RESUMO
The consultant nurse (CN) role is usually described in terms of four domains devised by the Department of Health - clinical practice, education and training, leadership, and research and service development. This study set out to explicate the diversity and complexity of CN roles in an NHS trust; to describe aspects of extraordinary practice and to identify perceived differences between this role and other advanced practice roles. Accounts were written by six CNs and subjected to concept mapping to facilitate identification of extraordinary practice. Four themes emerged: entrepreneurial activity and innovation; clinical autonomy and role dynamism; influential national and international research conduct; consultancy and education across discipline boundaries. These included descriptions of higher order skills that surpass usual requirements of 'expert' or 'advanced' practice. Comparisons with other advanced practice roles are drawn from the literature and data collected in this study. Differences between the roles have implications for sustainability.
Assuntos
Prática Avançada de Enfermagem/organização & administração , Consultores , Modelos de Enfermagem , Enfermeiros Clínicos/organização & administração , Profissionais de Enfermagem/organização & administração , Papel do Profissional de Enfermagem , Prática Avançada de Enfermagem/educação , Atitude do Pessoal de Saúde , Consultores/psicologia , Educação Continuada em Enfermagem , Inglaterra , Empreendedorismo , Humanos , Enfermeiros Clínicos/educação , Enfermeiros Clínicos/psicologia , Profissionais de Enfermagem/educação , Profissionais de Enfermagem/psicologia , Papel do Profissional de Enfermagem/psicologia , Pesquisa Metodológica em Enfermagem , Autonomia Profissional , Pesquisa Qualitativa , Pesquisa , Medicina Estatal/organização & administraçãoRESUMO
Long waiting times while receiving chemotherapy in an outpatient setting have been identified as contributing to patient dissatisfaction and discomfort by a number of authors. Following an observation of this practice in a non-medical establishment, and as part of our service improvement program, we introduced the use of message pagers to recall patients in our chemotherapy outpatient service. We audited the impact of this intervention by means of questionnaires directed at patients and nursing staff. Our audit found that this intervention was particularly popular with female patients. Perceived benefits included more freedom of movement, less boredom, and peace of mind at being contactable. There were no reported problems with pager operation. Nursing staff were keen promoters of the pagers to patients as they felt that their use gave them more control over work intensity and less disruption from patients enquiring about remaining "waiting time". We concluded that this intervention may benefit other outpatient chemotherapy services.
