What could you achieve with a career in primary care nursing?
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What could you achieve with a career in primary care nursing?
Do you want a rewarding and fulfilling career that improves the lives of others? Would you like to participate in community-focused work in which no two days are the same? Are you interested in using your kindness and compassion to help other people? If so, Dr Julia Lukewich, from Memorial University in Canada, and Professor Liz Halcomb, from the University of Wollongong in Australia, encourage you to consider a career in primary care nursing.
Talk like a primary care nurse
Primary care — (also known as family practice or general practice) the first point of contact most people will have with the healthcare system, usually in a community clinic
Acute care — healthcare that involves short-term treatment for injury or illness
Chronic condition — a long-term health condition, such as diabetes, arthritis or asthma
Core competencies — the knowledge, skills and attributes that healthcare professionals must have and uphold
Health equity — when everyone has the opportunity to attain their highest level of health
When you picture a nurse, where are they working? Most people think of nurses as working alongside doctors in hospitals, but in fact, nurses perform a wide range of healthcare roles, independently and as part of a healthcare team, in a variety of different settings. “Even many nursing students think that ‘real’ nurses work in hospitals,” explains Professor Liz Halcomb, a nurse researcher and educator at the University of Wollongong. “They have the view that working as a nurse in the community is boring, but this is not true.”
“It’s important to understand that a nursing degree can take you in a range of directions, depending on your interests and skills,” says Dr Julia Lukewich, a nurse researcher and educator at Memorial University. “We need to educate and prepare nurses to be leaders in all aspects of our healthcare systems.” Julia and Liz are encouraging nursing students to consider careers in primary care nursing – an area of nursing that is often overlooked but is highly important to healthcare systems.
What is primary care?
“Primary care is where people typically first contact the healthcare system to seek advice or treatment for a health issue,” explains Liz. Depending on the country, it may also be called family practice or general practice. Primary care is the community-facing aspect of the healthcare system, commonly based in neighbourhood clinics. “It involves the full range of coordinated care and addresses people’s needs throughout their entire life,” says Julia. “Primary care is the foundation of a high-functioning healthcare system.”
Why is primary care nursing undervalued?
“Many nurses enter the profession to work in acute care environments, such as hospitals,” says Julia. “However, there are many opportunities besides ‘traditional’ nursing that are less visible in undergraduate education.” Nursing education programmes often do not specifically prioritise an awareness of primary care nursing, which means that many nurses graduate with little understanding of what primary care is or what a career in primary nursing offers.
A day in the life of a primary care nurse
“Primary care nursing differs from hospital-based nursing as it works closely with individuals, families and communities to promote health and well-being, manage health issues and reduce lifestyle risk factors,” explains Liz. Primary care nurses have a range of roles, from conducting health assessments and managing care to supporting people living with chronic conditions and providing health education. Other services provided by primary care nurses include preventative health screening, immunisations, wound care and mental health support. A key aspect of their role is to help people take preventative steps to avoid or manage health issues, making hospital visits less likely. Looking after people’s long-term health is vital for improving their quality of life.
“The beauty of primary care nursing is that no two days are the same!” says Liz. “Each day, you will be faced with a diverse range of people attending the clinic for assessment, treatment and education.” You might find yourself taking a patient’s blood for testing, helping a patient manage their diabetes, conducting a sexual health screening, dealing with an eye infection, doing a health check for a baby, and then changing the dressing on a patient’s wound. “Primary care nurses may also leave the clinic to deliver care in the community,” says Julia. You could conduct home visits to monitor and treat patients who cannot attend the clinic, and you could visit schools to provide health education or carry out immunisation programmes in the community.
Why is primary care nursing a desirable career?
“The benefits of primary care nursing include independence, more regular schedules and opportunities to establish long-term therapeutic relationships with patients,” says Julia. The nature of primary care has advantages over hospital nursing. The long and intense shifts that may typify hospital work are less common, as primary care is generally delivered during ‘business hours’. To improve access to primary care, however, out-of-hours provision is increasing, through evening and weekend ‘walk-in’ clinics and virtual care options. “There is a lot more potential to optimise scope in primary care than in specialised acute care environments, as there are often fewer institutional policies that act as barriers,” says Julia. “This gives you greater autonomy and independence in your role.”
Liz and Julia emphasise the wide array of opportunities for career diversification and development within primary care nursing. “Beyond clinical practice, roles include research positions and opportunities in health education, leadership, administration and policy,” says Julia. “Given the vital importance of primary care, these opportunities should expand in the years ahead.”
“As the global population ages, we are seeing a rising incidence of chronic conditions, creating an important role for the next generation of primary care nurses,” says Liz. “It is extremely rewarding to work with people over time and see the impact of your care or health education on their well-being.”
The key qualities of a primary care nurse
“Primary care nurses perform a huge range of activities, requiring them to be agile, thoughtful and highly skilled,” says Liz. “In addition to being well-educated in nursing practice, primary care nurses must be good communicators who can listen to the people they serve to ensure that the care they provide meets their patients’ needs.” A good nurse is empathetic and compassionate, assessing and treating their patients’ physical and mental health conditions with care and kindness. And a career in primary care nursing requires determination and commitment.
While nursing education is key and personality traits are important, primary care nurses must also abide by a set of standards as outlined by the regulatory bodies in their country. Many countries have a list of core competencies that healthcare professionals are expected to uphold. Liz led the development of the professional practice standards for primary care nurses in Australia, and Julia led the development of the core competencies for primary care nurses in Canada. These standards and competencies are categorised into domains including professionalism (e.g., nurses must maintain a professional relationship with patients and are expected to participate in professional development training activities), collaboration (e.g., primary care nurses work with other healthcare professionals to support the transition of care as a patient moves within the healthcare system; for example, from primary care to acute care in hospital) and leadership (e.g., nurses should advocate for health equity).
Researching the role of primary care nurses
Julia and Liz believe that healthcare systems can be improved by optimising the primary care nursing workforce. “Research shows that team-based models of primary care that include nurses can alleviate many pressures on healthcare systems,” says Julia. “They do this by improving access to and continuity of care, promoting health equity and increasing cost-effectiveness. Our research addresses different challenges around integrating and optimising nurses in primary care, with a focus on policy and education.” For instance, Julia and her colleague, Dr Marie-Eve Poitras, co-led led the development of a national education programme for primary care nurses in Canada. Julia also conducts research to evaluate nurse education and measure the effectiveness of nurses in primary care teams.
Julia and Liz are also exploring the benefits that nurses can bring to primary care. “Our research has provided evidence to demonstrate how nurses can improve outcomes for people with chronic conditions, such as high blood pressure, respiratory disease and cancer,” says Liz. Another aspect of their research investigates how nursing education is preparing student nurses for careers in primary care, and they have uncovered a slow shift away from a focus solely on hospital nursing. “An increasing number of nursing graduates are seeking work in primary care as they see it as an exciting career path,” says Liz. “Our work is helping to raise the profile of primary care nursing by highlighting the opportunities in the field and demonstrating the benefits of this fulfilling and rewarding career.” What could you achieve with a career in primary care nursing?
Dr Julia Lukewich
Faculty of Nursing, Memorial University, Canada
Professor Liz Halcomb
School of Nursing, University of Wollongong, Australia
Field of research: Primary care nursing
Project: Encouraging young people and nursing students to consider careers in primary care nursing
Pathway from school to primary care nursing
“Nurses need to have good foundational skills and knowledge in sciences and communication, as well as an understanding of communities and family dynamics,” explains Liz. So, relevant subjects to study at school and college include biology, chemistry, languages, psychology and sociology.
If you visit a primary care clinic, observe the role of the nurses there and ask them about their work.
At university, study a degree in nursing and take courses related to primary healthcare. Julia notes that these are not always prioritised in nursing curricula, but you may also find them in public health or medicine departments. She also recommends taking courses related to healthcare policy and leadership.
Seek clinical placements in primary care settings to experience what primary care nursing involves, and get involved with community-based health initiatives to experience the care needs of your community.
Connect with your national primary care (or community health) nursing association to learn more about the opportunities in primary care nursing. Examples include the Canadian Family Practice Nurses Association (www.cfpna.ca) or the Australian Primary Health Care Nurses Association (www.apna.asn.au).
“Don’t forget that nursing isn’t just about clinical care!” says Julia. “Many nurses have successful careers as health leaders, educators, researchers and administrators.” While you are in nursing education, look for opportunities to get involved with research or to participate in nursing association committees, as these experiences will open doors beyond clinical practice.
Reference
https://doi.org/10.33424/FUTURUM540
Meet Julia
Growing up, I wanted to be a lawyer. But by the time I was finishing high school, I wasn’t sure what to study at university. I thought I might study medicine, but saw nursing as an alternative career in healthcare that was both challenging and provided many opportunities outside of the clinical environment.
My clinical nursing career was short but gave me valuable experience. Working in an emergency department, I saw many patients with no access to primary care or poor-quality primary care. This made me realise the enormous opportunity for nurses to contribute to primary care, to prevent patients from needing to go to hospital. I started working as a nurse researcher not long after graduating, focusing my attention on generating high-quality evidence to facilitate this contribution. It’s been a very full and rewarding career so far.
Working in academia, most of my time is spent leading research projects aimed at improving the primary care nursing workforce internationally. Alongside my research, I also teach research and statistics courses to graduate nursing students, and I supervise and mentor doctoral students.
I was honoured to receive the Memorial University President’s Award for Outstanding Research. This award validates the strides that my team and I have made towards generating evidence to support the integration and optimisation of nurses in primary care across Canada. It also highlights the far-reaching impacts that our research has had on national primary care nursing practice, policy and education.
I hope that health leaders prioritise the education of primary care nurses. Primary care is the cornerstone of a strong healthcare system, and it requires a strong primary care nursing workforce at its core. It’s where we should focus our efforts to keep our population healthy.
A career in primary care nursing is attractive and accessible, and offers many opportunities to lead and further develop our healthcare system.
Meet Liz
As a teenager, I was an aviation enthusiast. I got my pilot’s licence before I was able to drive a car! I also had a passion for working with others and was interested in improving health and well-being. So, with both my older sisters being nurses, I chose to follow their path. I wanted a career where I could work with people and make a difference.
I initially worked as an intensive care nurse, which involved caring for critically ill people. It was challenging as they usually required highly technical and specialised care. I also cared for their families, who often struggled to comprehend the situation and required careful explanation. It was very rewarding to spend dedicated time dealing with individual patients and their families. I moved into nursing education and research as it was an opportunity to contribute to shaping the future of nursing, particularly in primary care.
I was inducted into the Sigma Nurse Researcher Hall of Fame and named one of the 100 ‘outstanding women nurse and midwife leaders’ by Women in Global Health. As a teenager, I never dreamed that I would receive international awards for my work. In my younger years, teachers told me I wouldn’t amount to much. This only made me more determined to work hard and do well in the later years of high school. During my career, I have been fortunate to work with some excellent mentors who believed in me, and I am forever grateful for their support.
I hope that primary care nursing is increasingly recognised for its contribution to health and well-being. I also hope that future nurses continue to challenge the boundaries of nursing roles while providing the care needed by individuals, families and communities.
Do you have a question for Julia or Liz?
Write it in the comments box below and Julia or Liz will get back to you. (Remember, researchers are very busy people, so you may have to wait a few days.)
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