Nursing in general practice: Organizational possibilities for decision latitude, created skill, social support and identity derived from role

Aim. This article is a report of a study to describe the factors that support organizational opportunities for practice nurse decision-making and skill development for nurses employed in general practice in New South Wales, Australia. Background. Corresponding to the availability of subsidies from the Australian universal health insurer (Medicare), there has been an increase in the number of nurses employed in general practice. Currently, there is no Australian evidence as to the organizational possibilities for these practice nurses to make decisions, develop their own skills and abilities, derive identity from their role or how their role is influenced by social support. Methods. Over a 8-month period in 2008 practice, nurses employed in general practice in the State of New South Wales were invited to complete a 26-item self-administered online questionnaire utilizing constructs from Karaseks (1998) Job Content Questionnaire (valid n=160). Results. Confirmatory Factor Analysis indicated that all scales demonstrated acceptable levels of internal consistency. Sequential regression models revealed that social support exerts a weak influence on decision latitude (R ²=0·07); the addition of self-identity through work significantly improved the predictive ability of the model (R ²=0·16). Social support and self-identity through work exerted a negative influence on created skill (R ²=0·347), whereas social support was effective in predicting self-identity through work (R ²=0·148). Conclusions. Collegial and supervisory support in the work environment predicts organizational possibilities for practice nurse decision-making.