Wow, there are quite a few issues that you have raised here I wonder if I could address some of them.
Quote from karenG
be cautious of extending roles.........
I have extended my role- I'm an NP and an idependant prescriber in general pracitice.. where I am not another pair of hands but a respected member of the team, working independently.
Extended roles are brilliant but only when they are part of your professional development and its something you want to do.. rather something you do to fill a service gap as seems to be the case sometimes..
No arguments here, I think that we need to make sure that we are extending our roles for the benefit of the patients and not just for professional development, if it is not of benefit to the patient then why are we doing it. The nurse practitioners where I work are also prescribers now and they are attached to specialities under the supervision of a designated consultant. They are also a respected member of their team and work independently. THe major benefit for the patients is that these practitioners see them at intial booking clinic, during pre assessment and admission to hospital, then the are seen in follow up clinics for the duration of thier care. This provides fantastic continuity for these patients and the consultants are very keen to develop thier practitioners within their speciality. This continuity could not be got from the doctors as they move every 4 months.
training is needed and not always provided to a high standard.. life is going to get interesting for those NP's who cant prove that they are educated to masters level, and that that education meets the standards laid down by the NMC.. the register of NP's should open next year (as long as we get privy council approval). I'll be ok... but I think a lot of the hospital NP's who are 'gap' filling will find they cant use the title....... it will protected and only those on the register will be able to use it!!
Absolutely no arguments here, I too am very concerned about the implications of the new part of the register for exsisting nurse practitioners , fortunatley my trust has recognised this and is actively preparing its nurse pracs to achieve the competencies the NMC will require. I think this is an excellent way forward as it will mean that the patients will be dealt with by advanced practitioners who have the training and capabilities to do the role and that advanced practice will be regulated.
I've worked as a community matron.. and have to say there do not seem to be the nurses on the wards actually nursing patients these days... one of my patients who had had a CVA and was incredibly hypertensive had a weeks worth of medication on her locker because no-one had noticed she couldnt take it.. so it was placed on her locker to take when she was ready.......
where are the nurses actually nursing??
This sounds like appalling practice and something that should have been reported and dealt with as an untoward incident. This is not because of advanced practitioners its because of poor nursing practice.
I know I would not work in a hospital for all the tea in china.. no staff.. no resources.. nope..!! anyway.. I'd drive everyone nuts demanding patients have pressure area care(how come my patients are discharged with pressure sores and foot drop these days!), mouth care.... the beds would have to be made before coffee...
I actually love working in a hospital, I make sure that my patients do have pressure area care, oral hygine, mobilisation, are fed at meal times and not when thier dinner is cold, adequate pain relief and generally a good standard of nursing care. I am concerned about the level of expertise and knowledge on the wards but actively try to improve this with training, education, study days etc etc. I worry about the amount we delegate to our health care support workers but unfortunately with the amount of qualified staff it is a reality that we have to accept.
Thanks for your response, it is interesting to hear it from a communty perspective. I think we can all say how primary / secondary / social service care could do better but we also need to look at our own practice and try to improve what we do as well. I will now make an concerted effort to ensure that our discharge letters are prompt and informative to help our collegues in primary care better care for thier patients.