Nurses in general practice are spending much of their time on administration and exchanging front-desk pleasantries. Meanwhile those in EDs face rising violence.
A new study has found that four out of five GP nurses are undertaking long lists of non-clinical administration work, including manning the front desk, while hospital nurses and doctors are facing growing violence.
A national survey, undertaken by the Australian Primary Health Care Nurses Association, found that 80% of registered and enrolled primary care nurses, with an average of 21 years’ experience, were buried in paperwork rather than vital clinical work such as women’s health assessments, diabetes and arthritis education.
The survey found that almost 70% of nurses in GP clinics were doing recalls or patient appointment reminders, 32% were doing stock management and ordering, and 16% were working the front desk.
APNA President Karen Booth said the survey demonstrated a “chronically underutilised [workforce] at a time of severe shortage”.
“It really is a complete waste of time having highly qualified and very experienced registered nurses sitting on the front desk, while people are waiting longer and longer to see a doctor.
“Nurses in the survey told us they are ready, willing and able to do more clinically, and provide the care they’ve been trained to do.”
But while it seems many general practice nurses are being pushed into a life of paperwork and pleasantries, nurses, and doctors, in emergency departments are facing increasing violence.
New research conducted at Edith Cowan University, published in Collegian, has suggested that current strategies to target violence in hospitals may not be working.
Between 2015 and 2018, in-hospital assaults increased by 60% in Victoria, 48% in Queensland and 44% in NSW, said the researchers.
In 2017, the College of Emergency Nurses Australasia found that 87% of the nurses surveyed reported experiencing patient-related violence.
First author and PhD candidate Mr Joshua Johnson said anecdotal evidence from the study suggested aggression was on the rise and changing form.
“Participants in our study in Perth were overwhelmingly telling us that the occurrence of violence is on the increase,” he said.
“It is not a matter of if, but when.
“Additionally, our participants were telling us that the style of violence has become more aggressive in nature.
“Over the last 20 or so years, it has progressed from verbal or occasional physical abuse, where someone might be throwing a cup at a front-line worker, to the assaults we’re seeing now.”
The study, which consisted of a series of focus groups with medical doctors, nurses and health safety staff across five Perth EDs, found that drug and alcohol use, mental illness and psychiatric disorders were likely contributing to the increase.
Other common themes included longer wait times and communication barriers due to understaffing and overcrowding in triage areas.
While there have been initiatives implemented to target this violence, so far they don’t seem to be working.
“There appears to be quite a large variation in the quality of [violence management] training that is being delivered at different hospitals, as well as the frequency of this training,” said Mr Johnson.
“There is a definite need for hospitals to focus on reducing barriers to accessing effective training, and a standardised delivery of training should be investigated.”
The study also identified a number of systemic issues, such as barriers to incident reporting adding to workers already hefty workloads.
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Ultimately, such violence could lead to burnout and was often linked to reduced performance, personal mental health impacts and for some a push to leave the profession.
“Previous research has shown that student nurses who are planning on moving into the field often reconsider their chosen field when exposed to these aggressive and violent incidents while on clinical placement,” said Mr Johnson.
“This demonstrates that exposure to these events greatly impact staff and student mental health and could potentially lead to people leaving the field.
“This in turn puts greater stress on an already strained system, and further exacerbates the issue.”
