title: Promoting leadership and management in Australian general practice nursing: what will it take?
abstract: OBJECTIVE
  This paper outlines the current state of Australian practice nursing, describes the context of general practice and establishes the importance of promoting leadership and management in this setting.
  
  
  BACKGROUND
  Australian general practice nurses have emerged as key stakeholders in primary health care. However, their role in leadership and management has been largely invisible. The reasons for this are multifactorial, including the delay to establish a strong professional organization, their negative power relationships with general medical practitioners, limited nursing leadership and poorly defined roles. To date, the impetus for practice nurse growth has been largely external to the nursing profession. Growth has been driven by the increasing burden of chronic disease and workforce shortages. This has further weakened the control of nurse leaders over the development of the specialty.
  
  
  CONCLUSIONS
  The Australian practice nurse role is at a crossroads. While the practice nurse role is a viable force to improve health outcomes, the growing strength of the practice nurse challenges traditional professional roles and practice patterns.
  
  
  CONCLUSIONS
  There is an urgent need to develop practice nurse leaders and managers to not only embrace the challenges of Australian general practice from an operational perspective, but also undertake a clinical leadership role. As clinical leaders, these nurses will need to develop a culture that not only optimizes health outcomes but also advances the status of the nursing profession.
authors.affiliation: School of Nursing & Midwifery, University of Western Sydney, Sydney, Australia. e.halcomb@uws.edu.au
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Halcomb
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Davidson
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Patterson
mesh_terms: D026683:Advisory Committees / Q000458:organization & administration; D001315:Australia; D004509:Education, Nursing, Continuing / Q000458:organization & administration; D005194:Family Practice / Q000458:organization & administration*; D006801:Humans; D007857:Leadership; D009313:National Health Programs / Q000458:organization & administration; D020380:Needs Assessment / Q000458:organization & administration*; D009718:Nurse Administrators / Q000193:education / Q000458:organization & administration; D009722:Nurse Practitioners / Q000193:education / Q000458:organization & administration; D024802:Nurse's Role; D015399:Nursing Research; D009745:Nursing, Supervisory / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration; D011361:Professional Competence; D012956:Societies, Nursing / Q000458:organization & administration; D013192:Staff Development / Q000458:organization & administration