Missed care or missed opportunities in general practice nursing

Background: Research into missed care has been conducted in various acute and some community healthcare settings; however, the experiences of general practice nurses (GPNs) are poorly represented in the literature. 

Aim: To explore the role of the GPN and whether care activities are missed. 

Methods: A qualitative descriptive design was used, employing semistructured interviews with 10 participants. The participants were GPNs working in a metropolitan or regional general practice in Australia, with a minimum of three years of experience in the role. A six-step process for thematic analysis was utilised for the extraction and presentation of findings. 

Findings: GPNs rarely miss care; it is either delayed or rescheduled. Findings illustrate missed opportunities to provide care and enhance the role of the GPN. Factors contributing to missed opportunity are as follows: (i) difficulties navigating the GPN–general practitioner (GP) relationship, (ii) GPNs lack ongoing education commensurate with their scope of practice, (iii) Medicare policy fails to fund the GPN role, (iv) a rise in the number of salaried GPs leads to time pressures that limit the GPN role, (v) scope of practice constrained by time deficits, and (vi) communication problems within a siloed healthcare system limit GPN scope of practice. 

Discussion: The initial aim was to identify missed care; however, findings suggest that GPNs rarely miss care, but they do miss opportunities to provide care and practice to their full scope. 

Conclusion: Internal and external factors specific to the general practice context can contribute to missed opportunities for the work of the GPN.