A & E nurses' constructs on the nature of nursing expertise: a repertory grid technique.

The concept of nursing expertise has been the focus of considerable debate since the early 1980s, yet an agreed definition of the concept and the precise criteria by which it can be evaluated remains elusive. This paper will describe an exploratory study into A & E nurses' constructs of the nature of nursing expertise. Seven first level Accident and Emergency (A & E) nurses were interviewed using Kelly's Repertory Grid Technique. Each was asked to provide examples of nurses with whom they are working or have worked, to match eight given examples designed to represent varying levels of clinical expertise. The informants were asked to consider in what way two of their chosen examples were alike and differed from a third in their clinical practice. A total of 55 bi-polar constructs emerged which were clustered under four main headings. These suggested that A & E nurses perceived expert practice to be characterized by a high level of empirical knowledge, supportive team building, assertive clinical leadership and patient-focused involvement.