. Recommendations from this study address the need for improved piloting of new initiatives and an increase in continuing professional development for practice managers who are potential change agents.

Australian nurses in general practice, enabling the provision of cervical screening and well women’s health care services: a qualitative study

“…These findings contrast with earlier studies by Mills and Fitzgerald [3,4] and Jasiak and Passmore [2] that report GP resistance to practice nurses establishing new models of cervical screening and well women’s health services. In particular, Mills and Fitzgerald [3,4] identify female GPs as a barrier to PNs provision of cervical screening services.…”

“…These findings contrast with earlier studies by Mills and Fitzgerald [3,4] and Jasiak and Passmore [2] that report GP resistance to practice nurses establishing new models of cervical screening and well women’s health services. In particular, Mills and Fitzgerald [3,4] identify female GPs as a barrier to PNs provision of cervical screening services. More recently however, Peters [12] suggests clients’ preference for a female providing this service has led to more male GPs relinquishing clients to their counterparts, the implications of which for female GPs’ workloads has motivated their support of PNs expanding their role.…”

“…While previous studies have examined the role of PNs as Pap smear [cervical screening] providers [1-4] findings are limited to identifying barriers to implementing the role, while recommending further research in the area. This study builds on previous work in order to develop a solutions based approach for PNs and their employing general practices wishing to incorporate cervical screening and well women’s health care services into their work.…”

The Place of Knowledge and Evidence in the Context of Australian General Practice Nursing

“…These practices are small businesses that need to generate sufficient income to meet operating costs (including salaries and wages) and generate a profit. General practice nurses are employed to undertake a range of functions, some of which are allocated specific practice nurse item numbers for the purposes of Medicare reimbursement; for example, immunizations, wound care, cervical screening, and some health checks (Mills & Fitzgerald 2008). GPs also rely on the general practice nurse to assist with procedures that have associated GP Medicare item numbers, such as health care assessments, care planning, and the management of recall systems (Keleher et al 2007).…”

The role of Government policy in supporting nurse‐led care in general practice in the United Kingdom, New Zealand and Australia: an adapted realist review

“…In Australia, practice nursing is an emerging speciality with government being late in supporting PN role development when compared internationally (Halcomb et al. 2008a, Mills & Fitzgerald 2008). The two studies identified in the second review were exploratory studies (Table 1).…”