I note with interest comments from 'anonymous' in response to my own views. I would like to point out that I too have worked as a Cardiac specialist nurse very much on the front line, also in nurse education and training, acute medicine, practice development and strangely enough currently practicing in re-ablement, therefore appreciate possibly more than most 'that patients don't live in hospital beds and have lives to live'. However it would seem that the impact of poor care provided whilst in hospital beds for some people unfortunately means that they no longer have 'lives to live' !
As a specialist nurse practicing in A&E I understand fully that you are in the 'front line' as I suggested where I feel our specialist nurses should be! However having worked in many different areas I can assure you that many of our specialist nurses are tucked away in offices developing pathways, policies, procedures and audit tools, to name but a few. And yes of course each of the above mentioned are necessary but in my view not as necessary as 'quality patient care', in basic terms it matters not what is written on the documents if there are not enough nurses to deliver the care!
I would never suggest that we were to 'get rid of' our specialist nurses (myself included), my 'food for thought' I admit was not explained well. My thoughts are; that the specialist nurses should work alongside the less experienced nurses on the wards in the acute sector as part of their role, sharing their specialist knowledge and experience, increasing staffing levels and giving the support where it is needed most. Surely if we don't get it right at this stage on-going care becomes 'no longer required' or more complex and often results in readmission?
Believe it or not the answer is really simple, we do not need any complex systems, audits, documents or quality control measures to be put in place; we simply need more staff on the wards, on each shift to deliver the care we should all be able to expect and receive.
I am not denying the need for training, strong leadership, specialist skills and many other facets, however without sufficient work force the latter is irrelevant.
I was attracted to reading this article by the title of 'scapegoating' as in my opinion this is all too familiar. I particularly like the comments from Jenny ''Its the front line clinical nurses attempting to do their best in an impossible situation who become the target of relatives and the media''. In my experience this is very true, as a senior nurse for many years it deeply saddens me to see the nurses once again take the blame for poor standards. For many years now nurses have been crying 'help' as they cannot possilby cope with the ever increasing demands of fewer staff on the front line. In most cases 'the powers that be' seem to think the answer to the problems is to introduce document after document to record care given. In addition to this introduce specialist roles for every aspect or area of care one can imagine, often supported by a whole team of staff (nurses). When will someone realise that each additional document including the endless risk assessments mean more and more time away from the patient. On the 'front line' every minute sent writing often repetitively is a valuable minute of patient care lost. Further food for thought; if we took all of our 'specialist' nurses and placed them back on the 'front line' to increase staffing levels and expertise where it is needed, I believe the problems would very likely be resolved.