Irish Attitudes to Nurses and Midwives

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A survey of Irish attitudes to the changing role of nurses and midwives. Conducted for An Bord Altranais in September 2013.

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Irish Attitudes to Nurses and Midwives

  1. 1. Public Attitudes to Nurses & Midwives An Amárach Research Survey for An Board Altranais October 2013
  2. 2. 2 Table of Contents A. B. C. Background & Objectives Methodology Profile of Sample MAIN FINDINGS: SECTION 1: Comparison of Nurses & Midwives vs Other Professions SECTION 2: Awareness of Roles and Responsibilities SECTION 3: Importance vs Performance SECTION 4: Awareness of Expanded Roles SECTION 5: Social Media SECTION 6: Awareness of NMBI’s role
  3. 3. 3 A. Background & Objectives The Nursing & Midwifery Board (NMBI) commissioned public opinion research through Q4PR to : – Assess the public perception of nurses and midwives and how they compare with other professions. – Identify what nurses and midwives are best known for and what their responsibilities are. – Assess awareness of nurses and midwives expanded roles. – Determine what is important and how nurses and midwives perform across a number of attributes. – Identify the level of concern about social media usage by nurses and midwives in discussions about patient care. – Assess awareness of NMBI’s role in relation to nurses and midwives.
  4. 4. 4 B. Methodology A number of questions were placed on the Amárach Research September omnibus. The omnibus survey is a syndicated survey whereby clients can include questions within the survey. A total sample of 1001 was achieved with quotas set on gender, age, social class and region to achieve a sample aligned with national population. Due to the high proliferation of the internet among the Irish population, the Amárach Research omnibus is completed fully online. Interviewing fieldwork dates - 9-13th of September.
  5. 5. Profile of Sample
  6. 6. 6 C. Profile of Sample (Base: All Respondents) Sex Age Region Social Class % % % % 15-24 Male 49 17 Dublin 28 ABC1 22 ROL 35-44 Female 16 Munster 52 27 28 19 45-54 48 C2DE 25-34 51 55+ 26 Conn/Ulster 18 A nationally aligned sample of Irish adults was surveyed for this research with quotas set on gender, age, region and social class from the CSO 2011 Census.
  7. 7. 7 Looked After by Nurse/Midwife in Past Two Years (Base: All Respondents – 1,001) % Yes – personally in a hospital 31 59 Yes – personally in another location 7 Yes – other members of immediate family 25 No 39 Don’t know 3 The greater majority were either looked after by a nurse/midwife themselves or had another member of their family looked after by a nurse/midwife within the last 2 years. (Q13 – Have you or an immediate member of your family ever been looked after by a nurse and/or a midwife in the last two years?)
  8. 8. 8 Complaints (Base: All Respondents – 1,001) % % Considered Complaining % – Dublin 15 Never made a complaint 77 – ROL 20 – Munster 22 – Conn/Ulster 12 % Complained % – Thought I should have made a complaint but did nothing Thought I should have made a complaint but told family/friends and neighbours instead Made informal complaints about nurse/midwife to other nurses/midwives Made formal written complaint about nurse/midwife Other 11 7 31 2 18% 5% Dublin – ROL 4 – Munster 4 – Conn/Ulster 3 The majority did not make a complaint about a nurse/midwife, however a small number did make a complaint and a further one fifth considered making a complaint. (Q12 – Which of the following statements best describes your experience regarding a complaint about a nurse or midwife? ) 8
  9. 9. MAIN FINDINGS
  10. 10. SECTION 1: Comparison of Nurses & Midwives vs other Professions
  11. 11. 11 Honesty & Ethical Standards Rating (Base: All respondents – 1,001) Average Rating (3) 16 Mean Score Very Low (1) (2) (4) Very high (5) 23 36 43 Pharmacists 45 39 33 20 3.9 Doctors 35 40 28 24 3.8 Teachers 36 40 29 3.7 Dentists 35 44 28 3.7 Nurses & midwives 22 20 4.2 Scientists 37 35 23 32 3.7 Social Workers 47 37 21 31 3.6 Gardai 7 9 35 32 3.5 Psychiatrists 6 10 31 38 3.4 12 19 19 6 44 2.9 20 17 20 33 2.8 39 2.7 Civil Servants Priests Journalists Estate agents/auctioneers Car sales people Bankers Politicians 14 20 27 51 57 24 16 15 10 18 5 32 83 38 2.4 33 63 31 2.3 19 5 5 20 1.9 21 43 15 1.8 Nurses and midwives are considered the most honest and ethical profession. Nurses and midwives were ranked ‘high’ or ‘very high’ for honesty and ethics by 79% of the general public. (Q.1 - Please tell me how you would rate the honesty and ethical standards of people in these different fields. Please rate on a scale of 1 to 5)
  12. 12. 12 Caring & Compassion Rating (Base: All respondents – 1,001) Average Rating (3) 16 Mean Score Very Low (1) (2) (4) Very high (5) 34 34 43 Doctors 56 37 25 27 3.7 Pharmacists 56 39 24 26 3.7 Teachers 47 39 20 30 3.7 Social Workers 67 37 22 29 3.6 Dentists 49 37 33 3.5 Nurses & midwives 17 4.1 8 10 29 14 38 3.3 Gardai 10 12 29 11 37 3.2 Scientists 8 14 23 12 43 3.2 15 23 12 32 3.0 Psychiatrists Priests 18 Journalists 21 24 12 5 38 2.6 Civil servants 23 23 14 4 35 2.5 27 73 32 2.2 29 62 22 2.0 Estate agents/auctioneers Car sales people 31 41 Politicians 54 19 6 3 19 1.8 Bankers 59 18 53 15 1.8 Similarly, nurses and midwives are considered the most caring and compassionate of professions. Q.2 - Please tell me how you would rate the caring and compassion of people in these different fields. Please rate on a scale of 1 to 5)
  13. 13. SECTION 2: Awareness of Roles and Responsibilities
  14. 14. Perceptions of Nurses and Midwives – Best Known for 14 (Base: All Respondents – 1,001) % 80 Caring Bedside care 69 Hard work 55+ = 86% 68 45-54 = 79%, 55+ = 79% Assisting Doctors 65 55+ = 75% Being professional/responsible 64 45-54 = 78%, 55+ = 76% Compassion 61 Giving medication 57 Honesty/trust 55+ = 73% 45-54 = 69%, 55+ = 72% 48 Knowledge/critical thinking 39 Patient advocacy 36 Other negative comment* 4 Other positive comment Considering making a complaint (n=179) = 10% Made a complaint (n=49) = 8% 3 It is not surprising that nurses and midwives are best known for caring and bedside care. Two thirds also associate them with being professional and responsible and over half say that they are known for giving medication. * Very low numbers - many of the negative comments were about strike action/unions/pay and comments about level of caring/not as caring as they used to be (Q3 – What are nurses/midwives best known for? )
  15. 15. 15 Nurses & Midwives Responsibilities (Base: All Respondents – 1,001) % Provide safe and reliable patient care 88 Bedside care 70 67 63 57 57 57 54 50 44 41 37 32 28 Maintaining nursing and midwifery standards Being professional/accountable Providing emotional support/compassion Proper patient assessment Monitoring confidentiality Liaising/communicating with patient families/other health care members Ethical care Knowledgeable/ critical thinking Educating patients/health promotion Holistic care Gaining the trust of the public Advocating for patients/clients Other Don’t know 1 1 The general public’s perception of the most important aspects of nurses and midwives responsibilities are primarily focused on nurses providing safe and reliable patient care. Bedside care, maintaining nursing and midwifery standards and being professional/accountable are also important factors for many people. (Q4 – What are the most important aspects of nurses/midwives responsibilities?)
  16. 16. SECTION 3: Importance Versus Performance
  17. 17. 17 Important Attributes of Nurses/Midwives – I (Base: All Respondents – 1,001) Make patients safety a priority (9) (8) Take responsibility for care given to patients Retain patients confidentiality To be constantly upgrading their skills & abilities % Extremely important (10) Act in a professional manner % % % % % % 43 40 50 49 41 20 20 15 15 55 16 11 18 17 12 14 50 20 To collaborate Focused on with Doctors on-going and other delivery of care health care plan designed team members for a patient 18 11 14 10 8 8 6 (7) 6 5 5 (6) 7 7 6 8 6 8 6 (5) (4) 5 5 5 6 (3) - 5 5 - 11 11 - 5 - 1 (2) 1 111 - 11 - 1 - 1 1 1 1 1 1 Not at all important (1) Mean: 8.8 8.7 8.7 8.7 8.6 8.5 8.5 The general public perceive patient safety, acting in a professional manner, taking responsibility for care given and patient confidentiality as particularly important attributes for nurses and midwives. (Q5 – How important or unimportant do you believe the following attributes are for nurses/midwives in the Irish healthcare system? Please rate on a scale of 1-10.)
  18. 18. 18 Important Attributes of Nurses/Midwives – II (Base: All Respondents – 1,001) To have in-depth understanding of treatment patient receives To communicate with patients family To speak on behalf of patients to ensure most effective care is provided To provide leadership in healthcare To be a member of the health care team that decides on a patient care plan To provide leadership to their team and others % % % % % % 30 34 Extremely important (10) 42 40 40 26 16 21 (9) 17 21 19 13 16 17 17 (8) 15 14 16 13 13 11 (7) 10 (6) (5) (4) (3) (2) Not at all important (1) Mean: 8 5 1-1 1 9 8 8 5 1-11 9 5 11- 1 10 6 2 1 -1 12 14 9 121 1 8 2 1 1 2 8.5 8.5 8.4 8.1 8.0 7.7 Providing leadership and being a member of a team that decides on a patient care plan are considered least important. (Q5 – How important or unimportant do you believe the following attributes are for nurses/midwives in the Irish healthcare system? Please rate on a scale of 1-10.)
  19. 19. 19 Nurses & Midwifes Performance Rating – I (Base: All Respondents – 1,001) Retain patients confidentiality Act in a responsible and professional manner Expertise Making patients safety top priority Dedication to their patients Trustworthiness % % % % % % 29 26 27 29 29 27 21 18 19 18 21 Very good (10) (9) 20 (8) 20 22 23 19 20 21 (7) 11 12 14 12 14 12 (6) (5) (4) (3) (2) Very Poor (1) Mean: 11 10 10 10 10 10 6 1 - 1 1 5 1 -2 1 - 6 1 -1 6 2 1 1 1 6 1 -2 1 7 1 -2 8.0 8.0 8.0 8.1 8.1 8.1 Nurses and midwives are most highly rated for retaining patient confidentiality, acting in a professional manner and for their expertise. (Q6 – Thinking of nurses/midwives, how would you rate them on the following? Please rate on a scale of 1-10.)
  20. 20. 20 Nurses & Midwifes Performance Rating – II (Base: All Respondents – 1,001) Practice in an ethical manner Respect patients need Efficient in their work Always act in best interest of patients Keep their skills up to date % % % % % Very good (10) 26 26 27 26 26 (9) 21 21 17 18 16 21 20 14 13 16 10 11 12 5 1 - 2 1 7 2 1 1 1 8 - 2 1 1 7 -2 1 1 8.0 8.0 7.9 7.9 21 (8) 20 (7) 12 13 (6) (5) (4) (3) (2) Very Poor (1) Mean: 10 10 6 1 - 21 8.0 Nurses and midwives are also highly rated for practicing in an ethical manner, respecting patients needs being efficient in their work. (Q6 – Thinking of nurses/midwives, how would you rate them on the following? Please rate on a scale of 1-10.) 20
  21. 21. 21 Nurses & Midwifes Performance Rating – III (Base: All Respondents – 1,001) Communicate with patients family members Advocate for patients with other members of healthcare team Provide leadership in healthcare Provide leadership to their team and others Have respect from other healthcare professionals % % % % % Very good (10) 23 22 21 21 22 (9) 20 17 19 17 17 22 20 21 19 16 15 15 14 14 12 (8) 22 (7) 13 (6) 12 13 13 6 121 1 7 1 - 2 1 6 1 -2 1 8 3 -1 1 8 3 2 1 1 7.8 7.7 7.7 7.7 (5) (4) (3) (2) Very Poor (1) Mean: 7.9 There are lower ratings for leadership and having respect from other healthcare professionals. (Q6 – Thinking of nurses/midwives, how would you rate them on the following? Please rate on a scale of 1-10.)
  22. 22. 22 A Comparison of Importance Vs Performance Importance (8-10) Performance (8-10) Gap Makes patients safety a priority 82 67 -15 Acts in a professional manner 80 69 -11 Retains patients confidentiality 79 69 -10 To be constantly upgrading their skills and abilities 77 62 -15 To communicate with patients family 75 65 -10 To speak on behalf of patients to ensure most effective care is provided 75 61 -14 To provide leadership in healthcare 68 60 -8 To provide leadership to their team & others 59 59 - 74.4 64 -10 The greatest difference between importance and performance occurs for patient safety, nurses/midwives upgrading their skills and nurses/midwives speaking on behalf of patients.
  23. 23. Healthcare System is Producing Nurses/Midwives with the Right Skills to Meet the Needs of Patients (Base: All Respondents – 1,001) % Agree % Age Strongly agree % – 41 – 35-44 45-54 72 – Somewhat agree 25-34 – 67 15-24 – 26 55+ 70 66 61 66 Looked after by nurses/midwives Neither/nor Somewhat disagree Strongly disagree Don’t know Mean: 17 8 2 6 – 10 Yes – No 72 62 3.9 Two thirds of the general public agree that the Irish healthcare system is producing nurses/midwives with the right skills to meet the needs of patients. Over 45 year olds and those who had experience of nurses/midwives in the past two years were more likely to agree. (Q9 – How strongly do you agree or disagree that the Irish healthcare system is producing nurses and midwives with the right skills to meet the needs of patients/clients?) 23
  24. 24. SECTION 4: Awareness of Expanded Roles
  25. 25. 25 Awareness of Roles of Nurses and Midwives – I (Base: All Respondents – 1,001) % Yes Nurses and midwives can prescribe medication Gender % – – % Males Females 32 41 Age – – 37% 45-54 – Yes 35-44 – 63% 25-34 – No 15-24 55+ 31 35 33 38 49 Region – Dublin – Rest of Leinster – Munster – Connaught 40 39 34 33 Looked after by nurses/midwives – Yes – No 42 31 Around one third are aware of nurses/midwives expanded role of prescribing medication. Women, the over 55’s and those with experience of nurses/midwives are more aware of this role. (Q7 – Nurses and midwives have expanded their roles over the past number of years. Did you know that…….?)
  26. 26. 26 Awareness of Roles of Nurses and Midwives – II (Base: All Respondents – 1,001) % Yes Nurses and midwives can order x-rays Gender % – – % Males Females Age – 45-54 – Yes 35-44 – No 25-34 – 37% 15-24 – 63% 35 38 55+ 42 39 36 34 34 Region – Dublin – Rest of Leinster – Munster – Connaught 34 38 37 38 Looked after by nurses/midwives – Yes – No A similar proportion are aware that nurses/midwives can order x-rays. People who had experience of being looked after by nurses/midwives are more aware of this role. (Q7 – Nurses and midwives have expanded their roles over the past number of years. Did you know that…….?) 41 31
  27. 27. 27 Awareness of Roles of Nurses and Midwives – III (Base: All Respondents – 1,001) Some advanced practice nurses can diagnose and treat certain illnesses without the involvement of Doctors % Yes Gender % Males – % – Females 28 32 Age – – 30% 45-54 – Yes 35-44 – 70% 25-34 – No 15-24 55+ 30 31 29 27 32 Region – Dublin – Rest of Leinster – Munster – Connaught 32 29 32 24 Looked after by nurses/midwives – Yes – No 34 25 Less than a third are aware that some advanced practice nurses can diagnose and treat certain illnesses without the involvement of Doctors. (Q7 – Nurses and midwives have expanded their roles over the past number of years. Did you know that…….?)
  28. 28. 28 Implications of Expansion of Nurses and Midwives Roles (Base: All Respondents – 1,001) Expansion of nurses and midwives roles will improve the healthcare system The expansion of nurses and midwives roles will allow for better care provision to patients % % Strongly agree % Agree Age % 15-24 74% 54 25-34 35-44 84% 55+ 53 79% 45-54 82 Strongly agree % Agree Age % 15-24 70% 25-34 78% 35-44 84% 86% 45-54 86% 83% 55+ 84% 81 Somewhat agree 28 Somewhat agree 28 Neither/nor 14 Neither/nor 16 Somewhat disagree Strongly disagree Mean: 2 2 4.3 4 Somewhat disagree Strongly disagree Mean: 2 2 4 4.3 The majority of the general public agree that the expansion of nurses and midwives roles will improve the healthcare system and allow for better care to patients. (Q8 – Nurses and midwives have been trained in the interest of patient care to take on additional roles such as taking blood, putting in drips/cannulas etc. How strongly do you agree or disagree that ….?)
  29. 29. SECTION 5: Social Media
  30. 30. 30 Social Media & Patient Confidentiality Concerns (Base: All Respondents – 1,001) % Concerned % Very concerned 21 50 Fairly concerned 29 Neither/nor 30 Fairly unconcerned Very unconcerned Don’t know 9 5 6 14 Gender % – Male 51 – Female 49 Age – 15-24 43 – 25-34 44 – 35-44 49 – 45-54 60 – 55+ 53 Looked after by nurses/midwives – Yes 54 – No 45 Complaint – Never 57 – Considered it 58 – Made a complaint 63 Half of the general public are concerned that the use of social media sites by nurses/midwives in the discussion of patient care may compromise their privacy/confidentiality. Concern is greatest amongst over 45 year olds, those who were looked after by a nurse/midwife and those who considered or made a complaint. (Q10 – To what degree are you concerned that the use of social media sites by nurses/midwives in discussion of patient care, may compromise your privacy/confidentiality?)
  31. 31. SECTION 6: Awareness of NMBI’s Role
  32. 32. 32 Responsibility of Authorities/Organisations (Base: All Respondents – 1,001) Regulation of nurses and midwives Dept Of Health Irish Nurses & Midwives Organisation Hospital Other Setting code of professional conduct and scope of practice for nurses and midwives Setting professional standards of practice and levels of responsibility for nurses and midwives Acting on complaints from public about nursing and midwifery care and conduct % Nursing & Midwifery Board Ireland Ensuring nursing/ midwifery colleagues graduate students with acceptable levels of education to enter the profession % % % % 33 32 30 32 31 35 39 29 26 5 2 27 6 3 23 11 3 26 38 17 22 15 10 2 5 There is some confusion about who is responsible for nursing/midwifery with significant numbers mentioning 3 organisations for each role. The NMBI is mainly associated with the regulation and education of nurses/midwifes and setting a code of professional conduct, while the DOH is mainly linked to setting professional standards and acting on complaints. (Q11 – Which of the following authorities or organisations is responsible for ……? )
  33. 33. e. info@amarach.com w. www.amarach.com b. www.amarach.com/blog t. twitter.com/AmarachResearch

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