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Developing your advanced nursing practice to benefit your clinic

Dr Carole Farrell Nurse & AHP Research Fellow The Christie Hospital NHS Foundation Trust spoke at today’s Nurse Clinics conference on:

● expanding your skills and competence to meet the demands of your clinic and expand the service 
● governance frameworks and resources available to support your advanced practice
● demonstrating the value of your role 
● career development opportunities for advanced nurse practitioners

There have been tremendous developments in advanced nursing practice and nurse-led clinics within the past 10 years, however there remains a lack of transparency regarding nurses’ roles and titles. In addition there are no clear definitions for nurse-led clinics, therefore they are currently open to interpretation. 

The scope of advanced nursing practice is determined by nurses’ clinical skills, competencies and autonomy. In a survey of 103 senior oncology nurses undertaking nurse-led clinics there were great disparities in nurses’ titles, skills, competencies, training, roles, responsibilities and time for patient care (Farrell et al, 2011). Many nurses had undertaken training in clinical examination skills, however did not examine patients within nurse-led clinics. Similarly, 58% of prescribing in nurse-led clinics was undertaken by doctors. An ethnographic study of nurse-led chemotherapy clinics revealed 4 different levels of nurse-led clinics. Most nurse-led clinics were heavily influenced by medical consultants, many doctors restricting nurses’ autonomy, scope of practice and also the number and nature of patients that nurses could see (Farrell et al, 2014). Nurse consultations were unstructured and based on medical models and doctor-nurse substitution, not holistic / patient-centred care. 

It is important for nurses to consider what skills they need for nurse-led clinics, rather than what they want. There should be clarity in the aims and objectives for nurse-led clinics to ensure they meet patients’ needs. Evaluation of nurses’ roles and nurse-led clinics are crucial to determine their effectiveness.

Dr Farrell’s full presentation is available for download at the end of this page.

Biography of Dr Carole Farrell
I have over 25 years’ clinical experience in oncology nursing at The Christie in a variety of different clinical roles, including 10 years as a Nurse clinician in breast medical oncology. However, my current role is Nurse & AHP Research Fellow in the School of Oncology at The Christie, and I am also an honorary lecturer at The University of Manchester. 

I am passionate about developing nursing research that will deliver direct benefits to patients and clinical staff. I have recently completed my PhD, which was an ethnographic exploration of nurse-led chemotherapy clinics. My current research focuses on dignity and compassionate care for older people and their carers during chemotherapy. 

I am also Consultant Editor of Cancer Nursing Practice, and a board member of the UK Oncology Nursing Society. 

Future events of interest:

Nurse Prescribing
Friday 5 December 2014 
ICO Conference Centre, London

Nursing Appraisal and Revalidation
Tuesday 9 December 2014 
Manchester Conference Centre, Manchester

Nurse Appraisal and Revalidation in Mental Health
Wednesday 14 January 2015 
Hallam Conference Centre, London

Safe Staffing: Nursing Staffing Levels and Skillmix
Tuesday 27 January 2015 
Hallam Conference Centre, London

Advancing IV Therapy
Thursday 29 January 2015 
ICO conference Centre, London

Masterclass: Nursing Revalidation
Tuesday 10 February 2015 
Hallam Conference Centre, London

Download: Dr Carole Farrell full presentation

19 November 2014


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