The process of nurses' role negotiation in general practice: A grounded theory study

Area of Science:

• Primary Care Nursing
• Health Services Research
• Organizational Behavior

Background:

• Primary care nurses are vital in meeting population health needs using a social model of health.
• Task-shifting increases nurses' medical responsibilities amid workforce shortages.
• The processes of nurse role negotiation in primary care remain underexplored.

Purpose of the Study:

• To elucidate the negotiation process of nurses' roles within general practice settings.
• To develop a theoretical framework explaining how nurses establish their professional space and responsibilities.

Main Methods:

• A constructivist grounded theory approach was employed.
• Semi-structured interviews were conducted with 22 nurses across 17 New Zealand general practices.
• Data analysis utilized constant comparative methods to develop a substantive explanatory theory.

Main Results:

• A three-stage theory of 'creating place' emerged: occupying space, positioning to do differently, and leveraging opportunity.
• Role negotiation involves aligning individual concepts of need-responsive practice with organizational norms.
• Negotiation is facilitated by role models, mentorship, and supportive governance.

Conclusions:

• The 'creating place' theory offers novel insights into nurse role negotiation in general practice.
• Findings support strategies for nurses, employers, and managers to optimize nursing roles for population health.
• This research can inform efforts to advance general practice nursing roles to meet community health demands.