Building a foundation for a sustainable primary care nursing workforce A Career in Primary Health Care Sandra McDonald; MTchL, BN, RGON, FCNA(NZ) Sheona Watson; MHSc (Hons), RN

Background Drivers for increasing the Primary Health Care Nursing workforce are: Increasing health demands, ageing nursing workforce, projected population growth, Ministry of Health priorities for Primary Care – Better Sooner More Convenient (BSMC) The Dedicated Education Unit (DEU) model was used as a vehicle to increase numbers of nursing students in General Practice setting

Partners Procare Health Ltd™ (ProCare): An overarching organisation providing management support services to a network of 180 general practices which are individual autonomous businesses across greater Auckland. Manukau Institute of Technology (MIT): Faculty of Nursing based in South Auckland. Counties Manukau District Health Board (CMDHB): Responsible for Primary, Secondary and Tertiary health services based in South Auckland.

Process The DEU model can be adapted to meet the needs of specific services and areas. Unique to the General Practice model is: An initial orientation is provided to students about ProCare and General Practice context The Clinical Liaison Nurse(CLN) and Academic Liaison Nurse (ALN) are not on site therefore they visit the Practices weekly to support the Practice Team, Practice Nurse Preceptor and Student Internet, discussion boards and monthly tutorials are used to get students together to provide a sense of unity and collegial support The Geographical spread over multiple sites with one student in each practice.

Research W. Fourie, B. McClelland (2011) Action Research Report: Enhancing Nursing Education through Dedicated Education Units. Mullineaux, S. (2008). Does a first year clinical placement encourage student nurses to consider a career in primary health care? Unpublished masters research report, University of Canterbury, Christchurch, New Zealand Sandhu, P. & Chang, M. (2010) Preceptorship in nursing. Unpublished BHSc student research report, University of Auckland

Results Number of general practices engaged has grown from 3 in 2007 to 24 in 2011 Number of students, from 3 third year students in 2007 to: 32 first year students (follow a structured 4 day programme) 20 third year students including 3 transition students (12 week placements) Currently placing 2 new graduates in general practice

Benefits General Practice Extends nursing knowledge, skills and Competency of Practice Nurses Shared team approach to teaching and learning Establishes a relationship with students that facilitates future placements and new graduate opportunities

Benefits Students Are encouraged to link theory to their practice, actively participating in patient care Become bonafide team members in the General Practice Establish a relationship with General Practice that provides a career pathway

Student Feedback Presentations to practices were very useful: 1 presentation (a picture board) was kept by the practice Students felt part of the practice team and accepted by all staff Two different preceptors; two different ways of working and you can learn from each ALN/CLN visited at different times and were great supports

Next Steps Practice Nurse development as Preceptors with a focus on General Practice delivered as a series of workshops rather than 1 or 2 full days Student induction package to the Practice that complements the generic orientation Development of an Alumni of Students Extend the model

References Zigmond, J. (2008). Beyond the hospital. Modern Healthcare, June 28(32), Henderson, A., Twentyman, M., Heel, A., & Lloyd, B. (2006). Students perceptions of the psychosocial clinical learning environment; An evaluation of placement models. Nurse Education Today, 26(7), Fourie, W. & McClelland, B. (2011). Action Research Report: Enhancing Nursing Education through Dedicated Education Units. Christchurch, Ako Aotearoa.