Letter: Nurses remodel health service

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The Independent Online
Nurses remodel health service

Sir: The reduction of junior doctors' working hours and the inevitable changes in working practices (letter, 21 March) should be seen by other health professionals as an exciting opportunity to improve patient care.

The "Expansion of the Nurse's Role" initiative has allowed nurses to undertake many roles traditionally performed by medical staff. The "nurse practitioner" however should not be seen as a mere replacement for a junior doctor. The greatest benefit from this role change is in the quality of care that can now be offered to the patients and their families. Nurses tend to stay in post for longer than a six-month rotation, which allows them to build up greater skills and competence. Experienced nurses who understand the needs of their patients can offer more flexibility and continuity of care than the more task-oriented doctors.

In our children's emergency and investigation unit all members of the nursing team are empowered to expand their role. The funding made available from reduction of junior doctors' hours has been used to employ extra staff to support the additional roles rather than to employ a "nurse practitioner" to replace a junior doctor. This initiative has reduced waiting times and time spent in hospital and has improved continuity and quality of care. The nurses have also derived greater job satisfaction from the autonomous and holistic patient care and the medical staff now have more time to care for those children who require their special skills.


Ward Manager, Children's Day Unit (Ward 5)

Royal Victoria Infirmary

Newcastle upon Tyne