THE ROLE OF THE NURSE CONSULTANT

1. THE ROLE OFTHENURSE CONSULTANT Heather Newton Nurse Consultant Tissue Viability Royal Cornwall Hospitals NHS Trust.

2. PRESENTATION OVERVIEW • Background • Role definition • Role competencies • Outcomes of the role to date • Personal role / service developments • The future

3. NURSE CONSULTANTS “These new posts are intendedto provide better outcomes for patients by improving services and quality, to strengthen leadership and to provide a new career opportunity to help retain experienced and expert nurses, midwives and health visitors in practice” HSC 1999/217

4. DoH POLICY INFLUENCING NURSE CONSULTANT ROLE DEVELOPMENT • 1991 Proposed reduction in Junior Dr’s hours • 1992 Scope of Professional Practice • 1994 Greenhalgh Report • 1996 Proposed changes to Junior Dr’s working week

5. DoH POLICY INFLUENCING NURSE CONSULTANT ROLE DEVELOPMENT (cont’d) • 1997 New NHS Modern Dependable • 1998 Nurse Consultant role proposed • 1999 Making a Difference Nurse Consultant criteria outlined • 1999 Higher Level of Practice

6. Nurse Consultant Role As defined by the NHS Executive (1999): • Expert practitioner • Education, training and development • Professional Leadership • Practice and service development • Research and evaluation function.

7. Defining the Role • Expertise in clinical practice – not necessarily linked to a medical speciality. • Advancing nursing practice and service delivery.

8. Defining the role (cont’d) • Improving service delivery and the competency of other health care professionals. • Research, education and consultancy integral to the role. Reid and Metcalfe 2001

9. Nurse Consultant vs Specialist Nurse • Regional approval of posts • Job description framework • Level of experience in order to take responsibility for total episodes of patient care • Defined educational requirements

10. Nurse Consultant vs Specialist Nurse • Protected time for research, education and personal development • Publication / presentation portfolio • Leadership ability • Ability to influence local health policy • Research profile

11. COMPETENCIES Competency can be described in it’s broadest sense as: “the capability of an individual to carry out a particular role or function , and it’s use denotes the level of skill attained or required.” Reid and Metcalfe 2001

12. EXPERT PRACTICE • Ability to make critical judgements regarding patient care. • Undertake advanced clinical interventions. • Ensure a visionary approach to care and service delivery. • Take responsibility for a complete episode of patient care.

13. EDUCATION, TRAINING AND DEVELOPMENT • Map and plan education, based on local and national requirements • Work collaboratively with academic institutions • Develop strategies to meet educational needs of patients / carers • Critically appraise and reflect on educational outcomes

14. PROFESSIONAL LEADERSHIP • Develop clinical practice • Inspire and sustain change • Promote inter-disciplinary / multi agency collaboration • Strategic decision making • Anticipate and plan future needs

15. PRACTICE AND SERVICE DEVELOPMENT • Influence standards of practice through evaluation and monitoring • Promote the principles of Clinical Governance • Support changes in practice and delivery through role modelling and leadership • Explore new ways of working

16. RESEARCH AND EVALUATION • Promote the use of research / evidence in practice through education • Initiate and conduct research • Contribute to the dissemination of research findings in practice.

17. Preliminary evaluation of Consultant role - Kings College London 2001 • Survey conducted 2001 using a structured self-completion questionnaire • Aim to provide a systematic audit of roles, contexts and experiences • Sent to 162 Consultants in post by Feb.2002 • 95% response rate

18. Preliminary findings • Over 60 different work specialities • 53% of Consultants hospital based • 64% had a higher degree • 10% did not have a first degree • Average length of NHS service 21 years • 82% of posts completely new with 18% pre existing jobs upgraded

19. Preliminary findings • 51% posts filled internally • 77% had a detailed job description • Disparity in respondents salary scale • Supervision and interactions variable • 65% reported to be deeply involved in the activities detailed in HSC 1999/217

20. Preliminary findings • 44% of time spent in clinical practice • 19% increase in overall level of involvement with the greatest increase being within research and development function. • 67% of Consultants felt their role profile had changed • Positive opportunities for personal growth and professional development

21. Tissue Viability Nurse ConsultantOBJECTIVES • Raise the profile of the role through visual role modelling, expert consultancy and effective patient outcomes. • Work closely with Primary care teams and REC team to prevent admission to hospital and support early discharge of patients.

22. OBJECTIVES (cont’d) • Review referral criteria and develop pathways of care. • Provide flexible education to meet needs of Health Community. • Explore research opportunities particularly within Chronic wound management. • Forge close partnerships with education providers & fellow professional colleagues.

23. Nurse Nurse Consultants – The Future Exploring boundaries of the profession Competency development Transformational Leadership and vision Multi professional working and learning Organisational recognition