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This Scholarship honours the leadership and vision of Judith Chavasse (1933-1918), formally the Head of Nursing in UCD. Judith Chevasse was a leader in the development of nursing scholarship and education toward recognition of the profession as an academic discipline in Ireland.
Tell us a bit about yourself and your background.
I qualified as an RGN at University College Hospital Galway (UHG) in 1997 and have worked as a General Practice Nurse (GPN) for 24 years. General Practice Nursing is my passion and I aspire to highlight and promote the role and its potential. I have undertaken a wide array of postgraduate education courses including a Diploma in Asthma and Respiratory Care; Certificate in Family Planning and Well Woman Care; Diploma in Nursing Studies (NUIG); Cervical Cytology and Breast Cancer Screening Certificate; MSc. Women’s Health (RCSI), Certificate in Nurse Prescribing (RNP) (RCSI), and a Post Graduate Diploma in Advanced Nursing Practice (ANP) at NUIG.
My love of general practice was fostered by my dad who served as a GP for more than 60 years in Crossmolina, Co. Mayo. His general practice surgery was in our home so as I grew up, I observed and became familiar with the practical running of the surgery but more importantly learned how integral it was to the community I lived in. Watching my compassionate, community-spirited parents give their lives to general practice, I grew to appreciate and love it more. My dad’s GP role also involved caring for patients admitted to the local district hospital in Ballina, and on occasion, as a young girl, I would accompany him when he attended the hospital. I was deeply impressed and inspired by the nurses I met there. Following my graduation as an RGN from UHG, I felt very fortunate to be given the opportunity to introduce nursing into a general practice setting, working with my dad and the practice team at Deel Medical Centre between 1997 and 2000. Following this, I worked as a GPN in Knock Medical Centre from 2000 – 2021 combined for a period, with a staff nurse position in the medical assessment unit at Mayo University Hospital (2000 -2002). During my time in Knock, I qualified and began my practice as an advanced nurse practitioner. Having recently moved to Castlebar Family Practice, I am looking forward to introducing the role of ANP there.
In advancing General Practice Nursing I held the position of Irish General Practice Nurses Educational Association (IGPNEA) National Vice-Chair from 2007-2008 and IGPNEA National Chair from 2008-2011 and was also National PRO of the association from 2019-2020. I have represented GPNs and the IGPNEA, working in partnership establishing and strengthening links with other nursing, medical and healthcare organisations, and agencies. I am a current member of the Mayo branch IGPNEA.
The late Judith Chavasse had a vision for nursing roles in health promotion and prevention in primary care which predated and is reflective in the current Sláintecare policy. She saw the potential for nursing care in the proposed refocusing of services into the community, as a leader she encouraged nurses to embrace new professional partnerships and relationships in community service. As a GPN for the past 24 years, I hope Judith would have been proud of the evolving GPN role. I imagine she would approve of the effective teamwork and collaboration which has developed between nursing colleagues on the ground in public health, general practice, and in other services such as community mental health and palliative care.
What are you hoping to achieve with your research?
The GPN specialty has evolved significantly in Ireland over the past three decades, primarily in response to healthcare policy, service developments, and specific practice needs. It is indisputable that GPNs are making an impact, but in Ireland, to date, there is very little empirical evidence of this. Also, legacy issues remain for GPNs because of the ad hoc way the role has evolved, for example, there are concerns that the role remains unsupported and vulnerable unless formal standardised education and terms and conditions of employment are addressed. I aspire, through my proposed research to explore the role, demonstrate and document the care GPNs deliver. In 2021 I registered with the School of Nursing, Midwifery and Health Systems as a Ph.D. student under the supervision of Assoc. Professor Mary Casey. The focus of my research will be to develop a suite of nursing quality care metrics that will show the value, potential, and needs of general practice nursing to evolve and contribute safely to the delivery of healthcare in general practice.
Who will you be collecting data from, what kind of data, what questions will you answer with this data?
The primary aims of this research are to co-create and implement quality care metrics and standard indicators for nursing in general practice. The research will be carried out within Community Health Organisation (CHO) Area 2 comprising of counties Galway, Roscommon, and Mayo. Research participants will include GPN, GP, GP registrars, interns, practice managers, administrative staff, patients, and families who access general practice services. These participants will be drawn from a range of roles and diverse backgrounds from the geographical spread within CHO2.
The Research design framework will use Appreciative Inquiry (AI) as an Action Research (AR) approach, AR is a collaborative, interactive cyclic process of observing, reflecting planning, and acting, which links theory with practice. Action research is conducted ‘for’ and ‘with’ people as opposed to ‘on’ them. Knowledge is gathered collaboratively, and change is implemented during the action research process. Data collection will be undertaken initially using a survey developed to capture a baseline of Irish GPNs roles and explore perceptions regarding the professional standards of care. I will then conduct focus groups to analyse key areas of GPN interventions and evidence-based indicators of nursing in general practice. Following this, I will conduct Appreciative Inquiry (AI) groups to include all professionals who deliver general practice services and those who access general practice services. The objective of the AI groups is to build on the results of the survey and focus groups to co-create metrics for general practice nursing.
Why is this research important?
Over 29.1 million consultations take place in Irish general practice every year, with approximately 8 million of these patient contacts undertaken by GPNs. Currently, there are approximately 2,500 GPNs working in general practice which is a significant workforce. The GPN is involved in a wide array of general practice services including management of acute and minor illness, prevention and health screening services, long-term illness self-management support, and anticipatory care. In 2019 the Government of Ireland through Sláintecare reform committed to investing €120 million towards general practice service development. Of this, €80 million has been earmarked towards the management of chronic diseases (CDM), with €2.2 million paid into general practice as a CDM nursing support grant during 2020. I believe a critical element of any service investment analysis is to clearly ascertain value and outcomes. Considering state investment in general practice services, identifying, and defining metrics that demonstrate impact, ensure accountability, and inform future developments in care delivery is a novel and unique healthcare project in my opinion.
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