Hypothesis The majority of general nurses feel their roles should not be expanded.

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Nicola Sheppard

Research        -  -

Table of Contents


                                                                        Page Number


Statement of Confidentiality        2

Rationale        3

Hypothesis        4

Introduction        5-7

Methodology        8-12

Results/Analysis        13-16

Evaluation        17

Conclusion        18

Table of Reference        19

Bibliography        20

Appendices        21

Statement of Confidentiality

Please note that any information recorded during the compilation of this research will be kept strictly confidential, and at no time will any information be divulged to a third party.  All information collected and participants involved will be treated with the utmost respect and all matters disclosed will be used only for the purposes intended.  Under no circumstances will any information be falsified or altered in any way during the course of this research.


The aim of this research is to develop an understanding of the topic related whilst providing an un-biased view and raising public awareness.  As in any research the main aim is to promote information and establish what, if any improvements could be made.  This particular research will look at nursing and it’s ever changing role, which will in effect help the researcher to move forward in this particular field and also develop understanding and opinions of those directly and indirectly affected by any of the issues raised.  This type of research could highlight areas where the service made to the public could be made more efficient, which in turn may benefit the nursing profession as well as the researcher.


The majority of general nurses feel their roles should not be expanded.


Of the 1.3 million people now employed within the NHS, over 400,000 are nurses. Nurses are literally everywhere, spread right across primary, community and secondary care.  Not only do nurses deliver hospital care, they are seen in many other fields such as health visitors, school nurses, midwives and GP practice nurses.  (Medical sales.co.uk) (20.11.05)

Nursing through the years has improved dramatically, and most remember the 19th Century pioneer Florence Nightingale as the woman who changed nursing practice and opinions based around the nursing profession.  This, perhaps then coupled with the advancement of medical science and knowledge can be credited for the nursing practice we have come to depend on today, which has in fact grown from strength to strength with societies acceptance of the need to train, educate and co-operate.  ()  (29.11.05)

Nursing is a high paced occupation with pressures of time, resources and of dealing with pain, discomfort and the distress of others being dominant factors.  Balliere’s nurse dictionary defines a registered general nurse as:

“A person who is qualified in the art of science and nursing and meets certain prescribed standards of education and clinical competence.  The nurse’s duties include providing services that are essential or helpful in the promotion, maintenance and restoration of health and well-being”

() (no date available)

With this in mind it is essential to establish what exactly the expectations of a modern registered nurse are, and whether or not these expectations are met with opposition.

In August 2004 Beverly Malone the General Secretary of The Royal College of Nursing published the NHS plan for nurses which encompassed ten key roles:

  • Ordering diagnostic investigations such as pathology test and x-rays.
  • Making and receiving referrals direct, for example to a clinical psychologist, therapist or a pain consultant.
  • Admitting and discharging patients for specified conditions with agreed protocols.
  • Managing patient caseloads, for example those suffering with diabetes or clinical depression.
  • Running clinics, for example for ophthalmology or child development.
  • Prescribing medicines and treatments.
  • Carrying out a wide range of resuscitation procedures, including defibrillation.
  • Performing minor surgery and outpatient procedures.
  • Triaging patients, using the latest IT, to the appropriate health professional.
  • Taking the lead in the way local health services are organised and in the way they are run.

() (26.10.05)

These key roles urge nurses to become more entrepreneurial and this extra responsibility is not seen as merely increasing workloads but providing faster more efficient patient care combined with the opportunity for a wider career scope for the nurse.  

Many nurses wishing to broaden their horizons were once edged onto managerial positions which took away much of the fundamental nurse-patient care, replacing it with clinical based practice. With the emergence of consultant nurse posts or nurse practitioners as they are better known this provides scope for upward mobility in occupation, yet still carrying with it the prestige of managerial jobs. () (no date available)

Despite the multi tasks that a modern nurse can be involved in there is still a clear disparity between nurse and physician. The nurse’s main task remains to be caring for the patient and the physician’s task is to diagnose and treat the ill and injured.  However one key driver for the appearance of all these new roles is the shortfall in the number of both GP’s and hospital doctors.  This will inevitably mean that the nurses must pick up more work.

One of the major areas of development when examining expanding nurse roles is that of nurse prescribing.  For the last ten years community nurses i.e. district nurses, health visitors, and a small number of practice nurses have been able to prescribe from a limited list of medicines known as “The Nurse Prescribers Formulary”.  

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More recently however, all registered nurses have been eligible to be trained as prescribers with a wider range of items listed in “The Nurse Prescribers Extended Formularly”  (www.pionline.com) (15.11.05).  Nurse prescribing is an area of development that is changing constantly, and it is believed by many that it carries with it benefits to the medical, nursing and associated healthcare staff, but also to the patients.  As nurse prescribing grows it will affect all nurses at all levels with a need for increased educational requirements in life sciences, pharmacology, anatomy and physiology. There is some scepticism as to whether or not ...

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