Abstract
The reviewed study immediately triggered my interest, as a nurse who initially started working in general practice in 1987, then spent several years pursuing other interesting aspects of nursing related to general practice, including in higher education and research. The range of nursing roles in the general practice nursing team contributes to the healthcare of the entire population, from birth to end of life, encompassing health promotion, disease prevention and support and management for the widest breadth of health conditions. It is therefore entirely relevant to consider how research activity would assist nurses in meeting evidence-based standards of clinical practice, while enabling the contemporary development of nursing across all areas of professional practice, including research.
This study sheds light on academic nursing careers generally, but in addressing general practice specifically, the authors describe the reasons for nurses not pursuing research activity as related to career pathway, personal and professional attributes and organisational factors. It is interesting to see similar results to a PhD research study undertaken by Carrier (2020), who explored the ways in which practice nurses access and apply knowledge within their work. Carrier interviewed 11 nurses and two general practitioners (GPs) and found also that organisational structures and factors within general practice influenced the sharing, dissemination of and discussions about knowledge and information. Both studies indicate a remoteness from mainstream National Health Service (NHS) nursing networks, as well as the impact of and the views of non-nursing colleagues and employers on professional activity, knowledge and development. We learn about the shortage of opportunities for practice nurses to connect with academic resources and interest groups, which reduces the chance to be inspired or excited about engaging in the breadth of related activities.
In recent years we have seen the introduction of frameworks for nursing in general practice, including from the Royal College of General Practitioners (2015), the Queen’s Nursing Institute (2017), Health Education England, NHS England and Skills for Health (2020). Each of these frameworks refers to the four domains of clinical practice, leadership, education and research, pointing to the importance of evidence generating and sharing activity. However, these do not make connections to career pathways for nurses whose professional interests, skills and aptitudes might be well focused in generating and disseminating evidence for the ‘complex and unpredictable environment’ (Queen’s Nursing Institute, 2020) of general practice.
The reviewed study highlights that more could be done to engage practice nurses in intellectual enquiry and activities. I would welcome a national clinical academic career pathway for nurses in general practice, linked to an increase in posts that straddle clinical practice, research and local networking. Many will tell me the nurse consultant role is in place to achieve this and I would agree. However, a career pathway should address nurses at all levels, to embed confidence at grass roots and throughout the nursing team in general practice.