title: Nursing in general practice: organizational possibilities for decision latitude, created skill, social support and identity derived from role.
abstract: OBJECTIVE
  This article is a report of a study to describe the factors that support organizational opportunities for practice nurse decision-making and skill development for nurses employed in general practice in New South Wales, Australia.
  
  
  BACKGROUND
  Corresponding to the availability of subsidies from the Australian universal health insurer (Medicare), there has been an increase in the number of nurses employed in general practice. Currently, there is no Australian evidence as to the organizational possibilities for these practice nurses to make decisions, develop their own skills and abilities, derive identity from their role or how their role is influenced by social support.
  
  
  METHODS
  Over a 8-month period in 2008 practice, nurses employed in general practice in the State of New South Wales were invited to complete a 26-item self-administered online questionnaire utilizing constructs from Karaseks (1998) Job Content Questionnaire (valid n = 160).
  
  
  RESULTS
  Confirmatory Factor Analysis indicated that all scales demonstrated acceptable levels of internal consistency. Sequential regression models revealed that social support exerts a weak influence on decision latitude (R(2) = 0·07); the addition of self-identity through work significantly improved the predictive ability of the model (R(2) = 0·16). Social support and self-identity through work exerted a negative influence on created skill (R(2) = 0·347), whereas social support was effective in predicting self-identity through work (R(2) = 0·148).
  
  
  CONCLUSIONS
  Collegial and supervisory support in the work environment predicts organizational possibilities for practice nurse decision-making.
authors.affiliation: Faculty of Nursing, Midwifery, and Health, University of Technology, Sydney, New South Wales, Australia. eamon.merrick@iinet.net.au
authors.forename: Eamon
authors.initials: E
authors.lastname: Merrick
authors.forename: Christine
authors.initials: C
authors.lastname: Duffield
authors.forename: Richard
authors.initials: R
authors.lastname: Baldwin
authors.forename: Margaret
authors.initials: M
authors.lastname: Fry
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003299:Cooperative Behavior; D003657:Decision Making; D005163:Factor Analysis, Statistical; D005194:Family Practice / Q000458:organization & administration* / Q000639:trends; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D009517:New South Wales; D009722:Nurse Practitioners / Q000458:organization & administration* / Q000523:psychology; D024802:Nurse's Role; D015401:Nursing Administration Research; D015279:Organizational Culture; D016134:Organizational Policy; D012044:Regression Analysis; D015203:Reproducibility of Results; D012649:Self Concept; D012944:Social Support; D013192:Staff Development; D011795:Surveys and Questionnaires