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Nurse Consultant And Their Role, A Critique

4368 words - 18 pages

In order to critically analyze the role of a consultant nurse the author feels it is important to look at the definition of a nurse consultant role, discuss and examine events leading to the existence and development of such roles (history) and finally the impact on quality of patient care of a consultant nurse. The author's current area of practice- a nine bedded adult intensive care unit, where no such role currently exists. However, the author will examine the potentialities of such a role, the possible benefits to patient care and barriers which may be encountered by a consultant nurse in this environment. The model use on the analysis of such a role will be the Manley's 1997, see ...view middle of the document...

Thus nurses' expanded roles at this time appeared to be task orientated, and served the needs of doctors rather than necessarily those of patients.In 1992 the publication of the Scope of Professional Practice (UKCC, 1992) appeared to redress the balance, removing the need for certification and placing patient need at the centre of development of nursing practice. It stated simply that; 'Practice must be sensitive, relevant and responsive to the needs of individual patients and clients and have the capacity to adjust, where and when appropriate to changing circumstances....the range of responsibilities which fall to individual nurses should be related to their personal experience, education and skill' (UKCC, 1992). However, coming as did between the publication of the New Deal for Doctors (NHSME, 1991, cited by Hind et al, 1999) and The Calman Report (DoH, 1993), which respectively initiated reduction of junior doctors hours and shortening of specialist training, scope understandably created considerable tension within the nursing profession (Finlay,2000). Many were concerned about the 'medicalisation' of nursing and the loss of its intrinsic value (Edwards, 1995). It was feared that in medical terms, the interpretation of 'good' may be to the advantage of medical care and the interests of the physician, but at odds with the interests of the patient and nursing (Castledine, 1996). Tolley, (1994) while acknowledging the benefits of scope in ending confusion relating to task and extended roles, warned that nurses must take on new roles to improve patient care and diversify practice, rather than as a means of gaining power or status.The scope of practice appears to give nurses more freedom in practice. Koefmann and Woods (1995) described how scope enabled nurses in one trust to move the boundaries of care in almost unlimited ways, for example, the setting up of nurse led clinics. With the removal of need for certification and the placement of onus on individual nurses to decide in what ways to expand their practice, certain legal and professional issues are raised. These will be discussed later in further detail.In accordance with scope, a range of new roles for nurses have since evolved in response to the major changes in UK healthcare and therefore service delivery, national policies and moves to more patient focused care (Spilsbury and Meyer, 2001). Indeed, nurses could be said to have a formal responsibility for exploring way in which quality healthcare can be improved under the auspices of clinical governance (Levenson and Vaughan, 1999).More recently both 'Making a Difference' (DoH, 1999) and the NHS Plan (DoH, 2000) promote and encourage continued development of the nurses role. However, despite government and professional bodies continued promotion of expansion of nursing roles and support of advanced nursing practice, definition of advanced practice has not been forthcoming. Tume and Bullock (2002) quote the UKCC's failure to define...

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