Roles and functions of enrolled nurses in Australia: Perspectives of enrolled nurses and registered nurses

Endacott, Ruth; O'Connor, Margaret Mary; Williams, Allison; Wood, Pamela; McKenna, Lisa; Griffiths, Debra; Moss, Cheryle; Della, Phillip; Cross, Wendy

doi:10.1111/jocn.13987

Cited by 13 publications

(8 citation statements)

References 19 publications

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“…ENs in Healey and Reeds' (2015) study considered their role to be similar or the same of that an RN but that continued debate around scope of practice had led to confusion and discrimination. These findings are supported by recent research that demonstrates RNs' and managers' perceptions of the role are at odds to that of ENs (Endacott et al, 2018;Lavander, Suhonen, Turkki, & Merilainen, 2018). Perhaps significantly in terms of retention mature-aged ENs were more able to accurately identify which nursing tasks were the domain of the EN (Lavander et al, 2018).…”

Section: Discussionsupporting

confidence: 70%

An integrative review of Enrolled Nurse recruitment and retention

Blay

Smith

2020

Collegian

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Background: Australia is facing a severe shortage of Enrolled Nurses. Jurisdictions have introduced strategies in attempts to recruit and retain Enrolled Nurses in the health workforce. Aim: To explore factors impacting recruitment and retention of Enrolled Nurses. Methods: A systematic search of literature published in the English language from 2000 to 2018 that addressed the recruitment or retention of aspiring and current Enrolled Nurses (or global equivalents). The search yielded 6955 publications; 20 articles were retained for full-text review and eleven articles were included in the final review. Findings: Three major themes (Nursing work and the EN role, Educational structure and support, and Personal attributes) were identified that covered enablers and barriers to the recruitment of Diploma of Nursing students and Enrolled Nurses. Evidence of the efficacy of programs designed to integrate and retain Enrolled Nurses in the health workforce is scant. Enrolled Nurses viewed participation in a Transition to Practice Program as an integral step in the pathway to becoming a registered nurse. Discussion: Continued debate around scope of practice is contributing to organisational and collegial confusion and discriminatory practices with negative consequences for the recruitment and retention of Enrolled Nurses. Conclusion: The value of Enrolled Nurse Transition to Practice Programs for recruitment and retention is questionable. Greater recognition of Enrolled Nurses' contributions to patient care is essential and could provide Assistants in Nursing with a career opportunity.

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Section: Discussionsupporting

confidence: 70%

An integrative review of Enrolled Nurse recruitment and retention

Blay

Smith

2020

Collegian

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“…This is consistent with other studies (Geraci & Thigpen, ; L'Ecuyer, Hyde, & Shatto, ; Sambunjak, Straus, & Marusic, ). For example, most enrolled nurses (ENs) receive lower levels of education than advanced practice nurses (APNs) (Endacott et al, ; Harbman et al, ), but the work of ENs is increasingly complex when they provide direct care to residents and are involved in an educational role (Gibson & Heartfield, ). ENs can also be chosen as mentors.…”

Section: Discussionmentioning

confidence: 99%

Nursing home staff experiences of implementing mentorship programmes: A systematic review and qualitative meta‐synthesis

et al. 2020

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Aim To determine nursing home staff experiences in mentorship programmes, and staff perceptions of the enablers and barriers to implement mentorship programmes. Background Mentorship programmes are perceived as playing an important role in improving the quality of care in nursing homes. However, little is known about research evidence across the global about staff's experiences in the programmes. Methods A search for studies published from the earliest available date to April 2019 was undertaken. Two reviewers performed data extraction and an appraisal of eight studies using tools from the Joanna Briggs Institute. A pragmatic meta‐aggregative approach was applied to synthesise the findings. The qualitative research that was included was analysed to identify 63 findings that were organised into 12 categories and combined into three syntheses. Results The implementation of effective mentorship programmes is influenced by three factors: mentor capability, opportunity in the mentorship programmes, and motivation in the mentorship programmes. Conclusions There are a number of studies of nursing home staff experiences of mentorship programmes. However, systematic reviews that synthesise findings in this field are lacking. It is crucial to tailor the programme design to suit each unique nursing home care setting. We identified barriers and enablers, and learned that no barriers are insurmountable. Implications for Nursing Management Findings will inform nurse managers of an ideal environment for the implementation of a successful mentorship programme. Nursing homes need to establish and sustain mentorship programmes to help improve workforce capacity in delivering high‐quality care for residents.

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“…Eight factors were reported in the included studies as influencing scope of practice. These were education [ 15 , 36 – 49 ], competency [ 15 , 36 – 38 , 41 – 44 , 46 , 47 , 50 ], professional identity [ 36 , 51 , 52 ], role confusion [ 15 , 37 , 39 , 42 , 44 ], legislation and regulatory policies [ 47 , 50 , 53 , 54 ], organisational structure [ 36 – 38 , 42 , 44 , 46 , 55 ], financial factors [ 36 , 37 , 41 , 42 , 44 – 48 , 52 , 56 , 57 ], and professional and personal factors [ 48 , 52 ]. The factors identified in the literature have been reported verbatim, without interpretation or modification.…”

Section: Resultsmentioning

confidence: 99%

“…Several papers identified pre- and post-professional education as an enabler and/or barrier to scope of practice [ 15 , 42 , 43 , 46 , 47 , 53 , 58 ]. For example, Brown et al [ 53 ] and Endacott et al [ 39 ] found that when an enrolled nurse (EN) with a diploma-level qualification [ 59 ] completed post-professional education to transition to registered nurse (RN) (bachelor’s degree) [ 60 ], their scope of practice significantly increased. Their new responsibilities included undertaking wide-ranging patient assessment; developing a nursing care-plan in consultation with the multidisciplinary team and assessing the outcome; and administering medications and assessing the outcome.…”

Section: Resultsmentioning

confidence: 99%

“…For example, inconsistency in scope of practice language within professional codes and practice standards for nursing [ 15 ] combined with the development of new nursing roles [ 37 , 44 ], created role confusion and hindered the formation of a well-defined scope of practice. Additionally, Endacott et al [ 39 ] highlighted that the expansion of ENs’ scope of practice over the past decade had created an unclear function and competency differentiation between ENs and RNs which had led to role confusion and ongoing intra-professional debate. Furthermore, Jacob et al [ 42 ] discovered that staff shortages and economic pressures created role confusion which influenced scope of practice.…”

Section: Resultsmentioning

confidence: 99%

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Factors that influence scope of practice of the five largest health care professions in Australia: a scoping review

et al. 2022

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Introduction A well-functioning health system delivers quality services to all people when and where they need them. To help navigate the complex realm of patient care, it is essential that health care professions have a thorough understanding of their scope of practice. However, a lack of uniformity regarding scope of practice across the regulated health professions in Australia currently exists. This has led to ambiguity about what comprises scope of practice in some health care professions in the region. Objective The objective of this review was to explore the literature on the factors that influence scope of practice of the five largest health care professions in Australia. Methods This study employed scoping review methodology to document the current state of the literature on factors that influence scope of practice of the five largest health care professions in Australia. The search was conducted using the following databases: AMED (Allied and Complementary Medicine Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library, EMBASE (Excerpta Medica Database), MANTIS (Manual, Alternative and Natural Therapy Index System), MEDLINE, PubMed, and SCOPUS. Additional data sources were searched from Google and ProQuest. Results A total of 12 771 publications were identified from the literature search. Twenty-three documents fulfilled the inclusion criteria and were included in the final analysis. Eight factors were identified across three professions (nursing & midwifery, pharmacy and physiotherapy) that influenced scope of practice: education, competency, professional identity, role confusion, legislation and regulatory policies, organisational structures, financial factors, and professional and personal factors. Conclusion The results of this study will inform a range of stakeholders including the private and public arms of the healthcare system, educators, employers, funding bodies, policymakers and practitioners about the factors that influence scope of practice of health professions in Australia.

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Roles and functions of enrolled nurses in Australia: Perspectives of enrolled nurses and registered nurses

Abstract: Health service providers, policymakers and education providers need to work collaboratively to ensure that facets of enrolled nurse education and scope of practice in line with regulation are affirmed by all concerned.

Cited by 13 publications

References 19 publications

An integrative review of Enrolled Nurse recruitment and retention

An integrative review of Enrolled Nurse recruitment and retention

Nursing home staff experiences of implementing mentorship programmes: A systematic review and qualitative meta‐synthesis

Factors that influence scope of practice of the five largest health care professions in Australia: a scoping review

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