Independent nursing practice: a national survey of attitudes of practice employed nurses in Scotland

During the last decade, the number of practice nurses has increased dramatically and their role has evolved according to demand rather than through planning and design. Consequently, many nursing roles have become extended and nurses now perform many of the tasks previously performed by doctors. With increasing emphasis on primary care, their new role has become widely accepted and continues to develop. There is now a real question as to whether, with suitable training, it is timely to consider a formal extension to independent practice for at least some practice nurses.

The aim was to describe the characteristics of practice nurses and to explore their attitudes to independent practice. For the purpose of this study, independent practice was taken to mean specialised autonomous practice.

This was a descriptive, cross-sectional study undertaken by postal questionnaire. A two stage sampling process was used.

Firstly a 1/2 sample of all general practices in Scotland (n = 625) was asked for the names of all practice employed nurses. Secondly, one practice nurse from each practice was sent a postal questionnaire.

Five hundred and thirty eight general practices responded. Eighty six practices had no practice employed nurse. Four hundred and thirty three practices (96%; 433/452) were willing to allow their practice nurses to be approached to take part in the study. Four hundred practice nurses returned questionnaires (92%; 400/433). Fifteen were excluded because the nurses were not fully practice employed. Three hundred and eighty five were suitable for inclusion in the study (85%; 385/452). Most practice nurses were over 35 years of age and had been in post for more than three years. Almost half had at least one other nursing qualification in addition to registration. Eighty six percent thought that there should be independent practice for some nurses within the profession and 65% would, themselves, be happy to practise independently.

Most practice nurses throughout Scotland think that there should be independent practice for some nurses.