Registered Nurse Scope of Practice in Australian Primary Healthcare Settings: A Retrospective Longitudinal Study

Background: Registered nurses (RNs) play an important role in providing primary healthcare (PHC) services. Longitudinal evidence on how the RN scope of practice in these settings has evolved over the years is currently missing and is critical in understanding how Australian government health policies have shaped the reality of nursing practice.

Aim: To explore the scope of practice of RNs in Australian PHC workplace in both metropolitan and rural areas and among those with and without postgraduate qualifications during 2015–2019.

Methods: Longitudinal survey data were retrospectively retrieved, collated and analysed using variate and bivariate analyses in SPSS Version 27.0. Composite items were used to combine survey items into seven key areas of nursing practice.

Results: Majority of the 3882 participants were female (n = 3782, n = 97.4%), worked in general practice (n = 2916, 75.1%) and in metropolitan areas (n = 2145, 55.3%) and had completed a short course (n = 2470, 63.6%). A total of 904 participants (23.3%) completed at least one postgraduate degree. There was no significant and substantial difference in the frequency, and preference for frequency, of seven PHC practice areas by participants in different workplace localities, with or without a formal postgraduate degree as well as throughout the 5-year survey period.

Conclusion: The findings on the scope of practice by the RN participants might be explained by the interplay of interprofessional, organisational and institutional factors (more than individual factors).

Implications for Nursing Management: Multilayer strategies targeting interprofessional, organisational, institutional and individual factors should be in place to enable RNs to work to their full capacity and advanced level of education. RNs also need to be included in major policy- and decision-making that affects them to ensure their job satisfaction, retention in practice and contribution to patient health outcomes in PHC are sustained.