A phenomenological investigation into the role the clinical nurse specialist

Abstract

This research study adopts a phenomenological approach to investigate how a group of clinical nurse specialists think and experience their role. It reviews the literature on the clinical nurse specialist from 1943, when Frances Reiter first coined the phrase "nurse clinician', to the present time, when individuals are committed to a range of initiatives aimed at improving the quality of the British National Health Service and patient care. The study investigates and analyses their views and conveys the personal meaning of clinical nurse specialists' "lived experience' in the role. Findings of the study suggest that clinical nurse specialists are experienced practitioners who strive to be in positions in which they influence patient care and utilize advanced knowledge, expertise and leadership skills in a multidisciplinary environment. The literature proposes that for the role to be recognized and accepted individuals need to be educated at an advanced level, demonstrate practice based in research and have a firm base as a specialist in nursing. The findings clearly suggest that while the role of the clinical nurse specialist can be influenced in a positive manner by the organization and guided by the individual, it is important to acknowledge that the role is in a transitional phase. Finally, the research suggests the importance of establishing a clear role definition in a creative and supportive environment allowing for autonomy, professional growth and the development of individuals as clinically competent nurse specialists.

Nursing effectiveness: An evaluation of patient satisfaction with a nurse led orthopaedic joint replacement review clinic

“…Pinkerton and Bush (2000) and Mundinger et al (2000) indicated that patient satisfaction and outcomes of care by nurse practitioners and physicians were comparable and that no significant difference could be demonstrated between care given and patient satisfaction. Bousfield (1997) states that nursing should be considered a pluralistic culture containing a number of value systems and as such nurses should prepare themselves for major role changes. Dolinsky and Caputo (1990) found in their study into satisfaction with health care that one of the most important attributes of patient satisfaction was an ability to see a specialist Consultant surgeon.…”

Extended scope of nursing practice: a multicentre randomised controlled trial of appropriately trained nurses and pre-registration house officers in pre-operative assessment in elective general surgery

“…It has been argued that a nurse practitioner can substitute for junior doctors in various ways. [36][37][38] However, there is disagreement about the potential impact of these role changes on both the work environment and relationships within multi-disciplinary teams. For example, the role of nurse practitioner has been seen to be "strengthening team cohesion and increasing opportunities for shared problem solving".…”

The development of clinical nurse specialist roles in Ireland

“…Such challenges include time pressures, lack of resources, suboptimal organizational support, lack of understanding about the role and poor administrative support (Table 6). (Dowling, 2000;Gibson and Bamford, 2001) • Lack of resources (Begley et al, 2010;Wickham, 2011) • Organizational support (Booth et al, 2003;Wickham, 2011) • Team support (Bousfield, 1997;Begley et al, 2010) • Others perceptions (Bamford and Gibson, 1998;Wickham, 2011) • Administration support (Begley et al, 2010;Wickham, 2011) …”

“…These inconsistencies within roles and job titles of the CNS have been widely discussed in the literature and arguably illustrate the lack of clarity pertaining to the role (Dunn, 1997;Castledine, 1998;Cattini and Knowles, 1999;McCreaddie, 2001). Internationally, this phenomenon has been and remains a concern as CNS posts have developed across a wide range of practice areas, frequently in an unplanned and reactive manner, with differences in the preparation for the role as identified by Deloughery and Grace (1995), McSharry (1995), Bousfield (1997) and Bailey (2004). In addition, the terms 'specialist' and 'advanced' have been used interchangeably in job titles without clear definition or detail as to what is expected of the nurse in the position (Melchoir-MacDougall, 1992;Castledine, 2002;Schober, 2006).…”