Shared care practices between nurses and physicians in primary care

Objective
To explore the opportunities and challenges of shared care in primary healthcare from the perspectives of physicians, nurses, and key stakeholders, with the aim of reflecting on the implementation of Advanced Nursing Practice.
Methods
This is an exploratory study with a qualitative approach carried out with primary care physicians and nurses (working in the states of Paraná and Rio de Janeiro) and representatives of associative entities of both professional categories (at regional and national levels). Three online focus groups and one in-person focus group were held in 2022, with a total of 29 participants. Content analysis was performed according to Bardin.
Results
Professionals report that they already provide shared care, alternating consultations between physicians and nurses in the areas of childcare and prenatal care and chronic conditions and elderly care, thereby enhancing the overall quality of care. They identified that shared care is more harmonious in units with multiprofessional medical or nursing residences. They reflected that restrictions on shared care are promoted by power asymmetries between physicians and nurses, which can be deconstructed over time. They also emphasized the importance of better understanding each professional’s role, naming work overload as a particular challenge.
Conclusion
The activities currently shared between nurses and physicians in primary healthcare lay the groundwork for the implementation of Advanced Nursing Practice. However, it is essential to deepen the understanding of this practice among these professionals and optimize the conditions for its effective execution.