Irish Attitudes to Nurses and Midwives

Public Attitudes to

Nurses & Midwives An Amárach Research Survey

for An Board Altranais

October 2013

2

A. Background & Objectives

B. Methodology

C. 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

Table of Contents

3

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.

A. Background & Objectives

4

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.

B. Methodology

Profile of Sample

6

C. Profile of Sample

49

17 28

48

51

22

27

52

19

28 16

18 26

Male

Female

15-24

55+

25-34

35-44

Dublin

ROL

% %

Sex Region

%

Age

Munster

Conn/Ulster

(Base: All Respondents)

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.

%

Social Class

45-54

ABC1

C2DE

7

Looked After by Nurse/Midwife in Past Two Years

31

7

25

39

3

Yes – personally in a hospital

(Base: All Respondents – 1,001)

%

59

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?)

Don’t know

Yes – personally in another location

Yes – other members of immediate family

No

8

15

20

22

12

8

4

4

3

Complaints

77

11

7

3 2 1

Never made a complaint


%

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? )

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

%

% Complained

18%

5%

– Dublin

– ROL

– Munster

– Conn/Ulster

– Dublin

– ROL

– Munster

– Conn/Ulster

% Considered Complaining

%

MAIN FINDINGS

SECTION 1: Comparison of Nurses &

Midwives vs other Professions

11

Honesty & Ethical Standards Rating

3

5

5

6

5

7

7

9

10

19

17

24

32

33

19

21

2

4

3

3

3

3

4

7

6

12

20

14

20

27

51

57

36

39

40

40

44

35

37

35

31

19

20

18

8

6

5

4

43

33

28

22

20

23

21

16

15

6

10

5

3

3

5

3

Very Low (1)

Average Rating

(3)

Mean Score

16 4.2

20 3.9

24 3.8

29 3.7

28 3.7

32 3.7

31 3.6

32 3.5

38 3.4

44 2.9

33 2.8

39 2.7

38 2.4

31 2.3

20 1.9

15 1.8

Nurses & midwives

Pharmacists

Doctors

Teachers

Dentists

Scientists

Social Workers

Gardai

Psychiatrists

Civil Servants

Priests

Journalists

Estate agents/auctioneers

Car sales people

Bankers

Politicians

(2) (4)

Very high (5)

(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)

(Base: All respondents – 1,001)

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.

12

Caring & Compassion Rating

4

6

6

7

7

9

10

12

14

15

24

23

27

29

19

18

3

5

5

4

6

4

8

10

8

18

21

23

31

41

54

59

34

37

39

39

37

37

29

29

23

23

12

14

7

6

6

5

43

25

24

20

22

17

14

11

12

12

5

4

3

2

3

3

Very Low (1)

Average Rating

(3)

Mean Score

16 4.1

27 3.7

26 3.7

30 3.7

29 3.6

33 3.5

38 3.3

37 3.2

43 3.2

32 3.0

38 2.6

35 2.5

32 2.2

22 2.0

19 1.8

15 1.8

Nurses & midwives

Doctors

Pharmacists

Teachers

Social Workers

Dentists

Psychiatrists

Gardai

Scientists

Priests

Journalists

Civil servants

Estate agents/auctioneers

Car sales people

Politicians

Bankers

(2) (4)

Very high (5)

(Base: All respondents – 1,001)

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)

SECTION 2: Awareness of Roles and

Responsibilities

14

Perceptions of Nurses and Midwives –

Best Known for

%

Caring

Bedside care

Hard work

Assisting Doctors

Being professional/responsible

Compassion

Giving medication

Honesty/trust

Knowledge/critical thinking

Patient advocacy

Other negative comment*

Other positive comment

80

69

68

65

64

61

57

48

39

36

4

3

(Q3 – What are nurses/midwives best known for? )

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.


55+ = 86%

45-54 = 79%, 55+ = 79%

55+ = 75%

45-54 = 78%, 55+ = 76%

55+ = 73%

45-54 = 69%, 55+ = 72%

Considering making a complaint (n=179) = 10%

Made a complaint (n=49) = 8%

* 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

15

Nurses & Midwives Responsibilities

% Provide safe and reliable patient care

Bedside care

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

88

70

67

63

57

57

57

54

50

44

41

37

32

28

1

1

(Q4 – What are the most important aspects of nurses/midwives responsibilities?)

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.


SECTION 3: Importance Versus Performance

17

Important Attributes of Nurses/Midwives – I

55 50 49 50 43 40 41

16 18 17 18

20 20 20

11 12 14 11 14

15 15

5 5 6 6 8 10 8

6 6 6 7 7 8 8 5 6 5 5 5 5 5

1 1 1 -

1 1 1 - 1 - 1 1 - - 1 - 1 1 - - - 1 -

1 1 1 1 1

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.

Extremely important (10)

%

Make patients safety a priority


(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.)

Not at all important (1)

Mean:

(2) (3) (4) (5) (6)

(7)

(8)

(9)

8.8

%

8.7

%

8.7

%

8.7

%

8.6

%

8.5

%

8.5

Act in a professional

manner

Take responsibility for care given

to patients

Retain patients confidentiality

To be constantly upgrading their skills & abilities

To collaborate with Doctors and other health care

team members

Focused on on-going

delivery of care plan designed

for a patient

18

Important Attributes of Nurses/Midwives – II

42 40 40 30 34

26

17 21 19

21 13 16

15 14 16

17

16 17

10 9 8 11

13 13

8 8 9 10

12 14

5 5 5 6 9 8

1 1 1 2 2 2 1 1 1 1 1 1 - - - - 1 1 1 1 1 1 1 2

Providing leadership and being a member of a team that decides on a patient care plan are considered least

important.

%

To have in-depth understanding of treatment patient

receives


8.5

%

8.5

%

8.4

%

8.1

%

8.0

%

7.7

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

Extremely important (10)

Not at all important (1) Mean:

(2) (3) (4) (5)

(6)

(7)

(8)

(9)

(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

Nurses & Midwifes Performance Rating – I

29 26 27 29 29 27

20 21 18

19 18 21

20 22 23 19 20 21

11 12 14 12 14 12

11 10 10 10 10 10

6 5 6 6 6 7

1 2 1 2 2 2 1 1 - 1 1 1 - - - 1 - - 1 1 1 1 1 1

Nurses and midwives are most highly rated for retaining patient confidentiality, acting in a

professional manner and for their expertise.

Very good (10)

%


Very Poor (1) Mean:

(2)

(4)

(6)

(7)

(8)

(9)

8.1

%

8.1

%

8.1

%

8.0

%

8.0

%

8.0

Retain patients confidentiality

Expertise Making patients

safety top priority

Dedication to their patients

Trustworthiness

(3)

(5)

Act in a responsible and

professional manner

(Q6 – Thinking of nurses/midwives, how would you rate them on the following? Please rate on a scale of 1-10.)

20

Nurses & Midwifes Performance Rating – II

26 26 27 26 26

21 21 17 18 16

20 21 21 20

20

12 13 14 13 16

10 10 10 11 12

6 5 7 8 7 2 2 2 2 2 1 1 1 1 1 - - 1 - - 1 1 1 1 1

Nurses and midwives are also highly rated for practicing in an ethical manner, respecting

patients needs being efficient in their work.

Very good (10)

%

Practice in an ethical manner


Very Poor (1) Mean:

(2)

(4)

(6)

(7)

(8)

(9)

8.0

%

8.0

%

8.0

%

7.9

%

7.9

(3)

(5)

Respect patients need

Efficient in their work

Always act in best

interest of patients

Keep their skills up to date


21

Nurses & Midwifes Performance Rating – III

23 22 21 21 22

20 17 19 17 17

22 22 20

21 19

13 16 15

15 14

12 13 13 14 12

6 7 6 8 8

2 2 2 3 3 1 1 1 1 2 1 - - - 1 1 1 1 1 1

There are lower ratings for leadership and having respect from other healthcare professionals.

Very good (10)

%

Communicate with patients

family members


Very Poor (1) Mean:

(2)

(4)

(6)

(7)

(8)

(9)

7.9

%

7.8

%

7.7

%

7.7

%

7.7

(3)

(5)

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


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

66

61

66

72

70

72

62

Healthcare System is Producing Nurses/Midwives with

the Right Skills to Meet the Needs of Patients

26

41

17

8 2 6

Strongly agree


%

Mean: 3.9

Somewhat agree

Neither/nor

Somewhat disagree Strongly disagree

10

67

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?)

Don’t know

Age

– 15-24

– 25-34

– 35-44

– 45-54

– 55+

Looked after by nurses/midwives

– Yes

– No

%

% Agree

SECTION 4: Awareness of Expanded Roles

25

63% 37%

Awareness of Roles of Nurses and Midwives – I

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…….?)

%

Nurses and midwives

can prescribe

medication

No Yes

Gender

– Males

– Females

Age

– 15-24

– 25-34

– 35-44

– 45-54

– 55+

Region

– Dublin

– Rest of Leinster

– Munster

– Connaught


– Yes

– No

%

32

41

31

35

33

38

49

40

39

34

33

42

31

% Yes

26

63% 37%

Awareness of Roles of Nurses and Midwives – II

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.


%

Nurses and midwives

can order x-rays

No Yes

Gender

– Males

– Females

Age

– 15-24

– 25-34

– 35-44

– 45-54

– 55+

Region

– Dublin


– Munster

– Connaught


– Yes

– No

%

35

38

42

39

36

34

34

34

38

37

38

41

31

% Yes


27

70% 30%

Awareness of Roles of Nurses and Midwives – III

Less than a third are aware that some advanced practice nurses can diagnose and treat certain

illnesses without the involvement of Doctors.


%

Some advanced practice nurses can

diagnose and treat certain illnesses

without the involvement of Doctors

No Yes

Gender

– Males

– Females

Age

– 15-24

– 25-34

– 35-44

– 45-54

– 55+

Region

– Dublin


– Munster

– Connaught


– Yes

– No

%

28

32

30

31

29

27

32

32

29

32

24

34

25

% Yes


28

Implications of Expansion of Nurses and

Midwives Roles

54

28

14

2 2

Strongly agree


%

Expansion of nurses and

midwives roles will improve

the healthcare system

Mean: 4.3

Somewhat agree

Neither/nor

Somewhat disagree Strongly disagree 4

82

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 ….?)

53

28

16

2 2

Strongly agree

%

The expansion of nurses and

midwives roles will allow for

better care provision to patients

Mean: 4.3

Somewhat agree

Neither/nor

Somewhat disagree Strongly disagree 4

81

% Agree Age %

15-24 74%

25-34 79%

35-44 84%

45-54 86%

55+ 83%

% Agree Age %

15-24 70%

25-34 78%

35-44 84%

45-54 86%

55+ 84%

SECTION 5: Social Media

30

51

49

43

44

49

60

53

54

45

57

58

63

Social Media & Patient Confidentiality Concerns


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?)

Gender

– Male

– Female

Age

– 15-24

– 25-34

– 35-44

– 45-54

– 55+


– Yes

– No

Complaint

– Never

– Considered it

– Made a complaint

%

%

Concerned

21

29

30

9

5

6

%

14

50

Very concerned

Fairly concerned

Neither/nor

Fairly unconcerned

Very unconcerned

Don’t know

SECTION 6: Awareness of NMBI’s Role

32

Responsibility of Authorities/Organisations

39 33 32 30 26

29 32 31 35

38

26 27

23 22 17

5 6 11 10

15

2 3 3 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.

Nursing & Midwifery

Board Ireland

%

Regulation of nurses and midwives


(Q11 – Which of the following authorities or organisations is responsible for ……? )

% % % %

Ensuring nursing/ midwifery colleagues

graduate students with acceptable levels of

education to enter the profession

Setting code of professional conduct

and scope of practice for

nurses and midwives

Acting on complaints from public about

nursing and midwifery care and conduct

Irish Nurses & Midwives Organisation

Dept Of Health

Hospital Other

Setting professional

standards of practice and levels of

responsibility for nurses and midwives

e. [email protected]

w. www.amarach.com

b. www.amarach.com/blog

t. twitter.com/AmarachResearch

Health & Medicine

Irish Attitudes to Nurses and Midwives