The 'invisible assessment': the role of the staff nurse in the community setting

Abstract

• The number of community staff nurses working in district nursing teams in the UK has increased in recent years as a result of organizational and educational initiatives such as skill mix and the Diploma in Professional Studies in Nursing (Project 2000). • Although the wider economic, philosophical and educational arguments for the role creation has been discussed in the literature, little has been written on the reality of the role from the viewpoint of the staff nurse or the relationship between the role and service requirements. The researchers conducted 16 interviews with district staff nurses from two NHS Trusts. The interpretation was guided by phenomenology and focused on the subjective perceptions of the nurses. • The data revealed dissatisfaction with their role among this group of staff nurses. Having been given a considerable degree of autonomy and responsibility as staff nurses in the hospital setting, they found that their role was limited and their skills ‘suppressed’ in the community. • They recognized that nurses in ‘F’, ‘G’ and ‘H’ Grades had greater experience and more education than they, yet they believed that they had the ability to participate more in the assessment and planning of care than was currently permitted. • They saw two factors as being mainly implicated in limiting their role: the tendency of district nurses to want to retain their ‘authority’ as assessors of care; and the Trust policy guidelines, which were somewhat inflexible on this issue. D Grade nurses also expressed their need for continuing education and support and for clearer career opportunities. • Although these data cannot be generalized to the population of staff nurses as a whole, the authors make tentative suggestions relating to the insights which may be taken from them.