Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Investigating the Role of Clinical Nurse Consultants in One Health District from Multiple Stakeholder Perspectives: A Cooperative Inquiry

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Investigating the Role of Clinical Nurse Consultants in One Health District from Multiple Stakeholder Perspectives: A Cooperative Inquiry

Article excerpt

Introduction

Clinical Nurse Consultants (CNCs) in Australia and New Zealand offer an important service in health care, there is general agreement about this, but there is also some evidence that their roles can be difficult and complex. How the CNCs themselves see and view their roles, and how other health professionals see and view the CNC role may influence these difficulties and complexities.

This paper reports on the results of a 12-month participatory, qualitative descriptive investigation into the role of CNCs in one Health District in New South Wales (NSW), Australia. Specifically the researchers wanted to understand the CNC role as it is lived and understood by the multiple professional "social actors" in the clinical situation.

Stakeholders are people in any situation who both shape and are shaped in the social context under investigation. In this study, the central stakeholders are the CNCs who occupy and enact their roles in health services. Other stakeholders in the clinical situation are those who professionally work with and/or who socially and organisationally influence the CNCs in their work practices.

The research team comprised novice clinical researchers (10 CNCs and 1 Clinical Nurse Specialist) and experienced academic nurse researchers. In addition to researching the role of CNCs from multiple perspectives, the research team used the project as an opportunity for the novice clinical researchers on the team to be mentored and coached in research practice by the experienced academic researchers.

Background

The impetus for this research came from the group of novice researchers. This group, whose members are all from one clinical stream of the Local Health District, was involved in Clinical Supervision with the academic researchers in their capacity as supervision facilitators. Conversations about the CNC role in these supervision sessions suggested that throughout the broader organisation there were many complexities surrounding how the CNC role was enacted and wide diversity in the understanding of the role. The group of novice researchers identified that they had a strong understanding of their practices and relationships with the health care system but they had difficulty articulating this to others. They decided that the investigation of the CNC role from the multiple perspectives of people they worked with would assist them to critically think about their role with a view to further evolving as individual CNCs and as a District CNC group. In order to achieve this, these nurses partnered with the academic researchers of the Nursing Development and Research Unit to form a research team to cooperatively design and execute the research.

Aim

The aim of this research project was to investigate the role of the CNC from the multiple perspectives of CNCs and other stakeholders who work with CNCs in the Health District.

Research questions

. What are the CNCs and stakeholders perspectives and expectations of the CNC role?

. How does the CNC role develop?

. Who or what in fl uences the CNC role?

Literature review

CNCs, in the context of NSW, Australia, are expert clinical nurses, usually in a particular specialty area. Similar roles exist in the UK, New Zealand, and the USA where they are known as Consultant Nurses (CNs) (Franks, 2014; Kennedy et al., 2012; Maylor, 2005) or Clinical Nurse Specialists (CNSs) (NACNS, 2004; Roberts, Floyd, & Thompson, 2011). CNCs are expected to have a role as leaders, researchers, educators, and clinicians. In NSW, Australia, these expert nurses require at least five years of clinical experience before gaining such a position in one of the three CNC grades. Each of the three grades has a higher functionality than the previous grade (NSW Health Department, 2000) and operates across five domains: clinical service and consultancy, clinical leadership, research, education, and clinical services planning and management. …

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