Nine tips for successfully integrating nurses into primary care teams

Apr 12, 2021

A recently released GPSC case study highlights the benefits of team-based care and shows how nurses can make a positive difference within the team and in your primary care practice. Among the many benefits, family doctors who participated in the study said they feel that adding a nurse to the team resulted in a renewed sense of support, the ability to increase the team’s capacity to accept new and unattached patients, and the capacity to devote more time to existing patient relationships. Additionally, job satisfaction increased while feelings of stress and burnout decreased. The study reports significant patient benefits such as decreased wait times and access to new services. Patients also said they feel more empowered to maintain their health.

“Previously, there were always some days that I went home and thought, ‘Oh my goodness, what did I drop, what did I miss today?’ I don’t feel that anymore—not once since [the nurse has] been here. I feel like all the t’s are crossed and i’s are dotted.”

– Family doctor

Based on the findings of the study, here are nine tips to help recruit a nurse into your practice and help both the nurse and your existing team work together successfully.  

1. Understand the basics

Considering bringing a nurse into your team? It is important to understand the scope of practice for registered nurses as outlined by the College of Registered Nurses of British Columbia. The goal in team-based care is to ensure that every member is working to their full scope of practice.

2. Know your panel

Work with GPSC’s Practice Support Program (PSP) and your division of family practice to review your patient panel to determine the areas where a nurse will bring the most value to your practice and where they can best work to their full scope. You may wish to use this information to develop a possible roster of patients for the nurse before they join the team. This step is important as it will help you to focus your recruitment and align the needs of the practice and team with the existing skillset and interests of the nurse(s) you may hire.  

3. Be clear on your recruitment needs

Create clear requirements that will help you select the most appropriate candidate based on the needs of your clinic.

As part of a primary care network, you may be working with a health authority to recruit a nurse into your practice. This includes outlining the requirements and shortlisting candidates. A coordinated approach between all partners is important for successful recruitment.

4. Have supports in place to ease the transition period

The study found that providing an opportunity for the nurse to participate in clinical practice activities with another team member helps to ease the transition before the nurse takes on their own responsibilities. This is a great way for the new team member to understand how the practice works, the roles and responsibilities of each team member, and how they fit in. It’s also an opportunity for the new member to ask questions in an informal way.  

Regular team meetings can help clarify the roles of all team members, better define the role of the nurse, and help determine where they can provide the best value to patients and the practice. Keep in mind that the work of team members in relation to their scopes of practice may shift and evolve over time.

5. Ensure needs are met for space and information technology (IT) access

Practices will need to have a dedicated space for nurses to see patients, which may require modifying clinic space to accommodate a separate examination room or an additional sink.

If the nurse will be using the clinic EMR, they will need access to IT equipment as well as training so they can view or make notes, schedule appointments, and message other team members. They may potentially need an additional EMR user license. Information about EMRs can be found here.

6. Communicate with your patients

It is important to let your patients know that there will be a new team member joining your practice. Describe the nurse’s role to your patients, when the nurse will be joining the team, and the benefits to patients. Introduce the nurse to your patients directly as this can help patients feel more comfortable with the new nurse.

Together with the nurse, identify common questions that patients may ask and prepare answers as a resource for team members during patient visits.

7. Take steps to build strong relationships

When teams have a trusting relationship they are more likely to understand each other's roles and to work to the top of their scope. Actively encourage respect and trust, sincere two-way conversations build the trust in teams necessary to deliver effective team based care and build professional rapport. PSP coaches are available to provide team building exercises and resources.

8. Develop ongoing training and service expansion

Encourage the new team member to connect with a local network of nurses working in primary care who can act as mentors and peer supports. If one does not exist, your local division of family practice may be able to help create or support the development of a new network. Encourage the pursuit of continuing education and continually assess and discuss training needs.

9. Be patient

It is important to understand from the outset that it is natural to have a transition period with any new member joining the team and that building strong relationships takes time. Encouraging open and continuous communication among team members can help identify issues earlier on. Collective issue management can help team members feel invested in finding a solution.


If you have any question about team-based care and onboarding new care team members, please email tbc@doctorsofbc.ca.