Patients’ accounts of the differences in nurses’ and general practitioners’ roles in primary care

Journal of Advanced Nursing - Tập 57 Số 2 - Trang 172-180 - 2007
Sarah Redsell1, Tim Stokes2, Clare Jackson3, Adrian Hastings4, Richard Baker5
1Sarah Redsell BSc PhD RGN RHV Cpsychol Principal Research Fellow School of Nursing, University of Nottingham, Nottingham, UK
2Tim Stokes MB ChB MPH MRCGP PhD Clinical Senior Lecturer Department of Health Sciences, University of Leicester, Leicester, UK
3Clare Jackson BSc Research Associate Department of Health Sciences, University of Leicester, Leicester, UK
4Adrian Hastings MB ChB Senior Lecturer in Medical Education Department of Medical and Social Care Education, University of Leicester, Leicester, UK
5Richard Baker MB BS MD FRCGP Professor of Quality in Health Care Department of Health Sciences, University of Leicester, Leicester, UK

Tóm tắt

Abstract Title. Patients’ accounts of the differences in nurses’ and general practitioners’ roles in primary care Aim.  This paper reports a study of patients’ accounts of the differences in nurses’ and general medical practitioners’ roles in primary care.Background.  Nurses are now diagnosing and treating illnesses including conducting first contact care consultations. However, the findings of international studies reporting patients’ views of developments in nursing roles are not consistent. Whilst some studies report higher satisfaction following nurse consultations, others suggest that patients do not want nurses to replace general medical practitioners. Healthcare professionals’ views of the boundaries of their roles have been studied, but patients’ views have not been reported.Method.  Semi‐structured interviews were conducted with 28 adults attending general practices for urgent ‘same day’ appointments during 2004. Participants were interviewed prior to their consultation with either the nurse or general medical practitioner and 19 participants were interviewed after the consultation. Data collection and analysis were concurrent, and based on the constant comparative method.Findings.  Participants’ views reflected traditional hierarchies in primary care. They preferred to consult with general medical practitioners if they perceived their symptoms to be serious and with nurses for minor symptoms and reassurance. They thought that nurses had more time for them and were more compassionate. Interpersonal/relational continuity of care was important and for most participants this was with a general medical practitioner who knew them. Participants trusted known practitioners; they also placed trust in professional groups and familiar structures such as the practice.Conclusion.  New nursing services should incorporate patients’ views on continuity of care provider when developing models of care delivery. Patient information leaflets in general practices should be used to explain the roles of general practitioners and nurse practitioners/practice nurses. As these roles develop further, more research is needed into all aspects of their implementation and patients’ views should particularly be evaluated.

Từ khóa


Tài liệu tham khảo

10.1525/si.2001.24.1.75

BMA(2005)BMA calls for urgent meeting with Patricia Hewitt on plans to extend prescribing powers [press release 10 Nov 2005].http://www.bma.org.uk/pressrel.nsf/wlu/STRE‐6HZJ4X?OpenDocument&vw=wfmms(accessed 25 July 2006).

10.1016/S0277-9536(98)00121-X

10.1111/1467-9566.t01-1-00325

Department of Health, 1999, Making a Difference: Strengthening the Nursing, Midwifery and Health Visiting Contribution to Health and Health Care

Department of Health, 2000, The NHS Plan

Department of Health, 2002, Liberating the Talents

Department of Health, 2004, Agenda for Change

Department of Health, 2006, Improving Patients’ Access to Medicines: a Guide to Implementing Nurse and Pharmacist Independent Prescribing within the NHS in England

Department of Health and Welsh Office, 1989, General Practice in the National Health Service: A New Contract

Glaser B.G., 1967, The Discovery of Grounded Theory: Strategies for Qualitative Research

10.1136/bmj.327.7425.1219

10.1108/08876040410520708

Hegney D., 2004, Australian consumers’ expectations for expanded nursing roles in general practice, Australian Family Physician, 33, 845

10.1136/bmj.324.7341.819

10.1016/S0277-9536(00)00014-9

NHS Executive, 1999, Health Services Circular 217 Nurse, Midwife and Health Visitor Consultants

Nursing and Midwifery Council, 2006, The proposed framework for the standard for post‐registration nursing [online]

10.1093/fampra/17.6.564

10.1111/j.1365-2648.2006.03714.x

10.1046/j.1365-2648.1999.00946.x

10.1093/fampra/19.6.641

Thông tin
Thông tin xuất bản

Journal of Advanced Nursing

Tập 57 Số 2

172-180

Thông tin tác giả