Differences and similarities in scope of practice between registered nurses and nurse specialists in emergency care: an interview study.

Abstract

Wide variation exists between the nursing competence requirements seen in the emergency care context and the subsequent design of nursing education programmes. Clarifying nursing roles and scope of practice may shed light on inconsistencies and encourage nurses to work to their full potential. Describe and clarify the overarching similarities and differences in registered nurses' and nurse specialists' scope of practice in emergency departments. A qualitative study performed in Finland and Norway, based on 11 interviews analysed by means of qualitative content analysis. The results are presented in three main categories related to nurses' scope of practice: The nurses share the same role, Competence varies and Same accountability and responsibility, with potential for development of the specialist role. Given the varying educational systems that currently exist, management teams face a more or less impossible task if attempting to standardise the scope of practice for different professional nurse groups. Still, nurse specialists possess competence that could be utilised to improve patient care and some specialisations seem more suitable for emergency care than others. Individual skills and qualifications should be recognised, which would enable nurses to work to their full potential. No differences were seen between registered nurses' and nurse specialists' role, and professional accountability and responsibilities in the context studied here, although the level of nursing competence differed. Before and even after consensus on uniform competence standards for the different professional nurse groups is reached, management teams should invest in reviewing nurses' competence in relation to different expertise levels, and strategically recruit so that current health needs in the emergency departments can be met.