Family practice registered nurses: The time has come.

OBJECTIVE: To provide a picture of the unique role and competencies of family practice registered nurses (FP-RNs). DESIGN: Case-study approach using interviews and focus groups. SETTING: Ontario. PARTICIPANTS: Seven FP-RNs identified as exemplary by family medicine and nursing peers. METHODS: An e-mail was sent to 9200 health care providers from nursing and family medicine, asking them to identify names of exemplary family practice nurses. Using a purposive sampling methodology, 7 exemplary FP-RNs were selected, taking into consideration the number of years in practice as a nurse, location of practice, length of practice as an FP-RN, and type of family practice. Individual interviews were held, and focus groups were organized with colleagues. Narratives were analyzed iteratively by the project team. MAIN FINDINGS: Four main themes emerged: The first theme relates to the relationship-centred approach to care delivered by FP-RNs, founded upon trust. The second theme highlights the FP-RN's unique skills in balancing the priorities of patients, colleagues, and the clinic as a whole. The third theme capitalizes on the nurses' commitment to advancing their learning to enhance their abilities to be FP-RNs. The fourth theme illuminates the perspectives shared by FP-RNs that family practice is uniquely different from acute care in the manner in which care is delivered. We draw attention to the approach and role of FP-RNs in Ontario. The 4 themes that emerged have striking similarities to stories shared by family physicians and to the evolutionary development of the discipline of family medicine. CONCLUSION: We believe the findings from this paper can help shape the role of the FP-RN within clinical practice and that they will propagate discussion among nursing educators to consider the necessary educational preparation required to develop the FP-RNs needed in this country.

A Delphi approach to developing a core competency framework for family practice registered nurses in Ontario.

This paper describes the results of a Delphi panel process to gain consensus on a role description and competency framework for family practice registered nurses (FP-RNs) in Ontario. Based on the findings from interviews and focus groups with family practice registered nurses and their inter-professional colleagues throughout Ontario, a core competency framework for FP-RNs emerged consisting of six distinct roles - Professional, Expert, Communicator, Synergist, Health Educator and Lifelong Learner - with accompanying enabling competency statements. This framework was refined and validated by a panel of experts from various nursing and family medicine associations and organizations through a Delphi consensus process. This core competency framework for FP-RNs was developed as a stepping stone for clarifying this very important and poorly understood role in family practice. As a result of this research, we expect a greater acknowledgement of the contributions and expertise of the FP-RN as well as the need to celebrate and profile this role. This work has already led to the establishment of a network of stakeholders from nursing organizations in Ontario who are considering opportunities to move the development and use of the competency framework forward.