The well‐being of nurses working in general practice during the <scp>COVID</scp>‐19 pandemic: A qualitative study (The GenCo Study)

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AimTo explore how nurses working in general practice experienced remote and technology‐mediated working during the COVID‐19 pandemic.DesignExploratory qualitative study with nursing team members working in general practices in England and national nurse leaders.MethodsData were collected between April and August 2022. Forty participants took part in either semi‐structured interviews or focus groups. Data were analysed using Framework Analysis informed by the PERCS (Planning and Evaluating Remote Consultation Services) Framework. University of York ethics approval [HSRGC/2021/458/I] and Health Research Authority approval were obtained [IRAS:30353. Protocol number: R23982. Ref 21/HRA/5132. CPMS: 51834]. The study was funded by The General Nursing Council for England and Wales Trust.ResultsParticipants continued to deliver a significant proportion of patient care in‐person. However, remote and technology‐mediated care could meet patients' needs and broaden access in some circumstances. When remote and technology‐mediated working were used this was often part of a blended model which was expected to continue. This could support some workforce issues, but also increase workload. Participants did not always have access to remote technology and were not involved in decision‐making about what was used and how this was implemented. They rarely used video consultations, which were not seen to add value in comparison to telephone consultations. Some participants expressed concern that care had become more transactional than therapeutic and there were potential safety risks.ConclusionThe study explored how nurses working in general practice during the COVID‐19 pandemic engaged with remote and technology‐mediated working. It identifies specific issues of access to technology, workload, hybrid working, disruption to therapeutic relationships, safety risks and lack of involvement in decision‐making. Changes were implemented quickly with little strategic input from nurses. There is now an opportunity to reflect and build on what has been learned in relation to remote and technology‐mediated working to ensure the future development of safe and effective nursing care in general practice.ImpactThe paper contributes to understanding of remote and technology‐mediated working by nurses working in general practice during the COVID‐19 pandemic and indicates to employers and policy makers how this can be supported moving forward.Reporting methodStandards for Reporting Qualitative Research (O'Brien et al., 2014).Patient or public contributionThis was a workforce study so there was no patient or public contribution.Implications for the profession and patient careThe paper highlights specific issues which have implications for the development of remote, technology‐mediated and blended working for nurses in general practice, care quality and patient safety. These require full attention to ensure the future development of safe and effective nursing care in general practice moving forward.

Section: The S Tudymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Remote and technology‐mediated working during the COVID‐19 pandemic: A qualitative exploration of the experiences of nurses working in general practice (the GenCo Study)

Anderson,

Scantlebury,

Galdas

et al. 2023

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First‐line managers' experience of guideline implementation during the COVID‐19 pandemic

Fjordkvist,

Eldh,

Winberg

et al. 2024

Aim(s)To explore first‐line managers' experience of guideline implementation in orthopaedic care during the COVID‐19 pandemic.DesignA descriptive, qualitative study.MethodsSemi‐structured interviews with 30 first‐line nursing and rehabilitation managers in orthopaedic healthcare at university, regional and local hospitals. The interviews were analysed by thematic analysis.ResultsFirst‐line managers described the implementation of guidelines related to the pandemic as different from everyday knowledge translation, with a swifter uptake and time freed from routine meetings in order to support staff in adoption and adherence. The urgent need to address the crisis facilitated guideline implementation, even though there were specific pandemic‐related barriers such as staffing and communication issues. An overarching theme, Hanging on to guidelines for dear life, is substantiated by three themes: Adapting to facilitate change, Anchoring safety through guidelines and Embracing COVID guidelines.ConclusionA health crisis such as the COVID‐19 pandemic can generate enabling elements for guideline implementation in healthcare, despite prevailing or new hindering components. The experience of guideline implementation during the COVID‐19 pandemic can improve understanding of context aspects that can benefit organizations in everyday translation of evidence into practice.Implications for the Profession and/or Patient CareRecognizing what enabled guideline implementation in a health crisis can help first‐line managers to identify local enabling context elements and processes. This can facilitate future guideline implementation.ImpactDuring the COVID‐19 pandemic, the healthcare context and staff's motivation for guideline recognition and adoption changed. Resources and ways to bridge barriers in guideline implementation emerged, although specific challenges arose. Nursing managers can draw on experiences from the COVID‐19 pandemic to support implementation of new evidence‐based practices in the future.Reporting MethodThis study adheres to the EQUATOR guidelines by using Standards for Reporting Qualitative Research (SRQR).No Patient or Public Contribution.

Exploring the relationship between cultural and structural workforce issues and retention of nurses in general practice: A qualitative study protocol

Anderson,

Brady,

Adamson

2024

Aim(s)The aim of this study is to understand factors that challenge retention and support nurses to stay in general practice.BackgroundOne in four general practice nurse positions in England expected to be left unfilled within the next 10 years. Cultural and structural issues associated with working in general practice have been linked with nurses leaving general practice, re‐evaluating their professional futures, adjusting work‐life balance and bringing forward retirement. This has implications for the future of the general practice nursing workforce and patient care more broadly.DesignExploratory qualitative interview study funded by the General Nursing Council Trust for England and Wales. University of York ethics approval (Ref: HSRGC/2023/586/A) was gained in September 2023. The study will be conducted between September 2023 and August 2024.MethodsQualitative interviews will be conducted with a range of nurses working in, or who have worked in, general practice as well as nurse leaders associated with general practice across England and Wales. Recruitment will be via professional and social media networks and snowballing techniques. We aim to purposively recruit 30–40 participants for maximum variation. Cultural and structural influences which may contribute to retention decisions will be explored. Data will be analysed following framework analysis.Discussion/ConclusionThis study will explore how underpinning cultural and structural issues may impact on retention of this highly skilled professional group and identify factors to support retention.Implications for the Profession and/or Patient CareBy exploring factors that support or discourage nurses to remain in general practice, retention strategies can be better planned on order to address the general practice nursing workforce crisis.ImpactWhat problem did the study address? This study will address the retention crisis in nursing in general practice by exploring how cultural and structural issues may impact on retention of this highly skilled professional group and identify factors to support retention.Where and on whom will the research have an impact? From the study findings, recommendations will be developed to inform future policy and practice. Key factors to address attrition will be generated to support employers and policy makers in future primary care workforce planning, as well as supporting nurses, at an individual level, in negotiating their roles in practice.Reporting MethodStandards for Reporting Qualitative Research (O'Brien et al., 2014).Patient or Public ContributionAs this is a workforce study protocol, there is no patient or public contribution.