Acknowledge your true value as a specialist nurse

Abstract

Printed in Great Britain by Pensord Press Limited, Blackwood, Gwent NP2 2YA Acknowledge your true value as a specialist nurse Never has it been a more important time than now to focus on recognizing your true value as a nurse specialist, and ensuring your role is appreciated and understood by other healthcare disciplines. This particularly relates to the effect specialist skills can have on changing patient lives, and how specialist practice has the potential to save money. It has long been recognized that, for those people living within the UK suffering from a long-term illness, the specialist nurse not only has a direct impact on the life of the patient and their family, but also provides direct patient care and plays a vital role in promoting the patient’s health and wellbeing (Royal College of Nursing (RCN), 2010). As a result of this, specialist nurses are required to work at an advanced level of nursing. There have been differences in how advanced level nursing job titles are applied and the content of the roles. Advanced level nurses have had skills and responsibilities for some time, however, they are significantly more developed than the requirement for entry to the profession as a registered nurse. Expert practice, depth of knowledge, breadth of experience, professional judgement, complex reasoning and critical thinking skills are some of the areas that advanced level nurses should be able to demonstrate. In an attempt to standardize advanced level of practice, the Department of Health (DH) published Advanced Level of Nursing: a Position Statement (DH, 2010), which outlined a total of 28 agreed elements intended to be used as a benchmark to enhance patient safety and the delivery of high quality care. In response to this, the RCN also produced an advanced nurse practitioners guide that includes a definition of the role, domains and competences for advanced nurse practitioners, and standards for educational programmes. Further to this, the RCN (2010) carried out a national survey of health advocacy groups, demonstrating that patients consistently rated specialist nurses higher than any other health professional. This highlighted that the specialist nurse understands the needs of the patient, plans and implements direct care, listens to patient feedback and is transparent and honest during consultations. Despite the fact that there is evidence of the positive impact specialist practice has on direct patient care and the presence of guidelines to support the role, a survey of nurse specialists (RCN, 2010) highlighted that half were aware of cuts in their specialist service. More than one third reported vacancy freezes, one in four were at risk of redundancy, 47% were at risk of being downgraded, and over 45% were being expected to work outside of their speciality to cover staff shortages in more general clinical areas. In addition to this, 68% reported an increase in their patient caseload, bringing about concerns with regards to staffing and skill mix issues. Hutson (2011) recognized the current difficult financial climate and the need to use available resources within the endoscopy unit. While acknowledging the role of healthcare assistants, she also makes a sound case not to dilute specialist practice, encouraging us to maintain the presence of professional accountability at all stages of a patient’s care. Examples of the cost effectiveness of specialist nurses are evident, and not a particularly new concept (Fisher, 1993). More recently, studies have demonstrated how specialist nurses add value to patient care, while being creative in generating efficiencies for organizations through new and innovative ways of working (Coloplast, 2009; Jeyarajah et al, 2011). These studies showed that the work of specialist nurses led to a reduction in waiting times, avoided unnecessary hospital admissions, prepared for early discharge, maintained long-term support, follow-up and continuity of care, and, above all, enabled access to direct specialist advice for the patient and their families/carers. Opportunities to debate these issues will undoubtedly arise at conferences this year; however, in the meantime, this supplement aims to compliment the World Council of Enterostomal Therapists (WCET) (UK) conference in Liverpool entitled We Can Work It Out, and offers the reader a taster of an extremely full and packed conference exploring current specialist practice issues in stoma care nursing.