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Mentoring for nurses in general practice:

an Australian study

TERRI GIBSON & MARIE HEARTFIELD

University of South Australia, School of Nursing & Midwifery, Adelaide, South Australia 5000

Summary This paper presents findings from a project conducted to recommend a national

framework for mentoring for general practice nurses in Australia. The first phase identified challenges

and key issues; the second and third phases (reported here) engaged practice nurses and general medical

practitioners in discussion to advance thinking on the topic. Outcomes revolved around seven core

areas: role confusion and diversity of practice nursing; lack of a defined career pathway for practice

nurses; professional isolation of practice nurses; need for general practitioner support; expectations of

mentoring; importance of resourcing and infrastructure; and roles, skills and qualities of mentors.

Implications of these for the development of a systemic approach to supporting nurses in general practice

are discussed, taking into account the inter-professional context and special working relationship

between nurses and doctors. Findings revealed keen support for the idea of mentoring for nurses in

general practice and indicate success will depend on appropriate resourcing and infrastructure throughnational, state and local coordination processes.

Key words: Mentoring; general practice; practice nurses; general medical practitioners; research.

Introduction

Mentoring for nurses in general practice is attracting increased attention in Australia. General

practice is one aspect of community-based health care delivery in Australia which occurs

through a system of non-specialist primary care medical practitioners, known as generalpractitioners (GPs). These private businesses are co-ordinated through a government funded

infrastructure known as the Divisions of General Practice (DGP). While not all general

practitioners employ nurses, the contribution of nurses to general practice has been receiving

greater attention since 2001 – 2002, when the Australian Government allocated considerable

funding for the recruitment of practice nurses.

Mentoring is a useful mechanism for providing effective and systematic support for nurses

in general practice, for facilitating their professional development, and enhancing co-

ordination of care within the unique context of general practice. In 2002 the Australian

Correspondence to: Dr Marie Heartfield, University of South Australia, School of Nursing & Midwifery, Centenary

Building, City East, Adelaide, South Australia 5000, Tel: +61 8 83022341; Fax: +61 8 8302 1806; E-mail:

[email protected]

JOURNAL OF INTERPROFESSIONAL CARE, VOL. 19, NO. 1, JANUARY 2005


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Government Department of Health and Ageing commissioned a study to recommend a

national mentoring framework to support general practice nurses. Complexities of the project

related to fragmentation of the sector across eight states and territories, variation in size and

structure of practices in metropolitan, rural and remote locations, and diversity of nursing

roles to meet the needs of clients in settings ranging from city medical clinics mining sites to

Aboriginal communities. The study aims were to:

. identify key issues in mentoring for nursing in general practice

. identify a range of mentoring approaches in Australia and overseas

. assess the transferability of mentoring models from a range of sectors

. recommend an approach to mentoring for nursing in general practice, and

. identify key factors for successful implementation of the approach in terms of

organisational support, skills and attitudes, resources and collaborative structures.

The project comprised three phases. The first phase involved a teleconference with key

stakeholders that generated issues considered critical to the success of mentoring for nurses ingeneral practice (Gibson and Heartfield in press). Outcomes from the teleconference and a

review of mentoring literature highlighted the issues of choice, relationships, structures and

resources. These issues informed the development of an Options Paper (Heartfield et al .,

2003) that was circulated nationally for discussion by practice nurses and GPs in the second

and third phases of the project reported here.

Literature review

Though one of the problems with mentorship is that there is no common agreement about

roles and function (Armitage & Burnard, 1991), it is recognized that mentoring can involve

both career and psychosocial functions (Kram, 1985). Career functions encompass

sponsorship, opportunities for exposure, coaching and challenging mentees. Psychosocial

functions encompass role modelling, counselling, friendship and networking. These themes,

explored below, are particularly relevant to mentorship for nurses in general practice. The

National Workshop: ‘Future Directions in Practice Nursing’, held in 2001, identified

mentoring as an effective way of not only facilitating open communication and de-briefing

for nurses, but also of developing practice nursing in a sustainable way. Similar views are

expressed in the wider nursing literature (e.g., Haley-Andrews, 2001; Roberts, 2003;

Werner, 2002). Some proponents of mentoring (e.g., Roberts, 2003) recommend formal

mentoring programs, while others (e.g., Haley-Andrews, 2001) prefer the flexibility of

informal mentoring.

Informal mentoring

Informal mentoring occurs when one person takes an interest in the wellbeing and

advancement of another. The relationship can be initiated by either the mentor or mentee.

In Ragins and Cotton’s (1999) randomised study of men and women’s mentoring experiences,

44% of participants had informal mentors and reported greater satisfaction with mentors and

mentoring outcomes than those mentored formally. Overall, female participants gained greater

satisfaction from female mentors.

The most significant variable for success was the quality of the relationship between mentorand mentee. Informal mentoring, though, is dependent on personal favour and may be

difficult to access by women, who have traditionally been excluded from senior positions

MENTORING FOR NURSES IN GENERAL PRACTICE 51


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Formal mentoring

This occurs when an institution implements a formally recognised mentoring scheme, even if

there are no tangible rewards for the mentors. Analysis of numerous mentoring programs

operating at five Australian universities suggested the most successful schemes were those that

were formally established (ATN WEXDEV, 1999). Formal mentoring schemes have: a clearrationale; measurable goals and outcomes; mechanisms for assessment and selection of mentors

and mentees; and accountability, since results are monitored. They are typically structured and

funded, and have open recruitment and training. Colwell (1998) pointed out that formal

mentoring may be perceived as a threatening factor in socialising and inducting new staff.

Distance mentoring

The focus of distance mentoring is to provide a flexible arrangement that enables

geographically dispersed individuals to access mentors. It is possible to link people across

wide areas using different technologies such as telephones and e-mail. An evaluation of a pilotAustralian scheme found e-mail mentoring difficult to maintain in the face of other demands

on time. It is recommended that e-mail mentoring implements:

. initial direct face-to-face contact

. careful matching of pairs

. training for mentors and mentees, and

. a strong support network for mentors and mentees (ATN WEXDEV 1999).

Coaching as mentoring

Recent management practice has begun to draw attention to coaching, while criticising

mentoring for being too focused on individual needs. Coaching may involve:

. performance coaching, focussed on closing the gap between goals of the individual and

current outcomes

. skills coaching for enhancing critical key skills

. career coaching, focussed on new or future career goals, and

. strategic coaching for strategic planning and management support (Zeus & Skiffington,

2000).

In one USA study, 31 managers undertook management training followed by eight weeks

intensive one-on-one executive coaching. Coaching included goal-setting, collaborative

problem-solving, practice, feedback supervisory involvement, evaluation of end-results and a

public presentation. Coaching was found to be four times more successful in increasing

productivity than conventional training (Olivero et al ., 1997).

General practice implications

General practice has unique characteristics in Australia that prevent direct transfer of models

from other organisations or sectors. In particular, the general practice context comprises acomposition of organisations or small businesses, not one organisation.

It is noteworthy that European and North American approaches to mentoring differ as to

52 TERRI GIBSON & MARIE HEARTFIELD


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North America, career advocacy for the mentee (Clutterbuck, 1987). Analysis of literature

reveals organisations in different countries and in different fields are likely to blend both

models and emphasise different aspects depending on the organisational needs of the sponsor.

Such a scenario holds potential for the general practice context.

Informal mentoring may assist nurses in general practice, particularly if they are encouraged

to seek female mentors. Effort must be made to overcome isolation, so nurses have a sufficientpool of potential mentors. A mentoring scheme could also be designed to fulfil similar

objectives to a coaching scheme.

Coordination is important in general practice. A properly resourced scheme would fund a

coordinator to administer the scheme, set up training workshops, provide support, encourage

contact between participants and resolve any emerging difficulties. Boice (1992) found the

coordinator had a significant role in keeping in touch with participants. Pairings that had some

contact with a coordinator or facilitator proved much more resilient and successful than

pairings without such attention.

Overall, the literature indicates that mentoring within nursing occurs in multiple ways: it

may be formal, informal, or geographically distant, and has a salient influence on personal andprofessional development and satisfaction. It is also evident that the most successful mentoring

programs are those crafted to suit the needs and context of the particular organisation, taking

into account needs of individuals (Rolfe-Flett, 2002). The challenge here is that general

practice comprises many organizations, hence the need for research is clearly evident.

Study design

This research used focus group techniques and case studies within a qualitative framework.

Data were analysed using content and thematic analysis.

The project complied with National Health & Medical Research Council (NHMRC) ethical

standards for research (NHMRC 2002) and gained approval from the University of South

Australia Human Research Ethics Committee.

Development and circulation of an Options Paper

Outcomes of the teleconference and review of mentoring literature informed the development

of an Options Paper (Heartfield et al ., 2003) featuring:

. an introduction to mentoring and development of general practice nursing roles

. alternative mentoring models

. questions to stimulate decision making/responses about the models in relation totransferability to and sustainability for general practice nursing (Heartfield et al ., 2003).

The Options Paper was circulated to all participants prior to the subsequent phases of

consultation.

Participants

The 121 DGPs in Australia were recognised as vital to the success of any mentoring

framework and thus chosen as the primary sampling units through which GPs and general

practice nurses were accessed. The agreed selection criteria were that participants should:

. be able to provide strategic advice regarding key issues for mentoring for nurses in



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. represent the range of general practice contexts including urban, rural and remote

locations.

Key DGP representing urban, rural and remote locations forwarded invitations to GPs and

nurses to participate in the study. Additional participants were included following requests for

observers to attend (mostly DGP practice support persons, DGP nurses employed inspecialised roles or members of professional organisations). Table 1 shows the sample

composition.

Data collection and analysis

Participants’ responses to the Options Paper were generated though a series of focus groups

varying in size from seven to twenty-two participants in either face to face or telephone

discussions. Members of the project team facilitated discussion about the feasibility, successful

implementation and sustainability of mentoring for nurses in general practice.

Follow up telephone interviews were conducted with some nurse participants to provideillustrative case studies of mentoring experiences. Notes from focus groups were subjected to

content and thematic analysis, resulting in seven themes (core areas), discussed below.

Findings

Findings in relation to each core area are addressed discretely, although in practice they

interrelate. As detail is necessarily limited here, interested readers can contact the authors for

further information. Italics are used to indicate direct quotes from participants.

Role confusion and the diversity of practice nursing

‘I’m unsure whether my role is nursing’

Wide variation in the role and use of practice nurses in Australia was reported. Roles ranged

from providing mainly receptionist services, to combinations of receptionist/nursing work,

management of busy treatment rooms through to practice nurses operating their own list of

patients for care plans and health assessments. Practice nurses working in some rural areas and

city practices also provided a significant triage function, including telephone triage, such as

screening general patient enquiries, giving results, dealing with difficult patients over the

phone, and managing patient flow through multiple bed treatment rooms.Many nurses and some GPs considered that there is significant scope to enhance the

contribution of practice nurses. Factors identified as limiting their full utilization included:

Table 1. Participants by geographical location and professional classification ( n = 201)

Location Practice nurses GPs Observers

Urban 87 30 11

Rural 34 14 7

Remote 16 1 1

137 45 19



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. lack of training for general practice nursing

. lack of understanding of contemporary nursing roles by some GPs

. GPs’ concerns regarding liability for information provided by practice nurses to clients

. billing structure of a practice

. blurring of receptionist and nursing roles

. lack of standards and role descriptions for practice nursing

. cost of employing a practice nurse, and

. part-time and casual employment.

The lack of a defined career pathway for practice nurses

‘brave nurses enter general practice’

Nurses and GPs highlighted recognition of practice nursing as a career with relevant educationand training as necessary. Many nurse participants suggested lack of a career pathway was

partly related to a lack of understanding in the community and by nurses in other sectors about

practice nursing. The status of practice nursing in the health system was perceived as being

very low and participants cited a widespread perception that nurses working in general practice

do not require many skills, or that those who work in general practice may become de-skilled

and work for office hours rather than for a purposeful career. This was seen as being partly

linked to the historical emphasis on receptionist roles.

As many nurses identified, nursing in private practice involves a new set of problems

requiring a broader range of skills than nursing in hospitals, including business and

financial skills. Nurses in general practice also require a broader range of nursing skills; as

one put it:

Practice nursing is so different and so varied. You never know who is going to walk through

the door. At least in a hospital ward you have a focus on people with particular conditions

and age groups. In general practice you deal with any condition and ages from babies to the

elderly.

This broad role was reflected in dissatisfaction of some participants with the title of general

practice nurse. Several nurse participants suggested this title is not an accurate representation

of the general practice nursing role. As one remarked:

The title needs to be changed to something else that better reflects what practice nurses do.

People think you are practising to be a nurse, that you are still a student in training.

The lack of specific education for the practice nurse role was seen as contributing to the lack of

a career pathway. A recurring emphasis was the need for exposure to general practice in the

undergraduate curriculum and in continuing education. Participants also identified the need

for a role statement and standards for practice nursing, arguing this would enhance the

professionalisation, recognition and hence legitimation of practice nursing as a valid career

path in nursing. As one nurse said:

We need standards of practice nursing rather than just knowing what each doctor needs so

that our role is recognised and acknowledged as a legitimate nursing role which is integral to



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The development of practice nursing standards was also acknowledged as enhancing the level

of care provided to consumers.

The need for general practitioner support

‘Working hand in glove’

Both practice nurses and GPs highlighted the need for GP support of a mentoring framework.

The GPs were strongly supportive of mentoring for practice nurses, recognising their

importance to overcome the professional isolation experienced by many practice nurses. As

one GP noted:

Practice nurses don’t have a lot of support. Mentoring can be a support system for them where

they can develop a network of practice nurses who they can share information with about

what they do and get ideas from. I think this is needed for the sustainability of nursing in general practice.

Most GPs were familiar with mentoring (as part of medical training and the GP Training

Scheme in Australia) and had first hand experience of its benefits. They suggested a mentoring

scheme for nurses in general practice could form part of a wider training scheme.

Many GPs highlighted the importance of recognising general practice as a private enterprise

and that mentoring needs to have practical outcomes for the GP and the practice. As one stated:

I need to know that there is something in it for the practice and that it will be beneficial for the

practice’s income if I am going to support my practice nurses being involved.

While many GPs focused on financial implications, others pointed out benefits such as

improved quality of care that could accrue to a practice through mentoring of nurses. As one

stated:

Why are we focusing so much on cost effectiveness of the nurse’s role when we don’t do the

same with the receptionist? Mentoring can help practice nurses to be used a lot more

effectively, which will improve quality and standards.

Most GPs emphasised practice nurse mentoring should not interfere with the business of the

practice. While some indicated they would provide funding support for nurses to attendmentoring sessions, others required external funding if mentoring were to occur during

practice hours. It was suggested that one way to gain widespread GP support for mentoring

was to involve GPs. For example, one suggested:

There is a role for GPs to be involved in mentoring through the Division, which will help for it

to become part of the culture . . . and if you establish the culture, then people are going to want

to be involved.

Several GPs suggested mentoring was an important aspect of recruiting and retaining skilled

practice nurses and should be promoted widely as part of any recruitment strategy.Some nurses stressed the importance of GP support to enable them to mentor other practice

nurses. They said this would showcase the practice as having a culture of support for practice



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Professional isolation

‘hanging from a string in the wind’

Nurse participants in urban as well as rural and remote areas spoke of ‘feeling alone’ andwanting some form of contact with other nurses. As one nurse expressed:

I struggled for such a long period because I just felt isolated from the hospital nurses just next

door to me, because they all had no idea of my role . . . the isolation of being by myself with no

support was overwhelming. I had lots of support from the GP, but it is so different having

another nurse to talk to.

Professional isolation was compounded by geographical isolation for practice nurses working

in outlying rural and remote areas. One group of practice nurses from a remote region was six

or seven hours drive from another group. One nurse stated:

I didn’t know other practice nurses existed in the region . . . I would like to have a list of the

other nurses in the region and information about their role in the practice. I would then know

who I could contact for help about particular things.

It was also considered important to know about changes in other areas such as the public

hospital system to remain up to date with the contemporary nursing role. As one nurse

stated:

You lose touch professionally not being part of a system like a public hospital system . . . in a

clinic, as long as you’re functioning, and you’re swimming, and you’re just above water, then

the doctor is happy with that, I find.

Several nurses highlighted the value of an annual funded conference for remote practice nurses

where they could meet other nurses in similar situations. Many DGPs have recently

established practice nurse networks that provide opportunities for practice nurses within a

DGP to meet, share ideas, and attend education sessions relevant to their role. Those who

were part of these networks spoke positively of them. For example:

We went along to that first meeting and we were just like sponges. We just wanted to be in

touch with these other nurses who were in similar situations. Everyone was asking ‘What are you doing?’, What is this?, What is that? . . . It didn’t make me feel on my own anymore.

That’s how I’ve felt for years—on my own out there.

Practice nurses working in practices as the sole nurse also spoke of their acute sense of

professional isolation. One nurse in an urban practice said:

As the only nurse in the practice I feel really isolated. In the hospital there was always

someone to talk to. Here I sometimes feel like I am hanging from a string in the wind. I think

I’m probably desperate by three years at least for a mentor.

The majority of practice nurses attending the consultations were not connected with

formalised professional networks or organisations - citing cost, lack of relevance to their needs



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Expectations of mentoring

‘someone to laugh and share experiences with’

Understandings of mentoring varied considerably between nurses and between nurses andGPs. As noted before, GPs were familiar with mentoring as a part of their tertiary education

programs, though not all experiences described were positive.

Nurse participants’ expectations focused on:

Personal development including expectations mentoring could assist with confidence

building, debriefing, gaining recognition, career planning and provide an opportunity to

share ideas, problems and successes.

Professional relationship management including expectations mentoring could assist in dealing

with political issues and role boundaries and conflicts between nurses, practice managers

and GPs.Role development including expectations mentoring could assist nurses adapt to the practice

nurse role from other settings, clarify legal parameters of their role, and develop the role so

as to maximise their contribution to general practice. This included support when taking on

new aspects of the role such as health assessments and care plans.

The following extracts from nurse participants highlight the diversity of expectations and

understandings of mentoring:

Mentoring for me is further education. Not just nursing, it is organisation – you’ve got doctors

to chase after. We do health assessments as well in an outpatient area that we have at the

clinic, and we do a lot of treatments and things. It’s trying to get education and organisation,

and keeping the doctor happy.

I wish I had access to a mentor when I started doing health assessments. In a hospital

situation you would be always supervised when doing something new . . . it wasn’t so much

the clinical aspects of doing the assessment – it was more about having somebody to talk

through my judgements and how I put the assessment together.

. . .certainly more than attending some sort of education. It is about analysing information for

yourself, about self-understanding . . . to me, a mentor would be someone who would listen to

that and help me analyse it myself so that it is clear in my own mind.

I came into practice nursing with no experience of the area at all . . . I thought I knew a little

bit, but right now – I’ve worked alongside two experienced practice nurses, and between them,

with more than 40 years of nursing - I’m starting to learn things that I just didn’t even think

about.

When discussing expectations of mentoring for practice nurses, GPs emphasised providing

opportunities for nurses to think more broadly and laterally about their role. As one stated:

An important aspect of mentoring is personal and professional growth as well as providing theopportunity to step back from the day to day work and think differently about what you are

doing. This can help clarify and develop the role of a nurse in their practice which will also



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Resourcing and infrastructure

‘The dollar’s gotta follow’

GPs and nurses widely agreed the success and sustainability of mentoring would depend onappropriate funding and infrastructure support. Strong support was given for involvement of

local DGPs, as they are a visible, established and well-perceived infrastructure in Australian

general practice. The growing success of the DGP based Practice Nurse Networks was seen as

a valuable way of fostering a growing culture of collaboration and professional development.

For example:

I have found the DGP to be very supportive. I get frequent e-mails, mail, and phone calls

about the activities happening for practice nurses . . . I’ve actually got a lot of help, and I can

actually call any of these people at any time and ask their advice.

The nurse networks were seen to provide opportunities for face-to-face contact (a much

preferred mode of communication) and networking with people with similar experiences of the

local contexts of general practice nursing. Many participants suggested mentoring schemes

should be coordinated locally to allow for individual personalities and circumstances to be

accommodated in the matching of mentors and mentees. It was also said that links should exist

with the broader profession and professional organisations.

Confidentiality was recognised as essential to the success of mentoring relationships. It was

stated in several discussions that confidentiality could potentially be threatened in the single

DGP climate. Thus, despite majority support for the local DGPs as a coordinating location for

mentoring schemes, some nurses and GPs identified the importance of networking from a

broader, state and potentially national basis. As one nurse stated:

Who should run this? Not Divisions, not practices, not. . .[professional nursing organisa-

tions]. It needs nurses across different levels and roles, managers, educators, ENs, RNs with

government national support and an elected committee.

Role, skills and qualities of mentors

Nurses and GPs were asked to describe the role, skills and qualities required for mentors, and

to identify appropriate mentors for nurses in general practice.

A mentor was seen as someone who could provide support and encouragement, and assistwith career advice, and show how a nurse’s role can contribute more to the practice. The

abilities to challenge, provide direction to appropriate resources, and relate experiences from

elsewhere to help solve problems were considered important characteristics of a mentor.

Moreover, being available to debrief and share stories, acting as a sounding board and sharing

knowledge, and acting as a mediator for relationship problems within a practice were

considered important mentor roles.

Both nurses and GPs described a wide range of knowledge, skills, attitudes and experience

needed by mentors. These included knowledge of the general practice context, nursing in

general practice, contemporary nursing roles, and legislation affecting nursing. Relevant skills

included those related to building relationships, rapport and trust, telephone technique,reflective listening, and translating knowledge into the general practice context. Appropriate

attitudes identified included being positive, being professionally committed, having a mature



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necessary for mentors included experience in practice nursing, remote area practice, dealing

with political issues, a range of life experiences, and the general practice context.

Who should be mentors?

Both nurses and GPs voiced strong support for the involvement of practice nurses as mentors,citing the importance of a nurse experienced in the practice nurse role with knowledge of the

practice nurse context and issues. This was considered particularly important for mentoring

nurses new to the role. Some suggested the mentor did not necessarily have to be a nurse

depending on mentee needs. Other possible mentors included:

. allied health professionals

. senior nurses with wide experience in nursing

. community nurses; hospital nurses; nursing home nurses; nurse educators

. someone with known expertise such as immunisation

.

someone with professional skills in supporting people. someone from the DGP such as the practice support nurse, and

. an independent person external to the practice and DGP to provide objective assessment

of situations.

Throughout the consultations, nurses provided examples of situations where they were

mentored by GPs. The case study below provides an example of a positive (informal) peer

mentoring relationship between a nurse and GP.

Case study: peer mentoring between a GP and practice nurse

Table 2. Case study: peer mentoring between a GP and practice nurse

Practice Nurse Profile

Registered Nurse Practice Nurse for over 5 years Only nurse in the practice

Background

Val works in a University affiliated general practice as the practice nurse. She describes her role as isolated being

‘a solo person with no peer supports or influences’.

Through informal discussions with one of the GPs in the practice she established what she described as a

professional mentoring relationship. The GP had an interest in teaching nursing staff and medical students.

The Mentoring Relationship

Val initiated the mentoring relationship to discuss education and it continued on an informal, adhoc basis.

Initially, discussions focused on sharing information through journals and discussing education sessions relevant

to the practice and Val’s role. Discussions then broadened to explore career options including those beyond

general practice and career opportunities that could be funded in the general practice setting. They also

discussed interests, skills and abilities and what the doctor felt enhanced the practice. Val described this

mentoring relationship as reciprocal, saying that she was comfortable sharing information and ideas to

strengthen the doctor’s practice.

For Val, this mentoring relationship provided recognition of her role and future within the practice. She felt

valued as an individual with professional needs and aspirations and not just the person ‘who takes the blood,

does the ECGs’.

The mentoring included professional development, personal support, affirmation, and career guidance. It

occurred within a peer relationship between two professionals. The mentor had an understanding of Val’s roleand the general practice context and was respected and trusted by Val.



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Discussion

Study findings suggest a lack of previous exposure to mentoring. Together with the

overwhelming need for professional development for nurses in general practice, this posed

particular challenges for practice nurses in conceptualising the potential role of mentoring in

their work. With education and mentoring both strategies for professional development, it wasnot surprising many nurse participants initially had difficulty relating to mentoring when

education appeared to be the greater need. Through focus group discussions, GPs and nurses

perceived a benefit from mentoring, especially when linked to general practice specific

education and training programs.

The diverse mentoring needs of practice nurses and the roles, knowledge, skills and

attitudes required of mentors as identified during the consultations indicate the importance of

appropriate processes for the selection, training and support of mentors. Accessibility of

mentors is another important consideration.

In addition to issues raised by participants around the core areas of interest to this study, the

success of mentoring for nurses in general practice will depend on appropriate resourcing andinfrastructure through national, state and local coordination processes to develop awareness of

and commitment to flexible and accessible mentoring for nurses in general practice. As

reflected by the findings, at the local level, mentoring will be shaped by the needs of

individuals, current support systems, education, and other mentoring experiences. Nurse

participants’ expectations were inevitably shaped by their professional isolation as participants

in this project. For the majority of nurses, prior to participating in the project, their only

professional contact was through the GP, with little or no contact with other nurses until the

relatively recent introduction of Divisions of General Practice Nurse Networks. Professional

isolation is now well recognised as an impediment to meeting the demands of contemporary

nursing practice.

Conclusion

In the general practice context, the emergent, diverse, and inherently collaborative nature of

practice nurse roles requires a mentoring framework that is inclusive, non-prescriptive and can

accommodate the dynamics of the setting. Thus far in this project we have harnessed the

perspectives, experiences and expertise of key stakeholders and stakeholder groups, together

with relevant literature. These are currently being integrated into coherent statements about

the development of a sustainable, national mentoring framework that enhances the capacity of

nurses to contribute to positive outcomes for general practice in Australia.

Acknowledgements

We wish to sincerely thank all those who made the accomplishment of this project possible:

DGP; focus group participants; key stakeholders and stakeholder groups - your time and

expertise is much appreciated. We wish also to acknowledge funding support from the

Australian Government Department of Health and Ageing.

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