Skill Mix Solutions in Emergency Care

Role of the Nurse Consultant

Paula Bennett – Nurse ConsultantEmergency Department

• Background

• Domains of a Nurse Consultant role

• What can a Nurse Consultant offer in Emergency Care

• How can the effectiveness of a Nurse Consultant role be maximised

Background

• 1st proposed by RCN in 1975• Tony Blair 1999

– Clinical career path for senior nurses– Maintain expertise at the bedside– Better patient outcomes

• Improving quality• Strengthening clinical leadership

Domains of the NC role

• 4 domains (DH 2000)– Practice (>50%)– Education, training and development– Research & evaluation, practice and service

development– Leadership & consultancy

• Partnership working

• Whole role greater than sum of the parts

Current challenges

• Critical importance of– patient experience– safe and effective

care– productivity– innovation

• Emergency Care– Performance – Increasing attendances– Inexperienced

workforce– Recruitment problems

• Nursing• Medicine

Emergency Nursing• Senior Nurses

– Significant management remit– ED/MAU/ACU etc. etc.– Performance target and challenges with flow

• Nursing roles advanced beyond initial registration– Unique core ED nursing skills– ENPs– ANPs– Non-medical prescribing

What can an NC role offer

• Transformational culture– Change as a way of life

• Staff empowerment

• Practice development

• Partnership and cross-boundary working

What can an NC role offer

• Educator, trainer and developer– Practitioners increased confidence and

competency– Consistent practice– Improved patient safety – Risk reduction

Capturing the impact of NC roles

• Clear organisational objectives

• For patients, staff and the organisation– What is the

• Added value• Difference • Impact • Return on investment

How to maximise the impact• Organisations must

– Understand and recognise NCs’ value and contribution at executive level.

• ensure that NCs have the strategic and organisational authority and the ongoing support necessary to achieve their full potential

– Appoint NCs with the full range of skills required to transform practice and services

• provide ongoing support for those NCs without the full range of skills to develop these promptly

• actively implement succession planning for aspiring NCs – recognise the skills required when developing others for these

posts, and how outcomes are dependent on the skills and experience possessed

Manley & Titchen (2011)

References• Manley & Titchen (2012) Becoming and being a Nurse Consultant. RCN

http://www.rcn.org.uk/__data/assets/pdf_file/0005/444299/003574.pdf • Gerrish, MacDonald & Kennedy (2011) Capturing the Impact of Nurse

Consultants. Sheffield Hallam University http://research.shu.ac.uk/hwb/ncimpact/index.html

• Leary (2011) Capturing the return on investment of Nurse Consultants within English Acute NHS Trusts. Sheffield Hallam University http://research.shu.ac.uk/hwb/ncimpact/Return%20of%20Investment%20report%20final.pdf

• Gavin-Daley & Mullen (2010) Ten Years On – An evaluation of the non-Medical Consultant Role in the North West. NHS NW. https://www.ewin.nhs.uk/storage/northwest/files/Knowledge_Exchange/169/Executive_Summary_and_Main_Findings_September_20101.pdf

Any questions?