FACTORS AFFECTING THE ATTITUDE, READINESS AND MOTIVATION OF NURSES TO CREATE INDEPENDENT PRACTICES IN BULGARIA

Abstract

More than three years ago the nurses in Bulgaria definitively received the right to open and practice in outpatient clinics created by them for individual or group health care practice. Thus, they were given the opportunity to perform independently, without medical supervision, a number of activities within their competences and powers, which significantly increased their autonomy. It's no secret that in order to create and establish such a company, a great deal of financial resources are needed. On the other hand, to work effectively and adequately achieve their goals, nurses need access to information regarding the necessary documentation, to have undergone additional training, as well as to have enough free time. The aim of the present study is to establish and analyze the positive and negative factors affecting the attitude, attitudes and motivation of nurses in relation to their opportunities to disclose individual or group private practice. Materials and methods: An individual anonymous survey was conducted, the object of which were 404 nurses from all areas of the country, for the period from September to December 2023. For this purpose, a survey card with open and closed questions was developed and applied. The survey was conducted in an online environment, with forms for data collection, through the Google Forms application. Results and extracts: The survey found that, 88.6% of all surveyed nurses have a positive attitude and would practice the profession in their individual or group private practice. This, in turn, is a positive trend in their future development. The main leading motive for 72.0% of them is the increase of their professional development and income, followed by the desire to help those in need (60.6%). Other positive motivational factors are the opportunities provided to increase their autonomy and the exercise of managerial functions (43.3%). Expanded knowledge, skills and acquired higher competences are a guarantor for the implementation of quality health care. For 39.9%, the increase in knowledge and skills has a motivational nature, and 29.0% are of the opinion and believe that a higher authority would encourage them to get involved in the creation of their nursing practice. Factors with a negative effect for 60.6% of respondents are the lack of funding and the inability of health care practices to conclude contracts with the National Health Insurance Fund (NHIF) at the present time. The financial provision of health care clinics will lead to the opening of a greater number of nursing practices, and, respectively, significantly more patients in need of nursing assistance and care will be covered. A difficulty and challenge for 46.2% of the surveyed nurses is the lack of additional information and special training on how they can disclose their independent private practice. A considerable percentage of all respondents (27.3%) at the time of the survey were working in two, three or more jobs. This, in turn, leads to a lack of free time and for 16.8% of them it is the main obstacle in the new opportunities provided for independent professional development. Uncertainty and a lack of management and leadership skills have 17.6% of respondents, and 9.7% currently lack sufficient experience. Conclusion: Working in an independent nursing office and caring for people in outpatient settings undoubtedly gives nurses the opportunity to take on higher responsibilities and fulfill their important role in the promotion and prevention of various diseases. The high percentage of those who categorically stated their positive attitude and motivation to work in an independent clinic gives us reason to believe that in the near future health care practices will probably find their important place in the system and our health care.