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As COVID-19 spread across Australia, our research team undertook a rapid research project to capture the experiences of nurses working in primary healthcare during the pandemic. We were hearing stories of nurses losing their jobs, not having enough personal protective equipment, and concerns for patient care. We wanted to provide a voice for nurses working in primary healthcare who were otherwise invisible in the policy decision making and rapid changes occurring in health services. This research sought to quantify and document the workforce, professional and personal issues facing primary healthcare nurses to inform government, policy makers, and local managers both during the time of crisis and in the longer term.

Purpose: The COVID-19 pandemic has presented an international health crisis of a scope not seen in our lifetime. While much attention has been paid to health workers in critical care and acute areas, nurses working outside of hospitals are also significantly affected. This study sought to investigate the experience of nurses working in Australian primary healthcare during the COVID-19 pandemic. In particular, it sought to understand the implications on their employment status, role, and access to personal protective equipment. Design and Methods: Nurses employed in primary healthcare across Australia were invited to participate in a cross-sectional online survey through social media and professional organizations. The survey tool was composed of demographics, and of questions about the nurses’ employment, work role, and access to personal protective equipment. Findings: Of the 637 responses received, nearly half (43.7%) reported a decrease in hours and threatened or actual loss of employment. While most respondents felt that they had sufficient knowledge about COVID-19, they expressed concern about work-related risks to themselves and their family. Most respondents described never or only sometimes having sufficient personal protective equipment in their workplace. Just over half of respondents (54.8%) felt well supported by their employer. A third of respondents (34%) perceived that care provided in their workplace was significantly or slightly worse than before the pandemic. Conclusions: This is the first study of primary healthcare nurses’ experiences during the COVID-19 pandemic. The study findings highlighted a concerning level of insecurity around primary healthcare nursing employment, as well as issues with the availability of personal protective equipment for these nurses. The perception that the pandemic has resulted in reduced quality of care needs further exploration to ensure that those with chronic conditions are supported to maintain and promote health

Aim To identify Australian primary healthcare nurses immediate support needs during the COVID‐19 pandemic. Background COVID‐19 has had widespread implications for primary healthcare nurses. Supporting these nurses’ capacity to deliver quality care ensures that ongoing health needs can be met. Methods Primary healthcare nurses were recruited to an online survey via social media and professional organisations in April 2020. Results Six‐hundred and thirty‐seven responses were included in analysis. Participants provided 1213 statements about perceived supports required to provide quality clinical care. From these, seven key categories emerged, namely; personal protective equipment, communication, funding, industrial issues, self‐care, workplace factors and valuing nurses. Conclusion A number of key issues relating to personal health and safety, care quality, and job security need to be addressed to support primary healthcare nurses during the COVID‐19 pandemic. Addressing these support issues can assist in retaining nurses and optimising the role of primary healthcare nurses during a pandemic. Implications for nursing management Responding to the needs of primary healthcare nurses has the potential to facilitate their role in providing community based healthcare. This knowledge can guide the provision of support for primary healthcare nurses during the current pandemic, as well as informing planning for future health crises across the health service.

Increasingly, middle-aged people are demonstrating lifestyle risk factors that increase their risk of developing chronic disease. Reducing lifestyle risk in middle age can significantly reduce future morbidity and mortality and improve quality of life. Understanding peoples’ perceptions of health support is important to inform health professionals and policymakers regarding strategies to support lifestyle risk reduction. This paper seeks to explore middle-aged Australians’ perceptions of support for lifestyle risk reduction. Thirty-four middle-aged Australians were interviewed using a semi-structured interview schedule. Interviews were audio-recorded, transcribed and analysed using thematic analysis. The overarching theme ‘support for healthy lifestyles’ comprised three subthemes. ‘Engagement with general practice’ highlighted gender differences in why people attend and what impacts their access to general practice. ‘Providing information’ emphasised participants’ experiences of lifestyle risk communication in general practice. Finally, ‘Sources of support’ revealed participants’ current health advice-seeking behaviours. Findings highlight a need for general practices to better engage middle-aged people in behaviour change and educate them about the role of general practice in prevention and health promotion. Consistent messaging across the community and strategies that focus on gender-specific concerns are likely to ensure that middle-aged people are able to make informed choices about seeking support for lifestyle risk reduction.

Background: The general practice nursing workforce in Australia has grown exponentially in the last fifteen years. To understand the contribution and issues relating to this workforce we need to explore the evolution of the nurses' role and the nurses' perceptions of the work that they undertake. Aim: To describe trends in general practice nurse clinical activities, the extent to which GPNs use their knowledge and skills and their satisfaction with the general practice nurse role. Methods: Within a larger mixed methods project, a national cross-sectional survey of Australian primary health care nurses was undertaken. This paper details the survey findings related to the role of nurses working in general practice, the extent to which they use their knowledge and skills and their satisfaction with their role. Data about nurse roles was compared with previous workforce data to elucidate changes over time. Findings: Of the 1166 primary health care nurses who responded to the survey, 950 reported being employed in general practice. Participants reported undertaking activities related to health promotion and chronic disease management more frequently now than previously. They identified a desire to spend the same or less time on administrative activities and more time on health promotion, patient education and patient assessment. Nearly half of participants reported that often they feel that they could do more, or most of the time they don't use their skills to the full extent. Conclusion: Nurses working in general practice are increasingly undertaking activities related to health promotion and chronic disease management. However, these nurses remain underutilised. Having nurses working to their full scope of practice has the potential to increase job satisfaction and nurse retention, as well as improve patient health outcomes.

Nurses are increasingly needed in primary healthcare settings to support community-based healthcare delivery. Programs to facilitate transition of new graduate nurses are well established in acute care however, there are few similar programs reported in settings like general practice. This paper sought to explore the experiences of new graduate registered nurses and their registered nurse mentors in a new graduate program within Australian general practice. New graduates (n = 9) and their mentors participated in interviews before, during and at the conclusion of a 12-month new graduate program. Interviews were digitally audio-recorded and professionally transcribed verbatim before being analysed using thematic analysis. Eighteen new graduate and 10 mentor interviews were conducted, revealing four themes. Preparation and Opportunities describes the influence that pre-registration education had on preparing nurses for general practice employment. Exceeding Expectations highlights the positive experiences within the program. Program Challenges draws attention to the difficulties experienced by participants, and Future Career Intentions explores future career plans. This study highlights that a general practice new graduate nurse program has the potential to build the workforce. However, strengthening undergraduate preparation of nurses around primary health care and addressing funding issues in general practice, are important to promote the success of such programs.

Aim: To explore registered nurses' reflections on transitioning from acute to primary health care employment, and future career intentions. Background: Reforms in primary health care have resulted in increasing demands for a skilled primary health care nursing workforce. To meet shortfalls, acute care nurses are being recruited to primary health care employment, yet little is known about levels of satisfaction and future career intentions. Method: A sequential mixed methods study consisting of a survey and semi-structured interviews with nurses who transition to primary health care. Results: Most reported positive experiences, valuing work/life balance, role diversity and patient/family interactions. Limited orientation and support, loss of acute skills and inequitable remuneration were reported negatively. Many respondents indicated an intention to stay in primary health care (87.3%) and nursing (92.6%) for the foreseeable future, whilst others indicated they may leave primary health care as soon as convenient (29.6%). Conclusion: Our findings provide guidance to managers in seeking strategies to recruit and retain nurses in primary health care employment. Implications for Nursing Management: To maximize recruitment and retention, managers must consider factors influencing job satisfaction amongst transitioning nurses, and the impact that nurses' past experiences may have on future career intentions in primary health care.

Background: The primary health care (PHC) nursing workforce is growing to meet the demand for community based health services. To facilitate the recruitment and retention of nurses in PHC settings it is important that positive employment conditions exist. Aim: To explore the employment characteristics ofAustralian PHC nurses, including employment patterns and remuneration considerations. Methods: A descriptive survey of Australian PHC nurses was conducted during 2015 as part of a larger mixed methods study. This paper reports the survey findings relating to employment patterns, conditions and remuneration. Findings: One thousand one hundred sixty six nurses responded to the survey, most respondents were employed in general practice and many were employed part-time. Rates of pay were significantly lower for those employed general practice compared to other PHC settings. Most respondents hadn't received a pay increase in the last 5 years. There were considerable differences in the allowances received between nurses employed in general practice and other PHC settings. Conclusion: Whilst more nurses are moving into PHC, the remuneration and allowances differ between PHC settings and continue to lag behind the acute sector. To attract skilled younger nurses to meet future workforce requirements, there is an urgent need to review pay and conditions in PHC nursing. Equally, PHC nurses must develop skills to better negotiate their employment conditions and remuneration and industrial organisation must continue to support industrial advances in this area.