Woodward Valerie A, Webb Christine, Prowse Morag
School of Social Work & Primary Care, University of Plymouth, Plymouth, UK.
J Clin Nurs. 2006 Mar;15(3):272-80. doi: 10.1111/j.1365-2702.2006.01295.x.
This paper reports on organizational influences on nurse consultant post holders. The influence of individual characteristics has been the subject of another paper.
Nurse consultant posts were set up in the United Kingdom from the late 1990s onwards and, therefore, there has been little opportunity to report on evaluations of these innovative initiatives.
A cross-sectional design, using a convenience sample, was adopted.
Ten nurse consultants working in a variety of settings and specialties participated in in-depth, tape-recorded interviews. The data were analysed using the Framework approach.
Support systems were important influences on nurse consultants' role achievement levels. These took the form of internal trust networks, nurse consultant forums and links with higher education institutions. Post holders both gave and received support and acted to empower other nurses. Thus, relationships were vital to successful role integration. The culture and structures of the National Health System were also a powerful influence in terms of local and national modernization policies, and participants had to be careful in their choice of strategies to deal with the traditional medically dominated culture.
The new nurse consultant role is challenging and innovative, but a major area of contention is how much post holders are expected to take on work previously done by doctors rather than developing their nursing role. Organizational support and commitment are needed if nurse consultants are to maximize the benefits of this innovation.
The findings show that new nursing roles are not always easily accepted in multidisciplinary settings and that holders of such post need to have the appropriate previous knowledge, skills and personal characteristics, as well as the ability to negotiate their way through organizational influences.
本文报告组织对护士顾问职位持有者的影响。个人特征的影响已在另一篇论文中探讨。
英国自20世纪90年代末起设立护士顾问职位，因此，几乎没有机会报告对这些创新举措的评估情况。
采用横断面设计，使用便利样本。
10名在不同环境和专业领域工作的护士顾问参与了深入的录音访谈。数据采用框架分析法进行分析。
支持系统对护士顾问的角色成就水平有重要影响。这些支持系统表现为内部信任网络、护士顾问论坛以及与高等教育机构的联系。职位持有者既给予支持也接受支持，并致力于增强其他护士的能力。因此，人际关系对于成功的角色整合至关重要。国家医疗服务体系的文化和结构在地方和国家现代化政策方面也有强大影响，参与者在选择应对传统医学主导文化的策略时必须谨慎。
新的护士顾问角色具有挑战性和创新性，但一个主要的争议领域是期望职位持有者承担多少以前由医生完成的工作，而不是发展他们的护理角色。如果护士顾问要最大限度地从这一创新中获益，就需要组织的支持和投入。
研究结果表明，新的护理角色在多学科环境中并不总是容易被接受，担任此类职位的人员需要具备适当的先前知识、技能和个人特质，以及应对组织影响的谈判能力。
