Archives
Enhancing scope of practice for the second level nurse
A change process to meet growing demand for rural health services
Katrina Nankervis
Nursing Resource Manager, Bendigo Health, Bendigo VIC
Amanda Kenny
School of Health and Environment, La Trobe University, Bendigo, VIC
Melanie Bish
Mercy Health and Aged Care, Golden Square VIC
Abstract
This article reports on Australian research, funded by the Victorian Department of Human Services Nurse Policy Branch and conducted in two rural Victorian health services.
Predicted workforce shortages in the health professions and accompanying growth in demand for services have set the scene for exploring new ways of working. Focused on Victoria's second level nurse, the division two registered or enrolled nurse, this research explored opportunities to enhance scope of practice as one mechanism to meet anticipated workforce demand and expectations.
The study revealed a lack of collective wisdom as to how scope of practice may be enhanced, and an accompanying lack of organisational readiness to facilitate the broad changes needed to implement a different practice role. In response to these findings, the SCOPED model was developed as a tool to assist health services explore and implement an enhanced scope of practice for the second level nurse.
Keywords
nursing, scope, change, rural, enrolled, workforce
References
Access Economics (2001) Population Ageing and the Economy, Commonwealth Department of Health and Aged Care, Commonwealth of Australia.
Appelbaum S and Wohl L (2000) Transformation or change: Some prescriptions for health care organizations, Managing Service Quality 10(5): 279-98.
Ashbury J (1995) Overview of focus group research, Qualitative Health Research 5(4): 414-20.
Attride-Stirling J (2001) Thematic networks: an analytic tool for qualitative research, Qualitative Research 1(385-405).
Australian Health Ministers' Conference (2004) National Health Workforce Strategic Framework, Australian Health Ministers' Conference 2004, Sydney.
Australian Nursing and Midwifery Council (2002) National Competency Standards for the Enrolled Nurse, Australian Nursing and Midwifery Council, Dickson ACT.
Axelrod R, Axelrod E, Jacobs R and Beedon J (2006) Beat the odds and succeed in organizational change, Consulting to Management 17(22): 6-9.
Borthwick C and Galbally R (2001) Nursing leadership and health sector reform, Nursing Inquiry 8(2): 75-81.
Chesanow N (2001) A medical crisis: who'll care for your patients? Medical Economics 78(9): 67-74.
Community Services and Health Industry Skills Council (2007) Health Training Package HLT07, Community Services and Health Industry Skills Council, Melbourne, accessed at http://www.cshisc.com.au/ on 11 August 2007.
Cowin L and Jacobsson D (2003) Addressing Australia's nursing shortage: Is the gap widening between workforce recommendations and the workplace? Collegian 10(4): 20-24.
Department of Human Services Victoria (2001) Nurse Recruitment and Retention Committee. Final Report, Policy and Strategic Projects Division, State Government Victoria.
Department of Human Services Victoria (2004) Nurses in Victoria. A Supply and Demand Analysis 2003-04 to 2011-12, Policy and Strategic Projects Division, State Government Victoria.
Department of Human Services Victoria (2007a) Division 2 Extended Scope of Practice, Nurse Policy Branch, Melbourne, accessed at http://www.health.vic.gov.au/nursing/furthering/div2ext on 15 May 2007.
Department of Human Services Victoria (2007b) Nurse Practitioner, Nurse Policy Branch, Melbourne, accessed at http://www.health.vic.gov.au/nursing/furthering/practitioner.htm#dow on 15 May 2007.
Duckett S (2005a) Health workforce design for the 21st Century, Australian Health Review 29(2): 201-10.
Duckett S (2005b) Interventions to facilitate health workforce restructure, Australia and New Zealand Health Policy 2(14).
Francis K, Bowman S and Redgrave M (2001) Rural nurses: Knowledge and skills required to meet the challenges of a changing work environment in the 21st Century - A review of the literature. Commissioned research project, National Review of Nursing Education, Canberra.
Gibson T and Heartfield M (2005) Australian enrolled nurses have their say - Part 2: Scope of practice, Contemporary Nurse 19(1-2): 126-36.
Heath P (2002) National Review of Nursing Education 2002: Our Duty of Care, Department of Education, Science and Training, Commonwealth of Australia.
Hegney D, Mccarthy A, Rogers-Clark C and Gorman D (2002) Retaining rural and remote area nurses. The Queensland, Australia Experience, JONA 32(3): 128-35.
Kenny A and Duckett S (2003) Educating for rural nursing practice, Journal of Advanced Nursing 44(6): 613-22.
Kenny A and Duckett S (2005) An online study of Australian Enrolled Nurse conversion, Journal of Advanced Nursing 49(4): 423-31.
Kimball B and O'Neill E (2002) Health Workforce Solutions 2002. Health Care's Human Crisis: The American Nursing Shortage. The Robert Wood Johnson Foundation, Princeton NJ.
Kimberley A, Myers H, Davis S, Keogh P and Twigg D (2004) Enrolled nurse medication administration, Contemporary Nurse 17(1-2): 63-70.
Krueger R (1994) Focus Groups: A Practical Guide for Applied Research 2nd edn, Sage, Thousand Oaks,
McWilliam C and Ward-Griffin C (2006) Implementing organizational change in health and social services, Journal of Organizational Change Management 19(2): 119-35.
Milson-Hawke S and Higgins I (2004) The scope of enrolled nurse practice: A grounded theory study, Contemporary Nurse 17(1-2): 44-62.
Moran J and Brightman B (2000) Leading organizational change, Journal of Workplace Learning: Employee Counselling Today 12(2): 66-74.
National Nursing and Nursing Education Taskforce (2006a) National Nursing and Nursing Education Taskforce Final Report. December 2006, National Nursing and Nursing Education Taskforce, Melbourne, accessed at http://www.nnnet.gov.au/downloads/n3et_final_report.pdf on 20 February 2006.
National Nursing and Nursing Education Taskforce (2006b) Towards consistent regulation of nursing and midwifery in Australia: A select analysis of the legislation and professional regulation of nursing and midwifery in Australia, A report prepared by Amanda Adrian and Associates for the National Nursing and Nursing Education Taskforce, National Nursing and Nursing Education Taskforce, Melbourne, accessed at http://www.nnnet.gov.au/downloads/rec4_mapping_report.pdf on 12 September 2006.
Nurses Board of Victoria (2005) Report from Questionnaire Division 2 Registered Nurse Scope of Practice, Melbourne, accessed at http://www.nbv.org.au on 12 Feb 2006.
Nurses Board of Victoria (2006) Nexus 13(2) Nurses Board of Victoria, Melbourne
Nurses Board of Victoria (2007a) Guidelines: Scope of Nursing and Midwifery Practice, Nurses Board of Victoria, Melbourne.
Nurses Board of Victoria (2007b) Personal Communication, Nurses Board of Victoria, 5 October 2007.
Productivity Commission (2005) Australia's Health Workforce, Productivity Commission Research Report, Commonwealth of Australia, Canberra.
Queensland Nursing Council (2005) Scope of Practice Framework for Nurses and Midwives, Brisbane, accessed at http://www.qnc.qld.gov.au/upload/pdfs/qnc_policies on 01 Aug 2006.
Reid J (1994) Nursing Education in Australian Universities: Report of the National Review of Nurse Education in the Higher Education Sector, Commonwealth of Australia, Sydney.
Robinson N (1999) The use of focus group methodology with selected examples from sexual health research, Journal of Advanced Nursing 29(4): 905-13.
Sandelowski M (2000) Whatever happened to qualitative description? Research in Nursing and Health 23(4): 334-40.
Sax S (1978) Nurse Education and Training. Report of the Committee of Inquiry into Nurse Education and Training to the Tertiary Education Commission, Committee of Inquiry into Nurse Education and Training, Canberra.
Senate Community Affairs Committee (2002) The Patient Profession: Time for Action. Report on the Inquiry into Nursing, Commonwealth of Australia, Canberra.
St John W (2004) Focus group interviews, in Minichiello V, Sullivan G, Greenwood K and Axford R (eds) Handbook of Research Methods for Nursing and Health Science 2nd edn, Prentice Hall Frenchs Forest.
Victor P and Franckeiss A (2002) The five dimensions of change: An integrated approach to strategic organizational change management, Strategic Change 11(1): 35-42.
Victorian State Government (2002) Submission into the Senate Inquiry into Nursing. Government of Victoria, Melbourne.
Victorian State Government (2005) Productivity Commission Study into the Health Workforce - Victorian Government Submission, Department of Human Services, Government of Victoria, Melbourne.
Webb C and Jevern J (2001) Focus groups as a research method: A critique of some aspects of their use in nursing research, Journal of Advanced Nursing 33(6): 798-805.
eContent Home