Vaughan Karolyn, Wilkes Lesley M, O'Baugh Jenny, O'Donohue Robert
Child & Family Health, Wentworth Area Health Service.
Collegian. 2005 Jul;12(3):14-9. doi: 10.1016/s1322-7696(08)60496-5.
New South Wales Health introduced the role of the Clinical Nurse Consultant in 1987. A review of the role was undertaken by an area health service in Western Sydney, NSW, Australia in 1992 and a number of issues were highlighted in the review process, including diverse roles and responsibilities. In 2000, New South Wales Health acknowledged the diversity of roles and developed a grading system based on five domains of practice. This paper reports the second phase of a two-part study that investigated the scope of practice and perceived level of organisational support provided for the Clinical Nurse Consultants in the area health service. Focus group interviews, one for managers and two for nurse consultants, were conducted in order to collect data. Ten Clinical Nurse Consultants, representative of each grade and seven managers, covering various clinical streams, took part in the study. Data were analysed using content analysis and coded using constant comparison and contrast of codes. Results of the study reveal a lack of clarity and understanding of the new grading system. There is an indication that the role is very individual and the incumbents are often overloaded by work and the maze of demands put on them by numerous competing forces. Many of the Clinical Nurse Consultants felt they were working at a grade higher than their position classification. There appears to be a significant need to clarify the roles of each of these members of the health care system and to provide a better reporting scheme.
新南威尔士州卫生部于1987年引入了临床护士顾问这一角色。1992年，澳大利亚新南威尔士州悉尼西部的一个地区卫生服务机构对该角色进行了审查，审查过程中突出了一些问题，包括角色和职责的多样性。2000年，新南威尔士州卫生部认可了角色的多样性，并基于五个实践领域制定了一个分级系统。本文报告了一项分为两部分的研究的第二阶段，该研究调查了该地区卫生服务机构中临床护士顾问的实践范围以及所感知到的组织支持水平。为了收集数据，进行了焦点小组访谈，其中一次针对管理人员，两次针对护士顾问。来自每个级别的十名临床护士顾问以及涵盖各个临床领域的七名管理人员参与了该研究。使用内容分析法对数据进行分析，并使用代码的持续比较和对比进行编码。研究结果显示，对新的分级系统缺乏清晰的认识和理解。有迹象表明，该角色非常个体化，任职者经常因工作以及众多相互竞争的力量对他们提出的一系列要求而不堪重负。许多临床护士顾问觉得他们的工作级别高于其职位分类。似乎迫切需要明确医疗保健系统中这些人员各自的角色，并提供一个更好的汇报方案。
