The process of nurses' role negotiation in general practice: A grounded theory study.

Simple item page
dc.citation.issue5
dc.citation.volume80
dc.contributor.authorHewitt SL
dc.contributor.authorMills JE
dc.contributor.authorHoare KJ
dc.contributor.authorSheridan NF
dc.coverage.spatialEngland
dc.date.accessioned2024-07-16T03:28:26Z
dc.date.available2024-07-16T03:28:26Z
dc.date.issued2023-11-06
dc.description.abstractAIM: To explain the process by which nurses' roles are negotiated in general practice. BACKGROUND: Primary care nurses do important work within a social model of health to meet the needs of the populations they serve. Latterly, in the face of increased demand and workforce shortages, they are also taking on more medical responsibilities through task-shifting. Despite the increased complexity of their professional role, little is known about the processes by which it is negotiated. DESIGN: Constructivist grounded theory. METHODS: Semi-structured interviews were conducted with 22 participants from 17 New Zealand general practices between December 2020 and January 2022. Due to COVID-19, 11 interviews were via Zoom™. Concurrent data generation and analysis, using the constant comparative method and common grounded theory methods, identified the participants' main concern and led to the construction of a substantive explanatory theory around a core category. RESULTS: The substantive explanatory theory of creating place proposes that the negotiation of nurse roles within New Zealand general practice is a three-stage process involving occupying space, positioning to do differently and leveraging opportunity. Nurses and others act and interact in these stages, in accordance with their conceptualizations of need-responsive nursing practice, towards the outcome defining place. Defining place conceptualizes an accommodation between the values beliefs and expectations of individuals and pre-existing organizational norms, in which individual and group-normative concepts of need-responsive nursing practice are themselves developed. CONCLUSION: The theory of creating place provides new insights into the process of nurses' role negotiation in general practice. Findings support strategies to enable nurses, employers and health system managers to better negotiate professional roles to meet the needs of the populations they serve, while making optimum use of nursing skills and competencies. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Findings can inform nurses to better negotiate the complexities of the primary care environment, balancing systemic exigencies with the health needs of populations. IMPACT: What Problem Did the Study Address? In the face of health inequity, general practice nurses in New Zealand, as elsewhere, are key to meeting complex primary health needs. There is an evidence gap regarding the processes by which nurses' roles are negotiated within provider organizations. A deeper understanding of such processes may enable better use of nursing skills to address unmet health need. What Were the Main Findings? Nurses' roles in New Zealand general practice are determined through goal-driven negotiation in accordance with individual concepts of need-responsive nursing practice. Individuals progress from occupying workspaces defined by the care-philosophies of others to defining workplaces that incorporate their own professional beliefs, values and expectations. Negotiation is conditional upon access to role models, scheduled dialogue with mentors and decision-makers, and support for safe practice. Strong clinical and organizational governance and individuals' own positive personal self-efficacy are enablers of effective negotiation. Where and on Whom Will the Research Have Impact? The theory of Creating Space can inform organizational and individual efforts to advance the roles of general practice nurses to meet the health needs of their communities. General practice organizations can provide safe, supported environments for effective negotiation; primary care leaders can promote strong governance and develop individuals' sense of self-efficacy by involving them in key decisions. Nurses themselves can use the theory as a framework to support critical reflection on how to engage in active negotiation of their professional roles. REPORTING METHOD: The authors adhered to relevant EQUATOR guidelines using the COREQ reporting method. PATIENT OR PUBLIC CONTRIBUTION: Researchers and participants currently working in general practice were involved in the development of this study. By the process of theoretical sampling and constant comparison, participants' comments helped to shape the study design. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: An understanding of the processes by which health professionals negotiate their roles is important to support them to meet the challenges of increased complexity across all health sectors globally.
dc.description.confidentialfalse
dc.edition.editionMay 2024
dc.format.pagination1914-1926
dc.identifier.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/37929935
dc.identifier.citationHewitt SL, Mills JE, Hoare KJ, Sheridan NF. (2024). The process of nurses' role negotiation in general practice: A grounded theory study.. J Adv Nurs. 80. 5. (pp. 1914-1926).
dc.identifier.doi10.1111/jan.15938
dc.identifier.eissn1365-2648
dc.identifier.elements-typejournal-article
dc.identifier.issn0309-2402
dc.identifier.urihttps://mro.massey.ac.nz/handle/10179/70196
dc.languageeng
dc.publisherJohn Wiley and Sons Ltd
dc.publisher.urihttps://onlinelibrary.wiley.com/doi/10.1111/jan.15938
dc.relation.isPartOfJ Adv Nurs
dc.rights(c) 2023 The Author/s
dc.rightsCC BY 4.0
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectgeneral practice
dc.subjectgrounded theory
dc.subjectnegotiation
dc.subjectnurses
dc.subjectnursing
dc.subjectprimary care
dc.subjectprimary health care
dc.subjectrole
dc.subjectHumans
dc.subjectNegotiating
dc.subjectNurse's Role
dc.subjectGrounded Theory
dc.subjectGeneral Practice
dc.subjectWorkplace
dc.subjectNurses
dc.titleThe process of nurses' role negotiation in general practice: A grounded theory study.
dc.typeJournal article
pubs.elements-id484274
pubs.organisational-groupCollege of Health
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Published version.pdf
Size:
1013.91 KB
Format:
Adobe Portable Document Format
Description:
484274 PDF.pdf
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
9.22 KB
Format:
Plain Text
Description:
Download
Collections
Journal Articles