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Master Thesis

La pratique avancée en soins infirmiers : mise au point et perspectives pour la médecine générale

Abstract : Introduction: Among the projects of the Health Act 2018-2022 is voted the creation of a new specialty of nurses in advanced practice. They will be able to become medical assistants to liberal doctors but also to practice in a liberal way.
Objective: To develop knowledge and assess the perspective of future collaboration between physicians and nurses in advanced practice being assistant or liberal to general practitioners.
Methods: A qualitative survey was conducted among ten private general practitioners working in group or individual practices, in urban or rural areas, interviewed in semi-structured interviews from August to September 2019. The interviews were recorded, transcribed in full and then analyzed by axial coding.
Outcome: Communication on the creation of a new advanced practice nursing specialty is partial among the physicians interviewed and none are considering collaborating with an advanced nurse practitioner as a medical assistant. The main causes are responsibility, salary, cost, subsidies that is elitist, digressive eligibility criteria over three years and the objectives of increasing the number of patients who cannot be reached with a qualitative/quantitative imbalance in consultations as well as the lack of contact with patients. Concerning the liberal advanced nurse practitioner, the doctors interviewed refuse to give their stable chronic patients and question the level of training that allows them to prescribe and the responsibility of being the referring doctor.
Conclusion: This survey reveals the difficulty and often the refusal of future collaboration between general practitioners and nurses in advanced practice as medical assistants or liberal. For many, this new collaboration as it stands, offends their vision of general medicine. Generals physicians want a change in established competencies.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02507787
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Jean-François Colmas. La pratique avancée en soins infirmiers : mise au point et perspectives pour la médecine générale. Médecine humaine et pathologie. 2019. ⟨dumas-02507787⟩

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