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Unseen, unheard, undervalued: advancing research on registered nurses in primary care

02 April 2021
Volume 32 · Issue 4

Abstract

Julia Lukewich, Marie-Eve Poitras and Maria Mathews describe the current state of family practice nursing in Canada and explore the reasons for the lack of research on this topic

Funding model reforms have led to an increase in the number of nurses in primary care in Canada. Family practice nurses work alongside physicians and other healthcare providers, and are key members of primary care teams. Despite this, there remains a lack of clarity regarding the contributions of this unique role, as well as the absence of coordinated leadership and efforts to advance knowledge in this area. We describe the current state of family practice nursing in Canada and discuss challenges to generating evidence on roles, activities, and outcomes. We also provide recommendations to facilitate the advancement of nursing research that addresses primary care provision. Challenges include the absence of standardised terms for this role, a lack of distinction surrounding different regulated nursing designations in primary care, and the need for greater visibility. High-quality research will strengthen the evidentiary base from which to educate providers, inform administrators/policy-makers, and improve primary care outcomes.

The World Health Organization (WHO) declared 2020 to be the ‘International Year of the Nurse and Midwife’, in part, to mark the 200th birth anniversary of Florence Nightingale, the 19th century founder of modern nursing (WHO, 2020) who said ‘money would be better spent in maintaining health in communities rather than building hospitals to cure’ (Monteiro, 1985: 185). Since nursing's beginning, investing in community health and primary care have been identified as a means of improving health outcomes and reducing costs of the healthcare system as a whole. Despite this, two centuries later, the Lancet identified the need for ‘more evidence on the roles of nurses in primary care’ (The Lancet, 2020: 1879). To better understand why progress in this knowledge area has been slow, we discuss challenges to advancing the evidence on the roles and contributions of family practice nurses (known as general practice nurses in the UK) (The Queen's Nursing Institute, 2015). We also provide recommendations to facilitate the advancement of nursing research that addresses the provision of primary care. Over the past decade, Canada has made notable investments in primary healthcare research and policy development. Therefore, the landscape of family practice nursing within the Canadian context will be described and referred to throughout this article.

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