Determining the key drivers and mitigating factors that influence the role of the Nurse and/or Midwife Consultant: a cross-sectional survey

Fernandez, Ritin; Sheppard‐Law, Suzanne; Manning, Vicki

doi:10.1080/10376178.2017.1338525

Cited by 5 publications

(5 citation statements)

References 34 publications

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“…Where most specialist nurse participants in this study believed that they had the support of their medical colleagues, they speculated that their nursing colleagues either did not understand their role or did not support their advanced level of practice. A survey by Fernandez et al (2017) of 122 nurse or midwife consultants in New South Wales, Australia also found that while nurse and midwife consultants believed that their medical colleagues and other multidisciplinary team members accepted and understood their role, they saw a lack of understanding from their nursing colleagues as a limiting factor to their effective performance.…”

Section: Discussionmentioning

confidence: 99%

“…A survey by Fernandez et al. (2017) of 122 nurse or midwife consultants in New South Wales, Australia also found that while nurse and midwife consultants believed that their medical colleagues and other multidisciplinary team members accepted and understood their role, they saw a lack of understanding from their nursing colleagues as a limiting factor to their effective performance. Previous studies have identified that management support was a major facilitator and indicator of the success of clinical nurse specialist roles (Black & Farmer, 2013; Bousfield, 1997; Kilpatrick et al., 2016; Leary et al., 2014).…”

Section: Discussionmentioning

confidence: 99%

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The evolving challenges of specialist gynaecological cancer nurse roles – A qualitative study

Cook

Récoché

McIntyre

et al. 2020

Journal of Advanced Nursing

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Aims: To determine how specialist gynaecological cancer nurses experience and perceive their role. Design: An Interpretive Description qualitative study employing semi-structured interview methods was conducted. Methods: Specialist nurses working in Australia or New Zealand were recruited via the Australia and New Zealand Gynaecological Oncology Group and the Cancer Nurses Society of Australia to contribute to focus group, dyadic and/or individual interviews. Audio-recordings of the interviews were transcribed, de-identified, and subjected to a thematic analysis. Results: Specialist cancer nurses participated in the study via one focus group interview (N = 6), one dyadic interview (N = 2) and 13 individual interviews between April-August 2016. Three major themes were inductively derived from 19 minor themes: 'Working between worlds' locates the role of the specialist nurse in the provision of gynaecological cancer care; 'The patient's 'go-to' person' highlights participants' relationships with patients; and 'When so much depends on one person' explores the personal and professional impact of working in a specialist nursing role. Conclusion: Specialist nurses identified themselves as an accessible source of support and expertise for both women with gynaecological cancers throughout their disease trajectory and multidisciplinary team members. The main challenges they faced were the evolving and expanding nature of their bespoke roles and the dependence on them as individuals in these roles. Clearer role boundaries, guidelines for practice, effective professional support, and active succession planning are recommended. Impact: This study explored the experiences and perceptions of gynaecological oncology specialist nurses. Despite similar roles being in place across many countries for several years, the roles continue to evolve and lack clear definition which is burdensome to their incumbents. This research indicates that it is now time for nursing leaders and the broader nursing profession to delineate scope of practice, standardise nomenclature and practice and embed these roles in nursing career and education pathways.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The evolving challenges of specialist gynaecological cancer nurse roles – A qualitative study

Cook

Récoché

McIntyre

et al. 2020

Journal of Advanced Nursing

View full text Add to dashboard Cite

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“…Given the origins and strong person-centered focus of the profession, this is not surprising. This finding is echoed in a number of Australian and international publications where researchers identified the main motivations for the profession's drive toward expansion of scope were improved professional satisfaction, patient need (Fernandez, Sheppard-Law, & Manning, 2017), geographical limitations to patient access to medical, pharmacy, and allied health practitioners (Hegney, 1997), and management of increasing public health expenditure (Tsiachristas et al., 2015). A continued emphasis on person-centered approaches embedded in nursing practice, particularly as part of preparatory and continuing educational programs, would ensure that the power of this phenomenon is harnessed.…”

Section: Discussionmentioning

confidence: 99%

Enablers and Barriers to Registered Nurses Expanding Their Scope of Practice in Australia: A Cross-Sectional Study

Birks

Davis

Smithson

et al. 2019

Policy, Politics, & Nursing Practice

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A number of resources exist to assist registered nurses in Australia to determine their scope of practice; however, the ability of a professional nurse to expand his or her practice is highly context dependent. This article reports on barriers and enablers to expanding scope of practice, as identified by registered nurses across Australia. A cross-sectional survey administered online in 2016 returned 1,205 useable submissions. Results indicated that nurses wishing to expand their practice felt supported to do so by nursing colleagues and were aware of professional and regulatory documents relating to expanding scope of practice. Less support for this process was evident from other health professionals or employers. Respondents also indicated that they were motivated to expand their scope by professional satisfaction, potential for career advancement, and the desire to meet health service user's needs. The majority of respondents identified barriers to expanding scope of practice, including lack of remuneration and the absence of supportive guidelines. Respondents in the early stage of their careers were more likely to perceive organizational support for expanding their scope of practice. When required to expand their role, the majority of respondents indicated that they had undertaken additional training or accessed various resources to guide them in this process. Barriers to expanding nursing scope of practice can result in underutilization of the one of the greatest resources in the health care system. This article identifies a number of strategies that can facilitate role expansion to ensure that nursing continues to make a significant contribution to positive health service outcomes in Australia.

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“…DoNs highlighted that, in newly introduced roles and without evidence to support their impact, the individual characteristics of NCs are likely to be particularly important, as reported in other studies. McIntosh and Tolson () cited the need for NCs to have strong interpersonal skills and capacity for intellectual effort in order to meet the demands of the role, whilst (Fernandez, Sheppard‐Law, & Manning, ) reported Australian nurse consultants' views that that personal attributes, including motivation and communication skills, were key drivers to role performance.…”

Section: Discussionmentioning

confidence: 99%

The nurse consultant in mental health services: A national, mixed methods study of an advanced practice role

Brimblecombe

Nolan

Khoo

et al. 2019

Psychiatric Ment Health Nurs

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Accessible summary What is known on the subject? Internationally, systematic reviews have identified evidence of equal or improved clinical outcomes comparing advanced practitioner treatment with medical treatment as usual, across a range of specialities. Studies of nurse consultants in the United Kingdom have largely been non‐empirical. Most studies specifically related to nurse consultant roles in mental health services are case studies or reports of views on this role. What this paper adds to existing knowledge? The study demonstrates that nurse consultant numbers vary over time and by clinical specialty. This is influenced by the value invested in the role by local nursing leadership and by national policy change. A lack of role clarity affects the uptake and sustainability of advanced practice roles internationally and is also an issue for the nurse consultant role in England's mental health services. What are the implications for practice? Successfully introducing advanced practice nursing roles in mental health services requires role clarity and support from local nurse directors. The continued absence of robust evidence as to the clinical/cost‐effectiveness of nurse consultant roles in mental health settings places an onus on individual posts to generate data to justify the role at a time of financial constraint. Detailed post holder characteristics reported in this paper provide a basis for future comparison with other advanced practice roles in mental health services and other specialties nationally and internationally. AbstractIntroductionThe nurse consultant is an advanced practice role providing expert clinical practice, consultancy and professional leadership. To date, few studies have examined this role within mental health services and none have described the professional characteristics of post holders.AimsThe main aims of the study were to identify changes in nurse consultant numbers in mental health services, identify post holder characteristics and factors influencing number of posts.MethodWe used a triangulated mixed methods approach comprised of a longitudinal examination of national workforce data, a national cross‐sectional survey of post holder characteristics and semi‐structured interviews with directors of nursing.ResultsOf 58 mental health organizations, 51 (88%) responded, identifying 123 nurse consultant posts, and a range of 0–12 posts per organization. One in 229 mental health nurses and 1 in 186 learning disability nurses were nurse consultant. An average of 40% of nurse consultants' work time was reported as being in clinical practice. Themes identified as important in relation to role sustainability were cost and value, contribution of individual post holders, role clarity and domains of work.DiscussionNurse consultants are represented to a greater extent in the mental health service workforce than in nursing generally, but their roles often lack clarity. Attitudes of local professional leaders and national policies are likely to affect post numbers.Implications for ...

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Determining the key drivers and mitigating factors that influence the role of the Nurse and/or Midwife Consultant: a cross-sectional survey

Cited by 5 publications

References 34 publications

The evolving challenges of specialist gynaecological cancer nurse roles – A qualitative study

The evolving challenges of specialist gynaecological cancer nurse roles – A qualitative study

Enablers and Barriers to Registered Nurses Expanding Their Scope of Practice in Australia: A Cross-Sectional Study

The nurse consultant in mental health services: A national, mixed methods study of an advanced practice role

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