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

1. Public Attitudes to
Nurses & Midwives
An Amárach Research Survey
for An Board Altranais
October 2013

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
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
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. Profile of Sample

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
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
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. MAIN FINDINGS

10. SECTION 1:
Comparison of Nurses &
Midwives vs other Professions

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
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. SECTION 2:
Awareness of Roles and
Responsibilities

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
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. SECTION 3:
Importance Versus Performance

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
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
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
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
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
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. 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. SECTION 4:
Awareness of Expanded Roles

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
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
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
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. SECTION 5:
Social Media

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. SECTION 6:
Awareness of NMBI’s Role

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 ……? )

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