Practice nurses' workload, career intentions and the impact of professional isolation: a cross-sectional survey

O'Donnell, C.A. , Jabareen, H. and Watt, G.C.M. (2010) Practice nurses' workload, career intentions and the impact of professional isolation: a cross-sectional survey. BMC Nursing, 9(2), (doi: 10.1186/1472-6955-9-2)

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Background Practice nurses have a key role within UK general practice, especially since the 2004 GMS contract. This study aimed to describe that role, identify how professionally supported they felt and their career intentions. An additional aim was to explore whether they felt isolated and identify contributory factors.

Methods A cross-sectional questionnaire survey in one large urban Scottish Health Board, targeted all practice nurses (n=329). Domains included demographics, workload, training and professional support. Following univariate descriptive statistics, associations between categorical variables were tested using the chi-square test or chi-square test for trend; associations between dichotomous variables were tested using Fisher's Exact test. Variables significantly associated with isolation were entered into a binary logistic regression model using backwards elimination.

Results There were 200 responses (61.0% response rate). Most respondents were aged 40 or over and were practice nurses for a median of 10 years. Commonest clinical activities were coronary heart disease management, cervical cytology, diabetes and management of chronic obstructive pulmonary disease. Although most had a Personal Development Plan and a recent appraisal, 103 (52.3%) felt isolated at least sometimes; 30 (15.5%) intended leaving practice nursing within 5 years. Isolated nurses worked in practices with smaller list sizes (p=0.024) and nursing teams (p=0.003); were less likely to have someone they could discuss a clinical/professional (p=0.002) or personal (p<0.001) problem with; used their training and qualifications less (p<0.001); had less productive appraisals (p<0.001); and were less likely to intend staying in practice nursing (p=0.009). Logistic regression analysis showed that nurses working alone or in teams of two were 6-fold and 3.5-fold more likely to feel isolated. Using qualifications and training to the full, having productive appraisals and planning to remain in practice nursing all mitigated against feeling isolated.

Conclusions A significant proportion of practice nurses reported feeling isolated, at least some of the time. They were more likely to be in small practices and more likely to be considering leaving practice nursing. Factors contributing to their isolation were generally located within the practice environment. Providing support to these nurses within their practice setting may help alleviate the feelings of isolation, and could reduce the number considering leaving practice nursing.

Item Type:Articles
Glasgow Author(s) Enlighten ID:O'Donnell, Professor Kate and Jabareen, Mr Hussein and Watt, Professor Graham
Authors: O'Donnell, C.A., Jabareen, H., and Watt, G.C.M.
Subjects:R Medicine > RT Nursing
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
Journal Name:BMC Nursing
Publisher:BioMed Central
ISSN (Online):1472-6955
Published Online:25 January 2010
Copyright Holders:Copyright © 2010 BioMed Central
First Published:First published in BMC Nursing 9(2)
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher.

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