LEADING FOR OUTCOMES: Health system change / Community primary care / Population health / CVD / Diabetes

Q: What contribution can post-graduate study make to primary health care nursing?

“An important part of primary health care education is opening nurse’s eyes to the broader context of their practice. I teach a social epidemiology paper at post-graduate level which looks at the socio-economic determinants of health from a global perspective down to an individual level.

“A nurse working from this context will consider a range of socio-economic factors when assessing a patient. Why isn’t this patient managing their diabetes? What’s happening with the family? Is there enough food on the table?

“The post-graduate certificate in primary health care nursing at Massey gives students the chance to implement a specific project in their own practice. Students are required to put forward a business case by looking at resources, budgets and funding – things nurses haven’t traditionally managed and essential if we want to build an autonomous workforce.

“We have a practice nurse workforce which is to a certain extent disempowered and poorly funded. One of the key issues here is employee/employer relationships. However post-graduate study gives nurses the chance to think about what could be and how it could work.”

Q: Do you see any barriers preventing more practice nurses taking up
postgraduate study?

“The big issue for most practice nurses is release time. If their employer can’t replace them when they need to take study leave then it becomes too hard. The average age of the practice nurse workforce is mid-40s. Many have family commitments, and many work part-time. Taking on post graduate study is a big ask. Many have never studied at that level before and don’t realise the demands. They all have the ability to study – it’s just learning how – utilising literature, writing essays and referencinig etc.

“I’m optimistic this will change. The requirement to enter the workforce is now a Bachelor of Nursing or Bachelor of Health Sciences, so this will become the norm, and therefore going onto study at postgraduate level will also become the norm.”

Q: What are the opportunities for primary health care nurses with a
post-graduate qualification?

“I started studying for my masters ten years ago while working in secondary care. People would often ask me why I was studying at post-graduate level – you won’t get more money and what kind of position would it lead to? – were typical responses. Many of my peers then and students now have gone into senior nursing positions, or management, consultancy or research.

“To some extent masters qualified nurses may need to create their own career path. Many of the students at Massey go into research positions, nursing advisor positions and other specialist roles. One student has recently been employed as a breast nurse specialist. Another student has a contract with Healthwest PHO to provide wound care education and clinical support to practice nurses – and the feedback from the practices is fantastic.

“I’d like to see nurses setting up their own practices and employing GPs, or structures where there is a nursing line of management. I’d like to see nursing advisors in PHOs. All my research* has been on nurse-led clinics and I’m passionate about them.

“With the right counselling, guidance and support most nurses coming through post-graduate education will find a niche that works for them.

“I’m always inspired to work with students who are studying at postgraduate level. To see their achievements is stunning.”