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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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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
(Base: All Respondents – 1,001)
%
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.
(Base: All Respondents – 1,001)
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.
(Base: All Respondents – 1,001)
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
(Base: All Respondents – 1,001)
(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
(Base: All Respondents – 1,001)
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)
%
(Base: All Respondents – 1,001)
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
(Base: All Respondents – 1,001)
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
(Q6 – Thinking of nurses/midwives, how would you rate them on the following? Please rate on a scale of 1-10.)
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
(Base: All Respondents – 1,001)
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
(Q6 – Thinking of nurses/midwives, how would you rate them on the following? Please rate on a scale of 1-10.)
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
(Base: All Respondents – 1,001)
%
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.
(Base: All Respondents – 1,001)
(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
Looked after by nurses/midwives
– 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.
(Base: All Respondents – 1,001)
%
Nurses and midwives
can order x-rays
No Yes
Gender
– Males
– Females
Age
– 15-24
– 25-34
– 35-44
– 45-54
– 55+
Region
– Dublin
– Rest of Leinster
– Munster
– Connaught
Looked after by nurses/midwives
– Yes
– No
%
35
38
42
39
36
34
34
34
38
37
38
41
31
% Yes
(Q7 – Nurses and midwives have expanded their roles over the past number of years. Did you know that…….?)
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.
(Base: All Respondents – 1,001)
%
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
– Rest of Leinster
– Munster
– Connaught
Looked after by nurses/midwives
– Yes
– No
%
28
32
30
31
29
27
32
32
29
32
24
34
25
% Yes
(Q7 – Nurses and midwives have expanded their roles over the past number of years. Did you know that…….?)
28
Implications of Expansion of Nurses and
Midwives Roles
54
28
14
2 2
Strongly agree
(Base: All Respondents – 1,001)
%
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
(Base: All Respondents – 1,001)
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+
Looked after by nurses/midwives
– 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
(Base: All Respondents – 1,001)
(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