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The Role of Nurses in General Practice: An Integrative Review

ABSTRACT

Aim

To synthesise the literature around the roles of general practice nurses (GPNs) and the barriers and facilitators of their role.

Design

Integrative literature review using Whittemore and Knafls framework.

Methods

Papers were exported into Covidence for screening. Quality was appraised using the Mixed Method Appraisal Tool. Data were extracted into a summary table and analysed using thematic analysis.

Data Sources

CINAHL, Medline, and Google Scholar were used to identify papers published between January 2000 and February 2025 in English that reported primary research about GPN roles.

Results

Twelve papers were included in the review. The four overarching themes were role characteristics, the clinical role, the non-clinical role, and barriers and enablers. Findings suggest ambiguity surrounding the GPN role, with inconsistent perspectives and overlapping responsibilities contributing to underutilisation. GPNs played an important role in continuity of care and reported a desire to spend more time on health promotion, health education and assessment. GPNs were leaders in collaboration as they functioned as agents of connectivity for patients and staff. The GPN role faces both barriers and enablers, with the organisational structure, interprofessional relationships, and professional development.

Conclusion

The GPN role offers an opportunity to enhance access to general practice care. However, there is limited and mixed literature describing the roles of GPNs. Future research should more closely explore the current practice of GPNs to inform policy and optimal utilisation of the workforce to the full extent of their practice scope.

Implications for the Profession and/or Patient Care

Understanding the complex roles of GPNs requires more robust data on clinical activity. These data would have the potential to inform ways to optimise the GPN role within the multidisciplinary team.

Reporting Method

This study adhered to the PRISMA reporting guideline.

Patient or Public Contribution

This review did not include patient or public involvement.

Lives Transformed—The Experiences of Significant Others Supporting Patients With Severe Burn Injury: A Narrative Inquiry

ABSTRACT

Aim

To explore the experiences of significant others of patients with severe burn injury in the intensive care unit. Specifically, how severe burn injury impacted the significant other and their role within their loved one's life.

Design

This qualitative study employed a Narrative Inquiry approach.

Methods

Interviews were undertaken during 2021–2022 with 17 participants who were the significant others of a patient with severe burn injury in the Intensive Care Unit. Recruitment occurred in New South Wales, Australia, from two tertiary hospitals providing care for people with major burns. A narrative inquiry approach was utilised, capturing stories through semi-structured interviews.

Results

Significant others experienced necessary changes in their life in response to the catastrophe. These included advocating, being present and ensuring their loved one's needs were met, while often neglecting themselves. Significant others contemplated their future as a carer to their loved one with severe burn injury, and adjusting their own career, finances and lifestyle, often as a long-term measure. The shifting of their role to carer ultimately transformed and redefined their relationships and lives.

Conclusion

Significant others endure immense trauma when a loved one sustains a severe burn injury. They require support but prioritise the patient by virtue of their critical illness. The life of the significant other is changed as they take on the role of carer and provide support. It is, therefore, imperative that the support needs of significant others are recognised, understood and addressed to ensure their well-being while processing the trauma.

Implications for Practice

With increased understanding of the significant others' experiences, healthcare providers can adopt a consultative approach, where roles and boundaries can be clearly identified. Through this process, healthcare providers can strengthen rapport and provide targeted support for significant others, as they navigate this traumatic life-altering event.

Patient or Public Contribution

No patient or public contribution.

Nurses' Experiences of Mental Health Care in the Emergency Department: An Integrative Review

ABSTRACT

Aim

To critically synthesise current literature on the nurses' experiences in providing care for people presenting with mental health issues to the emergency department (ED).

Background

Mental health-related presentations to EDs are increasing. Understanding nurses' experiences of providing care for this patient group will inform future strategies to enhance the care delivered in the ED.

Methods

CINAHL, MEDLINE, APA PsycInfo and Psychology and Behavioural Sciences Collection were searched from 2009 to 2024 for peer-reviewed qualitative papers exploring emergency nurses' perspectives of providing care for people with mental health issues, published in the English language. Quality was appraised using the JBI Critical Appraisal tool. This review follows the PRISMA checklist for reporting.

Results

Nine papers, reporting eight studies, were included in the review. Three themes emerged: attitudes towards mental illness, education limitations impacting confidence and structural barriers impacting care quality. The review reveals a disconnect between nurses' compassionate intentions and barriers such as unconscious stigma and prioritising physical illness over mental health concerns. The findings highlight the need for targeted mental health education to enhance ED nurses' confidence and competence. Inadequate local mental health policies also impact care delivery, contributing to suboptimal patient outcomes.

Conclusion

This review provides a deeper understanding of ED nurses' experiences of caring for people with mental health issues. A need to implement a multifaceted approach to mental health education, clear policies to guide care delivery and systems that promote prioritisation of patients presenting with mental health concerns was identified.

Implications for the Profession and/or Patient Care

Insights into nurses' experiences can shape future ED practices and enhance outcomes for patients. Building ED nurses' capacity to deliver high-quality mental health care is critical.

Patient or Public Consultation

As a review paper, no patient or public consultation took place.

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