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Too general for a specialist? Too specialist for a RGN?


Last week the RCN congress debate over governments requiring all nurses to work across all clinical specialities brought up some interesing questions

There has been a lot of talk about specialist nursing recently. Am I the only confused?  

Last week nurse specialists were in the news after a survey showed one in 10 was at risk of redundancy. And just the week before they hit the headlines when a Nursing Times survey revealed they are treating more patients than ever before. Outpatient attendances at specialist nurse clinics have increased by 465% since 2005-06. So at risk of redundancy after doing a really good job? Not sure that makes much sense.

To add more to the mix, last week the RCN congress 2011 debated a resolution that proposed calling on UK governments to require nurses to work across all clinical specialties.

Many nurses in the audience appeared shocked that the resolution had made the podium, and it was whole heartedly rejected with 88.55% of the floor voting against.

But reasons for the resolution, as proposed by Verna Phillips from the Gloucester branch of the RCN, were interesting. She said that many specialist nurses are being increasingly asked to work on general wards and cover staff absences. If they’re being asked to do this, she said, they need to be properly equipped to meet patients’ needs. Her resolution also claimed that specialist nurses feel “alarmed” as they are “insufficiently prepared” to work on general wards.

But should they be asked to work on general wards in the first place?

Last May a Nursing Times investigation found that nurse union leaders were unhappy with specialist nurses being asked to tread the ward boards. Howard Catton, Royal College of Nursing head of policy development and implementation, said he was concerned it was an efficiency saving exercise that wasn’t driven by patient need. He also added that fewer nurses might be attracted to specialise if they’re always asked to take a step back from their role.

So should the RCN instead be focusing on why there is such a need for specialist nurses to be on general wards rather than asking specialist nurses to broaden their horizons? Where are all the general nurses?

Another interesting point made against the resolution pointed out that “role ambiguity” is a leading cause of workplace stress, so asking nurses to do everything would hamper staff wellbeing. Leave the specialist skills to the specialists, they said, we should have the choice to specialise or not.

I’m still confused. What do you think?


Readers' comments (3)

  • I am a specialist nurse (although i hate that elitist title), i am a nurse!
    I don't have a problem covering the wards when in dire straits as we should all work together and i do think that team spirit is lacking among many elite specialist nurses and nurses in general
    It is scary to go back to wards but as trained nurses we should all be able to work competently in an area and if we cannot, then maybe a few more shifts to re-skill is a good idea
    I don't think specialist nurses should be used as agency staff though as our work does get neglected whilst covering wards, although managers often don't realise what that is or what we do
    The figures show we do work fairly hard and see lots of patients

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  • As a nurse in a different role to the ward nurses I agree with Kate's comments. I have to work hard in my job and a lot of my time is spent with patients who see me as a personal contact. I will though, if a ward is busy and understaffed, help out for a period of time until the rush has passed. Patients come first and I am a nurse. BUT, I also have a job of my own to do and I get paid to do that not work on the wards. There has been talk in this Trust about removing the title of nurse if we don't wipe bottoms which I think is appalling. I worked hard to get my registration and have the title nurse, why should I give it up because I wanted to improve my standard of care in a more specialised role? If the wards can not cover then they need to call in their nurse managers to work. They took on the 24/7 responsibility for the ward and in my experience most say NO when asked to come in due to staff shortages after being in the job more than a year.

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  • I have been a specialist nurse in sexual health & contraception and now with to broaden out and become a GP practice nurse. Although I could use my existing knowledge and skills I would need further training for management of chronic conditions, travel health and minor illnesses. I have a degree and Nurse Independent Prescriber qualification, so have a proven track record of learning ability. A number of agencies recognise my transferable skills at registration but no work is coming my way! Too specialist perhaps?

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